Tobacco Use a Serious Health Concern in LGBT Community

Smoking contributes to a range of negative health outcomes, such as cancer, heart disease, and respiratory illness. In fact, tobacco use is the leading preventable cause of disease and death in the United States.

What is less commonly understood is that smoking is even more of a problem for the LGBT population. That’s because LGBT young adults are nearly twice as likely to use tobacco as other young adults. As a consequence, each year tens of thousands of LGBT lives are lost to tobacco use. Further, of the more than 2 million young adults ages 18-24 who identify as LGBT in the United States, more than 800,000 smoke occasionally – that’s 40%! So a campaign to prevent them from engaging in this harmful health behavior could be lifesaving.

Learn about the unique stressors that affect the health of LGBT/Q Youth. Click here.

“We know LGBT young adults in this country are nearly twice as likely to use tobacco as other young adults,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “We want LGBT young adults to know that there is no safe amount of smoking. Even an occasional cigarette can have serious health implications and lead to addiction.”

"This Free Life" Campaign

“This Free Life  that communicates serious information about the ugly side effects of smoking in a unique and engaging way. The new campaign is part of the FDA’s ongoing efforts to prevent death and disease caused by tobacco use and will complement the agency’s at-risk youth education campaigns. The $35.7 million “This Free Life” campaign is funded by user fees collected from the tobacco industry, not by taxpayer dollars.

Smoking and People Living with HIV

Just as in the LGBT community, smoking rates are disproportionately high among people living with HIV. According to CDC data, 42% of adults living with HIV were current smokers compared to about 21% of the general public. Unfortunately, smoking cigarettes can intensify the health risks of HIV, even for people who have their condition well controlled. Smoking increases the chances of heart disease, cancer, serious lung diseases and infections, which are all conditions that those with HIV are more vulnerable to developing. So quitting smoking—or never starting—may be one of the most important steps toward better health that a person living with HIV can take.

Source: Department of Health and Human Services

One Month After: 'Fear of Trump' Is Making Some Youth Physically Sick

One month after Trump's 'election,' many adults anecdotally and many children, documented, express more fear and anxiety about Donald Trump. In this excerpt from an article published by Common Dreams, we look at 'fear of Trump.'

To find more detailed information about fear, our most powerful emotion, get our book, Healing the Brain.

After a campaign built on xenophobic remarks, a pledge to construct a massive wall across the southern border, and promises to form "a deportation force" to rid the nation of millions of undocumented immigrants, it's not surprising the psychological impact of Donald Trump's rhetoric would be most sharply felt among those living within those communities.

"People worry their families will be broken up, that parents will be deported and children will end up in foster care, on a scale that we’ve never seen before. The feeling out there is one of great fear." —Marielena Hincapié, National Immigration Law Center

And now, with the reality setting in that Trump will soon by the President of the United States, the Guardian reports Friday how pediatricians serving in communities with large populations of undocumented immigrants are seeing a spike in anxiety-related physical illnesses, most notably among children expressing worry that they, their parents, or other loved ones will soon be arrested or deported.

As the Guardian's Andrew Gumbel reports:

One little boy in North Carolina has been suffering crippling stomach aches in class because he’s afraid he might return home to find his parents gone. In California, many families are reporting that their children are leaving school in tears because their classmates have told them they are going to be thrown out of the country.
Children are showing up in emergency rooms alone because their parents are afraid of being picked up by Immigration and Customs Enforcement if they show their faces. Even American-born children are suffering – one boy in the south-east asked a doctor for Prozac because he was worried about his undocumented friend.

"It’s as though a volcano erupted. It’s been awful," said Mimi Lind, director of behavioral health at the Venice Family Clinic, one of the largest providers of healthcare to low-income families in southern California. "People who don’t have a history of anxiety and depression are coming forward with symptoms they’ve never had before. And people who had those symptoms already are getting much worse."

It’s too soon to put precise figures on the wave of Trump-related anxiety, but health professionals and immigrant rights groups say it is unmistakable. "People worry their families will be broken up, that parents will be deported and children will end up in foster care, on a scale that we’ve never seen before. The feeling out there is one of great fear," said Marielena Hincapié of the National Immigration Law Center.

LEARN MORE ABOUT ANXIETY AND FEAR IN OUR NEW BOOK.

Heterosexism and the holidays

Thanksgiving marks the start of the trifecta of holidays that spike anxiety in LGBT youth and adults of all ages. In this excerpt from Healing the Brain, we look at the invisible but all-too-real phenomenon of heterosexism, the feeling of gay people that they must give deference to a straight-majority culture.

Despite, or in some cases because of social progress in marriage equality and other matters, pervasiveness of alienation in the lives of the current generation of gay youth is well established. Nevertheless, little is definitively known about the strategies these youth use to cope with stigma and discrimination based on their sexual minority status. Lesbian, gay, bisexual and transgender youth face an array of daunting challenges in addition to many of the developmental stressors facing straight teens.

