Tegan & Sara Foundation and GLMA Launch LGBTQ+ Healthcare Directory

LGBTQ+ Healthcare Directory

Tegan and Sara Foundation, the nonprofit started by award-winning musicians Tegan and Sara, alongside GLMA– Health Professionals Advancing LGBTQ+ Equality, the foremost organization of LGBTQ+ medical professionals, are announcing the launch of the LGBTQ+ Healthcare Directory with key support and collaboration from global health service company Cigna. Additional support was provided by Google.

he LGBTQ+ Healthcare Directory is a free, searchable database of doctors, medical professionals and healthcare providers who are knowledgeable and sensitive to the unique health needs of LGBTQ+ people in the United States and Canada. The directory, developed by Tegan and Sara Foundation, GLMA and Cigna, will reach vital and diverse audiences of medical professionals and LGBTQ+ patients in need of care.

LGBTQ+ patients deserve healthcare providers who they can be open and honest with —free from fear of stigma or bias. The simple act of connecting patients with care is a solution to this problem.

Over 15 years ago, GLMA built the very first directory of LGBTQ+ healthcare professionals. Through their vast membership, the directory grew to be the most respected resource of its kind in the United States. Together with input from LGBTQ+ health experts and community leaders, this resource has been updated with innovative search functionality, the highest standards of accessibility and a new set of guiding principles.

Cigna has been a lead supporter of the LGBTQ+ Healthcare Directory and the LGBTQ+ community overall. This includes its commitment to its employees who identify as LGBTQ+, as well as its commitment to address the health disparities the LGBTQ+ community often faces.

Cigna also recognizes the importance of providing cultural competency resources and education to health care providers in order to better equip them to understand and address disparities among customers and within our communities. Cigna engages providers on inclusivity and culturally competent care, providing them with access to LGBTQ+ specific trainings and resources.

LGBTQ+ Health Disparities

LGBTQ+ people experience a number of health disparities. They’re at higher risk of certain conditions, have less access to health care, and have worse health outcomes, including:

  • Greater risk of suicide, suicidal thoughts, mood disorders and anxiety, eating disorders, and alcohol and substance abuse
  • Transgender women, Black/African American and Hispanic/Latino men have the highest risk for HIV infection
  • Older LGBTQ+ adults are more likely to rate their health as poor and report more chronic conditions while having less social support
  • LGBTQ+ people are less likely to have a regular healthcare provider
  • Lesbian and bisexual women have higher rates of breast cancer, and transgender men and women are at greater risk
  • LGBTQ+ people have higher rates of HPV infection and related cervical or anal cancers

The LGBTQ+ Healthcare Directory identifies and provides a platform for healthcare professionals that understand these disparities and reflect the unique needs of LGBTQ+ patients in their care.

The LGBTQ+ Healthcare Directory is now open for provider registration and patient use. Learn more here.

About Tegan and Sara Foundation

Tegan and Sara Foundation (TSF) was founded in 2016 by Tegan and Sara to address inequalities faced by LGBTQ+ women. TSF’s mission is improving the lives of LGBTQ+ women and girls. This mission is founded on a commitment to feminism and racial, social and gender justice.

About GLMA

GLMA – Health Professionals Advancing LGBTQ+ Equality is the world’s largest association of LGBTQ+ healthcare professionals. GLMA utilizes its multidisciplinary membership to drive advocacy, education, and research to achieve LGBTQ+ health equity.

SOURCE Tegan and Sara Foundation

Raleigh Gay Bars and Restaurants

LGBTQ Raleigh

Ruby Deluxe
http://rubydeluxeraleigh.com
415 S Salisbury St, Raleigh, NC 27601
Underground bar featuring playful decor, theme nights & a snug stage for live bands & DJs.

Flex Nightclub
http://www.flex-club.com/
119 S Harrington St, Raleigh, NC 27601
Gay club in a basement setting with karaoke, drag shows, country dancing & more.

Legends Nightclub
https://legends-club.com/
330 W Hargett St, Raleigh, NC 27601
LGBT club with a dance floor, video bar, game room, patio & performance theater.

