Improving the Health, Safety, and Well-being of LGBT Populations


(chiming graphics) – [Jacqueline] Hello everyone,
this is Jacqueline Leskovec. I am the network librarian for the National Network of Libraries of Medicine Greater Midwest Region and I welcome you to our class today,
Improving the Health Safety and Well-Being of LGBT Populations. This session is being recorded and if you have any
questions throughout this, throughout the webinar,
please feel free to enter your questions in the chat box. If there are more than one of you at your site in your office
who’s logged-in today, if you could just pop in your zip code and let me know how many people are in attendance at
your particular location. I did manage to push the record button and so let’s get on with it. So this presentation is
brought to you by the National Network of Libraries of
Medicine Greater Midwest Region. There are eight regional medical libraries across the United States. We are currently located at
the Hardin Library for the Health Sciences at the
University of Iowa and Iowa City. You can see our little structure there in the middle of the US. Our mission is to advance
the progress of Medicine and improve the public health by providing all US health professionals
with equal access to biomedical information, and improve the public’s access to
information to enable them to make informed decisions
about their health care. Our program is coordinated
by the National Library of Medicine and it’s carried out through a nationwide network of
health science libraries and information centers, as well as public libraries
and other institutions. There are over 7,000 members nationally in the network and over 12,000
are located here in the GMR. For those of you who
remember me back in the day, I’m happily living still in Chicago and telecommuting to the GMR office with an on-site trip several times a year for our monthly staff meetings. So let’s get started. We’re gonna do a little introduction here. Go over some of the
terminology and such related. Before we get started though,
I am happy to say that we are right in the middle of
LGBT Health Awareness Week. That’s kind of a swinging target and I’ll explain that
later ’cause I always have trouble finding out the website for where that’s located. It’s also March and it’s also Bisexual Health Awareness Month. As we proceed, I just
want to remind all of you that we come from different
environments and experiences and we hope that everyone
will do their part to create a positive learning environment. Share what you’re comfortable sharing, ask what you want to ask. So if you have any questions now, you can post your questions or comments in the chat box and Sam, my colleague, is going to help out in the backend there to field any questions as we move forward. If you think of any
questions after the webinar, please feel free to email me directly. My contact information’s on the website as well as on the last slide. There are three generally
recognized components of sexuality used in scientific research. These are attraction,
behavior, and identity. Where a person’s attraction
lies are not behavior that is what is acted upon or
not, and how one identifies. Just a quick run over the definitions of some of these terms. The gender is a social construct of what it means to be male and female and we have that term thanks
to Ruth Bader Ginsburg. She was working on the
gender discrimination issues and before that it had referenced
as sexual discrimination. Sex is the anatomic distinction
between male and female and a gender identity, that’s
one’s internal, personal sense of being a man or a
woman or a boy or a girl. However, a person is non-binary if they identify as neither male or female no matter what sex they
were assigned at birth, and we’ll go a little more into the binary later on in the presentation. Gender expression is also another factor. This is an external manifestation
of one’s gender identity. This is usually expressed
through masculine or feminine or gender-variant behavior, clothing, haircut, voice,
or body characteristics. And then finally, what
we’re talking about here is sexual orientation and this
is our attraction to someone, else of the same or
different gender or both. It refers to the kind of relations that you have with others or you don’t. So you can still be sexually oriented one way but not act upon it. This is a really good graph that dissects sex, gender, and sexuality
and talks about the range that we have on this continuum. When we think about sex,
we’re looking at the genetic and anatomic factors on the continuum. If you look at the top bar
there in the deeper blue, you can see it’s on a continuum and it’s based both on a person’s chromosomes and the way that their
genes are expressed. Moving to gender in the next blue box, the second middle box on the screen. This is identity ranging from man to woman with trans and gender-queer
being somewhere in between. This is the role one plays being neutral or culturally masculine or feminine. Similarly with gender expression still in the blue box in the middle with androgynous formed
