Lesbian, gay, bisexual, and transgender people are at high risk for being victims of physical and sexual assault, harassment, bullying, and hate crimes, according to a new study by RTI International.
In a newly published report, funded by RTI, RTI researchers analyzed 20 years’ worth of published studies on violence and the LGBTQ+ community, which included 102 peer-reviewed papers as well as a few unpublished analyses and non-peer-reviewed papers. With The Henne Group, RTI also carried out a series of focus-group discussions with LGBTQ+ communities in San Francisco; New York City; Durham, North Carolina; and rural Wyoming.
“Our research indicates that LGBTQ+ people face significant danger in their daily lives – and that their victimization affects their education, safety, and health,” said Tasseli McKay, a social scientist at RTI and the study’s lead author.
The researchers found that in a range of studies with LGBTQ+ individuals, victimization experiences are clearly and consistently correlated with behavioral health conditions and suicidality, sexual risk-taking and HIV status, other long-term physical health issues, and decreased school involvement and achievement. Such effects are often sustained many years after a victimization event.
The focus groups touched on a variety of topics including bullying, hate crimes, harassment and violence.
A transgender participant in a focus group held in Durham, North Carolina said, “Once you’ve been read as being a trans person, you check out, they check out. For us it’s safety. For them, it’s discomfort. It’s a heightened stigmatization.”
Other key findings from the report include:
-Despite a public perception of greater acceptance of LGBTQ+ individuals in present-day society, disparities in victimization have remained the same or increased since the 1990s.
-Schools are a special concern. Many LGBTQ+ youth reported being afraid or feeling unsafe at school, and school-based victimization of LGBTQ+ youth was associated with decreased school attendance, poorer school performance, and steeply increased risk of suicide attempts.
-Contradicting the common perception of hate-related victimization as being committed by strangers or acquaintances, LGBTQ+ people are often victimized by close family members, particularly their own parents and, for bisexual women, their male partners.
“We need more research to better understand what policies will provide LGBTQ+ youth with safer school and home environments, what resources provide LGBTQ+ people who are victims of violence the best support and how we can ultimately create a larger societal climate that doesn’t tolerate persistent, pervasive, lifelong victimization,” McKay said.
Why U.S. Government Agencies Need Comprehensive Policies For Employees With Various Gender Identities
Sex and gender identities are becoming increasingly complex in America, creating new challenges for public administrative agencies. So far, the vast majority of U.S. federal agencies lack comprehensive transgender employee policies – which are currently in place for only nine of approximately 235 federal agencies (including sub-agencies).
Yet as the workforce evolves, federal employment policy must accommodate the needs of employees who do not fit traditional sex and gender categories – and particular attention needs to be paid to formulating policies specifying the responsibilities of employers when their employees undergo transitions meant to shift their anatomy or appearance to align with their gender identity.
What Should a Transgender Policy Include?
Employee policies specifically fashioned by agencies to deal with transgender issues should, at a minimum, cover matters that arise when employees undergo transition processes; restrooms and locker rooms; dress codes; and the use of proper names and pronouns. Many benefits come from transgender-specific employee policies. Such measures can educate supervisors and coworkers about what to expect when someone transitions in the workplace and, by providing protocols to follow, help supervisors and coworkers become more comfortable with and supportive of workplace transitions.
Transgender employees also benefit and gain a sense of security when specific policies are in place. Each federal agency should create its own internal set of transgender-relevant policies, to educate all employees and help transgender employees understand their rights and know where to go for assistance. More can be said about each of the major issues a good policy needs to address.
When Employees Go through Transitions
In the absence of a comprehensive transgender policy, most agencies are left unprepared when employees change their anatomy or appearance to align with their felt gender identity. An effective way to prepare for such processes is to spell out the agency’s workplace transition protocol. Without such an explicit plan, transgender employees who want to transition do not know where to go to begin the process or where they can find answers about what a transition might entail for an agency employee. Additionally, without a standard set of practices, agencies do not know what is required to change all applicable records. Confusion can leave transgender employees scrambling to deal with many different record changes. Submitting requests and medical records to many places can be unnecessarily cumbersome and intrusive.
