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Taiwan shows LGBTQ-friendliness doesn’t mean equality for all

In Taiwan, public attitude towards LGBTQ citizens are non-violent, at best. The rate of hate crimes is relatively low compared to other countries. Be that as it may, there are still a lot of tweaking to do when it comes to having a truly respectful and empowering environment for LGBTQ citizens.

Photo courtesy of Ketty W. Chen

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Taiwanese society, in general, is pretty accepting of diversity. The country is known to have the largest Pride Parade in Asia and leads in LGBTQ rights in the region.  Some queer-centric hang-out spots can be seen around its capital, Taipei – from gay-friendly clubs and cafes, a weekly social activity for LGBTQ folks to the existence of a welcoming Christian church and, presently, being home to the only Taoist temple in the world that hears the prayers of LGBTQ individuals seeking romantic love.

Public attitude towards LGBTQ citizens are non-violent, at best. The rate of hate crimes is relatively low compared to other countries. Be that as it may, there are still a lot of tweaking to do when it comes to having a truly respectful and empowering environment for LGBTQ citizens.

Working on SOGIE (mis)education

At face value, the Taiwanese government endorses LGBTQ rights through its public announcements, bills and policies. But actual implementation is another story. In the same way that the Ministry of Interior fails for years to deliver on its promise to do away with discriminatory requirements on legal gender change, the Ministry of Education (MOE) also disappoints with its crude implementation of the Gender Equity Education Act, which supposedly should promote comprehensive SOGIE awareness and education in schools.

Wayne Lin, consultant for Taiwan Tongzhi (LGBT) Hotline Association, shared that, In year 2004, Taiwan passed a very advanced, pioneering Gender Equity Education Act. So conceptually, schools need to teach [gender equity education] 4 hours every semester, supposedly. But what’s ‘gender equity education’? That has been the battlefield for the past years… When the government or some professional teachers try to draft a guideline for the teachers… the opposition tries to manipulate fear with misleading information [about gender equity education], and the government doesn’t really take a strong and clear stance [on this policy]… But some teachers still want to do that [impart SOGIE education] so the hotline is [sometimes] invited to schools to talk about gender equity education.”

Wayne added, “I think the MOE doesn’t want to take any political risk… It’s always asking the two sides to fight each other, and the government doesn’t make any decision.”

Anti-LGBTQ groups continue to figure out ways to get into the school system in order to influence policies. For example, they run for the head positions in the parent groups/associations in schools while hiding their identity as anti-LGBTQ. There are organizations dubbed as “parent groups” but are actually an offshoot of conservative religious groups opposing LGBTQ equality. Moreover, anti-LGBTQ groups spread misinformation that schools are teaching students how to have sex and converting them into homosexuality. They would stop at nothing to get Gender Equity Education off of schools’ curricula.

“Several years ago, one Christian legislator asked MOE to let anti-LGBTQ people to get into the Gender Equity Education Committee. They said that anti-LGBTQ opinion is also part of the diversified opinion; therefore, they can get into the committee… So now the Gender Equity Education Committee has a few seats for anti-LGBTQ members, which is very ironic,” Wayne lamented.

Presbyterian Church in Taipei offering its support for LGBTQ+ rights
Photo courtesy of Ketty W. Chen

Establishing an LGBTQ-inclusive environment isn’t only needed in educational institutions. Aside from empowering queer youth, Taiwan Tongzhi Hotline Association works on providing support to the elderly demographic as well. Wayne shared, “The other thing we also pay quite a lot of attention to is the Long-Term Care Policy Taiwan is forming at this moment… For example, in Taiwan, some long-term care institutions actually are religious, like Muslim or Christian, so we already know some people are so afraid of going into that institution because they don’t know how they will be treated.”

The indifference towards LGBTQ issues, which is also why their rights are not taken seriously enough to be prioritized, can also be felt in the workplace. For example, even though there are work regulations against discrimination, in reality, a lot of queer employees are still not that comfortable to be open about their sexual orientation or gender identity for fear of it affecting their career development. Sexual harassment or discrimination cases are also not properly addressed. Basically, as Wayne put it, “You probably would not hear really harsh discrimination, but typically you are ignored. LGBTQ’s are kind of invisible.”

