LGBTQ Health and Well-Being SIG


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The purpose of this SIG is to provide a forum within the Academic Pediatric Association (APA) for members to share research at various stages of development, innovative teaching activities and ideas, and advocacy efforts in support of LGBTQ children, youth, parents, health professional students and members of health professional faculties. The SIG may also contribute to the development of APA policy with respect to LGBTQ populations, and explore innovative models of health care delivery designed to address health and health care disparities and to promote the health and well-being of lesbian, gay, bisexual, transgendered and questioning (LGBTQ) individuals. SIG activities may occur in the domains of research, education, policy, health care delivery and advocacy.

Although increasing, research on LGBTQ youth is still relatively scarce. While most LGBTQ youth have the resilience to negotiate the developmental, social and health issues associated with sexual minority status and to thrive as healthy and prosperous adults, there are some notable risks along the way. Many LGBTQ youth experience homophobia or heterosexism which may damage emerging self-image, predispose to depression and self-destructive behaviors, and result in higher rates of bullying and violence. (Pediatrics 2013;132:198-203). Family rejection is another threat to mental and social health and well-being for LGBTQ youth. The Institute of Medicine's 2011 report, "The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for a Better Understanding, documented substantial disparities in health and health care for LGBTQ people and called for research to fill the gaps in our understanding of how to reduce these disparities. Some examples from the report include: increased risk for substance abuse and homelessness, and lack of access to health care professionals who can provide appropriate care. There is a greater HIV infection burden among young men who have sex with men (MSM). LGBTQ youth may not disclose their sexual orientation to their physicians, and there may be discomfort among physicians in addressing sexual orientation with their adolescent patients. (IOM Report, The Health of Lesbian, Gay, Bisexual and Transgender People, March 2011)

The American Academy of Pediatrics recently published a policy supporting Marriage Equality for all, including those who are of the same gender, adoption without regard to the sexual orientation of the parents, and foster care placement for eligible children to qualified adults without regard to their sexual orientation. (Pediatrics 2013;131(4):e1374-e1383). There are likely almost 2 million children younger than 18 years of age being raised by at least one gay or lesbian parent. Data reviewed in the technical document accompanying this policy support the conclusion that these children are not disadvantaged in any significant respect relative to children of heterosexual parents. Yet there is more research to be done in this area. For example, there is much less information about outcomes of children raised by gay male parents as compared to lesbian parents. While 13 states and D.C. have legalized marriage equality, and the defense of marriage act (DOMA) has been struck down by the Supreme Court, at least as it applies to legally married LGBTQ individuals, there are many disparities in the United States regarding LGBTQ marriage, parenting and adoption that still require research education, support and advocacy.

LGBTQ health professionals also face challenges in the work environment. Mark Schuster's, "On Being Gay in Medicine" (Academic Pediatrics 2012;12:75-78) is an elegant personal chronicle of challenges associated with heterosexism and homophobia that affected his professional and educational journey. While things have improved, there are still opportunities to address work environment disparities and optimize the work environment for all. As Mark wrote, "there's still much work to be done".

GOALS

The over-arching goal of the SIG is to provide a forum within the APA to promote the health and well-being of LGBTQ individuals through research, education, improvements in health care delivery, support and advocacy.

Specific goals include:

  • To promote research on LGBTQ issues.
    Activities:
    • Presentation of research ideas, preliminary data and/or completed projects at SIG meetings.
    • Networking with other members to create collaborative research projects.
    • Presentations by experts in the field at SIG meetings to stimulate thought and new ideas for research.
  • To promote education regarding LGBTQ health and well-being.
    Activities:
    • Develop a curriculum for residents regarding LGBTQ health and well-being.*
    • Develop educational content for SIG meeting.
    • Develop proposals for Workshops and other invited science at PAS.
    • Develop educational material for LGBTQ constituencies including parents and youth.
  • To develop innovations in health care delivery designed to improve care for members of the LGBTQ community, both parents and children.
    Activities:
    • Develop educational materials for present and future workforce.
    • Develop improvement strategies and activities for health care practice.
  • To advocate for policies that support and improve the health and well-being of LGBTQ individuals.
    Activities:
    • Develop APA policies.
    • Communicate with the Public Policy Committee to support relevant advocacy opportunities
  • Promote safe and supportive work environments for LGBTQ trainees and health care providers.