Fox Liquor Bar
https://ac-restaurants.com/fox/
237 South Wilmington Street Entrance on, E Martin St, Raleigh, NC 27601
Taproom serving cocktails plus meat & cheese boards in sophisticated, upscale environs.



Florida LGBTQ+ Democratic Caucus Congratulates Endorsed Candidates

Florida LGBTQ+ Caucus

The Florida LGBTQ+ Democratic Caucus congratulates its endorsed candidates who won their primaries on August 23rd. The Caucus endorsed in specific races, and echoed several endorsements that came from our chapters. Caucus President Stephen Gaskill issued the following statement:

“Florida Democrats are on the offensive this cycle. We’re taking on the Republicans for their poor management of state government, neglect of key economic issues like the property insurance crisis, support for anti-LGBTQ+ policies, and fealty to authoritarians like Ron DeSantis and Donald Trump. 2022 will be a Democratic success.”

Caucus Campaign Director Dave Cutler congratulated the candidates:

“Congratulations to our endorsed candidates who won their primaries yesterday. These candidates have demonstrated their commitment to LGBTQ+ equality and have earned voters’ trust. We look forward to helping ensure their victories in November.”

Among our victorious endorsed candidates with primaries are:

Statewide Candidates

Val Demings, US Senate
Aramis Ayala, Attorney General

Congressional Incumbents

Rep. Kathy Castor
Rep. Sheila Cherfilus-McCormick
Rep. Frederica Wilson
Rep. Debbie Wasserman Schultz

Congressional Challengers/Open Seats

CD-3 Danielle Hawk
CD-10 Maxwell Frost
CD-23 Jared Moskowitz
CD-27 Annette Taddeo
CD-28 Robert Asencio

Florida Senate Candidates

SD-5 Tracie Davis
SD-34 Shevrin Jones
SD-35 Lauren Book

Florida House Candidates

HD-13 Angie Nixon
HD-22 Brandon Peters
HD-36 Deborah Poulalion
HD-38 Sarah Henry
HD-40 LaVon Bracy Davi
HD-58 Bernard Fensterwald
HD-62 Michele Rayner
HD-92 Kelly Skidmore
HD-98 Paula Hawkins-Williams
HD-105 Marie Woodson
HD-106 Jordan Leonard
HD-109 Ashley Gantt
HD-113 AJ D’Amico
HD-119 Gabriel Gonzalez

# # #

The Florida LGBTQ+ Democratic Caucus represents lesbian, gay, bisexual, transgender, and queer Floridians to the Florida Democratic Party. The Caucus is a statewide organization with chapters in 25 counties across Florida from Pensacola to Orlando to Miami – including most major metropolitan areas and many rural counties in between.

Gender and Sexuality Pride Flags

Gender and Sexuality Pride Flags

Here is a quick guide to some of the most common flags used in the LGBT community (and beyond) to describe gender and/or sexuality related identities.  While definitions are provided for reference, please know definitions of many of these terms are evolving and changing all the time.  I encourage you to explore these identities further to learn more.

Agender Pride Flag

Agender Pride Flag
Agender Pride Flag

Agender refers to a person A person who does not identify themselves as. having a particular gender.  The Agender Pride Flag was designed by Salem X in 2014. 

The flag features a mirrored design of seven horizontal stripes. The black and white stripes represent an absence of gender, the gray stripe represents semi-genderlessness and the central green stripe represents nonbinary genders.

Asexual Pride Flag

Asexual Pride Flag
Asexual Pride Flag

An aromantic is a person who experiences little or no romantic attraction to others. Where romantic people have an emotional need to be with another person in a romantic relationship, aromantics are often satisfied with friendships and other non-romantic relationships.  An asexual person may or may not experience romantic attraction (see aromantic) but will feel no need to act out that attraction sexually.

In the Summer of 2010, a number of asexuality sites, led by users on AVEN, came up with a number of designs for an asexuality flag, then held a multi-stage vote to determine the winner.  The selected design was created by AVEN user standup

Aromantic Pride Flag

Aromantic Pride Flag
Aromantic Pride Flag

An aromantic is a person who experiences little or no romantic attraction to others.  Where romantic people have an emotional need to be with another person in a romantic relationship, aromantics are often satisfied with friendships and other non-romantic relationships.

