Outward
Expanding the LGBTQ Conversation

Aug. 14 2017 1:00 PM

We Don’t Know Nearly Enough About LGBTQ Health. A Massive New Study May Change That.

Any sufficiently large and well-defined community is likely to have health concerns that disproportionately affect it, and LGBTQ people are no exception. Some problems have had an unmistakable impact on the gender and sexual-minority population, HIV/AIDS being an especially obvious example. But we still lack a comprehensive understanding of the ways that being an LGBTQ person can influence one’s overall health, or of health disparities within the LGTBQ community itself.

Researchers at the University of California–San Francisco are hoping to close that gap.

Earlier this year, the PRIDE study opened for enrollment. The first of its kind, it aims to follow the same large group of LGTBQ people over the span of the next few decades, similar to other well-known, multi-generational cohort studies. Open to anyone who resides within the United States, identifies as a gender or sexual minority, and is over 18 (though the age limit may be dropped to 13 in the future), its enrollment has surpassed 6,000 since launching in May. The study’s authors hope for 100,000 people to enroll over the next 10 years.

By studying LGBTQ people specifically, researchers can uncover health issues specific to sexual and gender minorities that haven’t been previously detected because nobody has bothered to look. Further, by conducting a large-scale study that seeks to recruit as diverse a population as possible, problems that may disproportionately affect part of the community in a certain region, or may predominantly occur in other subpopulations, may become more apparent. Health concerns faced by gay black men in Dallas may be quite different from those of gay white men in San Francisco, for example, and a study solely focused on one may miss something important happening with the other.

Aug. 9 2017 12:40 PM

Why the First Lawsuit Against Trump’s Trans Troops Ban Is So Ingenious

On Wednesday, two LGBTQ rights groups filed the first lawsuit against President Donald Trump’s proposed ban on transgender service members. An estimated 15,000 trans individuals are already in the U.S. military, and Trump’s ban, announced via Twitter, would seem to require their immediate discharge. The complaint, filed on behalf of five trans women now serving openly, claims such a purge would violate their constitutional rights. The suit makes a very sound legal argument. It’s also a clever mechanism to force the government to reveal how serious it is about enforcing Trump’s tweeted diktat.

Trump announced his ban without consultation with the Pentagon, which has declined to implement any new policy absent further guidance from the White House. On Friday, the Los Angeles Blade reported on a draft of such guidance that has apparently received the approval of the White House Counsel’s office. The draft guidance would maintain the current bar on enrollment for trans people, which had been set to be lifted this July. It would also encourage trans troops who are already serving to retire as soon as possible, push out enlisted personnel once their contracts end, and terminate officers up for promotion.

In their lawsuit, the National Center for Lesbian Rights (NCLR) and GLBTQ Legal Advocates & Defenders (GLAD) allege the White House has turned Trump’s tweets into “official guidance … to be communicated to the Department of Defense.” They argue that this guidance infringes upon the equal protection and due process rights of trans troops. According to their complaint, the “categorical exclusion of transgender people from military service … based on their sex and transgender status” lacks any rational basis and is therefore too “arbitrary” to comport with the Fifth Amendment’s equal protection component. Moreover, the policy would deprive transgender service members of their property and liberty interests based exclusively on their gender identity, a “capricious” deprivation of due process.


Trump announced his ban without consultation with the Pentagon, which has declined to implement any new policy absent further guidance from the White House. On Friday, the Los Angeles Blade reported on a draft of such guidance that has apparently received the approval of the White House Counsel’s office. The draft guidance would maintain the current bar on enrollment for trans people, which had been set to be lifted this July. It would also encourage trans troops who are already serving to retire as soon as possible, push out enlisted personnel once their contracts end, and terminate officers up for promotion.

In their lawsuit, the National Center for Lesbian Rights (NCLR) and GLBTQ Legal Advocates & Defenders (GLAD) allege the White House has turned Trump’s tweets into “official guidance … to be communicated to the Department of Defense.” They argue that this guidance infringes upon the equal protection and due process rights of trans troops. According to their complaint, the “categorical exclusion of transgender people from military service … based on their sex and transgender status” lacks any rational basis and is therefore too “arbitrary” to comport with the Fifth Amendment’s equal protection component. Moreover, the policy would deprive transgender service members of their property and liberty interests based exclusively on their gender identity, a “capricious” deprivation of due process.