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Much ado about marriage equality

Currently, Taiwan lets LGBTQ couples have civil unions, but which is evidenced only by a piece of paper that brings zero spousal protection or benefits. They are not granted medical visitation rights, joint property rights, parental rights, adoption rights or any of the hundred or so rights given to married couples under the law. Surprisingly, even their national ID cards would still state their status as being “single”, not married. However, according to Reese Li, Secretary of Taiwan LGBT Family Rights Advocacy, although such civil unions are only done symbolically without any substantial partnership rights, one goal of this is to let government realize that there is actually a mass of LGBTQ couples who yearn for the right to marry. Hence, they must be given this basic civil right as citizens of the country.

In the past year, Taiwan’s Constitutional Court has declared that banning same-sex marriage is unconstitutional. It was ruled that marriage equality would be implemented after 2 years from May 2017. The options involve amending the Civil Code or, the less appealing route, by crafting a separate law for same-sex marriage. Despite the past media hype, Taiwan’s road to marriage equality is still actually stagnating in legislation. Without a clearly defined law protecting LGBTQ couples’ right to marry, as well as guaranteeing all their rights and benefits in marriage, the future for same-sex matrimony remains vague.

Taiwan’s prominent gay civil rights activist, Chi Chia Wei (祁家威), waves a rainbow flag atop a building.
Photo courtesy of Ketty W. Chen

While the government is being lax on this issue, anti-LGBTQ groups are continuously devising ways to block the progress of marriage equality. Early this year, opposing groups have passed a referendum proposal diluting multifaceted LGBTQ issues into 3 questions: (1) Should homosexuality be taught to primary and high school students? (2) Should marriage be defined as solely between a man and a woman? (3) Should same-sex couples have a different kind of union from marriage?

“Same-sex marriage must be implemented since the Constitutional Court already proclaimed it. It should not be overruled by the referendum. But the main question is ‘How?’… The aim of the anti-gay groups is for legislation to make a ‘special’ law for same-sex marriage, instead of amending the Civil Code [for marriage] because they believe that the Civil Code is theirs”, said Reese Li. “Special laws are written for disadvantaged people in society- for example, indigenous people or children. The purpose is to provide special protection… But the purpose behind anti-gay groups wanting a special law [for same-sex marriage] is from blatant discrimination, not to protect a minority group.”

Anti-LGBTQ protestors in Taiwan join hands as they stand menacingly.
Photo courtesy of Ketty W. Chen

In response to this, a pro-LGBTQ referendum was initiated by Social Democratic Party member Miao Po Ya. They are fighting against well-funded, threatening attempts to trash both the Gender Equity Education Act and marriage equality ruling. Reese shared that the coalition of opposing groups are quite strong since, aside from getting financial and mobilization support from local political and religious organizations, they are also backed by conservative groups in the US and Hong Kong.

At the end of August, the opposing groups’ referendum proposals have been submitted to election authorities. The last stage would involve placing the referendum on ballot in the coming local elections in November 2018. If anti-LGBTQ sentiments were to succeed, government might take this as a sign that Taiwanese society is not yet ready for the progress of LGBTQ rights; and thus, such atmosphere of discrimination could lead to the continuation of curtailing their civil rights.

The sign reads, “In Canada, we are a married couple. Under Taiwanese law, we are mere strangers.”
Photo courtesy of Andrea Toerien

Indeed, same-sex marriage stirs a lot of discussions not just in Taiwan but also in different parts of the world, which can be a good thing for advocating less discrimination for a minority group. However, it’s also getting slammed as a bourgeoisie movement that has strayed away from its roots, furthers inequality and ignores the struggles in structural intersectionality (the same goes for exorbitant celebrations of Pride parades) especially when, at times, it takes a huge slice of attention and funding at the expense of other important socio-politico-economic struggles experienced by LGBTQ’s (e.g. poverty, disability issues, homelessness, HIV-related issues). All this mainstream focus on marriage rights as the helm of LGBTQ advocacy can be rather dismissive and shortsighted.

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In a nutshell, critics assert that since the flawed neoliberal institution of marriage tends to emphasize the gap between the privileged and less privileged, between those with a family and those without a family, not to mention its historical subjugation of women, “marriage equality” then comes off as a misnomer that is not really pushing for equality in its truest sense.

