Skills Building to Reach

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Skills Building to Reach Serve LGBT Disparity
Populations
North Dakota Alcohol and Substance Abuse
Summit Thursday, September 9 By Gustavo Torrez
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Training Outline

• Intro to the Network for LGBT Tobacco Control,
  LGBTs
• LGBT Cultural Competency 101
• LGBT Health Disparities
• Reaching LGBTs Part 1 LGBTs in my state,
  community access points structures
• Reaching LGBTs Part 2 Local Community
  Perspective, Sherri Paxon
• Serving LGBTs Part 1 State Best Practices
• Serving LGBTs Part 2 Enhancing LGBT access for
  your agency Strategies for your work
• ACTION PLANNING
• Network Resources, Linking People Information
• Evaluation

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National LGBTTobacco Control Network

• Funded as one of six tobacco disparity networks
  by the Centers for Disease Control and
  Prevention.
• We are a project of The Fenway Institute, one of
  the largest LGBT healthcare organizations in the
  country.

Network Steering Committee
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National LGBTTobacco Control Network

• Because
• Lesbians, gays, bisexuals, and transgenders have
  been targeted by the tobacco industry.
• Interventions to counter tobacco use are rarely
  culturally tailored for LGBTs.
• Smoking kills more people than HIV, illegal drug
  use, alcohol use, motor vehicle injuries,
  suicides, and murders combined.

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National LGBTTobacco Control Network

• The National LGBT Tobacco Control Network links
  people and information to help eliminate LGBT
  tobacco and wellness disparities.

Evaluation excerpt showing how we network people.
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LGBT Cultural Competency 101Language 101
LGBTQ 101

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Language 101
Excerpted from A providers Introduction to
Substance Abuse Treatment for LGBT Individuals,
training curriculum.

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What is LGBT?

• LGBT is shorthand for the lesbian, gay, bisexual
  and transgender
• population. This population includes a diverse
  spectrum of people
• grouped together because they either choose to
  partner with same-
• gender people (LGBs) or they do not identify as
  the gender they were
• assigned at birth (Ts).
• SGM is another common phrase referring to the
  same population, it
• stands for sexual and gender minorities.
• Additional information on definitions and terms
  will be provided later in the training.

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Definitions
Gender femaleness or femininity and maleness or
masculinity Gender Role masculine or feminine
behaviors Gender Identity inner sense of
oneself, a persons self-concept, in terms of
gender Sexual Orientation distinct from gender
identity, describes one's attraction to, sexual
desire for, lust for, romantic attachments to
others lesbian, gay, bisexual, heterosexual.
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TERMS

• Categories
• SEX
• GENDER/GENDER ROLE
• SEXUAL ORIENTATION
• GENDER IDENTITY

• Descriptors
• Lesbian
• Gay
• Bisexual
• Transgender
• Transsexual
• Heterosexual
• Queer
• Male
• Female
• Masculine
• Feminine
• Genderqueer

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TERMS

• Categories Descriptors
• SEX
• Male
• Female
• SEXUAL ORIENTATION
• Lesbian
• Gay
• Bisexual
• Hetrosexual
• Queer

• GENDER/GENDER ROLE
• Male
• Female
• Masculine
• Feminine
• GENDER IDENTITY
• Transgender
• Transsexual
• Male
• Female
• Queer or Genderqueer

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Language Tips

• DO
• Use Lesbian, gay, bisexual, or transgender
• Try to use the words they identify with (unless
  they make you uncomfortable)
• Use the same pronoun someone refers to themselves
  with
• If you mess that up, apologize quickly and move
  on
• Ask if you dont know which pronoun someone
  prefers

• DONT
• Use queer or fag or dyke unless someone indicates
  they want it (and then only if you are
  comfortable)
• Forget queer started as a pejorative, but is
  changing for some younger people into an
  affirmation statement of identity.
• Forget to ask if you are unsure of anything.
• Get paralyzed with fear, jumping in with good
  intentions is a very powerful action!

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LGBTQ 101

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Question

• Is it legal to fire someone for being gay?

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Current State Nondiscrimination Laws

• Courtesy of the National Gay and Lesbian Task
  Force, as of July 1, 2009
• Blue States banning discrimination based on
  sexual orientation and gender identity
• PinkLaws banning discrimination based on sexual
  orientation

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In most of the country, yes it is.

• Is it legal to fire someone for being gay? On the
  last chart, in every white state it is legal to
  fire someone, kick them out of their house, or a
  restaurant for being LGBT.
• The pink states protect LGB only.
• In the blue states it is illegal to do these
  things to all LGBT people.

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How many people does this affect?

