Considering going to school in the US of A?

Colleges and universities have long been the place where young people find themselves and their people, developing into the people they will be through the rest of their life. That has, historically, been particularly true of LGBTQ youth, who could go from unsupportive homes and communities to find a place where they are accepted for who they are.

Today, while society in general is more tolerant than in the past, college can still be a crucial place of safety and growth for LGBTQ young people. This is why College Consensus published its ranking of 25 LGBTQ-friendly colleges in the US.

“By highlighting institutions that make inclusiveness an intentional aspect of their education and community, (we) encourage students to find the place they will feel welcome, and urges schools to consider their own policies and culture,” the group said in a statement.

Institutions in the ranking were chosen based on the strength of their student organizations, institutional inclusiveness policies, and recognition by the Campus Pride Index.

The top 25 (in alphabetical order) are:

• Augsburg University
• Elon University
• Harvey Mudd College
• Indiana University Bloomington
• Ithaca College
• Kansas State University
• Lehigh University
• Macalester College
• Montclair State University
• Pennsylvania State University
• Portland State University (tied)
• Princeton University
• Rutgers University
• San Diego State University
• Southern Oregon University (tied)
• The Ohio State University
• Tufts University
• University of Colorado at Boulder
• University of Louisville
• University of Maryland, College Park
• University of Massachusetts
• University of Oregon
• University of Pennsylvania
• University of Washington
• University of Wisconsin – Eau Claire
• Washington State University

“For decades, colleges and universities have been at the vanguard of culture, whether that meant protecting artistic expression or giving young people a forum to voice their political views.” However, for LGBTQ students, inclusive policies “can truly be a matter of life or death,” particularly as discrimination and hate crimes are still prevalent in many communities.

“LGBTQ-friendly colleges are critical for the safety and well-being of gay, lesbian, trans, and nonconforming young people,” the editors explained, providing “a safe space for queer young people, while helping prepare them for a workforce that is still frequently hostile.”

While ranking the most LGBTQ Friendly Colleges is somewhat subjective, College Consensus chose their criteria carefully: “a vocal and well-promoted campus pride organization is a clear sign” of acceptance, at least in the campus community, since many are student-led groups. The other level of impact is in official institutional policy: “inclusive language in their student handbook; gender inclusive housing (or gender neutral housing); explicit non-discrimination policies (for instance, women’s colleges that are openly welcoming to trans women).”

Lesbian and bisexual women are at increased risk of being overweight or obese compared to heterosexual women, according to new research from the University of East Anglia and UCL.

Gay men however are less likely to be overweight than their straight counterparts, and more at risk of being underweight.

The study (‘Sexual orientation identity in relation to unhealthy body mass index (BMI): Individual participant data meta-analysis of 93,429 individuals from 12 UK health surveys’), published in the Journal of Public Health, is the first to investigate the relationship between sexual orientation and body mass index (BMI) using population data in the UK.

The findings support the argument that sexual identity should be considered as a social determinant of health.

The research team pooled data from 12 UK national health surveys involving 93,429 participants and studied the relationship between sexual orientation and BMI.

Lead researcher Dr. Joanna Semlyen, from UEA’s Norwich Medical School, said: “We found that women who identify as lesbian or bisexual are at an increased risk of being overweight or obese, compared to heterosexual women. This is worrying because being overweight and obese are known risk factors for a number of conditions including coronary heart disease, stroke, cancer and early death. Conversely, gay and bisexual men are more likely than heterosexual men to be underweight, and there is growing evidence that being underweight is linked to a range of health problems too, including excess deaths.”

The study also found that gay men are significantly less likely than straight men to be overweight or obese.

According to the researchers, this study demonstrates that there is a relationship between sexual identity and BMI and that this link appears to be different for men and women.

“There are a number of possible explanations for these findings. We know that sexual minority groups are more likely to be exposed to psychosocial stressors, which impacts on their mental health and their health behaviours such as smoking and alcohol use and which may influence their health behaviours such as diet or physical activity,” Semlyen said. “These stressors include homophobia and heterosexism, negative experiences that are experienced by the lesbian, bisexual and gay population as a result of their sexual orientation identity and are known to be linked to health.”

Until 2008, sexual orientation wasn’t recorded in health surveys. This means that until recently it has not been possible to determine health inequalities affecting lesbian, gay and bisexual people.