Reese Li gave her two-cents on this particular critique.  “I think we have to look at the situation of each country. First, do the poor in Taiwan not think about marriage? Actually they still look for marriage, and this might be passed down from the conservative thinking in the past of need to marry to have children for manpower. I think many Asian country are like this… advancing marriage equality is not to oppress people or pressure gay people to marry. It only offer an option, a choice…When our organization supported marriage equality, it’s not because a lot of us want to have a wedding, but because a lot of same-sex couples already have kids…. A lot of protection, benefits, rights in society can be obtained through being registered as family. When it comes to single parent, there are less resources provided… Right now, we can only at least make baby steps to deal with the current situation. Personally, I, myself, don’t have any desire for marriage. But marriage can change our legal status and this can guarantee relevant rights and provide more resources. This is our reality now. We can’t just make a gigantic jump and demand government to provide subsidy on an individual citizen basis. That is impossible at this time.”

Wayne Lin is of the same tune with Reese. “Actually even within Hotline we have this kind of debate as well before we decide to work with other groups and the legislators to propose our bill. Yes, we all know that marriage cannot solve all the issues for LGBTQ. Of course, it’s better for everyone to enjoy the rights without getting married under certain circumstances… In the short-term, there’s no way for us to break the current marriage system in Taiwan… So for me it’s [marriage equality advocacy] more practical, just step-by-step… As long as this policy-making can benefit someone in our community, we should do that.”

According to Wayne, marriage equality can be a good talking point for society to start thinking about LGBTQ rights, as well as the concept of marriage and family. “I think majority of society probably doesn’t know LGBTQ that much, especially for the elder group. But this is an opportunity, you can talk to them, you can come out and showcase some story, so that they can better understand… I still believe the movement is really about how you make others understand our situation, and marriage equality is one easy way to open a dialogue. [If] They understand what’s the meaning, benefit or drawback of marriage,…as a beginning, then get a feeling of LGBTQ issues… it’s a methodology or way of doing public education… not everyone can still get married even if [same-sex marriage is] legalized due to economic status or not coming-out to family. So there are still so much work to be done.”

Anti-LGBTQ groups protest against amending Civil Code 972 on marriage.
Photo courtesy of Ketty W. Chen

What makes a family

Another human rights organization known as Taiwan Alliance to Promote Civil Partnership Rights (TAPCPR) is working on advocating a multi-family system that aims to provide, not only a legal option for marriage for the LGBTQ community, but also the proper rights and protections for different family structures in Taiwan.

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TAPCPR has 3 different proposals which include marriage equality. The second proposal pertains to a partnership system whereby two individuals can enter into a civil contract that customizes the obligations and rights that they would mutually agree on, such as those relating to inheritance, property and so forth. The third one proposes a multi-member family system that allows individuals to have a contractual option to live and be registered as a family with friends.

However, opposing groups argue that the multi-family system proposal would be dangerous to society as it would destroy traditional relationships and families. It is too radical of an idea to be discussed as of now.

Photo courtesy of Ketty W. Chen

Just with same-sex marriage alone, the voice of opposition can be virulent. While marriage equality advocates are merely fighting for LGBTQ’s right to enter into a monogamous married life and to build a family, anti-LGBTQ groups stretch the imagination beyond ridiculousness. Now, rather than posturing as messengers of God and using battlecries based on subjective interpretations of Bible verses, opposing groups – in an attempt to extend their influence – have rebranded themselves to be ordinary parents or citizens concerned about the future of families in Taiwan.

Aside from the usual conservative religious rhetoric, opponents are also operating out of misguided fear that marriage equality’s agenda is to erode monogamous relationships and family values, as well as to cause people into marrying animals or inanimate objects. They also posit that marriage equality would only worsen the country’s declining birth rate. Another extremist view is that same-sex marriage will lead to the eventual extinction of the human race. Unfortunately, the power of fear-mongering and misinformation over human emotions can never be underestimated.

Such antagonistic perspectives against same-sex marriage cannot be further from the truth. On the contrary, Reese explained that one crucial aspect of the legalization of same-sex marriage is for the protection of children under the care of same-sex parents.

“In legal papers, a kid raised by same-sex couples is indicated as being raised by a single parent only even though the kid is raised by a couple. This can lead to a lot of issues and insecurity when it comes to raising the child as a couple because the other ‘parent’ is considered a stranger under the eyes of law… Even with artificial reproduction done in other countries, when the gay couple comes back to Taiwan, they are not recognized as both parents.”, said Reese.