There are two different versions of the Aromantic Pride Flag.  This is the one currently most commonly used.

Bisexual Pride Flag

Bisexual Pride Flag
Bisexual Pride Flag

Bisexuality is romantic attraction, sexual attraction or sexual behavior toward more than one sex or gender identity, or romantic or sexual attraction to people of any sex or gender identity; this latter aspect is sometimes termed pansexuality.

The bisexual pride flag was designed by Michael Page in 1998.  The first bisexual pride flag was inspired by his work with BiNet USA.

Bear Pride Flag

Bear Pride Flag
Bear Pride Flag

In male gay culture, a bear is often a larger, hairier man who projects an image of rugged masculinity. Bears are one of many LGBT communities with events, codes, and a culture-specific identity.  In many communities bear clubs” have been created to provide social and sexual opportunities. Many clubs are loosely organized social groups; others are modeled on leather biker-patch clubs, with a strict set of bylaws, membership requirements, and charities.  Craig Byrnes created the Bear pride flag in 1995.

Genderqueer Pride Flag

Genderqueer
Genderqueer Flag

Genderqueer describes a person who does not subscribe to conventional gender distinctions but identifies with neither, both, or a combination of male and female genders. The Genderqueer Pride Flag was created by Marilyn Roxie in 2011. This flag has also been adopted by many in the Gender Non-Binary community.  While some currently use these two terms interchangeably, others maintain genderqueer and gender non-binary have overlapping, but separate definitions.

Intersex Flag

Intersex Flag
Intersex Flag

Intersex is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male. There are two distinct flags commonly associated with intersex identities.  The first one (not pictured here) is derivative of the Trans Pride flag and is not used as commonly these days.  The flag shown here was created by Intersex Australia in 2013.

Lesbian Pride Flag

Lesbian Visibility Flag
Lesbian Visibility Flag

While there have been different versions of the Lesbian Pride Flag over the years, this is the one most commonly used today.  Emily Gwen created this flag in 2018  based on the lickstick lesbian flag . This flag retained the seven stripes from the lipstick flag, but changed the top set to orange shades. The stripes, from top to bottom, represent ‘gender non-conformity’ (dark orange), ‘independence’ (orange), ‘community’ (light orange), ‘unique relationships to womanhood’ (white) , ‘serenity and peace’ (pink), ‘love and sex’ (dusty pink), and ‘femininity’ (dark rose).

Leather Pride Flag

Leather Pride Flag
Leather Pride Flag

Leather culture is most visible in gay communities and most often associated with gay men (“leathermen”), but it is also reflected in various ways in the gay, lesbian, bisexual, and straight worlds. Many people associate leather culture with the consensual exchange of power in romantic and/or sexual relationships.  The leather flag was created by Tony DeBlase in 1989.  He first presented the design at the International Mister Leather event in Chicago, Illinois, U.S. on May 28, 1989.

Nonbinary Pride Flag

Nonbinary Flag
Nonbinary Flag

Kye Rowan created the nonbinary pride flag in 2014.  It was meant to be flown alongside the genderqueer flag. 17-year-old Kyle Rowan created the binary flag for existing outside binary which is symbolized by the yellow. The white represents all genders, black is no gender, and purple is a mix of genders.

Pansexual Pride Flag

Pansexual Pride Flag
Pansexual Pride Flag

Pansexuals have the capability of attraction to others regardless of their gender identity or biological sex. 

A pansexual could be open to someone who is male, female, transgender, intersex, or agendered/genderqueer.

Poly Pride Flag

Poly Pride Flag
Poly Pride Flag

Polyamory is the philosophy or state of being in love or romantically involved with more than one person at the same time. Polyamory is the practice, desire, or acceptance of having more than one intimate relationship at a time with the knowledge and consent of everyone involved.

The flag was created by Jim Evans.

The Rainbow Flag

Rainbow Pride Flag
Rainbow Pride Flag

This is the inclusive flag most frequently associated with the entire lesbian, gay, bisexual, trans, queer, & questioning communities.  The original gay pride flag flew in the San Francisco Gay Freedom Day Parade on June 25, 1978 and was designed by Gilbert Baker.  The original Rainbow Flag had an additional hot pink stripe that is no longer used today.