Aug. 3 2017 2:01 PM

Most Americans Support Open Transgender Military Service

Donald Trump’s plan to ban military service for openly transgender people is deeply unpopular with the American public.

A Quinnipiac University National Poll released on Thursday found that 68 percent of American voters believe transgender individuals should be allowed to serve openly in the armed forces. 55 percent of voters in military households support trans service, as do 72 percent of independent voters. 60 percent of Republicans oppose trans service, but “every other party, gender, education, age or racial group” backs it by a margin of 22 percent or more, according to the poll.

These results roughly aligns with a Reuters/Ipsos poll released last week which found that 58 percent of American adults support trans military service. That poll also reported a huge gap on the issue between Democrats and Republicans, with 83 percent of Democrats backing trans service and 49 percent of Republicans opposing it. Few Republicans on Capitol Hill, however, have rushed to embrace Trump’s ban, and a number of GOP leaders have spoken out against the proposal.

We’ve long known that transgender rights are a winning issue for Democrats. Still, the margins in these polls surprised me given the overall lack of public dialogue about trans service. Why did so many Americans embrace trans troops so quickly? My guess: Most Americans assumed (incorrectly) that the 2010 repeal of Don’t Ask, Don’t Tell opened the military to transgender individuals in addition gay people. Thus, to them, the ability of LGBTQ people to serve openly and honorably is likely a settled issue. We already had a national debate on the matter and came to the conclusion that courageous individuals who wish to defend their country should not be disqualified because of their identity. That was seven years ago. Isn’t it time to move on?

Aug. 2 2017 1:59 PM

How Stigma Against Trans People and the Mentally Ill Poisons Our Politics and Culture

Last week, after President Trump announced his intention to ban transgender people from serving in the military in a series of tweets, the White House followed up this abrupt ill-considered decision by including an essay supporting the ban and pushing the view that transgender people are mentally ill in a daily emailed White House reading list. Although the Diagnostic and Statistical Manual of Mental Disorders and mainstream mental health professionals have shifted away from labelling transgender people as mentally ill, the belief that they are lingers in the public at large. Pre-existing biases towards people who fails to conform to societal gender norms combine with widespread ignorance about mental illness to form a particularly toxic combination, one that hurts trans people first and foremost, but also reinforces the widespread stigma towards those who are genuinely suffering from mental illness.

“Distress is the key to disentangling identity versus mental illness,” explained Dominic Sisti, an assistant professor in medical ethics and psychiatry at the University of Pennsylvania who runs the Scattergood Program for Applied Ethics in Behavioral Health Care. “With trans people there’s a confusion that feelings of gender mismatch are somehow unnatural or diseased, when in fact they’re not.” Sisti explained that distress is a “key necessary condition” for a condition to be considered a mental illness, and that being transgender by itself does not cause people to be distressed.

Gender dysphoria is the distress a person experiences when their physical, birth-assigned sex doesn’t match their inner sense of what their own gender is or should be. It replaced gender identity disorder in the DSM-V in an effort to shift the focus away from the incongruence between a person’s gender identity and their birth-assigned sex and onto the distress that this incongruence might cause. Not all transgender people experience gender dysphoria because not everyone feels pressured or conflicted over expressing their gender identity, and transitioning medically and/or socially usually relieves or significantly reduces gender dysphoria for those who do.

Aug. 2 2017 12:04 PM

Why the Lesbian Classic Desert Hearts Is Still Radical, a Quarter-Century Later

One of the most talked-about queer films of the year is as hot as its setting. It also happens to be more than 25 years old. In Desert Hearts, Donna Deitch’s 1985 lesbian classic that’s currently enjoying a rerelease and select showing across the country, prim and proper Columbia University professor Vivian Bell takes a train into the shadow of the Sierra Nevada in 1959. While plenty of people head to the Silver State to get gunshot-married, Vivian is there to get gunshot-annulled. But before she can set her American Tourister suitcase down, Cay, an expelled undergrad-turned-maverick casino gal, puts her black convertible in reverse on a dangerous strip of highway to say hello. A life-altering collision is imminent. Sparks fly.

