My Other Chelsea Neighbor

The rich white gay man does live in Chelsea. He is my neighbor and he is both buff and healthy. I recently met his “cousin” in the new Terrence McNally play last week,Mother and Sons, although that version had a fabulous Central Park West apartment with a view, a husband and a perfect child.

I live in Chelsea, too.

My friend Jay, a transgender man, lives in Chelsea also, but his apartment is in the housing projects. You won’t run into Jay in the neighborhood these days; he is homebound, recovering from surgery for lung cancer that cruelly developed only a few years after his difficult bout with breast cancer.

I am not pretending that I just invented the financial rainbow; we all know that the diversity in our community extends to the range of socioeconomic classes we belong to. I am writing because those of us who live in poverty are hidden, while the lives of the wealthy are highlighted in media and the news. More importantly, money has a huge impact on our health and health choices.

Jay attributes his poverty initially to being made homeless as a youth, thrown out of higher education, being physically assaulted and facing discrimination severe enough to cause PTSD. Exposure to DES in utero then created multiple chronic illnesses in early adulthood, derailing all his efforts to get his life back on track. The final drain on his remaining resources was his decision to care for his dying partner, Eleanor. It was during that time that Jay himself developed breast cancer. The healthcare system treated him just as poorly as they had Eleanor; the surgeon would not call to give Jay his malignant biopsy results, but referred him instead to the Psychiatry Department, simply because he was transgender.

Poor LGBT people may be hidden, but they are not a minority. The Williams Instituterecently found that we have substantially higher rates of poverty in our community than in the general public. Separate out different racial groups, and the numbers tell the same story, with more LGBT African Americans living in poverty than their African American heterosexual counterparts.

Chelsea, NYC

Chelsea, NYC

One out of five working-age LGBT adults received food stamps last year and one quarter of same-sex couples needed that government benefit in order to eat. (The national rate of food stamp eligibility is only 16 percent.) Jay ate organic food more often than most, because he supplemented his food stamps with dumpster diving at Chelsea grocery stores, where truckloads of fresh organic food was discarded. When his health permitted it, Jay collected far more than he needed and his neighbors, especially the disabled, were invited to stop over and take what they liked. (He gathered thrown out cleaning supplies as well).

Cancer is not for those without financial resources. A new study found that 25 percent of breast cancer survivors experienced financial decline and the difficulties were more often reported by those who began with lower incomes. Sadly, but not shockingly, poor people endure greater pain and suffering from cancer than most Americans.

Poverty exerts multiple additional stressors on cancer patients; it limits health care access, degrades nutritional status, restricts transportation alternatives to healthcare settings, limits access to alternative and complementary care, restricts the ability to research one’s cancer, “and frankly”, as Jay said, “the hopelessness and hardship of poverty grinds away the will to live.”

After returning home from the hospital, Jay had a friend go to the pharmacy with 5 prescriptions for post operative pain medications. Medicaid insurance refused to cover the main pain medication, a sustained release form of Oxycodone. Clearly, he couldn’t afford to pay for the drug himself. As a result, he had to use ibuprofen, which is contraindicated because of his kidney impairment, and the unmanaged pain made him unable to sleep. “That’s grisly”, he explained.

Since that time, Jay learned that what he believed to be stage 1 lung cancer turned out to be inoperable stage 4. He’s on borrowed time, navigating his way through all the issues that arise with very aggressive lung cancer, but compounded in his case by Medicaid’s refusal to cover not only his pain medications, but also diagnostic scans prescribed by his doctors. He is finding it impossible to fight for his care while too sick to function.

Jay said, “I can see why patients give up and just lapse into defeat. It’s way too much to deal with, and even I, lifelong fighter, often have moments of wishing to just fall asleep and never wake up.”

I run a national LGBT cancer organization and I am outraged and heartbroken.

Most of our research evidence addresses the greater cancer risks in the LGBT community, but that is only the beginning of our health story. LGBT people then face greater barriers to accessing quality healthcare and for people, like Jay, cumulative experiences like this have thrown him into poverty. Every life is unique and some have better outcomes, but the root cause of it all is discrimination. For Jay’s sake and for all our LGBT brothers and sisters, we must keep fighting. Discrimination is killing us.

Follow Liz Margolies, L.C.S.W. on Twitter:

As published on Huffington Post’s new LGBT Wellness blog, see original at:

The George Washington University is Now Accepting Applications

lgbthealth gwu

The LGBT Health Policy and Practice Graduate Certificate Program at The George Washington University is now accepting applications for the 2014-2015 class. This is the second year of the program at the university.

