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Cornell University study on impact of discrimination on LGBTQ of color

Around 25% of LGBTQ youth have attempted suicide, but the rates are starkly higher for LGBTQ youth of color than their white counterparts

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McGraw Tower, Cornell University (Photo Credit: Cornell University)

ITHACA, NY. – Cornell University’s What We Know Project in conjunction with a coalition of leading LGBTQ rights groups last month published a comprehensive curation of data on studies that chart the intersection of anti-LGBTQ and racial discrimination.

The findings found that discrimination inflicts profoundly greater harm on LGBTQ people of color in a wide range of areas, including grossly disproportionate rates of: experiencing discrimination over  the past year, poorer mental and physical health, greater economic insecurity, and attempts to die by suicide.

 In addition, LGBTQ people of color are more likely than white LGBTQ people to live in states without protections  against discrimination and that state anti-LGBTQ laws harm LGBTQ people. 

“This research brief makes clear the tangible harms that discrimination inflicts on LGBTQ people of color,  and the urgent need for public policy that reflects what the research tells us about how we can reduce those  harms,” said Dr. Nathaniel Frank, the study’s author.

Highlights of the research brief’s findings include

LGBTQ people are more likely than non-LGBTQ people to be people of color, and Black LGBTQ  Americans are disproportionately likely to live in states without protections against discrimination. For  example, 42% of LGBT people are people of color compared to 32% of non-LGBT people and the majority of  Black LGBT Americans live in the South (51.4%, more than twice the share of any other region), where most  states lack anti-discrimination protections. 

LGBTQ people of color face higher odds of discrimination than both non-LGBTQ individuals and LGBTQ  white people. For example, LGBTQ people of color are more than twice as likely to experience anti-LGBTQ  discrimination (slurs or other verbal abuse) when applying for jobs than white LGBTQ individuals (32% vs.  13%). LGBTQ people of color are more than twice as likely as white LGBTQ people to experience anti-LGBTQ  discrimination when interacting with the police (24% vs. 11%). 

Black LGBT Americans are more likely to experience economic insecurity than Black non-LGBT Americans.  For example, the majority of Black LGBT people (56%) live in low-income households (below 200% of the  federal poverty level) compared to 49% of Black non-LGBT Americans, and Black LGBT adults are also more  likely to experience food insecurity than Black non-LGBT adults (37% compared to 27%). 

Hundreds of studies conclude that experiencing anti-LGBTQ discrimination increases the risks of poor  mental and physical health, including depression, anxiety, suicidality, PTSD, substance use, and  psychological distress. 

LGBTQ people of color face disproportionate odds of suicidality, which is linked to discrimination. For  example, while 12% of white LGBTQ youth attempted suicide, the rate is 31% for LGBTQ Native/Indigenous  youth, 21% for LGBTQ Black youth, and 18% of LGBTQ Latinx youth.  

While supportive laws, family, and peers lower the risk of poor health outcomes for LGBTQ people of  color, anti-LGBTQ state laws inflict tangible harm on sexual minority populations. For example, states  with “denial of service” laws that give license to discriminate against LGBT residents between 2014 and  2016 were linked with a 46% increase in LGBT mental distress. Black LGBTQ youth who reported high levels  of support from at least one person, or who had access to an LGBTQ-affirming space, reported attempting  suicide at lower rates than those who lacked such support (16% vs. 24%). 

Supportive laws, family, and peers lower the risk of poor health outcomes  for LGBTQ people of color. 

• Suicide attempts by LGBT youth dropped by 7 percent in states that legalized same-sex marriage.22 

• The corollary is that anti-LGBTQ state laws inflict tangible harm on sexual minority populations. States with “denial of service” laws that give license to discriminate against LGBT residents were linked with a 46% increase in LGBT mental distress.23 

• Black LGBTQ youth who reported high levels of support from at least one person, or who had access to an LGBTQ-affirming space, reported attempting suicide at lower rates than those who lacked such support (16% vs. 24%). Those with high levels of family support had rates of past-year attempted suicide nearly one third as high as those who lacked such support (22% vs. 8%).24 

• Protective measures that have been found to help reduce anxiety, depression, and suicidality among LGBTQ youth include: Establishing inclusive practices and anti-discrimination policies; peer, community, and family support, including dedicated school groups; access to affirmative mental health and social services; societal confrontation of attitudes and norms that exacerbate minority stress; and practitioner training and interventions designed to disrupt negative coping responses and build resilience.

Experiencing discrimination is associated with greater odds of harm to  psychological and economic well-being, which is reflected in data on  disparities for LGBTQ people of color. 