from the Latin and Greek andro referring to masculine
and gynous feminine. I do believe this became
popularized in the 1970s as well as at the same time that gender, that the term gender was used. And then when we look down to
the last bar there, sexuality. This is the continuum of
attraction from homosexual to bisexual, to heterosexual and this can change throughout one’s life. Identity is cultural, sexuality in the terms of identity, that’s cultural. When one calls oneself straight or queer or butch or fem and reclaiming
of the term dyke or fag from their negative connotations. Behavior, again, as I said
before, I find this interesting. This is whether one acts
on that attraction or not, being with same sex,
other sex, both, or none. So how important is gender identity? In 2015 a 20 year old Peruvian woman who had gone to a bar with friends accused one man of raping her
while another one watched. According to doctors her injuries
were consistent with rape and her blood contained high
levels of benzodiazepines, a type of tranquilizer often
used as a date-rape drug. Both men were convicted of rape in 2016. However, the two Italian men
were cleared of rape charges in 2017 partly because
an Italian appeals court consisting of three female judges thought the alleged female
victim looked too masculine to be sexually assaulted or as this headline here says, that it was, they used a photo as proof that the woman wasn’t pretty enough to be raped. Although this ruling was handed out two years ago, the
reasoning it wasn’t made public until this last Friday
and then Italy’s finest, highest court rejected this decision and there’s a retrial
that’s being ordered. And also from the Guardian newspaper where this came, the hundreds
of people gathered outside the Italian courtroom to
protest the lower court’s dismissal the charges
according to Local Italy. Cultural Competence. Most of us are used to
heteronormative and cisnormativity. What does this mean essentially? Well heteronormative is talking about us, ourselves, our
community, all in terms of the heterosexual experience and viewpoint. With cisnormativity,
there’s the assumption that everyone is, that their sexuality is the same as their, excuse me. Their sex at birth… Their assigned sex at birth is what they considered themselves to be currently. This is different here in the sense that when we think about cultural competence, we often think just a racial ethnic group or a religion or socioeconomic status, but with sexual orientation
or gender identity, we see other characteristics linked to discrimination or exclusion. We’ll go through this more as we go ahead. So why do we talk about cultural
competency in LGBT health? Well, asexual and gender
minorities, LGBTQ people have specific healthcare
needs and concerns. With cultural competency how can we expect a health care practitioner
to provide appropriate care if there is not cultural competence? For lesbians, for example,
if a practitioner asks about their need for birth control
assuming heterosexual activity or a gay man and really
or having a patient, a gay man as a patient, and
not understanding risk factors. You also may have heard about cultural humility and this also applies in terms of the LGBTQ populations and this, the cultural humility, can be based on the medical
model but you can extend it to broader segments of the population. Here’s a nice little continuum describing the move towards cultural proficiency. We’re gonna start on the bottom
there and this is what I was saying before about the destructiveness with not being in tune with bisexual men’s orientation and what we can see here is that with cultural destructiveness can be attitudes, policy, structures, our practices, and that could be within a system or organization and those can be destructive to a cultural group. Moving up some improvement there. Cultural incapacity, I
guess you could call it an improvement in a sense, but this is the lack of capacity of
systems and organizations to respond effectively to the needs, interests, and preferences of culturally and linguistically diverse groups. So this might be, may
result in discrimination and hiring or promotion or just not, or having lower expectations for some racial or ethnic groups
and here, basically, we can say that for the LGBTQ populations that there’s just not that awareness to know that there are
differences culturally. Which brings us to cultural blindness. That’s treating everybody,
everyone, viewing them and treating them all as the same. Moving up higher again with a little more competence,
pre-competence level here. That’s the level of awareness within those systems again and their characteristics include, but they aren’t limited to, a system or organization and here we can have commitment to human and civil rights, hiring practices,
et cetera, et cetera. But there can be no real,
no clear plan for achieving those organizational
and cultural competence. Until finally we get to the top
and we look at those systems and organizations that exemplify cultural competence and then we can demonstrate an acceptance and respect