There are already a huge number of same-sex couples in Taiwan who encounter several issues when it comes to raising their child. A task as simple as taking their children to the doctor or fetching them from school already proves to be such a hassle if the not-legally-recognized parent is the one doing the job. How much more when heavier parental responsibilities must be done for the children’s well-being?

Reese continued on to explain, “Worse comes to worst, if the legally recognized parent dies, the surviving partner can’t continue to take care of the kid. The kid will be separated from the surviving parent because s/he is not recognized by law as parent. By law, the child has to go with blood-related relatives of the deceased parent. But we have to consider that not everyone can still be in good terms with relatives… It will be a bigger problem for the child.”

Photo courtesy of Ketty W. Chen

LGBTQ rights are universal rights 

While Taiwan is an LGBTQ-friendly destination, there are still undoubtedly a lot of obstacles to hurdle through and conflicts to sort out on the ground. Neighboring and distant countries need to keep a close watch and offer an intimate support to the Taiwanese LGBTQ+ community’s clamor for widespread equality – not just for the sake of marrying the person they love, but also to advance SOGIE awareness and education, to foster legal protection for diverse families that exist beyond the outdated concept of a traditional family, as well as to address the myriad of less talked about yet similarly important issues that affect LGBTQ+ folks. After all, their fight is also the fight of every LGBTQ+ and human rights movement around the globe. Even as a small Asian island, its wins could still pack a punch and contribute to putting an end to discrimination and hate crimes against people of different SOGIE.

A sure-footed wanderer. A shy, but strong personality. Hot-headed but cool. A critic of this propaganda-filled, often brainwashed society. A lover of nature, creativity and intellectual pursuits. Femme in all the right places. Breaking down stereotypical perspectives and narrow-mindedness. A writer with a pen name and no face. I'm a private person, but not closeted. Stay true!

Health & Wellness

One in five contract STI from somebody they met on a dating app

85% of 18-24 year olds have used dating apps. Unfortunately, of 2,000 respondents, 18% said they had caught an STI from someone they had met online.

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The sexual health risks for young adults are increasing through the use of dating websites and apps.

This is according to an original research by Zava, which found that 85% of 18-24 year olds have used dating apps. Unfortunately, of 2,000 respondents, 18% said they had caught an STI from someone they had met online, with chlamydia being the most common STI, with 10% of 18-24 year-olds catching the infection as a result of a meeting arranged through a dating app.

Interestingly, the rise in STIs like chlamydia and gonorrhea ought to be linked to lower levels of sexual health education; but as per Zava’s research, the opposite is true, with almost two thirds saying they feel informed about STIs.

The study also noted that young adults in rural areas are more likely to have been diagnosed with an STI as a result of their online activity than those in urban areas. Also, people who identify as gay are also more likely to have contracted an STI, with a third of young gay people testing positive for a sexually transmitted infections after meeting a partner online.

38% of people with an STI found out about the infection by noticing the symptoms, particularly for common STIs like chlamydia and gonorrhea rather than being told by the person they caught it from. Healthcare professionals suggest this could be partly due to the practice of people deleting the profiles of their previous partners, so they can’t always inform them if they are diagnosed with an infection later on.

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As an FYI: The most popular dating app among the respondents was Tinder, with 70% having used it, way ahead of Bumble (6%), Grindr (4%), Happn (2%) and Hinge (1%).

In terms of STI testing, it seems that for young people, the decision to get tested isn’t related to public service advertising. Only 5% of the general population and 12% of people who identify as gay reported that public service advertisements were their primary reason for getting tested. Overall, people who identify as gay or bisexual are more likely to get tested for STIs (34% and 33% respectively) than their straight counterparts (28%).

Commenting on the findings, Dr Kathryn Basford of Zava, said: “Both gonorrhoea and chlamydia are bacterial infections that can have serious health consequences if they remain untreated. Prevention is much better than treatment, so we advise all young adults meeting people online to use a barrier contraceptive like condoms, femidoms, or dental dams. Not only can barrier contraceptives prevent unwanted pregnancies, unlike other forms of contraception they also reduce the risk of contracting an STI.”

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Technology

How tech is shaking up the retail investing scene

Investors can check the price of stocks whenever they like, read associated stories, access balance sheets, and generally have all of the tools at their disposal to work out whether a company is a good buy. It’s fair to say that tech is shaking up the retail investing scene in more ways than one.