• Hundreds of studies conclude that experiencing anti-LGBTQ discrimination increases the risks of  poor mental and physical health, including depression, anxiety, suicidality, PTSD, substance use,  and psychological distress. 

• LGBT people of color have work-place experiences that are more negative than those of white  LGBT employees, reporting that their success and work-life balance are fostered less extensively,  they have less transparent evaluations, and they are respected less by supervisors. 

• Among LGBTQ people surveyed, 51% of Black respondents say discrimination harms their  ability to be hired, compared with 33% of white respondents; 41% say it has an impact on  their ability to retain employment, compared with 31% of white respondents; 77% of Black  respondents report that discrimination impacts their psychological well-being, a rate nearly 50%  higher than the total LGBTQ survey population. 

• While racial discrimination on its own is not associated with mental health disorders, the  combination of racial discrimination with gender and/or sexual orientation discrimination is  significantly associated with increased odds of a past-year mental health disorder.

LGBTQ people of color face disproportionate odds of suicidality, which is  linked to discrimination.  

• Around 25% of LGBTQ youth of all races have attempted suicide, but the rates are starkly  higher for LGBTQ youth of color than their white counterparts: While 12% of white LGBTQ  youth have attempted suicide, the rate is 31% for LGBTQ Native/Indigenous youth, 21% for  LGBTQ Black youth, and 18% for LGBTQ Latinx youth. 

• In a 95%-non-white LGBT sample, those who report experiencing anti-LGBT victimization (such  as bullying and harassment) are 2.5 times more likely to report a past-year suicide attempt  compared to those who do not report victimization. 

• Black LGBTQ youth who experience anti-LGBTQ discrimination face twice the rate of past year suicide attempts compared to youth who do not (27% vs. 12%). Black LGBTQ youth who  experience race-based discrimination also face higher odds of attempting suicide than those  who do not (20% vs. 14%).

• Black LGB adults are over 40% more likely to have made a serious suicide attempt in their  lifetime than white LGB adults. 

• Latinx and Native American/Pacific Islander LGBT youth are 50% more likely to attempt suicide  than white LGBT youth. Latinx LGBT girls are nearly twice as likely to attempt suicide than  white LGBT youth.

• LGBTQ students who experience discrimination “based on multiple social identities” report more  use of deliberate self-harm compared to LGBTQ students who experience racial discrimination  alone or who do not experience significant discrimination of any kind.

Reflecting on the study’s findings, key executives from participating LGBTQ Advocacy groups weighed in:

“These painful figures highlight an indisputable link between discrimination, economic security,   mental and physical health. People with multiple stigmatized, marginalized social and political identities, particularly Black LGBTQ+/Same Gender Loving people, bear a disproportionate amount  of the weight illustrated by the data in this study. Statutory equality for LGBTQ+ people nationwide is a necessary foundation to remove the gaps in existing civil rights laws if we are to ever live up to  our country’s founding promises of life, liberty, and the pursuit of happiness for all,”  said David Johns, Executive Director, National Black Justice Coalition.

The majority of Black LGBTQ people live in the South, with nearly half (44%) of all Black women couples raising children. Even today, most of these states still do not protect LGBTQ people from discrimination and have overtly discriminatory laws on their books. It is no wonder the disparities are so profound and it is a testament to the strength and resilience of our people that they are doing  as well as they are. For our community and for our children it’s time for federal action!” said Kierra Johnson, Executive Director, National LGBTQ Task Force.

“This important brief only further solidifies what we have known for a very long time—the combination of racism and anti-LGBTQ discrimination has serious and long-lasting effects for the health and well-being of LGBTQ people of color. This research highlights why federal non-discrimination protections are overdue and vital to protecting the most some of the most underrepresented and vulnerable members of our community. Federal anti-discrimination protections are absolutely necessary in protecting and supporting all LGBTQ people, and this is especially true for LGBTQ people of color,” said Imani Rupert-Gordon, Executive Director, National Center for Lesbian Rights.

“Study after study shows that nondiscrimination protections improve economic opportunities, public  safety, and physical and mental well-being of LGBTQ people. It is well past time for the essential protections available only in some of our states and cities to be extended to all LGBTQ Americans, especially LGBTQ people of color, who are disproportionately burdened by the lack of protections, ” said Kasey Suffredini, CEO and National Campaign Director, Freedom for All Americans.