Progress Pride Flag

Progress Pride Flag by Daniel Quasar
Progress Pride Flag

Graphic designer Daniel Quasar has added a five-colored chevron to the LGBT Rainbow Flag to place a greater emphasis on “inclusion and progression”.

The flag includes black and brown stripes to represent marginalized LGBT communities of color, along with the colors pink, light blue and white, which are used on the Transgender Pride Flag.  Quasar’s design builds on a design adopted by the city of Philadelphia in June 2017. Philadelphia’s version added black and brown stripes to the top of the Rainbow Flag, to represent LGBT communities of color.

 

Transgender Pride Flag

Transgender Pride Flag
Transgender Pride Flag

Transgender is a term used to describe people whose gender identity differs from the sex the doctor marked on their birth certificate. Gender identity is a person’s internal, personal sense of being a man or a woman (or someone outside of that gender binary). For transgender people, the sex they were assigned at birth and their own internal gender identity do not match. The Trans Pride flag was designed by Monica Helms in 1999

Straight Ally Flag

Straight Ally Flag
Straight Ally Flag

A straight ally or heterosexual ally is a heterosexual and/or cisgender person who supports equal civil rights, gender equality, LGBT social movements, and challenges homophobia, biphobia and transphobia.

Florida LGBTQ Families Speak Out about Legislation Targeting Classrooms

Florida Families

GLAAD, the world’s largest LGBTQ media advocacy organization, and Equality Florida are releasing video of LGBTQ families and educators in Florida speaking out about returning to school today with new laws in effect targeting them.

New laws are banning LGBTQ-related conversation in class, books are removed from shelves and state leaders are targeting evidence-based healthcare, despite the fact that every major medical association supports it as safe and lifesaving for transgender youth.

GLAAD’s poll of LGBTQ and ally voters in Florida finds 71% believe the laws’ intent is to attack LGBTQ people; 70% say the laws are emotionally damaging to children.

The poll shows 77% strongly agree it’s more important than ever to vote as human rights for women and LGBTQ Floridians are being taken away by elected state officials, and that 67% are “extremely motivated” to vote in the midterm elections.

77% of LGBTQ and ally voters have an unfavorable opinion of Gov. Ron DeSantis. The 2018 gubernatorial race was decided by 32,463 votes out of 8+ million. LGBTQ and ally voters are positioned to make a decisive difference in Florida’s election this fall. (Read the pollster memo.)

“Florida’s LGBTQ and ally voters must send an unmistakable message that they are not going back in the closet or back in time,” said GLAAD President and CEO, Sarah Kate Ellis. “Discriminatory, defamatory and dangerous rhetoric and behavior must stop now.”

“It is imperative that Floridians use the power of their votes to hold Governor DeSantis and his allies accountable for the hate they unleashed on our state,” said Equality Florida Press Secretary, Brandon Wolf.

4.6% of Floridians are LGBTQ; 24% of LGBTQ Floridians are raising children.

About Equality Florida:
Equality Florida is the largest civil rights organization dedicated to securing full equality for Florida’s lesbian, gay, bisexual, transgender and queer (LGBTQ) community. Visit eqfl.org or follow Equality Florida on Facebook and Twitter.

About GLAAD:
GLAAD rewrites the script for LGBTQ acceptance. As a dynamic media force, GLAAD tackles tough issues to shape the narrative and provoke dialogue that leads to cultural change. Visit www.glaad.org, connect on Facebook and Twitter, contact: press@glaad.org

LGBT Center of Raleigh Appoints Patricia R. Corbett

Patricia R. Corbett

The LGBT Center of Raleigh is announced the appointment of Patricia R. Corbett (she/her) following an extensive national search. Corbett has over 20 years professional nonprofit leadership experience and most recently served as Deputy Director of District and School Partnerships with Citizen Schools. She has led teams, organizations, projects in and around LGBTQ+ and BIPOC movements, including at Metro DC PFLAG and Richmond Organization of Sexual Minority Youth (now known as Side by Side).

Corbett is uniquely qualified to lead the Center into its next decade. Corbett, who is a natural collaborator with experience strengthening and growing community based nonprofit organizations, has a strong connection and commitment to the LGBTQ+ communities we serve. Additionally, she also brings the managerial and professional expertise the Center sought in its next chief executive.

