Outward
Expanding the LGBTQ Conversation

Dec. 9 2016 10:09 AM

Why the Arkansas Supreme Court’s Anti-Gay Birth Certificate Decision Is So Outrageous

For the third time in recent months, a state high court took aim at same-sex couples’ marriage rights even after the U.S. Supreme Court ruled for same-sex marriage nationwide in 2015’s Obergefell v. Hodges. This time, the Arkansas Supreme Court upheld a state law that strips married same-sex couples of their right to be named by default as parents on their children’s birth certificates.

The majority in Smith v. Paven determined that the state’s preferential treatment of opposite-sex couples was not an undermining of marriage rights but an “acknowledge[ment of] basic biological truths.” The majority astoundingly—and incorrectly—asserted that Arkansas law does not discriminate on the basis of sexual orientation. A basic understanding of family law reveals that, contrary to the justices’ conclusion, something more sinister is afoot.

Dec. 7 2016 12:08 PM

Beautiful, Catholic Malta Is the First European Country to Ban Conversion “Therapy”

Malta became the first European country to ban conversion “therapy” on Monday when the tiny island nation’s parliament unanimously approved a sweeping bill that categorized the practice as a “deceptive and unlawful act.” The new law prohibits medical professionals from attempting to alter a patient’s sexual orientation, under threat of fines or jail time. It also lowers the age at which a person may request a change in gender to 16, permitting anyone over that age to legally change their gender without filing an application in court or receiving parental approval. The law declares that no sexual orientation, gender identity, or gender expression constitutes a disorder or disease, and requires the government to recognize the “lived gender” of non-Maltans detained on the island.

Dec. 6 2016 11:57 AM

Comet Is D.C.’s Weirdo Pizza Place. Maybe That’s Why It’s a Target.

About five years ago, a band named Felt Letters, led by the longtime punk rocker Ian Svenonius, played a show in the backroom of Comet Ping Pong, a pizza parlor in a leafy, affluent neighborhood in Northwest Washington, D.C. In segues between songs, the band called hooded figures up to the stage. They held flashlights to their faces and moaned otherworldly advice from dead rock stars, like the Rolling Stones’ Brian Jones. It was a fake occult ceremony, the kind of thing that was obviously art (and obviously funny) if you understood the context. It was a pretty typical night at Comet. It was also the kind of thing that, looking back now, some 4Chan moron might interpret as actual satanism or witchcraft.

Comet is a pizzeria with ping-pong and punk shows. But to the alt-right believers of the now-notorious #pizzagate conspiracy theory, Comet is actually the locus of a satanic pedophilia ring connected to the most powerful figures in Democratic politics. This theory—espoused on 4Chan and Twitter, in a now-banned Reddit forum, and by the son of the president-elect’s choice for national security adviser—has inspired its adherents to harass the 40-person staff of Comet with threatening phone calls and social-media missives, forcing the restaurant to bring on extra security. But that wasn’t enough to keep out Edgar Maddison Welch, a 28-year-old man from Salisbury, North Carolina, who was arrested on Sunday afternoon after firing a shot inside Comet with what police called an assault rifle. According to the Washington Post, Welch told police that he went to Comet to “self-investigate.” Thankfully, no one was hurt.

Dec. 5 2016 3:27 PM

The Gay Rights Movement Just Scored a Massive Legal Victory Thanks to Walmart

Until recently, Walmart was not exactly a corporate leader on LGBTQ equality, often waiting to provide benefits and protections to LGBTQ employees until the law compelled it. Today, however, the company is a strong supporter of LGBTQ rights—and on Friday, it made an immense impact on civil rights in the United States by implicitly acknowledging that anti-gay employment discrimination is already illegal under federal law.

Walmart’s contribution to gay rights emerged, ironically, out of a companywide policy of discrimination. For years, the company provided health insurance benefits exclusively to opposite-sex spouses, refusing to extend benefits to same-sex spouses. Walmart abolished its anti-gay health insurance policy in 2014 as part of a push to shed its discriminatory image. But by that point, thousands of gay Walmart employees had been forced to pay huge sums of money to help pay their uninsured spouses’ medical bills.