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Monkeypox

Risk of monkeypox infection not high, but ‘numbers may increase’

Fauci said the current outbreak is predominantly among men who have sex with men among individuals who have had sexual contact

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Dr. Anthony Fauci, the director of the National Institute of Allergy & Infectious Diseases & Chief Medical Advisor to the President (Screenshot/YouTube)

WASHINGTON – Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and the Chief Medical Advisor to the President, who has been at the forefront of the battles against the HIV/AIDS and COVID-19 epidemics, downplayed Wednesday the idea gay and bisexual men are at high risk of contracting monkeypox as the outbreak begins to spread, but cautioned “the numbers may increase.”

“Given the numbers I would not say right now at this particular point, that it is a quote, high risk, but the numbers may increase, which means we just have got to be careful and pay attention,” Fauci said.

Fauci made the remarks in a conference call with reporters from LGBTQ news outlets on the heels of the Biden administration’s announcement that it would ramp up efforts to confront the emerging spread of monkeypox.

On Monday, the Department of Health & Human Services, announced a nationwide vaccination strategy against monkeypox, which consists of providing nearly 300,000 vaccines with priorities for individuals at risk and areas with high rates of infection. An estimated 750,000 vaccines are expected for delivery by the end of summer, according to HHS.

In response to a Blade question about the risk of gay and bisexual men contracting monkeypox, Fauci said that was difficult to quantify and he “wouldn’t say low, because then…that can be taken out of context,” but went on to express there’s a minimal risk of infection if precautions are taken.

“What we’re seeing given the number of cases and the rate in which they’ve accelerated, it’s clearly out there,” Fauci said. “But when you talk about the large number of gay and bisexual men who have sex with men, that on any given individual contact I think if one is careful, and make sure that both parties in a sexual interaction are aware of lesions that might go unnoticed, then you can go a long way in pure prevention to prevent that from happening, but I think it would be risky to classify it as low, medium or high.”

The U.S. has confirmed 306 monkeypox cases across 27 states and Washington, D.C., the Centers for Disease Control announced Tuesday. That represents a surge of 63 cases from the previous week.

Fauci said the current outbreak is predominantly among men who have sex with men among individuals who have had sexual contact. Monkeypox is technically not a sexually transmitted disease, Fauci said, because it’s spread through skin-to-skin contact, but “because of the close skin to skin interaction that occurs in sexual contact, that appears to be the modality spread.” Monkeypox, Fauci said, is “not fundamentally a lethal infection.”

Raj Panjabi, senior director for global health security and biodefense on the White House National Security Council, was also on the call and said the Biden administration’s monkeypox plan consists of “three pillars” of testing, vaccines, and outreach.

“In terms of outreach, there is no effective response to an outbreak without a community based response,” Panjabi said. “And so we’ve worked to ensure an open dialogue with leaders and stakeholders in the LGBTQIA+ community. What we’ve been doing is to try to understand from those most affected by this outbreak, learn from them, help them stay vigilant within the community to protect themselves from the disease and try to adjust our response according to the gaps that they’ve raised.”

The rise in monkeypox infections comes during Pride month, a time when LGBTQ community is engaged in celebrations and oftentimes in close contract and intimate settings, including sexual activity.

Asked by a reporter with NBC News whether this weekend’s Pride celebrations may have fueled the spread, Fauci said in theory “the risk is probably increased” in Pride activities “because people tend to get involved in sexual networking there,” but precautions at the end of the day would mitigate new infections.

“You don’t want to panic people but you want to get people to appreciate, particularly with the Pride activities that are going on now, to be aware and to just be careful,” Fauci said. “And being careful can be very practical, but making sure that you’re aware of things like skin lesions or lesions around areas of the body, particularly when you’re having a sexual encounter. Those are the things we’re trying to do.”

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Monkeypox

LA County Public Health confirms community transmission of Monkeypox 

Public Health is offering the JYNNEOS vaccine in a targeted manner to reach individuals at higher risk of monkeypox

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Monkeypox virus (Photo Credit: Centers for Disease Control and Prevention)

LOS ANGELES – Los Angeles County Department of Public Health has confirmed local transmission of monkeypox in LA County, as some of the more recent of the 22 cases of monkeypox in LA County thus far have no history of international or out-of-state travel. There have been no hospitalizations or deaths.   

Anyone can get and spread monkeypox, but some of the recent cases identified have been among gay, bisexual, and other men who have sex with men who attended large events where the exposure to monkeypox may have occurred. Public Health is working with event organizers to notify attendees of potential exposure.  

While supplies of monkeypox vaccine are limited, Public Health is offering the JYNNEOS vaccine in a targeted manner to reach individuals at higher risk of monkeypox.  This includes people who are known close contacts to someone diagnosed with monkeypox and individuals who attended an event where they may have had skin-to-skin contact with someone who later tested positive for monkeypox virus. The vaccine is being used in these cases to reduce the risk of developing monkeypox.