for cultural differences. Any questions about that? All right, let’s take a look
here about what that means for cultural competency for LGBTQ health. I’ve been throwing in the Q every now and then we just basically
have been using LGBT because that’s how the
class was signed up for with continuing education
credits and I suppose my next iteration will involve a Q and maybe a few more letters at the end. Again, with the cultural competency for LGBTQ health we can
look to healthy people 2020. There the competency falls into
the area of improving the health, safety, and
well-being of gay, bi, lesbian, bisexual, and transgender individuals. Reducing disease
transmission and progression. Increase mental and physical well-being. And reduce healthcare costs, as well as increasing the longevity
of these populations. When we talk about this with the culturally competent healthcare for sexual and gender minorities we hope to accomplish social, financial, practical, and health objectives and we are supported in this by both the joint in our work, by the joint commission, because of the standards encouraging the hospitals to develop patient
non-discrimination policies, inclusive of sexual
orientation and gender identity and also policies that define
family broadly for purposes of visitation and decision-making. I have some resources that
you may be able to share with your organization,
your hospital, later on. Also, the Accreditation
Council for Graduate Medical Education, ACGME, they do require cultural competency and
they are responsible for accreditation of post MD medical training programs within
the United States. So there’s some precedence
for this to happen. What causes these
differences in LGBTQ health? With social determinants, LGBT people are faced in many aspects of their life with stigma, rejection,
abuse, and violence. There’s unfair treatment
in the legal system, state and federal level. Undocumented lesbian, gay,
bisexual, transgender, and queer people live at the intersection of the LGBTQ equality and immigrant rights movement and many of them are the most vulnerable
individuals in our country. Are you familiar with the
word intersectionality? That’s here where we’re talking about LGBTQ and then how it’s
affecting immigrants. So those two areas intersect. A recent study said that
there are close to one million LGBTQ adult immigrants, about
whom two-thirds are documented and one-third are undocumented. And then what happens is when being for some LGBT people hiding some or all aspects of one’s life, lacking health insurance and
I know so much of this had been altered with the Affordable Care Act, but as you can see in news lately there are always challenges to that that we can face with health insurance and other legal positions. And there’s also a shortage of culturally competent health providers. So this is some place
where the health sciences librarians can make an impact. There’s a statement here
from Chris who says there was an article in yesterday’s New York Times on transgender women traveling between US and Mexico and the issues they face. Absolutely, yes. Thank you for sharing that. Here’s a sample of the health disparities experienced by LGBTQ people. 70% transgender or gender non-conforming, that’s with the GNC is. Patients surveyed said
that they had experienced some type of discrimination
in their healthcare. 56%, more than half, of the
LGB patients have experienced some type of discrimination in healthcare. 52% of transgender respondents
that they believed that they would be refused medical services because of their LGBTQ status. And almost 3/4 and 1/3, 3/4 of transgender and 1/3 of LGB respondents reported that they believe they would be treated differently
by medical personnel because of their LGBTQ status. Here’s another factor in LGBTQ health. You can see that this
is the latest from the CDC about new diagnoses of HIV in the US. And currently the top three categories of HIV transmission are amongst male to male sexual contact,
highest being in the black population followed by Hispanic Latino and then third white male. The lowest that they have
recorded here is among white heterosexual white women who have heterosexual contact. In terms of the top 10
states where HIV has been diagnosed, in order: Florida, California, Texas, New York, Georgia,
North Carolina, Illinois, New Jersey, Pennsylvania, and Louisiana. I’m going to just go in briefly to some of the LGBT plus terminology. There are two recordings that my colleague Elena Vitali and I put together for the LGBT Health Month last year and they are located on the NNLM website. You can go back and take a look at them. They go into much more
detail about these terms. Some of them here may be very,
very familiar and some not. SRS, for example, is sex
reassignment surgery. GNC, as we mentioned before,
gender non-conforming. When you see an A added into the into the alphabet soup of LGBT plus
that can be allies or asexual. And here, someone here is saying that A for allies is very inappropriate. Would you care to, okay so Smote says that A for asexual or
A gender that is also. Allies are supportive. Yes, however in the L… Okay, so we’re getting