One of the most difficult stressors gay youth face is heterosexism. This term describes the acculturated and pervasive (intentional or non-intentional) concept that denies, denigrates, and stigmatizes any non-heterosexual form of behavior, identity, relationship, or community. The experience of being stigmatized is at the root of a range of health problems faced by sexual minority adolescents including increased depression, suicide risk, and other mental health disorders. Few researchers have examined the emotional consequences of day-to-day encounters with heterosexism, but many have noted the challenge of maintaining a positive sense of self in the face of chronic negative feedback based in heterosexist attitudes. Recent research has revealed elevated levels of social anxiety in sexual minority adolescents, as well as associations between social anxiety and increased risky sexual behavior.

Forms of heterosexist experiences vary widely, ranging from casual anti-gay remarks to severe physical violence or total social exclusion. Youth encounter heterosexism in diverse settings, including home, school, church, parks, and on the street. Sources of heterosexism were equally wide-ranging, including family members, schoolmates, friends, and religious leaders.

Few researchers have examined the emotional consequences of day-to-day encounters with heterosexism.

Heteroterosexist attitudes by family appeared to be especially stressful for gay youth, in part due to these youths’ emotional and financial dependence on their families. The holiday season, the period between Thanksgiving and New Year’s Day, accounts for many family disruptions over the issue of a child’s sexulity. Youth see this period and the typical gatherings of their nuclear family as an opportunity to begin talking about their true selves. Not coincidentally, this time of year is when the highest incidents of family disruptions occur. Large cities such as San Francisco and New York see an influx of gay youth fleeing their homes and ultimately seeking social services. Relatedly, when television covers an LGBT matter, be it marriage equality or the trauma of the Orlando, FL mass killing at a gay bar, conflicts ensue in families. In 2011, when New York State passed marriage equality, the Ali Forney Center of New York reported a 40 per cent increase in drop-in rates at its youth shelter in New York.

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Depressed post-Trump? Know the signs.

Depressed after the recent election? Many Americans are. When does just having the "blues" turn into something serious, worthy of medical attention? Read this excerpt from our new book, Healing the Brain.

Scientists have long acknowledged the brain’s circuitry and biochemical processes as integral aspects of depression, specifically as these processes control neurotransmitters that control mood. Beginning in the 1970s, neuroimaging technologies rapidly advanced the study of how brains function – or fail to function. Functional magnetic resonance imaging (fMRI), which became available to researchers over the past 20 years, gives cognitive neuroscientists a 3-D view of neural activity within the brain.

Studies using this technology demonstrate the role of neurotransmitters serotonin, norepinephrine, and dopamine as they regulate mood in the human body. Scientists still aren’t exactly sure why individuals with depression have low amounts of these neurotransmitters, yet they do know that for some, antidepressants that specifically target how the brain balances these these neurotransmitters are an effective therapeutic intervention.

Studies show the benefits of combining medication and psychotherapy.

Yet much controversy surrounds the issue of prescribing antidepressants, with some claiming that too often an individual is prescribed a pill without receiving the benefits of psychotherapy or talk therapy. Leigh Matthews, psychologist and director of Urban Psychology in Brisbane, Australia, treats adult clients for depression. There is an abundance of studies evidencing the efficacy of the combination of medication and psychotherapy.

But psychology, Matthews said, tries to first focus on treatment without medication, so it’s not always respected by other disciplines, such as general practice physicians or psychiatrists. But the process of psychotherapy and its outcomes last far longer than simply prescribing medication. Yet there are times when medication is absolutely essential, according to Matthews, who also supervises psychologists-in-training at the University of QLD, and those completing their internships through the Australian College of Applied Psychology.

She said when clients are so depressed that they can’t get out of bed, think rationally, or use any of the strategies proposed in session, then it’s time for medication. Or when clients verbalize suicidal ideation and intent indicating severe depression, then medication is absolutely required.

Also if an individual has a long history of depression, or a strong family history suggesting a genetic basis, then “perhaps they, like a diabetic requiring insulin, need long-term pharmacotherapy to rectify neurochemical imbalances.”

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Minority stress, now on steroids

Fifty per-cent of America is angry at the election results. None more than minorities. Here is the section on minority stress from our book, Healing the Brain.

The following is adapted from “Public Health Implications of Same-Sex Marriage,” Am J Public Health. 2011 June; 101(6): 986–990. William C. Buffie, MD. (Dr. Buffie has provided medical information for A Thousand Moms.)

One only has to consider the rash of recent teen suicides resulting from anti-gay bullying to begin to comprehend the magnitude of the public health problem faced by this country and its LGBT sexual minority. Despite the prevalence of same-sex households and campaigns to protect human rights, gay persons find the very nature of their being constantly debated within our legislative bodies, the courts, and the mainstream media. They are subject to ridicule and are commonly the targets of demeaning and derogatory slang terms or insensitive jokes. Their morality and value as human beings are frequently questioned by individuals and organizations ignorant or unaccepting of current medical and social  science literature concerning the gay population….