This is an opportunity for grads or soon-to-be grads, with LGBT issues-focused career goals anywhere in the country, to add to their resumes while in graduate school or working full-time. The program is open to anyone in the U.S. or abroad with a Bachelor’s Degree who works or is training to work in the health care or health policy fields, and who wants core competency in LGBT physical and mental health domains.

Classes for the 10-month, 12-credit, hybrid online/on-campus program begin online June 23rd. If you are interested you should apply now. Applicants usually receive feedback within two weeks of submitting their applications. Tuition for the 2014-2015 program year is $10,800. To apply now, click here.

More information: You can view a video about the program here. For additional detailed certificate program information, please visit GWU’s website here.   If you are interested you can also contact Dr. Stephen Forssell by email or phone at or 202-994-6316.  

#SaludLGBTT Wrap-Up: Working Together as Advocates



Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.

This is a series of posts covering Corey’s work in Puerto Rico for the Salud LGBTT conference.


Corey captures the sun setting over the San Juan Bay – and a great summit.

Now that the hundreds of us who participated in the Salud LGBTT summit in Puerto Rico last weekend have had a chance to return home and recuperate (and, in my case, pour on the aloe vera), I wanted to write a quick wrap-up on my experiences there.

In addition to the two days we spent talking about topics ranging from trans health to e-cigs, many of us spent time networking, developing collaborations, and making lasting friendships. People came from all over the island and the continental U.S. not only to share their experiences but also – and more importantly – to learn from the experiences of others.

Chances are that those of you reading this blog, like the attendees of the conference, come from all different backgrounds and specialties. Some are students, activists, lawyers, healthcare providers, community health workers, and academics. Some are focused on tobacco control, others on LGBT rights, and still others on healthcare disparities generally. And we each have different intersectionalities with respect to our own orientations, gender identities, races, ethnicities, abilities, and social groups. In short, we each bring different things to the table, both personally and professionally.

Over the weekend, I had a realization that there is none among us who can “do it all” with respect to LGBT health. We can’t all prioritize everything or be experts on every topic. One prominent activist told me that she sometimes feels pressure to prioritize one sub-group within the LGBT community over another. But rather than despair at this truth, or just give in and pick favorites, she and I focused our discussion on how to create collaborations so that we’re all working together towards a common goal.  By recognizing and using the expertise of others, we can focus on doing novel work ourselves.

So that was my lesson from the Salud LGBTT summit: to not reinvent the wheel trying to change the world alone, but to join forces with others to keep our wheels moving forward together. That means creating more opportunities like this amazing summit to gather and not just speak, but also listen.

Congratulations to Juan Carlos Vega and the entire board of Salud LGBTT for a successful and inspiring weekend! I look forward to seeing the attendees – and hopefully many new faces – next year.

To read more coverage of the Salud LGBTT summit, click here.


HealthEquity Logo
CDC’s Office on Smoking and Health seeks ex-smokers
to be in Tips From Former Smokers campaign!
The Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health are recruiting additional candidates to be considered for an upcoming national education campaign, Tips From Former Smokers (Tips). This campaign is similar to previous campaigns seen here, real people who have had life-changing, smoking-related health problems will be featured. They are conducting a national search to find people with compelling stories who are willing to participate in their campaign.

The CDC and OSH are seeking people from all backgrounds, and are particularly looking for candidates who are of Asian descent. All applicants must be tobacco-free for at least 6 months.

They are looking for ex-smokers who:

·         Have or have had colorectal cancer that was linked to cigarette smoking (ages 30–65).
·         Have or have had macular degeneration that was linked to cigarette smoking (ages 40–65).
·         Used cigars with cigarettes or used cigarillos or little cigars with or without cigarettes, thinking cigars, cigarillos and little cigars were healthier than cigarettes and developed a serious health condition while smoking (ages 20-60).
·         Used e-cigarettes or smokeless tobacco for at least a year while continuing to smoke some cigarettes; and
·         Thought using e-cigarettes or smokeless tobacco to cut back on some cigarettes would be good for your health; and
·         Despite cutting back, you were later diagnosed with a serious health condition.
All individuals should be comfortable sharing their story publicly and be able to articulate how their smoking-related condition has changed their life. The association between smoking and their condition must be clear, and candidates’ physicians will be contacted to verify that smoking contributed to the condition.

The CDC and OSH would like for you to help distribute this flyer (below). Please feel free to email it to anyone who might be willing to help CDC recruit for this campaign. The flyer can be posted in public areas or shared with anyone who may know people who fit the criteria above.

