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Equality Forum: Picking up an Important Piece on Health Services

May 4th, 2009 No comments

On the day after Equality Forum’s week-long stampede finished trampling me, I’m able to stagger back to my computer and pick up a piece from last Saturday’s collaborative programming that I didn’t want to leave behind. (Tomorrow I hope to be able to post on the National Equality Rally that took place on Sunday.)

One of the panels I stopped in on, Health Care Reform: What Does it Mean for the LGBT Community?, ended up ranging over a wide swath of issues concerning the community. This wasn’t surprising, because the panel was conducted by the Mazzoni Center, an organization that delivers a staggering array of health-related services to the community; mostly for free. In addition to primary care, the Center: does anonymous HIV testing (and services for those infected with the virus); offers mental health counseling; provides a smoking cessation program as well as an array of support  groups; and has a number of education outreach programs, importantly including “The Collective.” This is a collaborative effort that does culturally targeted HIV prevention and services for gay and non-gay identified men who have sex with men (MSM, in the accepted public health acronym). This approach is generally recognized as the only one with a decent chance of working in communities that, for historical reasons, harbor a deep distrust of public health.

In short, the Mazzoni Center stands at the intersection of private health care and public health, recognizing that the prevention and education efforts at the center of the public health mission can reduce the need for chronic and acute medical care that consumes much of the health care time and dollar. So it was natural that the conversation was similarly expansive.

Listen to Nurit L. Shein, Executive Director, speaking of the need for coverage of services that are specific to the transgender community: “This is an issue that the LGBT community needs to coalesce around.” Is it reasonable to believe that whatever health care reform is on the table at the federal level will address this issue? Not unless advocates, like the Mazzoni Center and those they serve, get in touch with their officials, show up at public hearings, and agitate. Thus far, the LGBT response has been, too often, to let the “T” kind of dangle from the end of the alphabet string.

Mazzoni’s vital work, though, is often frustrated by the failures of public and private health elsewhere. Robert Winn, the Center’s Medical Director, somewhat surprised me by stating that he’d lost track of how many times patients had come to him after being informed by their former primary care providers that they didn’t want to care for gay people. (I  just checked my iPhone’s calendar; yes, it’s 2009.) Of course, this is a strictly illegal position in Philadelphia, but most people don’t sue: they just find another doctor. But until those with a public health, population-based approach combine with the AMA to drive these homophobic views out of existence, private prejudice will continue to negatively influence the medical and mental health outcomes of the community.

It’s well known that sexual, racial, and other minorities have much worse health outcomes than the majority. Every day, Mazzoni’s dedicated workers try to push a very large boulder up a very steep hill.

Lysistrata’s Daughters

March 27th, 2009 4 comments

In Aristophanes’ funny-through-the-ages play, “Lysistrata,” the title character (from Athens) leads a pack of determined Greek women in withholding sex from their husbands until these war-mongering hubbies cease the endless Peloponnesian War between Athens and Sparta.

Although the play is often (justifiably) remembered for its ribald descriptions of the sex that’s withheld  (my favorite is a position referred to as “The Lioness and the Cheese Grater”) 1 and the windy oath by which sex is renounced, the play also contains a serious message about the toll war takes on the women and children left behind, who are at the mercy of the idiotic and childish decisions the men are making. Using what power they have, these powerful women put a stop to it.

The women featured in the following trailer are Lysistrata’s spiritual daughters:

httpv://www.youtube.com/watch?v=Uon9CcoHgwA

No, these women are not withholding sex (as far as I know). But they — Christian and Muslim together — have taken a courageous and dangerous stand against the violence that long wracked Liberia, destroying their families, children, and husbands. Indeed, the training of children soldiers was one of the most egregious of former President Charles Taylor’s many human rights violations.

Liberia now has its first female President, the Harvard-educated Ellen Johnson Sirleaf. Following the model of South Africa, she has established a Truth and Reconciliation Commission to try and heal the wounds wrought by decades of brutal civil war. Her leadership is helping to inspire her countrywomen to seize control of their nation’s destiny, pulling it from the whirlpool of civil war onto the solid ground of a functioning democracy.

The empowerment of women is often cited as one of the most potentially powerful tools in achieving global public health; most notably, in fighting the HIV/AIDS epidemic that has especially devastated sub-Saharan Africa. As the Liberian women are demonstrating, the prevention of disease can be but one part of a larger moral, social, and political agenda.

Long live Lysistrata!

  1. Aristophanes was apparently unaware that lions are carnivores, who would have little use for a cheese grater.

Religion and Sex(uality)

March 17th, 2009 No comments

I recently received an email from a reader who thought I might find interesting a recent communication from the Presiding Bishop of the Episcopal Church. Good guess. The article reminds me that there are many intelligent people of faith who are capable of understanding the dynamic relationship between religion and the secular world. Here is what the Most Rev. Katharine Jefferts Schori had to say, to that point:

“[A]ll of us read Scripture through the lenses we have [including] our cultural norms [and] our scientific understanding….We also privilege particular parts of Scripture in the way we build our lectionaries.”

I really do encourage all of you to follow the link above to this remarkably nuanced and thoughtful article, especially in these times when so many of the most vocal religious figures are speaking mean-spiritedly or ignorantly.

On the nastiness front, Gary Bauer, President of the ironically named “American Values” group recently said that any effort by President Obama to extend domestic partner benefits to government workers (even though two federal appellate judges separately ruled that the workers were eligible for such benefits) would “provoke a furious grass-roots reaction, reinvigorate the conservative coalition and undermine his efforts to portray himself as a moderate on social issues.” Who’s immoderate here?

As for ignorance, the out-of-touch Pope Benedict XVI followed up his lifting of the excommunication of ultraconservative bishops (including one certified Holocaust denier) by statements he just made regarding the scourge of HIV in Africa. On the airplane taking him to Cameroon, he denounced the use of condoms as one tool in fighting the prevention of HIV infection: “You can’t resolve it with the distribution of condoms,” he said. So far, so good: condoms alone won’t solve the problem. But then came this statement: “On the contrary, [condom use] increases the problem.” Noooooooooo!

The same article that captured the latest foot-in-mouth escapade of the seriously out-of-touch pontiff also reported the mainstream public health view that, in a continent heavily burdened by HIV/AIDS, condom use is one of many needed prevention strategies. The trip, by the way, kicks off a year of attention to Africa by this pope.   Africa to Pope: “Thanks, but no thanks.”

Let’s end on a more positive note, by returning to the thoughtful article by Rev. Jefferts Schori. Surveying the landscape of cultural and social signifiers of gender and sexuality at the primates’ meeting in Alexandria, Egypt, she noted that the male-dominated culture there led to all kinds of behaviors that we would regard as either alien or dissonant: the almost complete covering of the female body while paintings of half-naked women adorned the wall of a conference room in her hotel; the view that one partner in a same-sex relationship must be acting the role of the “other” gender; and the hand-holding displays of affection by people of the same-sex that would be regarded differently here.

Rev. Jefferts Schori then concludes with an oddly moving encounter and her reaction to it. When she was greeting people in Texas after the meeting, one man described his friend in a wheelchair as “the most interesting gay man” he knew, and then said (apropos of nothing in particular, apparently): “All of this is really about male supremacy, isn’t it?” Here is the rest of the reverend’s article, set forth below without comment:

“His words, not mine, but worth consideration. ‘There is no longer Jew or Greek, there is no longer slave or free, there is no longer male and female; for all of you are one in Christ Jesus.’ Galatians 3:28.”