Jacqueline Cote was one of these employees. In 2012, Cote’s wife, Diana Smithson, lost her health insurance and was then diagnosed with ovarian cancer. Smithson attempted to enroll in Cote’s insurance plan, but Walmart rejected her, citing its anti-gay policy. The couple eventually incurred $150,000 of uninsured medical expenses. (Smithson died in March.) Cote filed a charge of discrimination with the Equal Employment Opportunity Commission, alleging that Walmart’s policy violated Title VII of the Civil Rights Act of 1964, which prohibits employment discrimination “because of sex.” The EEOC endorsed her legal theory, and Cote launched a class action lawsuit on behalf of herself and about 1,000 people who suffered from Walmart’s anti-gay insurance policy between 2011 and 2014. (A statute of limitations issue prevented the suit from reaching back further.)

Dec. 2 2016 2:46 PM

How Project ECHO Is Fighting to Make Health Care Welcoming to LGBTQ People

In March 2016, a program called Project ECHO: LGBT Health launched with its sights set on a vexing problem: LGBTQ people have specific health care needs, but far too often, providers are not equipped to meet them. Uniting physicians, nurses, and other medical practitioners from across the country for a yearlong collaboration, ECHO: LGBT has encouraged 10 major community health care centers and their related clinics to address an urgent question: How can the medical community transform to better serve LGBTQ people?

Conceived by the Wietzman Institute, an organization dedicated to research and innovation in primary care, ECHO: LGBT’s main focus is creating a forum for medical practitioners to learn about road blocks to health in the queer community and how to address them. Nine months into its run, the project has offered twice-monthly videoconferences where primary-care providers from Arizona, Pennsylvania, Colorado, Connecticut, Louisiana, and beyond share recommendations on challenging cases with expert, multidisciplinary faculty and colleagues.*

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Of course, these conferences touch on familiar health topics of importance to the LGBTQ community, such as HIV prevention and care. But they also encourage conversation about bigger questions concerning outreach, sensitivity, communication, and how to make every doctor’s office a truly welcoming place for queer visitors. In short, ECHO: LGBT is working—as quickly as possible—to inject the health care community with a healthy dose of social justice.

Or at least that’s how it feels to Dr. Andrew Cronyn, who is spearheading his community health center’s partnership with ECHO: LGBT in Tuscon, Arizona. Cronyn is passionate about queer health care issues. His work as a gay activist, which includes the launch of a transgender youth program at his health care center, was inspired in part by an alarming experience: “A year before I got involved with ECHO, I got call from a mother of a transgender child who had been dismissed from another doctor’s practice,” Cronyn told me. “I told her that I didn’t know very much. But I could promise her that I would not ever throw a child out of a practice.”  

That phone call, and other encounters like it, awakened Cronyn to the challenges that LGBTQ—especially trans—people can face during a simple visit to the family doctor. Those that are not rejected outright struggle with a broad spectrum of discriminatory policies that prevent some LGBTQ people from receiving quality care, or even being recognized by their preferred name. “For example, here, the Arizona Health Cost Containment System [Arizona’s Medicaid program] will not change the name you have on file unless your birth certificate has been changed,” Cronyn told me. “And in Arizona, trans people cannot change their birth certificate unless they’ve had surgery.”

But Cronyn hopes that ECHO: LGBT will change attitudes and policies in the medical community—that a focused dialogue about LGBTQ issues will not only strengthen queer activists like himself, but also create new practitioner-activists who can spark progress. He told me that health care staff who entered the program with trepidation—some due to religious concerns—are now among ECHO: LGBT’s most engaged participants. And participants with no particular investment in queer rights have become vocal advocates. “My medical assistants, when we first started the transgender youth program, they had no idea about queer and trans rights,” Cronyn said. “This year, a group of them made pride shirts and went to the pride parade so that they could cheer on our kids. When you know something, and really see someone, it makes a difference.”

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Providers in various locations prepare to start a training session.

Weitzman Institute


Weitzman Institute Associate Director Wanda Montalvo—who oversees the research institution's Transforming Primary Care for LGBT People initiative (of which Project ECHO: LGBT is a component)—is similarly heartened by the project’s impact over a few short months. “I’ll say that I’ve done a lot of work like this around a lot of disparity topics—asthma, diabetes,” Montalvo told me. “And one of the things I love about ECHO: LGBT is the level of enthusiasm and dedication from the health centers participating in the initiative. This project has touched a lot of people much more quickly than my previous topics.”