some discussion here about the A representing not… Smote says it’s a hot topic,
ah-ha-ha-ha, and I agree. Let me just say then there is some discussion on this hot topic about what to use in the terminology and next time I do this slide I’m gonna
put in some of the other As. So thank you very much for sharing that. And yes, there is much
discussion about this. And no problems there Smote. They say that they don’t want to override the healthcare discussion. For sure, but it’s something to consider and absolutely right. How do we know if we don’t
know what the terminology is? So thank you very much for that. All right, so very possibly we’re going to have a discussion about pronouns. And feel free to enter
your, in the chat box, any questions or comments
that you might have. So some of you may know that there’s a big discussion about why we focus on pronouns and how does this make it more inclusive for us? There’s a way of using
non-gender or gender non-conforming or gender
non-specific pronouns and you have every right
to introduce yourself and indicate the pronouns that are yours. For someone who chooses to use he, it could be he, him, his, himself. Someone who prefers to use
she, her, hers, herself. And as much as it was difficult for me to grasp the concept of they, them, their as a singular pronoun it actually historically
has been accepted as such. So in addition to they, them, their, or theirself there could be some used the pronoun… Okay, we got it here. Easy, quick guide to them, they, pronouns. Thank You, Margot. We’ll make sure that we
add that to our list. That’s in the chat box right now. Zie, for example, Z-I-E,
that is subjective and could be used instead of she or he. Hir, H-I-R, is also something
that’s been creative, both objective and possessive and is used instead of him, his, her, or hers. And then we talked about the
gender-neutral pronouns, they. Okay, not sure that I
watch Grey’s Anatomy, but there’s a comment going on here about there is some episode, Richard, during Grey’s Anatomy episode. All right, so also in addition there in the chat box about more
pronouns guides, resources I find this one from the
GLSEN, an excellent resource. Take a look at that. And it’s very useful for
educators and students. Sometimes you might see PGP. What about that? Well, see that brings up a whole new thing about preferred gender pronouns, which takes away some of its actual being. It’s like where we talked about where someone, the term transgender used to be used and that
is, it’s also insulting because it implies that
something happened to that person to make them transgender. I’m also getting some comments up here from someone named Anita. So we have, ah, very good point. All right, so we’re not
talking here about requiring. What if you don’t want
to share your pronouns? That’s totally okay. You can provide space and
opportunity for people to share their pronouns
and it doesn’t mean that everybody feels comfortable or needs to share their pronouns. Some people might not choose to share their pronouns for a variety of reasons. They could be questioning or transitioning and they don’t use or like any pronouns. Or as one of our commentators said that someone uses he, him, they, and their pronouns. So there are choices, so you’re not gonna be forced
into doing anything here. Also, okay, we got a comment here about PGP can be represented as personal gender pronouns
than preferred general pronouns. Okay, I’ll go with that. Thank you. Good discussion there, thank you everyone. So the binary, what is it
that we talk about the binary? Very simple, it’s male, female, M, F. What we’re seeing now is a
recognition that there is, that the binary does not represent all. There is non-binary,
there is gender-queer. I note that there are several states who have moved forward to add a third gender and they can
request the X identifier, but they still have to
submit a physician’s note or an amended birth certificate. With gender-neutral bathrooms, restrooms, we see that we’re getting support for that from the International Building Code. They are recommending changing
to gender-neutral bathrooms. Here’s a couple of images
that represent that. And I know there’s a lot
of discussion right now that’s going on with trans use with bathroom laws and just to go back in time a little bit, gender segregated public restrooms arose in the Victorian era. That was about the same
time widespread plumbing came into use and so they’ve
been around basically as long as the modern bathroom itself. But toilet laws, whether
we’re talking about transgender people today,
they originally primarily directed at protecting
women in the workplace. They were not intended as
gender-neutral regulations and this was basically
to reinforce the idea that women were the weaker sex and that they could possibly be… Basically that in the opposite… Let me try that again. Women are the weaker sex and
men are inherently predatory and so basically that’s the
concept that move these forward. And then the other thing too
is that at the same time there were some ladies-only waiting rooms in train stations and female-only reading rooms in libraries. But the bathrooms seem to be