Plans for Restrooms and Locker Rooms
One aspect of transgender employee policy that has garnered significant attention – and sometimes controversy – is the issue of who uses which restrooms and locker-rooms. A key example comes from North Carolina’s “House Bill 2” that banned individuals from using public restrooms that do not correspond to their biological sex assigned at birth. The United States Department of Justice declared this law in violation of Title VII and Title IX of the Civil Rights Act as well as the Violence Against Women Reauthorization Act of 2013.
Openly transgender employees have, at times, been discouraged or outright or prohibited from using the restroom or locker room that correspond to their gender identities. Many federal employees use a locker room to change into their uniforms or when they enter the agency gym. Additionally, some jobs, like those in the Forest Service, necessitate the use of showers in the locker room. Existing open-shower floor plans in many facilities may not afford transgender individuals a sense of privacy and safety that everyone should have in their workplace. Inside particular workplaces, conflicts and awkward situations can often be headed off by spelling out clear guidelines for appropriate restroom and locker-room use by all employees, including transgender individuals.
Flexible Dress Codes
A comprehensive transgender policy could also resolve problems related to dress codes. Overall, transgender individuals should be allowed to wear clothing consistent with their gender identity; failure to do so could cause harm to their mental health. Obviously, this applies to employees who have gone through transitions. In addition, although dress code policies often assume that all individuals fall into a female-male binary; many individuals identify in non-binary ways. Someone who identifies as gender neutral, for example, may not fit into sex-specific dress codes.
Because it is discriminatory for employers to force transgender people to conform to gender norms, an agency-specific transgender policy should articulate dress and grooming standards that allow employees to dress and groom in ways that are consistent with varied gender identities. The policy should state that no employee will be required to dress and groom in conformance with a particular sex or gender stereotype.
Respectful Use of Proper Names and Pronouns
Another concern to be addressed is the proper use of the name and pronoun corresponding to a transgender individual’s gender identity. After a person transitions, managers and coworkers often use the wrong name and pronoun. The Equal Employment Opportunity Commission found in 2013 that the intentional and repeated misuse of a transgender employee’s new name and pronoun could harm the employee and thus substantiate a claim of sex-based discrimination and harassment. A further issue is that agencies often have no policy about pronoun use for individuals who request designations other than the traditional “he,” “she,” “him,” or “her.”
When coworkers refuse to use the correct pronoun for a transgender colleague it is disrespectful. The Office of Personnel Management should expand the definition of “transgender” to include gender non-binary employees and clearly communicate this definition to agencies. Transgender policies for each agency should include clear guidelines indicating that all employees – including transgender, non-binary, and other gender non-conforming employees – are entitled, both verbally and in writing, to be called by their preferred name and pronouns.
Read more in Nicole M. Elias, “Constructing and Implementing Transgender Policy for Public Administration” Administration and Society 49 no. 1, (2017): 20-47.
Applying the Cass Identity Model to Social Work
Individuals who identify as lesbian, gay, bisexual, transgender (LGBT+) or other gender and sexual minorities can have significant mental health issues – not just as a result of their sexuality or gender identity but also because of discrimination and isolation. These individuals may find themselves seeking case management, counselling, or other social work support services and it can be helpful to have a framework for understanding their coming out process.
Coming out is the process a lesbian, gay or bisexual (LGB+) individual follows in order to disclose their sexual orientation or gender identity to those around them. It can be an intensely personal and challenging process.
Cass Identity Model
The Cass Identity Model was created by Vivian Cass in 1979 in order to better understand the coming out process for LGB+ individuals. It consists of 6 stages or phases that a person will proceed through. The six stages are:
Identity confusion is the very first stage of the model. In this stage, an individual is confused by their sexual identity and begins to become aware that sexual identities are a concept. They are possibly in early puberty and noticing individuals expressing their sexuality.
At some point though, the individual will experience thoughts or feelings regarding an individual of the same-sex that will make them wonder if they are actually LGB+. This might lead to a denial that the individual is LGB (repressing these feelings.)