But Montalvo’s ambitious vision goes beyond winning short-term investment from direct ECHO: LGBT participants. She envisions a medical community that does more than correct its treatment of queer people—a community that allows a newfound embrace of LGBTQ life to shape its attitude toward all patients. “We hope to improve overall knowledge about LGBT care, but we really want to see that this knowledge is being applied in primary care as a routine, not as a special project or in special cases,” Montalvo told me. “I want to see physicians learn that when you ask someone about their sexual histories you’re not just asking because they have responded that they are LGBT. That’s absurd. LGBT people are not the only ones having sex. It would be a very boring world.”

Montalvo knows, however, that ECHO: LGBT is only a small step. Though it will directly affect ten major health care centers, and indirectly impact their many satellite locations, there are over 1,500 health care centers to reach nationwide, and ECHO: LGBT will only run for one year. Meanwhile, some of the project’s key activities have hit roadblocks. For instance, data collection around LGBTQ care has been stymied by the limitations of the project’s participants—some health centers simply do not have the administrative, financial, or technological capacity to gather the information that ECHO: LGBT wants to use in its meetings, reports, and recommendations.

Sitting in on an ECHO quality improvement session with healthcare team members in October, I felt overwhelmed by the amount of material that participants were trying to engage with—conversations about race, gender, sexuality, health, and well-being—right in the middle of an intensely busy shift. It’s wonderful to think that these twice-monthly meetings have planted a seed of change. But is that enough? And is the change sustainable?

For Cronyn, just making people aware of the unique challenges LGBTQ people face is an excellent start. After all, his passionate advocacy work was fueled by a small encounter that opened to his eyes to an endemic problem. “When that first mom called me, she had three requests,” Cronyn told me. “Call my son by his name, call him by his gender, and don’t look at his genitals unless it’s related to the reason of the visit. I was like, She must be insane to think doctors would do that. But as I’ve learned, she’s not insane.” And that awakening alone has been part of the fuel for new projects, programs, and real change in the hearts of caregivers around him.

*Correction, Dec. 5, 2016: This post originally misstated the number of times per month Project ECHO: LGBT meets. Additionally, the type of session the writer attended and the professional role of Weitzman Institute Associate Director Wanda Montalvo have been clarified.

Dec. 1 2016 2:03 PM

Surrender Donald! A Queer Call to Action Since 1989

 

On Oct. 31, 1989, roughly 100 protesters from the AIDS activist group ACT UP New York descended on Trump Tower at 5th Avenue and 56th Street. One protester, dressed as Dorothy from The Wizard of Oz, waved a sign demanding, “Surrender Donald.” ACT UP was in a fight for the lives of people with HIV and AIDS, striking out against government indifference and corporate greed. And they saw Trump for what he was: a monster in the making.

ACT UP, short for AIDS Coalition to Unleash Power, had been formed two-and-a-half years earlier, out of mounting anger over inadequate city, state, and federal government responses to rising numbers of HIV/AIDS cases and related deaths. The group quickly became known for their disruptive, theatrical demonstrations, calling for expanded and faster drug research, more affordable medications, and greater AIDS education. The Trump Tower protest was organized by ACT UP’s Housing Committee, which hoped to draw attention to the lack of housing for homeless people with AIDS.

 

Dec. 1 2016 1:20 PM

Listen to Federal Judges Shred Arguments That Civil Rights Law Doesn’t Protect Gay Employees

On Wednesday, the U.S. Court of Appeals for the 7th Circuit heard arguments in Hively v. Ivy Tech Community College, a critical gay rights case that could wind up at the Supreme Court. Hively involves Title VII of the Civil Rights Act of 1964, which prohibits employment discrimination “because of sex.” Some federal courts, as well as the Equal Employment Opportunity Commission, have found that sex discrimination encompasses sexual orientation discrimination—and that anti-gay workplace discrimination is thus already illegal nationwide. Wednesday marked the EEOC’s first opportunity to test this interpretation in a federal appeals court since it adopted the theory in 2015.