the last holdout on that one. Several states do have the X. I think Maryland just put a bill in process to move that forward. So since this is sort of an overview of new things since my last presentations, let’s just take a look very quickly about bisexual and transgender. One of the things I found
is that you have to kind of look around sometimes for
some of the information. It gets moved on websites. For example, we were, I
was looking for the lesbian and bisexual health fact sheet which used to be on HHS
Office of Women’s Health and I found it in another location. So be persistent in looking
around for your resources. Some of the conditions,
medical conditions, experienced by lesbians, bisexual women: obesity, smoking, stress, which includes depression,
anxiety, and heart disease. Of course heart disease is the number one killer of all women. For gay and bisexual men there’s a stigma and discrimination. They can be faced with
sexually transmitted diseases. Revealing their sexual orientation can be extremely difficult. Also, it’s important that
maintain good mental health. So some researchers found out that some who identified themselves as bisexual were more likely to commit suicide. They reported high levels of depression, more likely to use illegal drugs, as well as cigarettes, and
more likely to have risky sex. I just came across this
website by Doctor Jeanie Austin and they have a wonderful video here which is, if you can keep
up with it, it’s very fast. They have posted something
by Riley J Dennis. This is not on the resource page, but it will be added later. Doctor Austin got her PhD in
Librarian Information Science from the University of
Illinois Champaign, Urbana. So what we think about with social determinants for transgender people. A variety of factors from health
coverage, legal protection, low self-esteem, lack of education, and lack of curriculum including the lack of of providers who are able to work with them effectively. Transgender teens. This showed up in the Morbidity
and Mortality Weekly Report. I thought this was pretty
good for them, you know, having some nice graphics and stuff. Transgender students’ health risks. About 1/3 feel unsafe
going home or school, about 1/3 are bullied,
and 1/3 attempt suicide. So let’s go into some of the
resources and references. What’s new and newly discovered. This wouldn’t be in an NNLM presentation if we didn’t start off with MedlinePlus. We have the standard MedlinePlus web page, but also added on here is this opportunity to rate a page. So if you take a look on here, you go in here and you
find the information, you can give some feedback. If you can’t find what
you want by going in and looking at here, under health topics, and then population types you can just use the search function in the
upper right-hand corner. That’s always a good place to start. I did have some trouble
finding information on teens in MedlinePlus. So if we looked back on that gay and lesbian, bisexual,
and transgender page we can see that there
is a link to teenagers and these are the various sources that are cited for teens. I also did a search on gay teens and it came up with a variety of information resources
and one of the related topics came under teen’s sexual health and that was very descriptive. So NLM classification. We’re still here in the
2019 Winter Edition. We can take a look. Homosexual is still there. It comes up in many, many
different categories. We see under homosexual
female, this is a new… This MN 620.5.86, this is new. There’s some other new terms that we’ll take a look and all of these do come under the MeSH term gender
and sexual minorities. So here are some of the
new headers that came out. Before WM referred to
just sexual dysfunctions, gender identity, and sexual behavior. Not very descriptive
and not very inclusive. So seven new class members were added and these are as expressed here. I won’t go through each of them, but it’s really nice to
see so much inclusion in these headers. Historically we saw that transition from transsexual into transgender be a MeSH. Transsexualism used to be a term. But then if you’re gonna look up MeSH, the Medical Subject Headings for you non-health sciences librarians, you could see that there are two terms that show up as medical subject headings if you do a search transgender and that would be health services for transgender persons
and transgender persons. Note that transgender is an adjective, not a noun, and as such it’s
always used to modify a noun. So transgender persons,
transgender populations. Here is the scope note on
that MeSH descriptor data from 2019 on sexual and gender minorities. You can take a look at this. It has a… It’s pretty well self-explanatory, including LGBT, queer, intersex, gender non-conforming people
in the other populations. And here the term, here the
phrase reproductive development is considered outside cultural, societal, or physiological norms. Also there is a description
of gender identity and this is, as we talked before, about that person’s concept of self. What is GSM or gender