As vaccine supply increases, Public Health will focus on making the monkeypox vaccine available for other high-risk groups in efforts to prevent widespread community transmission.   

Monkeypox does not spread easily between people.  The spread of monkeypox from person to person can occur through contact with body fluids, monkeypox sores, items that have been contaminated with fluids or sores (like clothing or linens), or through prolonged exposure to respiratory droplets. Because of this, transmission may also occur during sex through skin-to-skin and other intimate contact.

LA County encourages persons who experience symptoms consistent with monkeypox (such as characteristic rashes or lesions), persons who traveled to countries where monkeypox cases have been reported or persons who have had close contact, including sexual contact, with someone who has a similar rash or received a diagnosis of suspected or confirmed monkeypox, to contact their health care provider for a risk assessment. Those who do not have a regular provider should call 2-1-1 for assistance. 

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Monkeypox

AHF urges community outreach & education around monkeypox

“Our hope is this [monkeypox outbreak] is a passing issue, not something that’s ultimately a great cause for alarm and concern”

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Dr. Carl Millner (Screenshot/Press briefing June 20, 2022 AHF)

LOS ANGELES – During a press conference Monday, representatives from the AIDS Healthcare Foundation (AHF) urged public health officials and other healthcare stakeholders to ramp up educational and outreach efforts to slow the current rates of the monkeypox virus transmission.

“Our hope is this [monkeypox outbreak] is a passing issue, not something that’s ultimately a great cause for alarm and concern,” AHF President Michael Weinstein said. “But it’s better [to be] safe than sorry.”

Weinstein, joined by the organization’s Interim National Director of Infectious Diseases, Dr. Stuart Burstin, and its West Coast Regional Director of Internal Medicine, Dr. Carl Millner, stressed the importance of minimizing community spread through measures that can reduce the likelihood of exposure to monkeypox.

These measures, they said, include avoiding skin-to-skin contact with individuals who are known to have an active infection or who were previously infected but may still carry a risk of transmitting the virus. 

Weinstein and Burstin both pointed to public health experts’ calls for patients who are recovering from monkeypox to use condoms during all sexual activity for at least 12 weeks, pursuant to guidelines from the World Health Organization’s (WHO) that were last updated June 17.

As the virus can also be spread by exposure to bedding and clothing that has been contaminated by infected persons, contact with these items should also be avoided wherever possible, Burstin said. 

“We can reduce [the risk of transmission] by behavioral means,” Burstin said. “What we have to do is to educate people so that the risk remains low to zero,” he said. “If that fails, there’s vaccination and therapy.”

Infections are currently concentrated in Europe: the U.K. has reported 524 cases, and Spain, Germany, Portugal, and France have reported 313,303, 241, and 183 cases respectively. Many of the infections in Europe and the Americas can be traced back to LGBTQ+ events where men gathered — specifically a LGBTQ+ fetish festival in Belgium and a gay pride event in the Canary Islands. 

No deaths have been reported, and most monkeypox cases are mild — symptoms include rashes, initial flu-like symptoms, and lesions or sores.

Men, particularly gay men, and men who have sex with men (MSM), have been disproportionately represented in the clusters of cases documented.

The Centers for Disease Control and Prevention (CDC) reports there have been 113 confirmed cases in the U.S., of which 24 have been reported in California. Burstin said that figure is probably far lower than the number of actual cases, as the significant overlap in symptoms caused by monkeypox with those caused by other illnesses, including COVID-19, raises the likelihood of underreporting and misdiagnoses. 

Millner said it can even be easy to miss the prototypical rash that develops with monkeypox infections, which he described as a lesion or multiple lesions that usually appear on the hands, mouth, feet and genitals. These are often, and reasonably, misidentified as pimples, infected hair follicles, or – especially when located on or near the genitals – blisters caused by sexually transmitted diseases like herpes or syphilis. 

Screenshot of infected patient via AHF press conference

Burstin said that while monkeypox can, in rare cases, cause serious and even life-threatening symptoms, the disease has a low case fatality rate, around one percent. Plus, he said, the possibility that future variants may be deadlier or more contagious appears to be slim, given what epidemiologists have learned about the widely studied and now eradicated but closely related smallpox virus.  

There are vaccinations and treatments available for monkeypox, Burstin said, which are reserved for cases of serious illness and for populations deemed high-risk, which include pregnant women, young children, the elderly and the immunocompromised. 

Instead of mass vaccination campaigns, public health experts say immunizations should be administered based on assessments of patients’ risk of becoming seriously ill. For those deemed eligible, if given within the first four days after contracting the virus, vaccines can reduce the number and severity of symptoms, Burstin said.

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