The 7th Circuit is currently dominated by Republican appointees. But its conservatives are famously astute and open-minded, and by the end of oral arguments, it seemed clear that a majority of the court would rule that Title VII bars sexual orientation discrimination. This consensus developed right around the time that John Robert Maley approached the lectern to defend Ivy Tech’s right to discriminate against gay employees. The ensuing colloquies were at once slightly painful and extremely amusing, as the top legal minds in the country excoriated Maley’s sophistry and revealed the flimsy intellectual foundation of his arguments. Below are five of the most entertaining exchanges of the morning. (Note: Visit this article via Slate.com if you are unable to see any audio players.)

Nov. 30 2016 5:45 PM

The 7th Circuit Likely to Rule Anti-Gay Employment Discrimination Is Illegal

CHICAGO—The United States Court of Appeals for the 7th Circuit is very certain that lesbians exist, but it is not entirely sure why, or what to do about them. On Wednesday morning, the entire court heard arguments in Hively v. Ivy Tech Community College, a firecracker of a case that could overhaul nondiscrimination law across the country. The question: Does an existing federal civil rights law already prohibit workplace discrimination on the basis of sexual orientation? The answer: Probably—but nobody can quite agree why.

Here’s the trouble. Congress has repeatedly considered adding sexual orientation to Title VII of the Civil Rights Act of 1964, which prohibits several forms of employment discrimination, and ultimately declined to do so. But Title VII has, from the start, included a ban on discrimination “because of sex.” In 1989’s Price Waterhouse v. Hopkins, the Supreme Court defined sex discrimination to include sex stereotyping—mistreating employees because they fail to comply with gender norms. Since then, a number of courts have held that this expansive definition of sex discrimination may also encompass anti-gay discrimination. In 2015’s Baldwin v. Foxx, the Equal Employment Opportunity Commission declared that sexual orientation discrimination is sex discrimination under Title VII.

Hively marks LGBTQ advocates’ first opportunity to press the EEOC’s latest position in a federal circuit court. It’s a landmark case any way you slice it, but the molten tension in the courtroom on Wednesday is heightened by the looming possibility of Supreme Court review. If the ideologically diverse 7th Circuit issues a strong ruling affirming the EEOC, it would provide the justices with an excellent opportunity to take the case and settle the issue nationwide—and for Justice Anthony Kennedy to cement his gay rights legacy.

Nov. 30 2016 11:30 AM

Seventy-Eight Percent of LGBTQ Voters Went for Hillary Clinton. I Talked to Some Who Didn’t.

If everyone in America were queer, Hillary Clinton would have won by a landslide. According to CNN exit polls, 77 percent of people who answered “yes” to the question “Are you gay, lesbian, bisexual, or transgender?” also said they voted for Clinton. Clinton did better with queer voters than she did with Latinos by more than 10 percent, even though Trump himself believed his statements had so poisoned Latinos against him that an American-born judge of Mexican descent could not be trusted to be impartial in a fraud case against Trump University.

The second most popular candidate among LGBTQ Americans was Donald Trump, but queer voters also seem to have been more likely to vote for a minor-party candidate than most Americans. I say “seem,” because none of the exit polls I found differentiated between votes for minor parties and “decline to answer.” About 9 percent of the queers surveyed in exit polls either voted for someone other than Clinton or Trump or else declined to answer. This is a lot higher than the roughly 4 percent of the vote won by Jill Stein, Gary Johnson, or Evan McMullin.

Nov. 30 2016 8:30 AM

Why Don’t Doctors Tell Patients the HPV Vaccine Can Prevent Anal Cancer?

A widely available vaccine can substantially lower the risk of various cancers for those who receive it. For men who have sex with men, the benefits may extend further. Those potential benefits for gay and bisexual men, however, are often left out of the conversation.

Whether they should be, and how to raise them, are more complicated issues than one might think.

The vaccine in question prevents infection against several strains of the human papillomavirus, known as HPV. The most common sexually transmitted infection, HPV can both cause genital warts and increase the risk of several different kinds of cancer, though the strains that cause warts are different from those that raise cancer risk. Almost all cases of cervical cancer are caused by infection with HPV, and in 2006 a vaccine was licensed in the United States for administration to girls to lower their risk of that disease. The vaccine has been found to be so effective that the Centers for Disease Control recently lowered the number of shots recommended from three to two if they are first administered before age 15. (Three shots are still recommended for those starting later.)

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