“As I think about this position, I am eager to amplify my work for the LGBTQ community. I believe that the sum of who we are as a community is not strictly defined by our sexuality or how we identify. We must consider the entire being of our constituents and strengthen the Center’s core by providing services that reflect the needs of the most vulnerable of our community while celebrating the strength we have collectively,” notes Patricia R. Corbett, “I am honored to serve as the Executive Director and to support, affirm, empower, and provide positive experiences that are reinforced by internal and external communities.”

Board Chair Kaye Vassey noted, “The Center board unanimously appointed Patricia R. Corbett as our next chief executive because she has the experience and vision necessary to expand our programs and services in new and more inclusive directions.”

Patricia R. Corbett, who currently lives in North Carolina and will relocate to Raleigh for this position, will start on July 25. When asked about Corbett’s appointment, Raleigh Mayor Mary-Ann Baldwin shared that “ The LGBT Center of Raleigh has been a critical partner in supporting our LGBTQ+ community, providing programs and services to our diverse residents. We welcome Patricia Corbett as the new executive director and look forward to working with her to ensure that Raleigh is a welcoming and thriving community for all.

Find out more about the LGBT Center of Raleigh at: www.lgbtcenterofraleigh.com

New TV Campaign Spotlights Trans Kids Finding Joy In Sports

Gender Cool Project

Have you ever met a transgender kid? That is the question The GenderCool Project asks in a national television campaign launching today.

The high-energy 30 second spot features 11 transgender and non-binary kids ages 13 through 17 playing the team sports they love while talking about how participating in sports makes them feel.

Known as the GenderCool “Champions”, these young people are at the core of GenderCool, a youth-led, youth-inspired organization with a simple mission: help replace misinformed opinions with positive, powerful experiences meeting transgender and non-binary youth who are thriving.

The spot, airing nationally, is part of GenderCool’s national education initiative called Play it Out, which aims to help people understand fact from fiction about transgender kids and their connection to sports.

“I play sports for the same reasons all kids play sports,” said 17-year-old Amir (he/him), who is prominently featured in the spot. “Sports is like family to me. We show up for each other. I even want to be a coach someday so I can help others get to where they want to be.”

Jen Grosshandler (she/her), GenderCool co-founder, lifelong athlete and parent of four children, including a 15-year-old transgender daughter named Chazzie, said this spot is just the beginning. “Communities everywhere deserve the facts around a conversation that is in need of clarity,” said Grosshandler. “When folks have a chance to spend time with our kids, they often come to the same conclusion. Our kids play sports to be part of a community and have fun with their friends. All kids belong in sports. It’s that simple.”

The spot ends with a powerful closing statement “transgender kids are part of your team” as the Nike Swoosh and GenderCool logo appear below.

A shocking number of bills across states continue to attempt to stop transgender kids from participating in sports. Despite this legislative pushback, schools across the country recognize the important benefits of equal participation in sports for all young people, including transgender youth.

“Kids are kids, and as a coach, you want to create that environment that’s all inclusive,” said Jon Mall (he/him), a teacher from Chicago who’s been coaching K-12 athletics for the past 20 years and is featured in the spot. “Sports brings kids from all walks of life together, and the differences often fade away.”

“It’s time for folks to meet these remarkable young people and understand that they are on your team,” said GenderCool co-founder Gearah Goldstein. “This is why GenderCool is taking to the airwaves. We are bringing the positivity and joy that comes from being part of a team to communities everywhere.”

The spot was created by director Kobi Swissa of Swissa Creative, Inc. Swissa used a docu-style approach to filming, allowing viewers to experience the simple humanity and joy of watching kids play and talk about something they love.

Join the conversation using #PlayitOut and visit gendercool.org/playitout.

About The GenderCool Project

The GenderCool Project is a youth-led movement replacing misinformed opinions with positive, powerful experiences meeting transgender and non-binary young people who are thriving. Our movement is creating positive change by evolving understanding, business and culture.