• There are an estimated 8.8 million gay, lesbian,
  and bisexual (GLB) persons in the U.S.
• This is roughly equivalent to the population of
  the state of North Carolina
• The Census does not count LGBTs, but does count
  same sex couples, if we use these couples as a
  proxy for all LGBTs, we then know
• LGBTs are found in all Congressional districts in
  the U.S.
• The number of LGBTs generally even across racial
  and ethnic groups.

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LGBT Health DisparitiesAlcohol Substance Abuse
Access to Care Tobacco

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Alcohol

• Lesbian Women are 3.6 times more likely to have
  alcohol dependence, compared to their
  heterosexual counterparts.
• Bisexual women and gay men were 2.9 times more
  likely to have alcohol dependence, compared to
  their heterosexual counterparts
• Bisexual Men are 4.2 times more likely to have
  alcohol dependence, compared to their
  heterosexual counterparts.

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Substance Abuse

• Lesbian Women are 11.3 times more likely to have
  Marijuana dependence, and 12.4 times more likely
  to have other drug dependence compared to their
  heterosexual counterparts.
• Gay men are 4.2 times more likely to have other
  drug dependence, while bisexual men where 6.3
  times more likely to have other drug dependence
  compared to their heterosexual counterparts.
• Sexual orientation, substance use behaviors and
• substance dependence in the United States,
  Addiction Research Report
• Sean Esteban McCabe1, Tonda L. Hughes2, Wendy B.
  Bostwick3, Brady T. West4 Carol J. Boyd5

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Access to care

• 25 of respondents on recently released TG needs
  assessment report being denied healthcare as a
  result of being transgender.
• Movie Southern Comfort from 2001 documented a
  trans smoker who was turned down for care by 19
  providers before dying of cancer without
  treatment.
• Studies of LGBTs report varied access to care
  barriers from negative reception by providers,
  to hiding LGBT status, up to avoiding care for
  fear of discrimination.

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Tobacco

• LGBT tobacco disparities have been established
• by a series of studies over the last decade.
• The studies consistently show LGBT smoking
  prevalence
• is 35 to almost 200 higher than the general
  population.
• This prevalence disparity is among the largest
  among
• different population subgroups.

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Why LGBTQs smoke more

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1 Homophobia, racism, and sexism

• LGBT people live in a world where most are
  routinely discriminated against, denied civil
  rights, and harassed on the streets and
  workplaces
• Such homophobia, along with racism and sexism,
  likely contributes to higher levels of substance
  abuse as a coping strategy, especially in LGBT
  communities of color.

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2 Where are my people?

• Often, a primary social outlet for GLBT folks are
  bars and
• clubs, where drinking and smoking are prevalent
  and
• used as tools for socializing and meeting people.

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3 Youth coming out

• LGBT youth most often come out in their late
  childhood
• through teen years. The stressors of coming out
  occur
• just when the youth is at greatest risk for
  smoking uptake.

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4 Tobacco companies love to target us.

• Big Tobacco has successfully targeted our
  communities
• They have invested a LOT of money
• They are good at twisting our civil rights
  messages to look like pro-tobacco messages

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Targeting

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How they target ushttp//www.youtube.com/watch?v
F5-6eH18E4U

• Direct advertising
• Indirect advertising
• Event sponsorship
• Outreach efforts and community promotions

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Reaching LGBTs Part 1LGBTs in my State
Community Access Points

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LGBTs in my state?

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This presentation is excerpted from
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Total population

• There are an estimated 8.8 million gay, lesbian,
  and bisexual (GLB) persons in the U.S.
• Same-sex couples are found in all Congressional
  districts in the U.S.

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Is it an epidemic?

• From 2000 2005, the number of same sex couples
  in the U.S. increased by 30.

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No its probably not

• Those increases are most likely due to a
  combination of factors
• People do feel increasingly safe to come out
• People feel increasingly safe to disclose this on
  surveys
• LGBTs have run campaigns encouraging people to
  disclose on surveys.

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Same-sex Couples and the Gay, Lesbian,Bisexual
Population New Estimates fromthe American
Community Survey
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North Dakota Excerpt

• Same sex couples 2005 1,070
• Estimated LGB population 11,003
• of total ND population 2.3

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For the full report

• http//www.law.ucla.edu/williamsinstitute/publicat
  ions/
• SameSexCouplesandGLBpopACS.pdf
• Thank you to Gary Gates and the other
  demographers
• at the Williams Institute for this ongoing work.