Feel free to print and share! click to enlarge

Feel free to print and share! click to enlarge

If you have questions, please send them to the CDC representative, Crystal Bruce,
Please put “Recruitment Question” in the subject line.



Michael G. Bare
Program Coordinator
National LGBT Cancer Network 

During the Conference on LGBT Suicide Risk and Prevention at the San Francisco State University, the component that struck me most (and made me want to make this a 2 part blog) was the work being done by the Family Acceptance Project around LGBT youth’s families and faith communities to increase support for LGBT youth and decrease the various problems that LGBT youth face: family and community rejection, depression, homelessness, substance abuse, STDs and suicidal thoughts and attempts. Caitlin Ryan, Project Director of the Family Acceptance Project, spoke at length about the issues the project tackles.

The theme that Caitlin pointed out that was, to me, the greatest take-away was the need to change the paradigm of the way LGBT activists and service providers think of the family in a social context. Historically, families were excluded from programmatic frameworks because of unsupportive or toxic relationships with LGBT young adults; the norm was to build an individuals self-acceptance outside of the need of a families acceptance. But with the emergence of an LGBT youth population, in part due to access to information, positive representation of LGBT people in the media, changes in public perception and increases in support programs for LGBT youth, excluding the family is no longer an appropriate option.

The Family Acceptance Project works at the systems level and at the community level with families, providers and faith communities to outline what are truly their family values: caring for, and creating supportive environments for their adolescents, regardless of their LGBT status. Identifying, and educating communities about how family rejection leads to negative health and mental health outcomes and how family acceptance helps protect against risk and promotes their LGBT adolescents’ well-being is a core component of the Family Acceptance Project’s prevention and intervention work.

While the Projects work in the Mormon community has been highlighted in the media, the Family Acceptance Project has worked across Christian faiths, and with Muslim and Jewish families with LGBT children and is currently working to develop specific research-based “Best Practice” resources for families from other faith backgrounds. Family acceptance is an integral part of ensuring healthy adolescents grow into healthy adults, and working with their faith is central to this work.

The Family Acceptance Project has produced this press release to spread the word about their Utah-Based program which addresses the risk for suicide and rapidly increasing reports of homelessness among Utah LGBT Youth.

Click “LGBT Suicide Prevention (Part 1 of 2)” to read the prior segment.

I Did It: Lunch With a Total Stranger

liz margolies



Liz Margolies, L.C.S.W.

Founder and Executive Director, National LGBT Cancer Network




As published on Huffington Post’s new LGBT Wellness blog, see original at:

When a white, atheist psychotherapist has lunch with the founder of Depressed Black Gay Men (DBGM), they each get food for thought.

We met by email when someone forwarded his information to me. The email didn’t even contain a last name, but it was one of the most eloquently written requests for information about LGBT cultural competency trainings I had ever read. Over the course of that day, Antoine Craigwell and I corresponded several times about our respective organizations, but he always avoided answering my direct questions about himself, his profession, or how he came to write so well. Instead he asked to meet for a one-hour lunch the next day at a Cuban restaurant in my neighborhood. I requested a picture so that I would recognize him when he arrived; he sent me a selfie with an intense gaze.

I arrived on time. (Remember, I’m a psychotherapist.) He was 20 minutes late, meaning a full third of our time was already gone, but he vanquished my annoyance with an immediate apology and charm. We took the last two seats at the counter, and I ordered the only vegetarian options available: rice, beans and tostones. He got liver and onions over his rice and beans. I tried to find out more about his personal life, but again, he gently deflected those attempts, keeping our discussion fascinating but academic, until we gradually moved to the focus of his work.

Several years ago, after attending the funeral of a young, black gay man who had taken his own life, Antoine decided to write a book. He is not a mental health professional but noticed three things that can make the experience of depression different for many black gay men: religiously fueled homophobia, stigma, and intraracism. Through interviews and extensive research he discovered that in this population depression is expressed not only in typical ways but often in ways that may include violence, anger, drug use and unsafe sexual practices. We engaged in an intense conversation about racism in diagnoses and untreated depression. When the form of depression is unrecognized and therefore undiagnosed, it is also left untreated. In fact, most studies report far lower rates of depression and mood disorders among blacks and Latinos than among whites. And yet, just as Antoine said, LGB youth who are also members of racial/ethnic minorities have a significantly increased risk of suicide attempts. Clearly, the measurement tools for diagnosing depression are inadequate for recognizing depression in many black gay men. In one report that I found after that lunch, 43 percent of black gay youth reported having thought about or attempted suicide as a result of issues related to their sexual orientation.