and sexual minorities? The previous indexing in
the Medical Subject Headings was bisexuality, homosexuality, transgender persons, and transsexualism. And before that I actually
think it was transgendered persons in 2013 and then transgender person came out in 2016. The things I have to say about that is that you can have an effect upon the these MeSH subject headings. If you think that something is incorrect feel free to go in and write via the help desks to explain your concerns. Or the information that you wish to share. This is kind of a cool thing. Just one of our, several of our colleagues in the medical library
just had their article in the Journal of Medical
Library Association show up as a winner in the Medical Library Association Eliot prize for 2019. And why do I cite this,
except I’m so proud and happy for my colleagues and friends, is that you can take a
look to see the MeSH terms that are used on this article
advancing the conversation. Next steps for lesbian, gay, bisexual, trans and queer LGBTQ
health science librarianship and you see that sexual and gender minorities comes up as a term. Bookshelf, still there and still can be searched just with the same kind of subject headings that you use, excuse me, the same terminology that you use in searching PubMed. So there are full-text books in there. You can go in and just
do a search on lesbian or gay and come up with
a number of resources. I talked about this before
in a previous recording. So if you need more
details you can go look at the part two from last year. Healthy people 2020 is still
there, right up on top. Back in the day, 2010, it took a group of gay and lesbian Medical Association people to come together and put this companion document because when healthy people 2010 came out there was no actual healthy people page for lesbian, gay, bisexual, and transgender health and this is new in 2020. 2030’s coming around. If you see an opportunity to
provide feedback please do so. For those of you who wish to work with your healthcare professionals or wish to work with your hospital in getting some forms
and policies that are much more culturally appropriate the Fenway Institute has a number
of tools that you can use. For example instead of having male and female anatomy
these are gender-neutral images so the patient
can just mark the spot where, in this case here, you know. Please use the diagram below to indicate any areas of pain or
concern, so x marks the spot. There’s also a variety of words that can be used that are gender and that are inclusive to all LGBT people. Instead of using terms
such as husband or wife use spouse or partners,
although I do know some several people who use the term wife or husband
in same-sex marriages, but then that wouldn’t work
out real well if you’re providing forms that say, you know, if it’s a man we’ve identified it’s male then moving on to, you know,
what does your wife do? Another point would be to not
use the word marital status. Talk about relationship status. You can talk about sex and gender. You can ask, you can
choose not to disclose. Lots of ideas there that you can use with sexual orientation. Questions of how you think of yourself, family history, blood relatives. That’s really important,
particularly with same-sex parents. And then bottom line literally is remove sex-specific language and include not applicable as a response option. Here’s some more good stuff
from the Fenway Institute. Since our last presentation
there is a new publication that you can download full in PDF and this is Caring For Transgender People With Severe Mental Illness, May 2018. So that’s the only one
that was new since we talked about this last
year that I could find. This is something new. I didn’t know about this before. I suspect some of you already have and that is from LGBT MAP.org. MAP stands for Movement
Advancement Project, not map and that’s something
that was founded in 2006. Their point is to advance the conversation and advance policy and
there are some really good resources that they provide and the URL for that is lgbtmap.org. The section on parents was, I thought, very, very good in the February 2019th. On their February 2019 page. So they talk about family
acceptance and youth and it’s information that can be used by parents, family,
friends, transgender youth. And, again, gets that conversation going and helps to change the policy. Think about that in terms of the cultural competency
grid that we, excuse me, continuum that we talked about before. I did not know that this existed, but I think it’s really great that it does and I love the image on this page. This is from the National
Institute of Health. This is their Sexual and Gender
Minority Research Office. They coordinate sexual
and gender minority, and they abbreviate that SGM, related research and activities across the NIH institute’s centers and offices. And you can see what their
goals are and that is basically to expand knowledge base and evaluate the progress
on advancing SGM research. The NIH Office of Equity,
Diversity, and Inclusion also has a mission to support gender, sexual and gender minorities and they maintain the following