SOURCE GenderCool Project

Mama Bears Launch Giving Circle to Fund LGBTQ Non-Profits

Mama Bears

Real Mama Bears, an online community dedicated to supporting the LGBTQ+ community and their families, has launched a giving circle in partnership with Legacy Collective. The giving circle monthly donors will collectively issue grants to nonprofits dedicated to supporting LGBTQ+ individuals. Members of the Mama Bears Giving Circle will have the opportunity to actively participate by nominating and voting for nonprofits that directly benefit LGBTQ+ causes.

Founder of Mama Bears, Liz Dyer, leads an online community of 40,000+ moms who come together to love, support, and empower parents of LGBTQ+ youth and the LGBTQ+ community. The community encourages every parent with a LGBTQ+ child to fully affirm and celebrate their child as they are.

“I’m excited and honored to partner with Legacy Collective to create the Mama Bears Giving Circle,” states Dyer. “The best thing about the Mama Bears Giving Circle is the opportunity it offers those of us who love and support LGBTQ+ people to collectively invest in making the world a kinder, safer, more loving place for all LGBTQ+ people to live and thrive. Together our impact will be greater! Together we can change the world!”

The Mama Bears Giving Circle aligns with Legacy Collective through common values of commitment to diversity and inclusion. Legacy Collective not only has a strong LGBTQ+ presence on their Boards, but they also vet all grant recipients and partners to ensure there are DEI policies in place protecting the LGBTQ+ community before any funds are distributed and partnerships are formed.

“Legacy cares deeply about the LGBTQ+ community. We are excited for this partnership with Liz Dyer and the over 40,000 Mama Bears where we can come together to collectively support nonprofits across the country addressing a variety of LGBTQ+ community needs,” says Erin Arnheim, CEO of Legacy Collective.

The first round of donations collected from the Mama Bears Giving Circle will be allocated to the following organizations:

  • The Trevor Project: The Trevor Project is the world’s largest suicide prevention and crisis intervention organization for LGBTQ young people. 
  • Gender Spectrum: Gender Spectrum works to create gender sensitive and inclusive environments for all children and teens.
  • Tyler Clementi Foundation: The Tyler Clementi Foundation works to address bullying challenges facing vulnerable populations, especially LGBTQ communities.
  • GLSEN: GLSEN believes that every student has the right to a safe, supportive, and LGBTQ-inclusive K-12 education.

To learn more about the Mama Bears Giving Circle, visit https://legacycollective.org/mamabears/

Palm Springs Gay Bars, Restaurants, and Clubs

Chill Bar Palm Springs

Chill Bar Palm Springs
www.chillbarpalmsprings.com
217 E Arenas Rd
This roomy gay bar & lounge offers cocktails in a sleek, contemporary space with an outdoor patio.

Toucans Tiki Lounge
www.toucanstikilounge.com
2100 N Palm Canyon Dr
Gay cocktail bar & lounge with drink specials, drag queen performances & other entertainment.

Hunters Palm Springs
hunterspalmsprings.com
302 E Arenas Rd
Long-running gay club draws a mostly male crowd for DJ beats, happy hour, BBQ events & theme nights.

Tool Shed Palm Springs
www.pstoolshed.com
600 E Sunny Dunes Rd
This gay-friendly joint provides drinks, DJs, go-go dancers & special events in a laid-back setting.

Eagle 501 Bar
www.eagle501bar.com
301 E Arenas Rd
Light-filled bar catering to a lively, varied gay crowd, with events on weekends.

Street Bar
www.facebook.com/psstreetbar
224 E Arenas Rd
Anyone can be a performer at this lively gay bar offering standard cocktails & live entertainment.

Photo: Chill Bar Palm Springs. Photo by @crispypicsphoto

Gay, Bi, and Trans Youth of Color at Higher Risk for Transactional Sex

LGBTQ Youth and Transactional Sex

Johns Hopkins Medicine

About a fifth of young sexual minority males and transgender females are estimated to be engaging in transactional, or survival sex, according to results of a new survey study by Johns Hopkins Medicine researchers. The findings, which define the practice as trading sex for money, housing and other necessities (e.g., food, clothing), were published in the February 2022 issue of the Journal of Adolescent Health and first appeared online Jan. 16. The findings affirm that transactional sex may place young Black and Latinx gay or bisexual males and transgender females at risk for exposure to HIV.