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Retail investors used to have to make a stark choice. Either they bought and sold equities through a broker – somebody who would buy shares in companies on their behalf – or they’d pile all their capital into a mutual fund and wait. Without the internet, investors usually had to wait for their statements in the mail before they found out about the performance of their investments. It wasn’t always good news.

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Technology has changed all that. Retail investors now have information that is nearly as good as top hedge funds. Investors can check the price of stocks whenever they like, read associated stories, access balance sheets, and generally have all of the tools at their disposal to work out whether a company is a good buy. It’s fair to say that tech is shaking up the retail investing scene in more ways than one.

Software Advisors

It was only a matter of time before somebody applied new artificial intelligence software to the retail investing scene. In the past, retail investors had to do their research if they wanted to understand how markets worked. Investing is a technical discipline, as well as an art, and an understanding of key terms is essential. But robo advisors take some of the edge off the otherwise steep learning curve. People new to finance can quickly get up to speed with all the relevant concepts and jargon. Robo advisors can give information about complicated investment plans, 401(k)s and many other things.

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Retail investors can also put their faith in machines too if they see fit. The world’s first AI-powered investment ETF launched last year. The ETF is a collection of funds managed by a computer based on all available data. The software takes data from the market to predict which firms will perform best over a 12-month horizon. So far, the software hasn’t convincingly beaten the market, but it’s early days.

Trading Apps

In the past, if you wanted to buy shares in a company, you had to physically visit your broker, give the order, and then get them to buy the shares on the open market. Things have moved on a lot since then. Thanks to smartphones, the average investor can now just fire up an app on their phone, place an order, and take ownership of shares on the same day. Apps are usually linked to major trading houses, so be careful which you choose

High-Frequency Trading Products

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The market is continually looking for new ways to create profit opportunities. A controversial method of doing this is the so-called high-frequency trading where an automated trading system makes dozens of trades per second. High-frequency trading is shaking up the retail investment scene because it is changing the strategy that regular traders should use.

Retail investors can either invest in funds that take advantage of automated, rapid trading or they can adopt a value-investing approach, ignoring all the short term fluctuations in the market. The good news is that there are now products that cater to both. Some funds use high-frequency trading, while others attempt to follow companies with value potential.

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Health & Wellness

Trans hormone therapy less risky than birth control pills, according to studies

A study suggests that hormone therapy for transgender people increases the risk of blood clots less than birth control pills and does not increase the risk of cardiovascular disease at all.

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Studies published in the Men’s Health Issue of AACC’s journal Clinical Chemistry suggest that hormone therapy for transgender people increases the risk of blood clots less than birth control pills and does not increase the risk of cardiovascular disease at all. These preliminary results could help more transgender individuals to access essential hormone therapy by increasing physician comfort with prescribing it.

Major medical associations agree that transgender individuals need to be able to express their gender in ways with which they feel comfortable and that this is the most effective treatment for psychological distress caused by incongruence between sex assigned at birth and gender.

For many transgender individuals, expressing their gender involves physically changing their body through medical steps such as taking hormone therapy.

However, transgender patients often experience difficulty getting hormone therapy prescriptions, to the point that one in four transgender women have to resort to illegally obtaining cross-sex hormones. Part of this is because existing research on transgender hormone therapy is limited and conflicting, which has led to some physicians denying patients this treatment out of concern that it could significantly increase the risk of health problems such as blood clots and cardiovascular disease.

A team of researchers led by Dina N. Greene, PhD, of the University of Washington in Seattle in the US estimated that in transgender women prescribed estrogen, blood clots only occur at a rate of 2.3 per 1,000 person-years. While this is higher than the estimated incidence rate of blood clots in the general population (1.0-1.8 per 1,000 person-years), it is less than the estimated rate in premenopausal women taking oral contraceptives (3.5 per 1,000 person-years), which means that it is an acceptable level of risk.

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In order to determine this, Greene’s team performed a systematic review of all studies that have included the incidence rate of blood clots in transgender women receiving estrogen therapy, identifying 12 that were most relevant. The researchers then used meta-analysis to combine the results of these 12 studies and calculate a risk estimate that is based on all available evidence to date.  

“Documenting the risks associated with hormone treatment may allow for prescribers to feel more comfortable with prescribing practices, allowing for better overall management of transgender people,” said Greene. “Our data support the risk of thrombotic events in transgender women taking estrogen therapy being roughly comparable to the risk of thrombotic risks associated with oral contraceptives in premenopausal women. Given the widespread use of oral contraception, this level of risk appears to be broadly accepted.”

