I'm very proud to be an epidemiologist. I'm deeply committed to public health.
And, I can't stand how public health thinks about the public's health these days, the trends that the field has taken lately. Especially in regards to gay health, but really it's much broader than that.
So, I'm trying to gird myself for what I know will be a very frustrating experience - seeing a ton of deeply committed people - deeply committed to doing good in the world - and with a few great exceptions, failing at it.
What I need, from you, is the strength to get through this APHA meeting with grace and charm. I need to listen with open ears, do my little bit to shift how people think about queer health, and most importantly, get a job back East!
Queer health on the agendaThere is a very active LGBT caucus within the APHA, with programming booked from cover to cover in the program. One could easily attend only the LGBT caucus events and never really interact with the thousands of other programs happening simultaneously. So the good news is we're there, we're taken seriously, we're in leadership roles (openly). That's great progress from the last time I went, when the LGBT caucus was insignificant, essentially a support group. Great sex, though.
But taking a closer look at the talks and posters, it becomes very clear that there is a very odd view of LGBT health being explored at APHA's meeting. I say 'odd' and not 'queer' because the view of LGBT health that comes screaming through the program book is one that focuses almost exclusively on disease and negative health outcomes, and even more troublingly, rarely interrogates homophobia / heteronormativity / stereosexism (my neologism for the view that there are but two sexes), at least does not interrogate these fundamental causes directly.
Health disparities rule the day. Not just in LGBT health, but most definitely in LGBT health. That, and individual-level analyses that can just as easily be interpreted to mean that we are inherently sick or sinful as they can be interpreted to mean that homophobia is unhealthy.
And if there is something good going on in gay health, like gay men being less likely to be obese, it must be because of some deep-seated pathology, like lousy body image.
I'm not sure where we went awry. How we came to wear these bizarre prism glasses that only allow us to see such a small fragment of LGBT health. A small fragment? Yes, a small fragment. Because what the average person steeped in LGBT health knows is a laundry list of health outcomes that we do worse on: for gay men: HIV, STD's, depression and suicidality, drugs and alcohol misuse, tobacco dependence, violence victimization, etc. For women, being obese, higher breast cancer risk, drugs and alcohol misuse, tobacco dependence, violence victimization, etc. For trans women, HIV, STD's, lack of access to care, violence victimization, drugs and alcohol misuse, etc. and for trans men, lack of access to care, and probably more, but we forgot to ask who was transmasculine and who was transfeminine, so we can't really say.
If I were then to ask OK, so what about the health advantages that LGBT people enjoy? Most probably would have to think a while before coming up with the fact that gay men are less likely to be obese. And a few might toss off the idea that lesbians, at least "out" lesbians, are less likely to experience an unintended pregnancy. How many would claim that gay men are less likely to perpetrate violence? More likely to volunteer, to provide intimate care for someone not related to them? Less likely to get someone unintentionally pregnant? To enjoy a vibrant, exciting, and life-affirming sex life?
But by far the biggest category is health similarities, and I doubt that anyone could name a single one with confidence. I'd have a lot of trouble with that myself despite thinking about it for a few years now.
At any rate, if you've been reading this blog, you've heard all these arguments before. And I need to make myself cheerful and winsome. Wish me luck.