In the Identity Comparison phase, the individual will ask themselves more openly if they are homosexual. They will confront the idea that they might be alone in their LGB+ experiences compared to those around them and the resulting social alienation or need to keep their LGB+ identity hidden. This is especially challenging for people living in repressive societies or communities where LGB+ identities are not tolerated.
Once the individual has reached Identity Tolerance, they have understood that they are firmly LGB. To those around them, they may be perceived one-dimensionally – as only homosexual. This can cause these individuals to seek out other LGB+ individuals and begin to build a support network.
Some individuals may continue to deny their identity and thus experience self-hatred, which may delay their coming out process and cause much distress.
Identity Acceptance is exactly what it sounds like. The individual has accepted themselves as an LGB+ individual. They make begin to make the LGBT+ subculture a larger part of their life. This can lead to an insulation of one’s support network as a differentiation is made between those people who are openly supportive of the individual’s LGB+ identity and those who tolerate their sexuality as long as it is not displayed openly. Limiting the role these other individuals play in the LGB+ person’s life serves to reduce distress and alienation.
The Identity Pride stage is the one most associated with LGBT Pride events. The person’s sexuality continues the pendulum swing from lack of awareness to tolerance to complete pride, overtaking the other aspects of their identity. The person may even dichotomize the world into an LGB area and a second, less important heterosexual category.
The understanding of heteronormativity may appear here as well, with the individual reminding others around them that the assumption they are heterosexual is a false one.
Finally, in Identity Synthesis the individual has come to the realization that their LGB+ identity is merely one part of them and does not dominate their life. It is one part, like their career, hobbies, ethnicity and other aspects are simply other pieces of the puzzle that makes them up. At this stage, they fully accept themselves and experience little or no distress as a result of their LGB identity.
Applying the Model
A Social Worker may apply the Cass Identity Model by noting where in the six stages their client seems to be and reading the primary literature to better understand the conflicts that may occur at each stage. This can help ensure interventions are targeted to the unique distress the client is experiencing and continue to deepen the therapeutic relationship by demonstrating a strong understanding of the client’s inner-pain.
The Cass Identity Model is a six-stage model that demonstrates a lot of value in understanding the coming out process as it relates to LGB individuals.
Certain Moral Values May Lead to More Prejudice, Discrimination
People who value following purity rules over caring for others are more likely to view gay and transgender people as less human, which leads to more prejudice and support for discriminatory public policies, according to a new study published by the American Psychological Association.
“After the Supreme Court decision affirming marriage equality and the debate over bathroom rights for transgender people, we realized that the arguments were often not about facts but about opposing moral beliefs,” said Andrew E. Monroe, PhD, of Appalachian State University and lead author of the study, published in the Journal of Experimental Psychology: General.
“Thus, we wanted to understand if moral values were an underlying cause of prejudice toward gay and transgender people.”
Monroe and his co-author, Ashby Plant, PhD, of Florida State University, focused on two specific moral values –what they called sanctity, or a strict adherence to purity rules and disgust over any acts that are considered morally contaminating, and care, which centers on disapproval of others who cause suffering without just cause – because they predicted those values might be behind the often-heated debates over LGBTQ rights.
The researchers conducted five experiments with nearly 1,100 participants. Overall, they found that people who prioritized sanctity over care were more likely to believe that gay and transgender people, people with AIDS and prostitutes were more impulsive, less rational and, therefore, something less than human. These attitudes increased prejudice and acceptance of discriminatory public policies, according to Monroe.
Conversely, people who endorsed care over sanctity were more likely to show compassion for those populations, as well as support public policies that would help them.
“The belief that a person is no better than an animal can become a justification for tolerating and causing harm,” said Plant. “When we believe that someone lacks self-control and discipline, we may make moral judgments about their life choices and behaviors, which can lead down a dark path of discrimination and hate.”
The first experiment involved people who were generally moderate politically and religiously. They rated their agreement with five moral values (care, fairness, sanctity, loyalty and authority) and then read short descriptions of five different men: a gay man, a man with AIDS, an African-American man, an obese man and a white man. Afterward, the participants filled out questionnaires about their thoughts on each man’s state of mind (e.g., “John is rational and logical”) and emotions (e.g., “John is rigid and cold”) and their attitudes and feelings of warmth toward each man.