The Outfest UCLA Legacy Project, a partnership between the Los Angeles LGBT Film Festival and the Bruin’s Film & Television Archive that works to preserve “lesbian, gay, bisexual, and transgender moving images at risk of becoming lost due to deterioration and neglect,” is largely responsible for Desert Hearts’ renaissance. The Project’s other restorations include The Watermelon Woman, Cheryl Dunye’s seminal meta-feature about cinema and Black queer representation, and Mona’s Candle Light, grainy yet heart-stopping footage of a midcentury lesbian bar that’s not too far removed from Vivian and Cay’s story.

Laura Karpman first saw Desert Hearts while a graduate student at Juilliard. Now an accomplished film composer (The Beguiled, Paris Can Wait) and Motion Picture Academy Governor, she keenly remembers the experience of that first viewing.

“It was life-changing,” Karpman says. “I was living with a woman, but we were both kind of in the closet. I saw it with her. I remember wearing tight Guess jeans. It was the first time I had ever seen anything like that. I almost had to look away and yet I couldn’t stop watching.”

For Karpman, that paradox is a sign that a movie was groundbreaking. “As we look to really bring equality to Hollywood, we see how important it is to see images of ourselves on the screen. Recently when I saw Wonder Woman, I had the same reaction: I didn’t know how much I needed to see what I saw.”

 

Aug. 1 2017 12:10 PM

The Fight Against Mississippi’s Anti-LGBTQ Law Isn’t Over

On Monday, the 5th U.S. Circuit Court of Appeals signaled that the fight against America’s worst anti-LGBTQ law isn’t over yet.

In June, a panel of judges for the 5th Circuit ruled that Mississippi’s HB 1523 could take effect, imperiling the rights of gender and sexual minorities throughout the state. HB 1523 is an “religious freedom” statute with a narrow definition of both religion and freedom: It protects onlyanti-LGBTQ religious beliefs at the expense of all others. Under the law, landlords, doctors, employers, businesses, adoption agencies, and schools are explicitly permitted to discriminate against LGBTQ people if their religion compels it. No other religious convictions are granted these extra rights.

Because HB 1523 favors certain religious beliefs over others, it would seem to violate the neutrality principle at the heart of the First Amendment’s Establishment Clause. By singling out specific religious viewpoints for special treatment, HB 1523 also endorses religion in contravention of the First Amendment. Moreover, the law accommodates religious practice in a way that imposes a burden on third parties—namely, LGBTQ people—which the Establishment Clause likewise forbids. For these reasons, a federal judge blocked the law in its entirety before it took effect.

The 5th Circuit panel, however, reversed the lower court without addressing these vital constitutional questions. Instead, the panel ruled that the plaintiffs, a group of LGBTQ Mississippians and religious leaders, lacked standing to challenge the law in court because they had no “person confrontation” with it. The logic of this decision was dubious, to say the least. An individual has standing to sue under the Establishment Clause when she encounters a stigmatizing government endorsement of religion: She can, for example, challenge a crèche in a town hall, or religious symbol in a municipal logo, or a sectarian prayer during a public school graduation. But according to the panel, she cannot challenge a law that endorses religion because she cannot “personally confront” the “statutory text.”

Aug. 1 2017 8:35 AM

“Unit Cohesion” Isn’t a Real Reason to Ban Trans People From the Military

In explaining his tweeted announcement that transgender Americans will not be allowed to serve in the U.S. military “in any capacity,” President Trump cited “the tremendous medical costs and disruption” that he alleged transgender service would entail. “Based on consultation that he’s had with his national security team,” echoed White House press secretary Sarah Huckabee Sanders, the president concluded that transgender service “erodes military readiness and unit cohesion.”

The unprecedented nature of such a groundless attack by the Commander in Chief against his own troops is so breathtaking—if implemented, the policy would mean rounding up 12,800 ably serving U.S. troops and dismissing them for reasons unrelated to performance—that it’s difficult to know where to begin dismantling such claims. But the assertions are particularly excruciating to my ear because I spent more than a decade researching and then fighting the very same baseless contentions that were being used to prop up the failed “don’t ask, don’t tell” policy barring open service by lesbian, gay and bisexual (LGB) troops.