    *It is anticipated that the SIG will collaborate with the new Provisional Section on LGBT Health and Well-Being in the American Academy of Pediatrics, the new LGBTQA Pediatric Education Group (PEG) in the APPD, the Public Policy Committee, relevant committees and SIGS of the APA, and other interested organizations in pursuing these goals.

CONTRIBUTIONS TO APA

This SIG will contribute to the rich tapestry of activity in support of the health and well-being of children characterized by the multiplicity of SIGs in the APA. All of the goals and activities are highly consistent with the mission, vision and values of the APA.

Mission:

The APA is dedicated to improving the health and well-being of all children and adolescents by promoting research, advancing a scholarly approach to education, developing innovations in health care delivery, advocating for an equitable child health agenda, and fostering leadership and career development of child health professionals.

Vision:

To create a better world for children and families by advancing child health and well-being through the work of our members and collaborators.

Core Values:

  • Optimal health for all children
  • Focus on the whole child
  • Scholarship
  • Inter-disciplinary collaboration
  • Diversity
  • Professional development
  • Partnership with children, families and communities

Every goal and activity in this proposal is consistent with the mission, vision and/or core values of the APA.

All interested APA members are encouraged to join this proposed SIG. The SIG environment is intended to be safe and welcoming to all, regardless of sexual orientation.


April 2016 Newsletter Article


PLEASE JOIN US!

The LGBTQ Health and Well-Being SIG will meet at the PAS this year on Sunday May 1, 2016 from 12:00 noon until 3:00 PM in the Hilton Baltimore Hotel, Latrobe Room.

This year's program will be extremely topical and stimulating.

12:00 Noon - 12:30 PM:   Introductions / Networking

12:30 PM - 1:30 PM:
Caring for Gender Non-Conforming Youth
Our understanding of gender identity and the medical services available to transgender youth are rapidly evolving, which can make it difficult for providers to keep up. The aim of this presentation will be to build an understanding of gender development theory, some of the most current terminology being used, as well as best-practices for making clinical settings “safe spaces” for transgender youth. We will address risks factors and strategies that can be used to prevent “gender dysphoria,” which is a significant distress related to the incongruence between their gender assigned at birth and their affirmed gender which if untreated can contribute to significant mental health problems, such as anxiety, depression and suicide. Finally, medical services available to transgender youth, including agents to block endogenous puberty, cross-sex hormones, and surgical interventions, will be reviewed.

Jason R. Rafferty, MD, MPH, EdM
Resident Physician in
Pediatrics, General Psychiatry, Child & Adolescent Psychiatry ("Triple Board")
Brown University

1:30 PM - 2:30 PM
The State of State LGBTQ Policy
Since the landmark US Supreme Court marriage equality decision in 2015, states have seen an influx in proposals that threaten the health, well-being, and family and social relationships of LGBTQ youth and LGBTQ parents and their children. Bills and policies to deny access and accommodation to LGBTQ people, promote conversion therapy, challenge adoption rights and foster parenting, and isolate transgender students were seen in 2016. But progress continues to be made, too. Protections for LGBTQ students against bullying, bans on conversion therapy, and nondiscrimination in health care and family leave laws are advancing. Join us for a closer look at what's happening and learn what you can do to make a difference.

Jim Pawelski
Director, Division of State Government Affairs
American Academy of Pediatrics
Elk Grove Village, IL

2:30 PM - 3:00 PM Questions and Group Discussion

We will have the opportunity after both presentations to ask questions and also to share personal advocacy stories and suggestions. 

As always all APA members and PAS attendees are invited and encouraged to attend. 

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