belief that sexual and gender diversity adds value to the workforce and to scientific research
and all persons deserve equal access to employment opportunity. From the CDC more about LGBTQ health and one thing that I
really want to bring to your attention is the HIV
risk reduction tool or RRT. This is an a beta version, but I’m going to show you an example of what it is. You can go in, you can customize the content for information that you want so that you say that you’re looking for information for someone who is male, female, transgender, or not. You don’t have to answer
any of these things if you don’t want to, but you can customize the content and what happens as a result if you put in the information
that you are female and you are HIV negative and that you want to know about sex with women this will then guide all the continuing information forward based on this data. So you can also find HIV testing sites and that’s been there before and a very useful tool. Again, there is a link up at the top, tell us what you think about
our site, so please do. Again CDC HIV AIDS has a great section on pre-exposure prophylaxis or PREP and you can find resources
in your community by just plugging in your zip code. They have fact sheets for
pre-exposure prophylaxis and also for PREP during conception, pregnancy, and breastfeeding. Also there’s information about what’s called post-exposure prophylaxis or PEP. This is not so new, except that it’s the new version from HRC. The HEI is a healthcare
quality index from 2018. You can find that on their website. And just as I had promised
we’re going to talk a little bit about emergency readiness to include gender and sexual minorities in emergency planning response and recovery. So whether it’s accidental
or deliberate, often LGBTQI people, their needs and
vulnerabilities are, just like all populations, can be exacerbated in times of a disaster. So a little history here. When I was in nursing
school I was intrigued to find out that before there
was a prevention of cruelty to children there
actually was the American Society for the Prevention
of Cruelty to Animals. And then following the Civil War all the maimed and killed horses in the battlefields brought to light the importance of man and his horse. So basically in the 19, excuse me, in the 1870s animal
protectionists started to safeguard both children
and animals equally and then it was not until 1874 that the New York Society for Prevention of Cruelty to Children came about. Well, one of the things
we found out during Hurricane Katrina is that it was a transformative moment in our relationship with our pets, with our cats and dogs. For the first time society as a whole recognized how important
these animals were to us and before the… The pets were told to stay at home, not to bring them along to the shelters and yet because of Katrina
much was learned and then it was made possible for many shelters to take in their pets. But one thing we know is that disasters tend to worsen any kind of pre-existing poor physical, emotional,
or mental well-being and with sexual and gender minorities this can result in higher rates of stress, anxiety, poor coping,
and poor mental health, especially for LGBTI people. So what are we talking about over here? Well, we can turn to
the Disaster Information Management Research Center,
DIMRC as you may know it and they have specific
resources that you can find regarding disaster preparedness. You can go to their Disaster
Lit section and you can search specifically by a topic
and put in lesbian, transgender and resources will come up. There’s also a hurricane preparedness information for trans people from the National Center for Transgender Equality, transgenderequality.org
and this is only archived, but it used to be from the US Department of Health and Human Services. And this was the Disasters Don’t Discriminate But Sometimes People Do. So the information’s archived. It’s still useful to take a look at. What do we want to do really? First, in terms of disaster preparedness and response to learn
more about LGBT community and understand their challenges. And those of you who are attending today I’m sure subscribe to that belief. Also be inclusive. If possible involve your
community in developing plans and make sure that representatives from the LGBT community are involved. It’s also important, of course,
to show respect for families and also to create a safe environment. This is one resource that I think is really helpful as we talked about Hurricane Katrina. During that time many transgender people were victims of harassment based on their gender
identity and or expression. So as we know that
displacement to shelters is difficult for anyone, but
for especially trans people there are some tools, some techniques, some ways that we can
make it easier for them to adjust in this situation. Everyone should have
copies of prescriptions. For some of the LGBTQ population syringes, alcohol swabs, et cetera in case there’s a need for
injectable medications. All of these should be
put together in a kit so not just a flashlight, but also making sure that there you have copies of legal documentation,