“We found that people who placed more value on sanctity were more likely to believe that the gay man and man with AIDS had less rational minds than the obese, African-American or white men,” said Monroe.
Experiment two focused on how political affiliation might affect responses. The researchers recruited an equal number of self-identified liberal and conservative participants and used the same morality survey as in the first experiment, but this time, participants rated their thoughts on the state of mind for only four men: a gay man, a man with AIDS, an African-American man and a white man. The liberals and conservatives then assessed their feelings of prejudice for each man (e.g., “I would rather not have a black person/gay person/person with AIDS in the same apartment building I live in”), their attitudes about public policies that would help or harm gay people (e.g., conversion therapy) and people with AIDS and their willingness to help them by being involved with pro-gay/AIDS awareness activities.
Liberals tended to value care and fairness more while conservatives were more focused on loyalty, authority and sanctity. And the people who valued sanctity were more likely to discriminate against the gay man and man with AIDS but not the African-American or white men, according to the study.
Experiment three focused on perceptions of transgender people and found that participants who endorsed sanctity were more likely to hold prejudiced attitudes about transgender people and to support discriminatory public policies.
The fourth experiment tested whether temporarily increasing sanctity values, relative to care, increased dehumanization and prejudice. Experimenters collected survey responses on a college campus on two separate days –Ash Wednesday—a day associated with sanctity and spiritual cleansing in the Christian faith—and a non-religious day. Participants filled out a survey intended to assess their moral beliefs and attitudes toward a woman described as a prostitute.
Participants surveyed on Ash Wednesday reported much higher concerns about sanctity compared to care and this caused participants to become more likely to dehumanize and express negative feelings towards the prostitute, according to the study.
The final study explored whether heightening concern about care was an effective method of reducing prejudice about gay and transgender people. To prime care values, participants listened to a radio news clip about the importance of safe spaces for people of color, while in the control condition participants listened to a clip about Brexit. Afterward, the participants rated their moral values, made judgments of a transgender woman, a gay man and a white man and indicated their support or disapproval of three public policies that would either help or harm gay and transgender people (e.g., national legislation for marriage equality, banning transgender people from the military).
Participants who listened to the clip about safe spaces emphasized caring as an important moral value over those who listened to the clip about Brexit. Caring individuals showed less prejudice toward gay and transgender people and less acceptance of discriminatory policies against them.
“Our study suggests that a person’s moral values can be altered, at least temporarily, and that highlighting certain values, like caring, can be an effective way to combat prejudice,” said Monroe. “We hope that by showing the moral roots of bias and discrimination against sexual and gender minorities we encourage others to conduct further research to increase equity and inclusion.”
The Power of Language and Labels
A while ago I posted a meme which said, “Better to have lost in love than to live with a psycho for the rest of your life.”
I liked it, of course, otherwise, I wouldn’t have posted it. Eleven others did too, some commenting on Facebook, “Amen to that,” and “Definitely!!”
Then this: “Hate it. It’s beat up on people with mental illness time again. Ever had the amazing person you love tell you that they just can’t deal with your mental illness anymore? Our society is totally phobic about people with mental illness having intimate relationships.”
Woah, that came a bit out of the blue. I hadn’t made the link between “person with a mental illness” and “psycho”, otherwise I wouldn’t have posted it. It didn’t say, “Better to have lost in love than to live with a person with a mental illness for the rest of your life.” I had linked “psycho” with the often weird, unspoken assumptions people make when in relationships, which have kept me out of long-term relationships all my life.
It made me think, though. Suppose it had read, “Better to have lost in love than to live with an idiot for the rest of your life.” Would that have been a slight against people experiencing unique learning function?
Probably a more accurate meme would have been, “Better to have lost in love than to live with an arsehole for the rest of your life.” But that’s not what the image said.
For the record, I have had someone I loved tell me he couldn’t cope with my unique physical function anymore. It was hard to hear, but ultimately he was the one who lost out. And I know intuitively many would-be lovers haven’t even gone there — again, their loss and my gain, because why would I want to be with anyone so closed-minded?