In a second study, a team of researchers led by Guy G.R. T’Sjoen, MD, PhD, also conducted a systematic review of all studies that measured risk factors for cardiovascular disease in transgender people taking hormone therapy. The researchers identified 77 relevant studies in this area and found that the majority of them report no increase in cardiovascular disease in either transgender men or women after 10 years of hormone therapy. The studies that did indicate a higher cardiovascular disease risk for transgender women in particular mainly involved patients using ethinyl estradiol, a now obsolete estrogen agent, and are therefore no longer valid.

T’Sjoen’s team does state that their results are not conclusive due to the small sample sizes and relatively short duration of the studies in this area (and Greene’s team included a similar caveat for their work). However, it is important to look at Greene and T’Sjoen’s studies in the context of transgender research as a whole. The field only began to receive National Institutes of Health funding in 2017 and is also lagging due to the fact that transgender patients often aren’t identified in medical databases that provide data for research. In light of this, these studies are significant not only because they suggest that transgender hormone therapy is safe, but also because they underscore the need for longer-term, large scale studies involving this underserved population.

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Health & Wellness

Sexual, gender minority patients report greater comfort when SOGI’s collected via nonverbal self-report

Registrar form collection is the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department.

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Sexual or gender minority patients reported greater comfort and improved communication when SOGI was collected via nonverbal self-report.

This is according to “Assessment of Patient-Centered Approaches to Collect Sexual Orientation and Gender Identity Information in the Emergency Department”, a study done by Adil Haider, MD, MPH; Rachel R. Adler, ScD; Eric Schneider, PhD; et al and publisher din JAMA Network Open.

For this study, the researchers wanted to identify the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department (ED).

So they tapped four EDs on the east coast of the US that sequentially tested two different sexual orientation and gender identity (SOGI) collection approaches between February 2016 and March 2017.

A total of 540 enrolled patients were analyzed; the mean age was 36.4 years and 66.5% of those who identified their gender were female.

In particular, two SOGI collection approaches were tested: nurse verbal collection during the clinical encounter vs nonverbal collection during patient registration. The ED physicians, physician assistants, nurses, and registrars received education and training on sexual or gender minority health disparities and terminology prior to and throughout the intervention period.

Multivariable ordered logistic regression was used to assess whether either SOGI collection method was associated with higher patient satisfaction with their ED experience. Eligible adults older than 18 years who identified as a sexual or gender minority (SGM) were enrolled and then matched 1 to 1 by age (aged ≥5 years) and illness severity (Emergency Severity Index score ±1) to patients who identified as heterosexual and cisgender (non-SGM), and to patients whose SOGI information was missing (blank field). Patients who identified as SGM, non-SGM, or had a blank field were invited to complete surveys about their ED visit. Data analysis was conducted from April 2017 to November 2017.

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The study found that sexual or gender minority patients had significantly better Communication Climate Assessment Toolkit scores with nonverbal registrar form collection compared with nurse verbal collection (mean [SD], 95.6 [11.9] vs 89.5 [20.5]; P = .03). No significant differences between the 2 approaches were found among non-SGM patients (mean [SD], 91.8 [18.9] vs 93.2 [13.6]; P = .59) or those with a blank field (92.7 [15.9] vs 93.6 [14.7]; P = .70). After adjusting for age, race, illness severity, and site, SGM patients had 2.57 (95% CI, 1.13-5.82) increased odds of a better Communication Climate Assessment Toolkit score category during form collection compared with verbal collection.

In a gist (and to emphasize): Registrar form collection is the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department.

“Our interventional study assessing two potential methods to collect SOGI in the ED found that SGM patients reported significantly higher satisfaction with their experience in the ED with registrar nonverbal collection compared with nurse verbal collection,” the researchers stated. “In other words, SGM patients preferred a standardized collection process where all patients could report SOGI along with other demographical information vs being asked by a nurse during a clinical encounter. Non-SGM patients and those without reported SOGI information were no less satisfied with form collection compared with verbal collection.”

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Health & Wellness

Non-heterosexual adolescents more vulnerable to depressive symptoms from 10 years old

Gay, lesbian, bisexual and questioning youth are more likely to experience depressive symptoms from as young as age 10 and these symptoms persist at least into their early 20s.