“Previous studies have focused on transactional sex among young gay or bisexual males and transgender females, but few have tried to understand the prevalence among Black and Latinx youth in these groups,” says Johns Hopkins Children’s Center adolescent medicine specialist Renata Sanders, M.D., M.P.H., Sc.M. She is the study’s first author and an associate professor of pediatrics at the Johns Hopkins University School of Medicine.

From August 2017 and January 2021, researchers surveyed 454 teenagers and young adults who are Black or Latinx. Most (385) identified as gay or bisexual, 65 identified as transgender women, and 389 identified as men. All of the subjects were between the ages of 15 and 24 and lived in Baltimore, Philadelphia, Washington, D.C., or St. Petersburg/Tampa, Florida — urban locations that have high rates of HIV and unstable housing among youth. Participants were recruited through peers, advertisements on webpages and in social media, and flyers at clinical sites serving lesbian, gay, bisexual and transgender youth, community-based organizations and events. The study included a 45-minute base line web-based survey and HIV testing. The average age of participants was 21, and about 15% of participants identified as transgender.

In addition to questions about their gender identity, experiences of sexual violence, substance abuse and financial well-being, participants were asked, “Have you ever had sex with a male in exchange for money, a place to stay or food?”

Some 22% (slightly more than one in five respondents overall) reported engaging in transactional (survival) sex. Among survey participants with HIV, 32% reported survival sex experiences. The researchers say a positive response to the question about transactional sex was associated with transgender identity, unstable housing in the previous 12 months, poorer perceived financial well-being, coerced sex and marijuana use. Youth and young adults who had a job were less likely to be engaged in transactional sex. 

“A lot of the people who identify as sexual minority men or transgender woman are vulnerable and may not be accepted in their own personal environments or families,” Sanders says. “They are often displaced, and they don’t have a place to stay, which puts them at risk for transactional or survival sex and HIV.”

In addition, the researchers found that transactional sex was associated with substance use disorder. In particular, “alcohol or marijuana use may be a way of coping with engaging in transactional sex or not having a place to live,” Sanders says. More than 25% of all participants who reported using substances engaged in transactional sex, with 31% of tobacco users, 27% of marijuana users and 26% of alcohol users reporting transactional sex. Marijuana use was associated with transactional sex among young sexual minority men, while alcohol use was associated with transactional sex among youth living with HIV.

Researchers noted some limitations in the study. For example, while there was a wide recruitment of participants, the results may not represent all sexual and gender minority youth in this age group, including youth in rural areas. Also, the survey results are based on the participants’ experiences, and in some situations, youth may underreport transactional sex, or may not view sex to survive as harmful or placing them at risk.

The researchers plan to devote future studies to building and testing interventions that address economic, housing and social vulnerabilities that predispose sexual and gender minority youth and young adults to transactional sex.

For now, Sanders says health care providers, parents and others involved with sexual and gender minority youth should screen them for vulnerabilities and other health inequities, and link them to information about preventing sexually transmitted infections including HIV. Health care providers can encourage the use of condoms and pre-exposure prophylaxis medication, which can prevent HIV transmission. Parents should also talk with their adolescents and create a safe environment that accepts them, even if they don’t agree with or understand aspects of their sexual or gender identity. The goal, Sanders says, is to help those at risk understand that they are not alone, and that resources to help them are available from health professionals, community organizations and elsewhere.

The research was supported by the National Institutes of Health (R01DA043089), through the National Institute on Drug Abuse and the Johns Hopkins University Center for AIDS Research (P30AI094189).

Other scientists who contributed to the work are Aubrey Alvarenga from the Johns Hopkins University School of Medicine; Noya Galai, Ph.D., Andrea Wirtz, Ph.D., M.H.S., Chris Beyrer, M.D., M.P.H., David Celentano, Sc.D., and Joyell Arscott, Ph.D., from the Johns Hopkins Bloomberg School of Public Health; ; Rashida Carr from Children’s National Hospital; Alexander Lopez from Children’s Hospital of Philadelphia and Rebecca Nessen, M.P.H., from Metro Inclusive Health.

Click here to see the original study