Tuesday, December 07, 2010

HHS: Gay Health = Victimhood

(Michael Callen, sixth man from the right, and other PWAs, after they created the Denver Principles, guidelines for better health, in 1983.)

To prepare for a test at San Francisco General Hospital this morning, I wrote down a few questions and concerns before my appointment, as I usually do before seeing my regular physician. It's part of my strategy to empower myself, take responsibility when accessing health care and be an active participant in maintaining my wellness.

Such thinking was planted in my head by the likes of the late Michael Callen and other deceased people with AIDS who founded the PWA Coalition, in the early years of the epidemic. It's good advice for everyone, but especially so for gay people who don't want to base their health needs on victim ideology.

I'm not saying that gays and PWAs have had the easiest time dealing with medical professionals and institutions over the decades, but I do fear that last week's release of info on the needs of gays by the federal government is largely based on victimhood.

The Healthy People web site of the Department of Health & Human Services recent updating to now include gay people and focusing attention on our wellness is a positive development. However, the HHS foundation is predicated on the deficit and disparity model, explained thus:

Research suggests that LGBT individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights. Discrimination against LGBT persons has been associated with high rates of psychiatric disorders, substance abuse, and suicide. Experiences of violence and victimization are frequent for LGBT individuals, and have long-lasting effects on the individual and the community. Personal, family, and social acceptance of sexual orientation and gender identity affects the mental health and personal safety of LGBT individuals. [...]

Missing from the HHS site is reference to the many community-created assets used by gay people, such as no/low cost clinics, mental health centers, lesbian-specific agencies, recovery programs and hundreds of HIV/AIDS orgs and health sites. The resiliency of the gays when dealing with medical matters is truly heroic, but it's overlooked by the Healthy People campaign.

I've long complained that AIDS Inc has worked overtime to deny the community-driven safer sex practices, and use of cocktails to drive down viral loads and infectiousness, that have directly contributed to the significant decreases of new HIV infections. For too long, AIDS Inc only knew how to shriek alarming messages and ad campaigns, always failing to say one damn good thing about gay men doing an amazing job of building and maintaining wellness.

That same institutional "never say a positive word" about gay health is on display at the HHS site:

Understanding LGBT health starts with understanding the history of oppression and discrimination that these communities have faced. For example, in part because bars and clubs were often the only safe places where LGBT individuals could gather, alcohol abuse has been an ongoing problem. [...]

While I recognize that biases and fears against us have had a detrimental impact on gay health, I object to those factors being the only start for thinking about our health needs. The tone of the site is one that says our health starts and ends with oppression.

Even before the Stonewall Riots and while sodomy laws were on the books, there were always plenty of well and functioning homosexuals. Would it be so terrible for HHS to recognize the bad and the good historical markers of gay health?

I see the mention about the bars as emblematic of HHS's victimhood for the gays, because the footnote for that reference is a 1996 study. How about a more current citation, HHS, and an acknowledgment of all the other gathering spots and methods we have to connect with each other, that don't lead to drinking problems?

The HHS site does at the end of the info section state a few issues that need further study in the coming decade, including the following:

Resiliency in LGBT communities [...] Need for a LGBT wellness model [...] Recognition of transgender health needs as medically necessary [...]

Sounds good to my ears, but I'd prefer for HHS to see the historic and current resiliency, model and recognition that shape gay health now, not just as future goals to eventually be met. Let's see the Healthy People focus on gay people move away from the victimhood status for us and instead take a more nuanced, asset-based approach.

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