The researchers hope that policy makers and clinicians will be able to use this evidence “to provide better healthcare and tailored advice and interventions for lesbian, gay and bisexual people.”

“We need longitudinal research to understand the factors underlying the relationship between sexual orientation and BMI, and research to understand more about being underweight, especially in this population,” Semlyen ended.

Patients who identify as transgender have lower odds of being screened for cancer. This was suggested by a new study from St. Michael’s Hospital, which also explored how doctors can address the disparity.

The study assessed screening rates for cervical, breast and colorectal cancer among 120 transgender patients eligible for screening and compared these with screening rates among the cisgender (i.e. non-transgender) patient population at the St. Michael’s Hospital Academic Family Health Team.

The study found that transgender patients had 70% lower odds of being screened for breast cancer, 60% lower odds of being screened for cervical cancer, and 50% lower odds of being screened for colorectal cancer. And this is even after accounting for other factors like age and the number of visits to the team.

“Our overall cancer screening rates were improving and if we hadn’t thought to look at this particular patient population we would have been happy with our results,” said Dr. Tara Kiran, a family physician and a researcher at the Centre for Urban Health Solutions of St. Michael’s. “This study stemmed from a realization that our system had the potential to miss patients whose gender had changed on their health card but who still required screening,” Dr. Kiran said. “Our findings have prompted us to develop a system to include transgender patients in the outreach we do to patients overdue for cancer screening so that we’re not missing anyone.”

Patients who have transitioned from female to male and still require cervical cancer screening are often missed when provincial agencies send reminders to those overdue.

This analysis of cancer screening rates at the Family Health Team led Dr. Kiran and her colleagues to embark on a quality improvement project to learn more about perspectives towards cancer screening among transgender patients.

“In many cases, physicians had discussed cancer screening with patients and patients had made an informed decision not to get screened,” Kiran said. “That was really important for us to understand. For people who have transitioned from female to male, having a Pap test can be upsetting as it can sometimes be gender dysphoric.”

The research team is still investigating reasons to explain the lower rates of colorectal cancer screening among transgender patients.

Kiran and her team hope this research helps increase awareness among primary care providers of the unique health needs of transgender patients and helps prompt decision-makers to address systems that overlook these unique needs.

“This study shows the importance of an equity approach,” Kiran said. “Improvements in care may not reach everyone and we need to have targeted strategies to reach those with unique needs. Our research also highlights the importance of tracking not just whether patients have had a test but whether they have had an informed discussion… Improved shared decision-making may be a more appropriate quality improvement goal than increasing cancer screening rates. We are hopeful that engaging trans patients in our quality improvement efforts will help us challenge our assumptions and provide better care to the trans population.”

Sexual minorities – or people who are attracted to members of the same sex or who identify as gay, lesbian or bisexual (LGB) – are at a higher risk for several different health problems at different points in their lives.

This is according to Penn State researchers who found that sexual minorities were more likely to experience drug and alcohol use disorders, anxiety and depressive disorders, and cardiovascular disease, among other negative health outcomes.

Cara Rice, assistant research professor in Penn State’s Methodology Center, said increased stress stemming from discrimination and prejudice could be a potential reason for these disparities.

“It’s generally believed that sexual minorities experience increased levels of stress throughout their lives as a result of discrimination, microaggressions, stigma and prejudicial policies,” Rice said. “Those increased stress levels may then result in poor health in a variety of ways, like unhealthy eating or excessive alcohol use.”

Stephanie Lanza, professor of biobehavioral health and director of the Edna Bennett Pierce Prevention Research Center, said the results — recently published in Annals of Epidemiology — help shed light on health risks that have been historically understudied.

“Discussions about health disparities often focus on the differences between men and women, across racial and ethnic groups, or between people of different socioeconomic backgrounds,” Lanza said. “However, sexual minority groups suffer substantially disproportionate health burdens across a range of outcomes including poor mental health and problematic substance use behaviors.”

While previous research has shown that sexual minorities are more likely to experience health problems like substance use disorders and mood or anxiety disorders, Rice said it is not as well known if those risks remain constant across age.

“As we try to develop programs to prevent these disparities, it would be helpful to know which specific ages we should be targeting,” Rice said. “Are there ages where sexual minorities are more at risk for these health disparities, or are the disparities constant across adulthood?”