helpful phone numbers such as Lambda Legal, also the National Center for Transgender Equality. There is a FEMA helpline. Also make sure with identification, should be included a passport,
marriage certificate, if appropriate and spousal or significant other contact information. One thing to consider too is
that if identification does not match the gender, a
letter from the therapist or doctor affirming gender identity should be included in the kit. Other items: cosmetics,
toiletries, clothing items for presentation should be at the ready. And also one of the things I found out with the, some of the information
on this handout here from the National Disaster
Interfaiths’ page is out of date. It talks about inability for married same-sex couples not to receive each other’s disaster benefits. Well that’s not true, but this is a good handout because it helps to describe why it is important that all faiths respond
to the needs of LGBT needs in times of a disaster. So this just in, literally. I watched a webinar
yesterday and this morning Sam put in the chat box
and Skype about a resource. So these are some things that I’ve just come up with in the last week or so. I don’t know if you know about
this, but I love its name. It’s called Queer MEDucation. The the purpose is to improve
the quality of healthcare for LGBTQI and GNC
people, so I guess we can look at that as saying
lesbian, gay, trans. Lesbian, gay, bi, trans, Q, I, intersex, and gender non-conforming people. There are a number of podcasts there. There’s expert interviews. There’s also the disclaimer
about it being of their opinion and also I’m not sure how this is gonna go moving forward, but I do note that they have a group page which is members only on Facebook, so I think things
are moving along with that. This is only season one
for the Queer MEDucation, so hopefully they will continue. The purpose of this really is to educate medical professionals in the general population on these needs. The founder of this
resource, she’s, excuse me, they are a physician assistant licensed under the National
Certification Commission of Physician Assistants and also has a clinical practice on queer health, sexual health, PREP and PEP, as well as HIV care and dermatology. This is a site that Sam brought
to my attention this morning and I think it’s long overdue. This is the gender spectrum collection of stock photos beyond the binary. So this features images of trans and non-binary models that goes beyond the cliches that we usually
see in the public press. It aims to help media better represent members of these communities. As people, not necessarily
defined by their gender identities, people with careers, relationships, talents,
passions, and home lives. So the they also say, you know, talk with people, your LGBTQ colleagues, bring them onboard, consult with GLAD, National Lesbian Gay
Journalists’ Association so that you can… So that you are actually
at the highest level of cultural competence. Also the nice thing about this is that any of the images, the
attribution for non-commercial, is through the commons,
so I think that’s a, that was the first
thing I was looking for, making sure that the Creative
Commons license was available. So with this one here you
cannot create derivative work from images or use the images
for commercial purposes beyond the basic license stipulations. It is vital for anyone using this research to make appropriate contextual decisions. This is a webinar I watched yesterday. It was from San Jose State and these were librarians, all trans, who worked in Seattle at the University of Washington Seattle Public Library. It was a really great presentation. This URL is not on your resource
list, so it will be later. And also happy LGBT Health Awareness Week. Typically it’s the last week of March and that’s where it is. I found it actually on the National Coalition for LGBT health. As I said this is like a moving target. And with that this is my last slide. We have two minutes. If you have any questions,
please let me know. You can pop ’em in the chat box now. You can go on and put them in. You can call later. You can email later. You can look at the references that are located in the LGBT health class. And for everyone, even if you don’t want to get continuing education please make sure that you go
in and you do the evaluation. The link was just put up there in the chat box by Sam, thank you Sam in the background and thank you all very much for attending today. Thank you very much for your input. I know I missed a couple of questions. I’ll see if I can address those later. And if you haven’t taken
a look at the at the recordings from last year please do. Thank you again. All right, I’m gonna
close this up for today. Thank you everyone. Thank you Sam. – [Narrator] Thanks for watching. This video was produced by the National Network of Libraries of Medicine. Select the circular channel icon to subscribe to our channel. Select a video thumbnail to watch another video from the channel. (perky instrumental music)

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