June is Pride Month in Kansas and across the United States, a month of events and awareness recognizing the impact LGBTQIA2S+ people have had (and currently have) in the world. Pride Month commemorates the Stonewall riots, which occurred at the end of June 1969.
Below are a number of resources to learn more about Pride Month, ways to support your patient populations, and ideas on how to commemorate this time.
From the Centers for Medicare & Medicaid Services (CMS) & the Office of Minority Health (OMH)
In recognition of this health observance, it is important to mention that the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, Two spirit (LGBTQIA2S+) community is comprised of various groups that have their own unique health disparities. While members of the LGBTQIA2S+ community share the burden of often being stigmatized for their sexual orientation or gender identity and expression, their individual experiences vary by race, ethnicity, income, and other characteristics.
Pride Month is also an opportunity to focus on health care outcomes and access of the LGBTQIA2S+ community. For example, compared to other men, gay, bisexual, and other men who have sex with men are impacted by higher rates of HIV and other sexually transmitted diseases, tobacco and drug use, and depression. Lesbians are less likely to get preventive services for cancer. And among transgender men and women, Black people had the highest rates of new HIV diagnoses, followed by Hispanic people.
Since the passage of the Affordable Care Act, uninsured rates among LGBTQIA2S+ populations have seen a sizeable decrease, falling from 17.4% in 2013 to 8.3% in 2016. The overall uninsured rate for the LGBTQIA2S+ population was 12.7% in 2019, compared to 11.4% for non- LGBTQIA2S+ individuals. Despite improved insurance rates, this population continues to face barriers to care. These barriers include being more likely to delay care, less likely to have a usual source of care, and more likely to be concerned about medical bills than their non- LGBTQIA2S+ counterparts. In addition, barriers can include a lack of health care professionals adequately trained in providing culturally competent care, as well as high cost-sharing and/or lack of coverage for certain services including hormone treatments and other gender-affirming care. Telehealth has become a way to deliver “life-saving” health care for this community, especially for those that live in rural areas or other locations without access to inclusive facilities, providers, and treatments.
During Pride Month, CMS OMH is highlighting how you can help address these barriers and disparities impacting the LGBTQIA2S+ community. Below is a list of resources that you can share during Pride Month and beyond to help individuals get the most out of their health coverage.
Resources From CMS & OMH
- Use the Sexual and Gender Minority Clearinghouse to find health surveys that include questions about sexual identity, attraction, and behavior.
- Take the MLN training “Improving Health Care Quality for LGBTQ People”.
- Download and share the HIV/AIDS Disparities in Medicare Fee-For-Service Beneficiaries for an overview of HIV/AIDS prevalence among racial and ethnic groups as well resources.
- Share Coverage to Care Consumer Resources and Prevention Resources to help patients learn to make the most of their health coverage. Also use the Roadmap to Behavioral Health to understand how to use your coverage to improve your physical and mental health.
- Download the Office of the Assistant Secretary for Planning and Education’s Health Insurance Coverage and Access to Care for LGBTQ+ Individuals: Recent Trends and Key Challenges issue brief, which discusses demographic characteristics of the LGB+ community, recent trends in insurance coverage for this population, and various challenges and barriers to care faced by the broader community.
- Review Telehealth.gov’s Telehealth and LGBTQ+ patients resource for providers to learn how telehealth can support LGBTQIA2S+ patients.
- Visit the Substance Abuse and Mental Health Service Administration’s Center of Excellence on LGBTQ+ Behavioral Health Equity, which provides behavioral health professionals with information on supporting the LGBTQIA2S+ population.
Resources From HHS
HHS works to ensure that LGBTQI+ people, their families, and communities receive equal access to health services by providing enhanced resources for LGBTQI+ health issues; developing better information regarding LGBTQI+ health needs; and working to close the LGBTQI+ health disparities gap that currently exists.
Join us in advancing equality for LGBTQI+ children and families and preventing discrimination against LGBTQI+ people.
- Read the White House Fact Sheet on Advancing Equality and Visibility for Transgender Americans.
- Read the LGBTQI+ Youth – Like All Americans, They Deserve Evidence-Based Care blog from Miriam E. Deplhin-Rittmon, PhD, SAMHSA’s Assistant Secretary for Mental Health and Substance Use.