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Community Access Points
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National

• The Human Rights Campaign
• As the largest national lesbian, gay, bisexual
  and transgender civil rights organization, HRC
  envisions an America where LGBT people are
  ensured of their basic equal rights, and can be
  open, honest and safe at home, at work and in the
  community.
• www.hrc.org
• The National Gay and Lesbian Task Force
• The mission of the National Gay and Lesbian Task
  Force is to build the political power of the
  lesbian, gay, bisexual and transgender (LGBT)
  community from the ground up.
• www.thetaskforce.org

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North Dakota Briefing Sheet
Advocacy Organizations Equality North
Dakota Equality North Dakota (END) is a statewide
gay, lesbian, bisexual and transgender rights
organization P.O. Box 5222Fargo, ND 58105Phone
701-388-9227E-mail info_at_equalitynd.org The
North Dakota Human Rights Coalition (NDHRC) Is a
broad-based coalition of individuals and
organizations with an interest in the furtherance
of human rights in North Dakota. We work toward
the enhancement of human rights in North Dakota
through information, education and legislative
action. P.O. Box 1961Fargo, ND 58107-1961 Phone
701-239-9323Fax [phone]Email
info_at_ndhrc.org http//www.ndhrc.org/wp-publish/con
tact-us
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Reaching LGBTs Part 2
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Local Community Perspective

• Sherri Paxion
• Sherri Paxon, MSPH, MT(ASCP)BB
• QPax Unlimited
• 705 23rd St SE
• Mandan, ND 58554
• 701-663-7598
• 701-400-7598 cell
• spaxon_at_bis.midco.net

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Serving LGBTs Part 1 State Best Practices
Examples
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State Best Practices

1. Initiated by the community members from advanced
   states
2. Wisdom-based document, community signors
3. Compiles common best practices of the most
   advanced states
4. A template for states and communities to use for
   their local work
5. Available online at www.lgbttobacco.org

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Preamble

• It is the opinion of the undersigned that these
  strategies represent the current best practices
  available to address LGBT tobacco disparities,
  and as such, we strongly encourage states to
  adopt as many of these best practices as
  possible.

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Simple and powerful

1. Include LGBT community members in planning steps
2. Monitor impact of tobacco on LGBTs
3. Establish cultural competency standards for
   statewide programs
4. Fund community based programs
5. Disseminate findings and lessons learned

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1. Include LGBT community members in planning
steps

• Example
• Many states are putting LGBT community members on
  their tobacco disparity planning groups. Many are
  putting LGBT reps on their statewide tobacco
  planning bodies.
• In Washington, the LGBTs join other disparity
  populations to do cross leadership development,
  planning and training.

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2. Monitor impact of tobacco on LGBTs

• Example
• MN just tested new question to enable them to add
  good LGBT data collection question to their
  quitline and ATS.
• No adverse response during testing and many other
  states report negligible issues in this area. (In
  general straight people are pretty comfortable
  declaring that theyre straight.)
• But brace yourself for potential opposition, the
  Network has a briefing paper to help overcome
  common myths about LGBT data collection.

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3. Establish cultural competency standards

• Example
• WV, KS, IA, DC, TX, and others are training their
  state staff/grantees in LGBT cultural competency
• MN, IA, CA have also trained their quitlines
• Key elements of training
• How to make your services welcoming
• Having best resources to refer to LGBTQ community
  resources when desired
• Update training regularly

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4. Fund community based programs

• Example
• 5 states have statewide networks of LGBT grantees
• Often uses main LGBT group as access point,
  sometimes subgrants from there.
• Want impact? This funding builds great community
  energy on tobacco issue.

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5. Routinely integrate LGBT tailored efforts into
largerwellness/tobacco campaigns.

• Example
• MN has expanded mission of tobacco control
  program to incorporate wellness.
• GA program launched to be wellness-ready,
  collecting data on diet/exercise in tobacco
  assessment.

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6. Disseminate findings and lessons learned

• Example
• OR got local community press on their pride
  tobacco survey
• CO did case study of their lessons learned in
  creating statewide network
• We have Lessons Learned newsletter, let us help
  you share yours!

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Serving LGBTs Part 2 Enhancing LGBT Access
for Your Agency
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Enhancing LGBTQ access at your agency
Strategies for your work

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So, how do you make your work responsive to the
needs of the LGBT community?

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2 Main Strategies

• Take basic steps to make your programs
• welcoming to LGBTs.
• Have updated information about LGBT focused
• resources if they want a referral.

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LGBT cultural competency strategies

• 1. Adopt and post a non-discrimination statement.

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LGBT cultural competency strategies

• 1. Adopt and post a non-discrimination statement.
• 2. Include LGBT advisors on planning groups,
• community advisory groups.