July 31 2017 12:48 PM

Trump’s Trans Troops Ban Would Require a Cruel and Exorbitantly Expensive Witch Hunt

How should Americans, the Pentagon, and the more than 2 million active duty and reserve service members interpret President Donald Trump’s order to purge the military of its transgender soldiers, sailors, airmen, and Marines? Particularly when this unprecedented order—both a ban and a purge—was conveyed not via the deliberative and thorough interagency process culminating in an executive order, but rather through a series of tweets that some in the Pentagon initially believed might be an announcement of war?

First, it’s worth putting these tweets in their proper context. Trump’s trans tweetstorm began, “After consultation with my Generals and military experts,” leading many to wonder: With whom, exactly, did the president consult?

I served in the Pentagon for over six years, ending the Obama administration as the chief of staff to the Secretary of the Army Eric Fanning, where I was heavily involved in decisions related to taking care of the Army’s 1.4 million soldiers and civilians. I’ve seen up close how the White House and Pentagon are supposed to work together on high-profile policy decisions and announcements.

That’s not what happened here. According to the New York Times, when Trump refers to “my Generals,” he means a troika of two retired generals, Secretary of Defense Jim Mattis and incoming White House Chief of Staff John Kelly, as well as his national security adviser, Lt. Gen. H.R. McMaster. But Mattis, who reportedly supports open transgender service, happened to be on vacation when Trump made his announcement. Also apparently out of the loop was Gen. Joe Dunford, chairman of the Joint Chiefs of Staff, who hastily issued an internal clarification that there would be “no modifications” to current Defense Department policy allowing transgender service, pending written “implementation guidance.” The day after the announcement, the Army’s top general, Mark Milley, admitted that he learned of the policy change via the media. It is clear that Trump did not actually involve our nation’s most senior military leaders in his decision. Instead, his decision appears to have been rooted solely in politics.

 

July 28 2017 12:50 PM

On Sexuality, the Law Still Caters to the Norms of Public Disgust

We tend to assume that law is objective and disembodied, but the story of the decriminalization of homosexuality in the U.K. shows that, like the people who create it, it is in fact an emotional creature, animated by visceral human feelings – and as far as sexuality is concerned, the chief emotion at work is often disgust.

You don’t have to look very hard to see how much it was disgust, not a concern for morality or justice, that shaped the laws governing homosexual activity. In fact, in the U.K., homosexuality was long deemed so perverse that to even speak of it in public would stain your character.

July 28 2017 10:53 AM

The Navy Doctor Who Pushed for Trans Troops to Serve Openly Pushes Back on Trump’s Ban

On Wednesday, President Donald Trump announced on Twitter that transgender people would be barred from serving in the United States military “in any capacity.” To justify his impulsive decision—which he made without consulting the Pentagon—Trump cited “the tremendous medical costs and disruption that transgender in the military would entail.”

To gauge the accuracy of this justification, I spoke with Jesse Ehrenfeld, one of the country’s foremost experts on both transgender health care and military service. Ehrenfeld, a practicing physician, serves as the director of the Vanderbilt University Medical Center Program for LGBTI Health and as the secretary of the American Medical Association Board of Trustees. He has worked with hundreds of trans patients and helps to train medical students and physicians across the country in LGBTQ health care needs. Ehrenfeld is also a commander in the Navy and serves as a medical reserve officer. In 2015, he helped to set in motion the repeal of the ban on open transgender service that Trump is attempting to reverse.

I spoke with Ehrenfeld on Thursday about his work with trans troops, the looming threat of a new ban, and many misconceptions about open transgender service. Our interview has been edited for clarity.

How were you involved in the effort to lift the ban on transgender troops?

I had the incredible pleasure of serving in Afghanistan from 2014 to 2015. When I was there, I helped provide care to a transgender airman named Logan. We became friendly and I learned a lot about his experiences. In February of 2015, I found myself sitting with Logan at a troop town hall for our new Secretary of Defense Ash Carter in Kandahar, Afghanistan. I turned to Logan and said, “if you could ask the secretary any question, what would it be?” He told me he’d ask him about open transgender service. So I stood up and asked the defense secretary for his thoughts on transgender service. He gave a very favorable response.

After I got home from my deployments, I was asked to provide input on the health care needs for trans service members to a group that the secretary set up to study the issue. Given my role as a uniformed person as well as a physician with expertise in LGBT health, I think I was able to provide helpful info that was credible and useful to the process.

READ MORE STORIES