Being cast in such a light strongly contributes to the phenomenon known as “minority stress,” which members of this community experience in their struggle for validation and acceptance in our heterosexist society.

Wikimedia Commons

To assert and celebrate their community, each year LGBT/Q individuals gather in June at Pride events worldwide.

Unique to the LGBT form of minority stress—as opposed to minority stress engendered by societal prejudice based upon race, ethnicity, gender, or disability—is that one's sexual orientation usually is invisible to others. As a result, in addition to being the target of overt discrimination, LGBT individuals are constantly subject to subtle, inadvertent, or insensitive attacks on the core of their very nature, even by people who profess no disdain or disrespect for them.

For instance, if someone has a lesbian colleague but doesn't know the colleague's orientation, an innocent question—such as asking her if she has a boyfriend, rather than asking “Are you seeing someone special?”—implies a judgment regarding what is “normal.” When the “other” is invisible, faceless, or nameless, it is common for those in power to ignore the reality of the other's existence and the challenges the other faces. This interplay of power and prejudice, whether overt or covert, constitutes the phenomenon of heterosexism. Similarities to the racism and sexism so prevalent during the civil rights movements of past generations are obvious.

Internalizing Prejudice

This sexual-minority status, as explained by Riggle and Rostosky, is defined by a culture of devaluation, including overt and subtle prejudice and discrimination, [one that] creates and reinforces the chronic, everyday stress that interferes with optimal human development and well-being.

LGBT individuals, stigmatized by negative societal attitudes directed at the essence of their being, struggle on a daily basis to balance the dual dangers of publicly engaging their need for equality and validation and remaining closeted to find some calm through an escape from public scrutiny. Many gay persons internalize such discrimination and prejudice. Fractured social-support mechanisms and minority-stress–associated low self-esteem contribute to a high prevalence of self-destructive behaviors, such as substance abuse, suicide, and risky sexual behavior.

Institutionalized stigma stands at the begets higher rates of sexually transmitted diseases, depression, suicide, and drug use.

Hatzenbuehler et al. studied more than 34,000 lesbian, gay, and bisexual participants and found empirical evidence of the negative health effects of discriminatory policies relative to marriage equality. They surveyed participants in 2001 and 2002 on a range of psychological health indicators, and they administered the same survey in 2004 and 2005, after 14 states approved constitutional amendments limiting marriage to opposite-sex unions. In the second set of responses, participants reported significantly higher rates of psychiatric disorders, with increases of 36% for any mood disorder, 248% for generalized anxiety disorder, 42% for alcohol use disorder, and 36% for psychiatric comorbidity. In the comparable control group from states without such amendments during the same time period, there were no significant increases in these psychiatric disorders.

Although causality may be difficult to establish, the association and prevalence of these disorders suggest that institutionalized stigma and its attendant internalized prejudice (i.e., minority stress) stand at the forefront of this cycle, begetting higher rates of sexually transmitted diseases, depression, suicide, and drug use—all of which, when combined with suboptimal access to health care and fractured family-support systems, eventually contribute to higher overall mortality as well as morbidity from various cancers, cirrhosis, hypertension, and heart disease….

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VP debate an insult to LGBT community

From the Advocate:

It’s still sinking in: Mike Pence’s discrimination against LGBT people as governor of Indiana wasn’t deemed important enough to discuss during the vice-presidential debate Tuesday.

How can that be? 

Pence is still the governor of Indiana. He signed the so-called Religious Freedom Restoration Act just last year. It was among the most famous of these laws, but similar ones have been proposed across the country. The effect of such legislation is that businesses can legally refuse service to LGBT people merely by citing their religious beliefs.

The Pence version of the RFRA was partly repealed in Indiana, but an even more draconian version of the law passed in Mississippi; it's now been blocked by a federal court. No one could blame the LGBT people of Mississippi if they’re feeling a little invisible today. 

Honestly, I feel a little insulted that as my community faces a wave of discrimination, we were ignored.

Sometimes it feels like the world read about the Supreme Court’s ruling on marriage equality and just checked a box; the gays are fine now. 

Has the media already forgotten that, just a few months ago, a man went into the Pulse nightclub and killed 49 people in an incredibly bloody act of hate against LGBT people? I haven’t forgotten. Orlando Pride is later this week. Trust me that no one there has forgotten.  

Mike Pence helps create an atmosphere in which we are targets, in which we are not safe. RFRAs like his send the message to crazies that LGBT people are less human. Pence ought to be confronted — or at least asked — about whether his policies and rhetoric bear any responsibility for breeding a culture of homophobia and transphobia.

Debate moderator Elaine Quijano, a respected CBS news correspondent, deserves credit for asking about implicit bias among our police force against African-Americans, for confronting Pence about how exactly his boss plans to deport millions of people. But to not ask Pence about his level of responsibility for a culture of hate against LGBT people is itself irresponsible. To instead ask Pence about how his faith plays a role in his governing only adds to the insult. 

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