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LGBT cultural competency strategies

• 1. Adopt and post a non-discrimination statement.
• 2. Include LGBT advisors on planning groups,
• community advisory groups.
• 3. Make sure staff are trained in LGBT cultural
• competency, esp. frontline staff.

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LGBT cultural competency strategies
1. Adopt and post a non-discrimination
statement. 2. Include LGBT advisors on planning
groups, community advisory groups. 3. Make
sure staff are trained in LGBT cultural
competency, esp. frontline staff. 4. Promote
LGBT welcoming materials.
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LGBT cultural competency strategies
5. Co-brand or partner with LGBT groups.
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LGBT cultural competency strategies

• 5. Co-brand or partner with LGBT groups.
• 6. Consistently use preferred pronouns and names.

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LGBT cultural competency strategies

• 5. Co-brand or partner with LGBT groups.
• 6. Consistently use preferred pronouns and names.
• 7. Dont make assumptions (gender on phone,
• sexual behavior, etc.)

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LGBT cultural competency strategies

• 5. Co-brand or partner with LGBT groups.
• 6. Consistently use preferred pronouns and names.
• 7. Dont make assumptions (gender on phone,
• sexual behavior, etc.)
• 8. Examine program materials for alienating
• language/processes.

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We all can feel it when folk are well meaning
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We all can feel it when folk are well
meaningAnd we all can feel it when its a cold
or hostile environment
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We all can feel it when folk are well
meaningAnd we all can feel it when its a cold
or hostile environmentWhich is your program?
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Action Planning

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Resources

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The Network for LGBT Tobacco Control Online
Resources
LGBTTOBACCO.ORG

• Key content of interest
• Library of LGBT resources Including literature,
  reports, ads, etc.
• Online directory of people and projects
• Factsheets more

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Resources

• Quitline LGBT targeted poster
• Space for co-branding with your
• organization name at bottom.
• Available from the Network for LGBT Tobacco
  Control

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Resources

• LGBTQ motivational
• quitguide pamphlet.
• Intended to be used in conjunction
• with professional counseling.
• Available from the Network for LGBT Tobacco
  Control

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Resources

• Sharing Our Lessons Series
• This issue highlights the successful
  implementation of culturally-competent and
  tailored cessation quitline services for LGBTQ
  Minnesotans
• Available from the Network for LGBT Tobacco
  Control

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Resources

• Tobacco Education Clearinghouse of
• California has a variety of promotional
• items for purchase.
• http//www.tobaccofreecatalog.org

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Other Network Resources

• Surveillance Briefing Paper
• Facts about why LGBT data collection is feasible
• Which instruments to collect data on
• Examples of tested questions

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Other Network Resources

• State Best Practices 2007
• Consensus document from community about the best
  current strategies to eliminate LGBT tobacco
  disparities

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Other Network Resources
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Resources- New Pride Ad
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The Network on Social Media

• Twitter? _at_lgbttobacco
• Facebook? www.facebook.com/lgbt.tobaccocontrol
• Blog? lgbttobacco.wordpress.org

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Other Resources

• Business Inside Out Bob Witeck
• GLMA, www.glma.org
• Gay Yellow Pages
• LGBTQ Tobacco Control Summit

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Linking People

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1. DISCUSSION listserv 300 pros who ask
questions and talk to each other.
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2. Online directory of 100 pros by expertise
area available for direct contact.
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3. Social networking stake Facebook 1160
friends Twitter 869 followers
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And information

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4. NEWS listserv 800 people who get bimonthly
newsletter
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5. Direct mailings to list of 1200 policymakers
and community advocates
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6. Online resource library with hundreds of local
and national items.
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7. Blog (4000 views)
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Our aim?
TC communities
TC communities
LGBT communities
LGBT communities
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lgbttobacco.org
1. Join DISCUSSION listserv. Ask questions of
200 pros and get monthly newsletters.
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1a. Want newsletters only? Join NEWS listserv
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2. Search online resource library for hundreds of
relevant docs.
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3. Find contact info for 100 pros by expertise
area. Ask questions directly.
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THANK YOU!

• The Network for LGBT Tobacco Control looks
  forward to working with you to collaboratively
  address LGBT tobacco health disparities.
• Additional questions
• Feel free to contact us whenever needed
  lgbttobacco_at_gmail.com
•  
• Gustavo Torrez Program Manager
• National LGBT Tobacco Control Network
• The Fenway Institute Fenway Health
• Ansin Building, 8th Floor
• 1340 Boylston Street Boston, MA 02215
• voice 617.927.6451 fax [phone]
• www.lgbttobacco.org
•  
•