- Find technical assistance and trainings on how to build inclusive and supportive health care spaces for LGBTQI+ individuals and families (HRSA).
- Learn about gender-affirming care – PDF and how it improves the mental health and overall well-being of gender diverse youth (OASH’s Office of Population Affairs).
- Read the Ryan White HIV/AIDS Program letter – PDF about the importance of gender-affirming care to effectively meet the health and medical needs of transgender people with HIV (HRSA’s HIV/AIDS Bureau).
- Read Statements by HHS Secretary Xavier Becerra and HHS Principals on Pride Month.
- Read the White House proclamation on Lesbian, Gay, Bisexual, Transgender, Queer, And Intersex Pride Month, 2022.
Resources From StopBullying.gov
Lesbian, gay, bisexual, transgender, queer, intersex, nonbinary or otherwise gender non-conforming (LGBTQI+) youth and those perceived as LGBTQI+ are at an increased risk of being bullied. Results from the 2019 Youth Risk Behavior Survey (YRBS) show that, nationwide, more U.S. high school students who self-identify as lesbian, gay, or bisexual (LGB) report having been bullied on school property (32%) and cyberbullied (26.6%) in the past year than their straight peers (17.1% and 14.1%, respectively). The study also showed that more LGB students (13.5%) than straight students (7.5%) reported not going to school because of safety concerns. Students who identified as “not sure” of their sexual orientation also reported being bullied on school property (26.9%), being cyberbullied (19.4%), and not going to school because of safety concerns (15.5%).
Historically, YRBS and other studies have gathered data on lesbian, gay, and bisexual youth but have not included questions about transgender, non-binary, gender non-conforming, intersex, or queer youth. As that changes and data becomes available, this content will be updated to include information regarding these youth.
Additionally, LGBTQI+ youth are diverse and have other social identities, (e.g., religion, race/ethnicity) that may compound their experiences with bullying and harassment.
Bullying puts all youth at increased risk for depression, suicidal ideation, misuse of drugs and alcohol, experiencing sexual violence, engaging in unsafe sex practices, and can affect academics as well. For LGBTQI+ youth, that risk is even higher.
There are important and unique considerations for strategies to prevent and address bullying of LGBTQI+ youth. While some strategies are specifically for LGBTQI+ youth, most, if adopted by schools and communities, make environments safer for all students.
It is important to build a safe environment for all LGBTQI+ youth. Parents, schools, and communities can all play a role in preventing bullying and helping LGBTQI+ youth feel physically and emotionally safe.
- Encourage respect for all students.
- Prohibit bullying, harassment, and violence against all students.
- Conduct social-emotional learning activities in school to foster peer-relationships and help students develop empathy.
- Identify “safe spaces,” such as counselors’ offices or designated classrooms, where LGBTQI+ youth can receive support from administrators, teachers, or other school staff.
- Encourage student-led and student-organized school clubs that promote a safe, welcoming, and accepting school environment (e.g., gay-straight alliances or gender and sexuality alliances). Schools must allow these clubs or groups if they have other “non-curricular” clubs or groups. Learn more about the right to form a GSA under the Equal Access Act.
- Ensure that health curricula or educational materials include HIV, other STD/STI, and pregnancy prevention information that is relevant to LGBTQI+ youth.
- Use inclusive language and avoid making assumptions. The words we use can make help people feel acknowledged and create a sense of belonging. For example, using “y’all” when referring to a group conveys gender equality rather than using “guys.” Use gender-neutral pronouns like “they” or “them” instead of “he/she” or “him/her.” You can also use words like “parent” instead of “mother” and “father.”
- Use students’ chosen names and pronouns.
- Train school staff on how to create safe and supportive school environments for all students, including LGBTQI+ youth.
- Facilitate access to community-based providers who have experience providing health services, including medical, counseling, social, and psychological services, and HIV/STI testing for LGBTQI+ youth.
What Does LGBTQIAS2+ Stand For?
The letters LGB stand for lesbian, gay and bisexual. These terms mean:
Lesbian
Women sexually and romantically oriented toward other women.Gay
Any person attracted to the same gender.Bisexual
Those who are sexually and romantically attracted both to men and women.
The T in LGBTQIA+ can have several different meanings but typically deals with gender identity. Some words have fallen out of favor or their meanings are slightly different depending on the person.