Antoine explained to me that the black church is the bedrock of many families and the community, but that in spite of offering invaluable systems for coping with sociocultural stressors, it often espouses a fundamentalist perspective on sexuality, causing some mothers to cast their sons out of families, sometimes for even a hint of homosexuality. The results are often disastrous. As an atheist mother of a queer son, my heart twisted in despair: I don’t think about religion very much, so I was struck by how support and condemnation contradict each other yet are so closely intertwined.

Feeling an urgency to reach more people than books can, Antoine switched directions, producing the documentary You Are Not Alone and founding DBGM, a nonprofit organization with a mission to raise awareness and save lives. “If by what I’m doing, one black gay man could be prevented from killing himself, then my job is done; his healing begins,” he said. Antoine has been showing the documentary around the country. It features powerful interviews with black gay men, religious leaders (Christian and Islamic) and mental health professionals.

According to Antoine, DBGM will soon launch a program entitled “I Am Working on Healing,” with two support groups: “Sons and Mothers” for black gay boys and their mothers, to encourage acceptance of their gay sons, and “My Sons” for black mothers whose sons have committed suicide. Antoine also offers cultural competency trainings wherever possible. “Aha!” I thought. “This may be where our work together begins.”

After lunch I thought about my own social activism, which is primarily focused oncancer, a disease that usually strikes later in life. I then thought about the young black gay men who would never reach adulthood and whose untreated and undiagnosed depression would mean that they would also never likely reach a psychotherapist’s office. I thought about how a good psychotherapist had saved my own son’s life and realized how fortunate we both are that he did. The 40-minute lunch shook me.

When I returned home, I Googled Antoine’s name and learned that my humble lunch-mate is an award-winning journalist. He is also, surely, a powerful agent for change.

To learn more about DBGM, visit their website.

Need help? Visit The Trevor Project or call them at 1-866-488-7386. You can also call 1-800-273-8255 for the National Suicide Prevention Lifeline.

Follow Liz Margolies, L.C.S.W. on Twitter:

#SaludLGBTT Summit: Spotlight on Trans Health



Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.

This is a series of posts covering Corey’s work in Puerto Rico for the Salud LGBTT conference.


A transgender health panel at the summit.

There is a human right to have competent health care that preserves the dignity of all people, said Ericka Florenciani, launching the Salud LGBTT summit’s panel on trans healthcare. While trans issues were woven throughout the summit, this panel was one of many efforts to ensure that the issue of trans health would be front and center – a necessity given the difficulty the trans communities face getting care in Puerto Rico.

One of the speakers, Zil Goldstein of the Persist Health Project and Beth Israel Medical Center, noted that many trans people attempt to leave Puerto Rico to get transition-related care. Improving trans care here “has to start with hormone treatment,” she said. In New York, Zil sees sixteen to eighteen patients a day to provide hormone treatment; here in Puerto Rico, advocates say it is nearly (if not entirely) impossible to access.

But even in New York, the trans communities face many barriers to receiving quality care. “Anytime a trans person accesses healthcare, we’re dealing with transphobia,” Zil noted. This explains why, for example, 30% of trans youth in the U.S. put off receiving medical care out of fear discrimination, said Susan Mash of the Trans Youth Equality Foundation.

The problem is certainly national. Lambda Legal attorney Dru Levasseur noted that in their 2011 report on LGBT health, When Health Care Isn’t Caring, it was the trans population that faced the most obstacles in the field of healthcare. And the roots go deeper than health, starting with the socioeconomic position of trans individuals in our society; according to the study, seven percent of trans individuals reported that they had no income at all, which makes even basic health care an impossibility.

Speaking to doctors, Dru said, “You don’t have to be a specialist,” but you do need to take the time to educate yourself on the basics of trans care so that you are not turning people away. Noting that Lambda can connect them to resources, “there really is no excuse,” he added.

Dr. Carmen Milagros Vélez of the Universidad de Puerto Rico has been working on improving services for trans people in the community health clinics across Puerto Rico. Often, medical personnel think that LGBTT people want special treatment, and do not want to do anything different than they do for their other patients. But given the unique health needs of the community, and the disparities it faces, LGBTT people do need specially-tailored care – although this is about basic equality, not about “special” treatment.

And the need for that equality is urgent: in Dr. Milagros Vélez’s research, 35% of clinic respondents said they were not prepared to work with trans clients. The advocates at the summit agree that that needs to change.

Stay tuned to the Network blog and my twitter account, @LGBTadvocacy, for lots of live coverage of the summit!