The power we let labels have over us can be overwhelming. If I had a dollar for every time a person called someone a “spaz” in my presence, I’d be wealthy. If I got offended because “spaz” is a shortened version of “spastic”, which is one of my diagnoses, and I got another dollar for that, well — I’d be angrily living in the Bahamas.
I think the evolution of language — and the generalization of words like, “gay,” “spaz,” “idiot” and “psycho” — creates the opportunity for them to lose their charge and liberate us from their stigma. By allowing them to continue having power over us, though, we re-traumatize ourselves every time we hear them. Words are symbols and they change meaning over time and in different contexts.
I celebrate that “gay” means “not for me” rather than “fag”; that “spaz” means “over-reacting”, not “crippled”; that “idiot” means “unthinking”, not “retarded”; and that “psycho” means “someone with weird, unspoken assumptions”, not “a crazy person”.
By letting words change meaning for us, we are redefining diversity and creating social change. It’s not a case of, “Sticks and stones will break my bones but words will never hurt me.” It’s recognizing that, unless someone is looking directly at us menacingly, calling us gay, spaz, idiot or psycho, we’re not in their minds — they’ve moved on.
Maybe it’s useful for us to move on with them?
Right from the Start: Investing in Parents and Babies – Alan Sinclair
It is widely accepted the earliest months and years of a child’s existence have the most profound impact on the rest of the lives. Attachment theorists believe the early bonds and relationships a child forms with his/her carer(s) or parent(s), informs that child’s ability or inability to form successful and healthy relationships in the future.
Alan Sinclair’s ‘Right from the Start’ is the latest in the Postcards from Scotland series of short books, which aim to stimulate new and fresh thinking about why us Scots are the way we are.
In my previous book review in the Scottish Journal of Residential Child Care, I commended the author of ‘Hiding in Plain Sight’ (another book in the same series) Carol Craig for her ability to write succinctly and accessibly about a complex subject matter. I feel the same way about Alan Sinclair’s writing in this book.
The premise of this book, put simply, is laying out the bare truths of how good and bad us Scots are at parenting as well as having the appropriate supporting systems in place for parents and carers of our most vulnerable children.
A consistent thread throughout the book is the author arguing that by investing in parents and babies ‘from the start’, governments and the surrounding systems who support children and families can relieve the heartache of tomorrow in the form of poorer outcomes in education, employment and in health.
The book begins by acknowledging the UK’s position on the UNICEF global league table of child well-being, ranking 29 of the world’s richest countries against each other. The UK is placed 16th, our particular challenge being a high proportion of young people not in work, training or education. Although the league table did not single out the devolved nation of Scotland, the author describes the UK as a ‘decent proxy for Scotland’.
The first 1,000 days
The author goes on to explore the theory of the first 1,000 days of a child’s life. This theory suggests this is the most significant indicator of what the future holds for them. He touches on child poverty, which we know from well-cited research can lead to adversities in life, but he also mentions too much money can be an issue as well.
This point is explored more deeply later in the book’s in a chapter titled: ‘Is social class a factor?’. The author is effective at challenging the popular rhetoric that it’s the least educated and most poverty-stricken parents in society who are most likely to neglect their children. He talks about the longitudinal study, Growing Up in Scotland, which tracks the lives of thousands of children and families from birth to teens. Amongst many other findings, the survey shows 20% of children from the top income bracket have below average vocabulary; it also finds problem-solving capabilities are below average for 29% of this group. This proposes child poverty is only a small indicator of the child’s developmental prospects.
Where the Dutch Get it Right
The most intriguing part of the book from my point of view is the comparison the author makes between raising a child in Scotland versus the Netherlands (which ranked first in the UNICEF league table). In Holland, pregnant women have visits from a Kraamzorg, an omnipresent healthcare professional who identifies the type of support required. Post-birth the Kraamzorg plays a very active role and can typically spend up to eight hours a day supporting the new mother in her first week of childcare. The Kraamzorg also becomes involved in household chores including shopping and cooking. And it doesn’t stop there. The Dutch system includes Mother and Baby Wellbeing Clinics, which support families from birth to school age and have been doing so effectively for the last century.