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Depressive symptoms are more common among sexual minority youth than heterosexual youth at age 10, develop faster during adolescence, and continue into young adulthood (even if they start to decline from age 18).

This is according to “Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study”, an observational study that followed almost 5,000 young people from 10 to 21 years of age in the UK. Published in The Lancet Child & Adolescent Health, it was authored by Madeleine Irish, MSc; Francesca Solmi, PhD; Becky Mars, PhD; Michael King, PhD; Glyn Lewis, PhD; Rebecca M Pearson, PhD; et al.

Previous research found that annually, in the UK alone between 2001 and 2014, on average across 10- to 19-year-olds, around 37 per 10,000 girls and 12 per 10,000 boys were treated for self-harm.

The findings suggest that sexual minority youth and are four times more likely to report recent self-harm at ages 16 and 21 years than their heterosexual peers, and are at higher risk of depressive symptoms from as young as 10 years old.

“We’ve known for some time that sexual minority youth have worse mental health outcomes, and it’s quite concerning that we’ve found this trend starts as early as 10 years old, and worsens throughout adolescence,” said the study’s senior author, Lewis.

To make for a robust sample of LGBQ youth, all participants who were not exclusively heterosexual were grouped into the same ‘sexual minority’ category, including 625 people (13%) who had described themselves as homosexual, bisexual, mainly homosexual, mainly heterosexual, unsure or not attracted to either sex.

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The participants responded to questions about depressive symptoms seven times from age 10 to 21, and at 16 and 21 were asked if they had attempted to hurt themselves in the past year.

Depressive symptoms increased throughout adolescence in both groups but the increase was greater for sexual minority youth, who already were more likely to report depressive symptoms from age 10. Self-harm was more common among non-heterosexuals at both 16 and 21.

At age 18 years, the LGBQ adolescents were twice as likely to fulfil the criteria for a clinical diagnosis of depression.

Mental health outcomes were worse for each of the sexual minority groups compared to heterosexuals.

The researchers said that there may be numerous factors likely involved here.

“As these differences emerge so early, we suspect that a sense of feeling different might affect mental health before children can even articulate that difference. As they progress through adolescence, a range of stressors could be involved, such as discrimination, stigmatization, feelings of loneliness, social isolation, shame or fear or rejection, including at home or at school,” said the study’s first author, Irish.

The findings suggest that clinicians who encounter young people, whether in primary or secondary care, sexual health services, the emergency department, or as school nurses, should be mindful about sexuality in considering the wider context for depressive symptoms or self-harm.

“Clinicians should use language and questions that reflect openness about sexuality, and not assume heterosexuality, and they should be aware that a young person who identifies as not exclusively heterosexual may have struggled with mental health problems from early in development,” said co-author Pitman.

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The fact we found mental health disparities at such a young age suggests that early interventions may be useful to prevent and treat such mental health challenges, Lewis said.

“Despite changes to public perceptions and attitudes in recent years, gay, lesbian and bisexual youth remain at increased risk of long-term mental health problems – addressing this inequality should be a research, policy, clinical and public mental health priority,” Lewis ended.

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Health & Wellness

7 Tips to control your acid reflux

Acid reflux, unlike many other medical conditions, can be almost completely preventable – that is if you do the right thing. The following steps will help you reduce your symptoms of acid reflux.

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Gastroesophageal Reflux Disease (GERD) commonly known as acid reflux or heartburn is a very common digestive disease. It happens when acid from the stomach escapes into the esophagus, the aftereffect is felt as heartburns, pain, and inflammation.

The condition is noticed when the barrier between the stomach and the esophagus becomes impaired, causing the acid and food in the stomach to flow back into the esophagus. If not treated over time, the reflux of stomach acid into the esophagus through the lower esophageal sphincter can result in a more serious condition including throat cancer.

Acid reflux, unlike many other medical conditions, can be almost completely preventable – that is if you do the right thing. Acid reflux can cause sore throats and hoarseness and may literally leave a bad taste in your mouth. The following steps will help you reduce your symptoms of acid reflux.

1. Avoid Going to Bed After a Meal

Sleeping immediately after a meal one sure way to trigger acid reflux. Why? When you lie down (horizontally that is), you create a somewhat level field for the stomach acid and all that you’ve eaten to move freely into the esophagus. However, when you sit or stand, gravity help keeps the stomach acid in the stomach, where it belongs.