For the study, the researchers used data from about 30,999 participants between the ages of 18 and 65 from the National Epidemiologic Survey of Alcohol and Related Conditions-III. Data included information about past-year alcohol, tobacco, and drug use disorders, as well whether they had a history of depression, anxiety, sexually transmitted infections (STIs), or cardiovascular disease.

Lanza said the researchers used a method developed at Penn State, called time-varying effect modeling, to analyze the information.

“Using the time-varying effect model, we revealed specific age periods at which sexual minority adults in the U.S. were more likely to experience various poor health outcomes,” Lanza said, “even after accounting for one’s sex, race or ethnicity, education level, income, and region of the country in which they reside.”

The researchers found that overall, sexual minorities were more likely to experience all the health outcomes. Nearly a quarter — 24 percent — of sexual minorities had an alcohol use disorder in the year prior to the survey, compared to 15 percent of heterosexuals. Sexual minorities were also about twice as likely to experience anxiety, depression, and STIs in the previous year.

Additionally, risks for some health problems were higher at different ages. For example, the increased odds for anxiety and depression among sexual minorities was highest in their early twenties, while increased odds for poor cardiovascular health was higher in their forties and fifties.

“We also observed that odds of substance use disorders remained constant across age for sexual minorities, while in the general population they tend to be concentrated in certain age groups,” Rice said. “We saw that sexual minorities were more likely to have these substance use disorders even in their forties and fifties when we see in the general population that drug use and alcohol use start to taper off.”

Rice said the findings could potentially be used to develop programs to help prevent these health problems before they start.

“A necessary first step was to understand how health disparities affecting sexual minorities vary across age,” Rice said. “These findings shed light on periods of adulthood during which intervention programs may have the largest public health impact. Additionally, future studies that examine possible drivers of these age-varying disparities, such as daily experiences of discrimination, will inform the development of intervention content that holds promise to promote health equity for all people.”

Sara A. Vasilenko, Syracuse University, and Jessica N. Fish, University of Maryland, also worked on this research.

The more people know, the more they are able to identify with the LGBTQIA community.

So it seems in Japan, where a survey conducted by advertising giant Dentsu Inc. found that at least one in eleven people identify as lesbian, gay, bisexual or transgender, while more than two-thirds of respondents were familiar with the acronym LGBT.

The survey was done in October 2018, and it involved 60,000 people aged between 20 and 59. Of that, 8.9% self-identified as LGBT individuals, a rise of 1.3 percentage points from the previous survey conducted in 2015.

The survey also found that 68.5% either knew that LGBT was an acronym for sexual minorities or had heard of the term. In 2015, 37.6% of respondents answered similarly. Better yet, almost 80% of the respondents said they wanted a “deeper understanding of the LGBT community to ensure that they would not make LGBT individuals feel uncomfortable instead of just knowing the acronym”.

Other findings of this study included:

• 65.1% of LGBTQIA respondents said they had not told anyone about their sexuality, indicating the still-difficult process of coming out in Japan
• 78.4% approved or were likely to approve of marriage equality
• 72.1% wanted stronger legal protections for the LGBT community

Angola’s parliament voted to remove the so-called “vices against nature” provision in a newly adopted penal code, in effect decriminalizing all same-sex conduct. In addition, the government has also banned discrimination against people based on sexual orientation, with offenders liable to face up to two years in jail.

Speaking in Geneva, the spokesperson for the UN High Commissioner for Human Rights (OHCHR) welcomed the development. Rupert Colville said that the Government has also prohibited discrimination against people based on sexual orientation.

The UN Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, Victor Madrigal-Borloz, added that such legislation “was one of the root causes behind grave and pervasive human rights violations against gay, lesbian, trans and bisexual people”.

Madrigal-Borloz urged other States to follow Angola’s move, adding that “all other countries that still criminalize homosexuality, must observe these processes of decriminalization as motivation to examine their own legal frameworks, and to bring themselves to full compliance with this human rights imperative”.

Of the 193 countries recognized by the UN, 68 still criminalize same-sex conduct.

Homosexuality remains illegal in several African countries, where antiquated colonial-era laws are maintained. In Nigeria, for instance, homosexuality is punishable by a 14-year jail term after an anti-gay law was passed in 2014; in Uganda and Zambia, the maximum penalty is life; and in Tanzania, an anti-gay crackdown, including arrests, has drawn international criticism and seen aid donors suspend donations.