On reading how the Dutch system operates, it’s hard to not make comparisons to the system here in Scotland (and the wider UK) within our NHS where mothers are wheeled in to give birth and very quickly wheeled out again to free up bed space. I exaggerate slightly here and I do not want to discredit the incredible job hard-working NHS staff do, but I’m sure I’m not alone in feeling envious of the Dutch system and thinking they’ve got something right, in comparison with Scotland. This was neatly summarised at the start of the book in a quote from a Dutch woman who had spent time living in both Holland and Scotland when she said: ‘In Holland we love children. In Scotland you tolerate children.’
But it’s not all bad. As the author remarks himself: ‘Scottish parenting is not universally awful: if we were we would not be almost halfway up the global table of child well-being’ (p. 12).
The penultimate chapter explores some real-life examples of parents who are struggling and striving to succeed in bringing up children with some success despite the odds stacked against them. I found the author’s injection of such human stories among the explanation of evidence useful as it allowed a chance for the reader to reflect on how all this is applicable in everyday life in Scotland.
To me, there was, however, a glaring omission in these stories: a voice from the LGBT community. Gay adoption in Scotland was legalised almost 10 years ago in 2009, and at the same time the Looked After Children (Scotland) Regulation 2009 came into force allowing same-sex couples to be considered as foster parents. It would have been interesting to hear from this historically marginalised part of our society what the experience has been like and how different, or similar, this was from the other stories included in this chapter. Are they arguably better equipped as carers of Scotland’s most vulnerable children given their own life experiences of being marginalised?
The book ends with the author setting out his vision for a better future for Scotland’s children where they have better life chances and are fully nurtured. It’s clear we have some way to go but reading this book makes you feel a glimmer of hope that could, one day, become a reality.
National AIDS Awareness Month
Even though the overall number of people with HIV and AIDS has fallen, it is still a disease which predominately affects gay males. An estimated 67% of new HIV cases are transmitted via male-to-male sexual contact, with heterosexual contact accounting for 24%, and 6% due to drug use. Young people are also more likely to be infected. Young people ages 13-24 account for 21% of new AIDS cases. The most at risk individuals are young gay and bisexual men which “accounted for 81% of all new HIV diagnoses in people aged 13 to 24 in 2016, and young African American gay and bisexual men are even more severely affected,” according to the CDC.
Since 1987, the first year Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) was listed on death certificates, over 500,000 people have died in the United States from HIV/AIDS. That’s more than the number of people who have died in the Syrian War. Currently, in the United States, AIDS is the 9th leading cause of death in people 25-44 years old.
The AIDS epidemic reached its peak in 1992, with an estimated 78,000 cases diagnosed annually. Since then, AIDS diagnosis began to steadily decline until stabilizing in the late 1990s at approximately 40,000 cases diagnosed annually. The latest statistics from the Center for Disease Control and Prevention (CDC) show between 2010 and 2015 the estimated number of annual infections declined 8% from 41,800 to 38,500.
Victims of intimate partner violence (IPV) are also at a greater risk for contracting HIV. People who report a history of being a victim of IPV are more likely to engage in risky behaviors – intravenous drug use, prostitution, unprotected anal sex – increasing their risk of contracting HIV. HIV-positive women also report higher rates of IPV than the general population.
The opioid epidemic is responsible for the first uptick of HIV diagnosis attributed to intravenous drug use in two decades. In 2015, opioid use led to 181 individuals being diagnosed with HIV in Scott County, Indiana. Lowell, Massachusetts has also seen a recent spike in HIV cases attributed to opioid use.
One of the biggest obstacles faced by HIV/AIDS patients is a healthcare system which is less than perfect. A recent Times article stated, “no class of medicines is more scandalously expensive than for H.I.V.” In the U.S., HIV medication can cost $39,000 a year, while countries in Africa the same medication costs $75 a year.
The U.S. healthcare system may not be perfect, but HIV treatments are getting better. Experts think it’s possible HIV transmission can be stopped in the United States within 3-7 years. The most current and powerful antiretroviral drugs on the market can lower the amount HIV in a person’s system to a level so low it cannot be transmitted.
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