Sleeping immediately after a meal one sure way to trigger acid reflux.
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To prevent this, eat your meals at least two to three hours before lying down. This will give food time to digest and get out of your stomach. Furthermore, by this time, the acid level would have also gone down.

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2. Get to Know Your Triggers and Run from Them

For every person living with acid reflux, there are certain foods which trigger this condition. Onions, peppermint, chocolate, beverages with caffeine, citrus fruits or juice, tomatoes, high-fat and spicy foods are some known culprits. The list of triggers is relative, as what can cause an explosive heartburn for one may just be digested normally in another.

Get a list of foods and how you react with them. You can rank the heartburn effect you feel after eating them using a scale of 1 to 5 or 1 to 10 or even 20.
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To help with this, we advise that you get a list of foods and how you react with them. You can rank the heartburn effect you feel after eating them using a scale of 1 to 5 or 1 to 10 or even 20. The lower numbers on the list should represent the foods that leave mild heartburn symptoms.

It may take quite some time to get a comprehensive list when you finally do, it becomes easier to control your heartburn.

3. Reduce Your Mealtime Portions

Eating smaller meal portions is also another way of controlling acid reflux. When you overstuff your stomach, you give acid in the stomach no space – looking for where to stay, they move into the esophagus. If you cannot manage the small meals three times a day, you can eat up to four or five times a day. Just don’t overstuff your stomach.

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4. Eat a Little Bit Slower

Even if it is not your thing, you may need to consider eating more slowly to control your acid reflux. By slowing down your eating you will end up with less food in your stomach at any one time. It takes time for the chemical messengers in our stomach to let the brain know we’re getting full. Give those messengers time to work, and your body will better tell you when you’ve had enough.

By slowing down your eating you will end up with less food in your stomach at any one time. It takes time for the chemical messengers in our stomach to let the brain know we’re getting full.
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If you are a vigorous eater, you can mix food with conversation to spend more time on each meal. As a final resort, you can begin eating with your non-dominant hand. Unless you are ambidextrous or created to eat with both hands, this can be an easy way to slow down.

5. If You Do, Stop Smoking and Drink Moderately

While these are habits some consider cool and normal, they would worsen your heartburn. Cigarettes contain nicotine which will weaken the esophageal sphincter – the muscle saddled with the responsibility of controlling the opening between your esophagus and your stomach. When it’s closed, it keeps acid and other things in your stomach from going back up.

Alcohol increases the production of stomach acid and also relaxes the lower esophageal sphincter (LES).
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While alcohol may be a great way of blowing off steam after a stressful day, we recommend exercising, walking, meditation, stretching, or deep breathing instead of turning to the bottles. Alcohol increases the production of stomach acid and also relaxes the lower esophageal sphincter (LES), allowing stomach contents to reflux back up into the esophagus.

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Taking alcohol may not leave the same effect on everyone. If some people, a bottle is more than enough to trigger reflux, others may be able to tolerate two, maybe three before the symptoms surface. The important thing is that you know how much you can take before reflux, and stick to it.

6. Use Medication

There are great medications to help with your acid reflux. First are antacids which will typically work very quickly on heartburn – but for a short period of time. Mylanta, Rolaids, and Tums, are common Antacids. Next up are H2 blockers. These group of drugs will work for a longer period of time, usually up to 12 hours. Cimetidine, Famotidine, nizatidine, and ranitidine.

Finally, we have proton pump inhibitors, and Omeprazole is one of the most popular of these. Omeprazole works by reducing the amount of acid that your stomach produces and so helps to reduce the symptoms associated with acid reflux. Omeprazole is an effective and established medicine for the treatment of acid reflux.

There are great medications to help with your acid reflux.
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As a part of your medication, your doctor may advise that you drop some weight. Many experts believe that extra belly fat increases pressure on the stomach, forcing food and acid back up through the esophagus. Please, do this only after your doctor has recommended.

7. Sleep on an Inclined Plane

To put it simply, elevate your bed – the bedposts to be exact. By raising your bedpost up to six or eight inches, you give gravity the chance to keep gastric acid down in your stomach. Avoid using pillows as this can put your head at an angle that can put more pressure on your stomach and make your heartburn worse.

To put it simply, elevate your bed – the bedposts to be exact.
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