Trans
An inclusive term for anyone whose gender identity does not match their sex assigned at birth.Transsexual
Can mean someone transitioning from one sex to another using surgery or medical treatments; not in common usage.Transgender
Term for someone who identifies as a different gender than what was assigned on their birth certificate.
QIA stands for questioning or queer, intersex and asexual. These terms mean:
Questioning
When a person is exploring their sexuality, gender identity and gender expression.Queer
An inclusive term or as a unique celebration of not molding to social norms.Intersex
Used for individuals who don’t fit into specific gender norms of woman or man; can also be used for those with reproductive anatomy that isn’t biologically typical.Asexual
Uses for those who don’t feel sexual attraction to either sex or that don’t feel romantic attraction in the “typical” way.
The plus sign at the end of LGBTQIA+ can include members of other communities, including allies — people who support and rally the LGBTQIA+ cause even though they don’t identify within the community itself. Other identities included in the LGBTQIA+ are:
Agender
Refers to those who do not identify as any gender at all.Demisexual
Describes someone who requires an emotional bond to form a sexual attraction.Genderfluid
Describes one’s gender identity as self-expression and not static.Graysexual
Refers to the “gray area” between asexuality and sexuality.Non-binary/genderqueer
A term used for those who do not conform to binary gender identities.Pansexual/omnisexual
A term for individuals with desire for all genders and sexes.Polyamorous
A term for those open to multiple consensual romantic or sexual relationships at one time.Sapiosexual
Describes a person who is attracted to intelligence, regardless of a person’s gender identity.Two-spirit
A term used by Native Americans to describe a third gender (sometimes included as 2S in the main acronym as LGBTQIA2S+).
Other Terms in the LGBTQ Community
In today’s society, people are challenging social norms associated with relationships, sexuality and gender identity. These people may not be gay, so other terms to describe them were created or popularized.
Ace
Short for asexual.Bi
Short for bisexual or bicurious.Cis
Shortened version of cisgender (a person who identifies as the gender they were assigned at birth).Closeted
State of being totally private about one’s sexual orientation or gender identity.Coming Out
The act of sharing one’s sexual orientation or gender identity with loved ones.Fluid
Term that describes one’s sexual identity or gender identity as not set or binary.Gray-A
Short for graysexual.Pan
Shortened version of pansexual.Per
Gender-neutral pronoun for those who do not identify as male or female (short for person).Poly
Short for polyamory or polyamorous.
It’s important to use these and any slang terms you may have heard sensitively. Even when someone outside the LGBTQIA+ community means well, they may unknowingly use one of these words in an offensive way. When in doubt, it’s best to ask someone from the LGBTQIA+ community or check a resource such as GLAAD (Gay & Lesbian Alliance Against Defamation) about the use of these or any slang terms.
Resources From GLAAD
As the LGBTQ community continues to expand and become more visible, the 2021 Accelerating Acceptance study takes a deeper look at non-LGBTQ Americans’ familiarity, comfortability, and understanding of the LGBTQ experience.
This year, the Accelerating Acceptance Study found that non-LGBTQ Americans are becoming more understanding that the LGBTQ community is not just one homogenous group, but rather a diverse community of various identities across gender and sexuality. Additionally, the findings show that non-LGBTQ Americans are becoming increasingly aware that there are more than two genders, with many polled also understanding that transgender and nonbinary people will continue to be a more visible and familiar part of life.
However, with expanding visibility does come new challenges for acceptance. While understanding is advancing in some areas, approximately half of non-LGBTQ people find conversations about gender identity and the LGBTQ community complicated or confusing.
An alarming result from the poll shows that LGBTQ people say they’ve experienced discrimination at higher levels in 2021 than last year, with 6 in 10 LGBTQ respondents reporting discrimination based on sexual orientation and/or gender identity. During a year when state legislatures across the U.S. introduced an unprecedented number of anti-LGBTQ bills, many targeting the trans community, the importance of passing the Equality Act has never been more critical.
This year’s Accelerating Acceptance study highlights clear opportunities for education and a redoubled commitment to advancing visibility and representation, particularly responsible and nuanced depictions of trans and nonbinary people, as well as the diversity of identities within the entire LGBTQ community. GLAAD remains hard at work to encourage stories that present audiences everywhere with the richness and humanity of our communities, changing the narrative from animosity to embrace, and educating audiences, voters, journalists, and politicians about the lived realities of our lives.