White House Holds LGBT Health Conference

PHILADELPHIA -- The White House rolled out its first campaign-season LGBT conference Thursday, one focused on health care issues facing the community and headlined by Secretary of Health and Human Services Kathleen Sebelius. The conference series was first announced by the White House last month.

Sebelius didn't break big news on health care initiatives during a morning address at Philadelphia's Thomas Jefferson University. But the White House's engagement on the issue, coupled with the HHS secretary's attendance, brought national visibility to what Sebelius accurately described as a health care system that has been "especially broken for LGBT Americans," who have lower rates of coverage and have been historically excluded from federal health surveys.

"Given the discrimination that often is faced in the workplace, LGBT Americans often have a harder time getting access to employment-based coverage," Sebelius said at the conference, also attended by gay White House officials including Gautam Raghavan, the LGBT liaison in the Office of Public Engagement; and John Berry, director of the Office of Personnel Management.

But "all Americans, regardless of where they live, what age, sex, race, sexual orientation, or gender identity, have a basic right to get the health care they need here in the United States, and that's a principle we are committed to fighting for in this administration," Sebelius said.

The speech was similar in tone and structure to Sebelius's address before the National Coalition for LGBT Health in October, where she enumerated the administration's regulatory accomplishments over the past three years -- most famously a hospital visitation mandate for same-sex couples -- and touted health care reform as a major step toward improving health care access for the community. The U.S. Supreme Court will hear arguments on the law's constitutionality in late March.

The lack of marriage rights can be a major barrier to care, as Sebelius discussed with The Advocate in an interview published last month. President Obama has endorsed legislation to repeal the Defense of Marriage Act, which prohibits federal recognition of same-sex marriages, though the White House has not budged in recent months beyond talking points of the president "evolving" on the issue of full marriage rights and opposing "divisive and discriminatory" measures against same-sex couples -- this in reference to anti-gay marriage ballot measures in states such as North Carolina and Minnesota.

The issue-specific LGBT conferences, ranging from HIV/AIDS to aging-related and antibullying efforts, are slated to take place around the country over the next several months, ending in June. Invites have already been sent out for a March 9 event in Detroit focused on housing and homelessness.

At the Creating Change conference last month in nearby Baltimore, Shaun Donovan, the secretary of Housing and Urban Development, announced the agency had finalized a rule prohibiting antigay and antitransgender discrimination in housing programs that HUD oversees. The rule, Donovan said at the January conference, "says clearly and unequivocally that LGBT individuals and couples have the right to live where they choose."

Donovan has stood out in pushing the envelope on LGBT rights in Obama's cabinet, coming out ahead of the president in support of full marriage equality last November.

The Democratic Party has been urged to follow suit by supporting a pro-marriage equality platform with inclusive language on the issue, as proposed earlier this week by the group Freedom to Marry. A spokesman for Rep. Nancy Pelosi told Metro Weekly Tuesday that the House Democratic leader supports the proposed language (read the report here).

Another trending topic discussed Thursday was that of cultural competency standards for health care professionals treating LGBT patients. There are no uniform standards for doctors and medical staff on how (and how not) to treat LGBT individuals. Sebelius said in January that she does not necessarily believe codified regulation needs to be implemented, though the Office of Minority Health is working to add sexual orientation and gender identity into the language of its Culturally and Linguistically Appropriate Services in Health Care standards.

Liz Margolies, founder and director of the National LGBT Cancer Network, said mandatory training is essential for creating a health care environment where the specific needs of LGBT patients are thoroughly understood and addressed.

"Offering optional cultural competency is simply preaching to the choir," said Margolies, who attended Thursday. "The people who don't get it are the people who probably need it. So the only way to make a difference is to make sure every single person is trained."

Such training should not be limited to medical school programs, she said: "Think of how many people you see and talk to during an emergency room visit before you are even seen by a doctor."

Of the conference, Margolies said that face time with White House officials was highly important, though the campaign value of the event for the administration was also clearly evident. "There's an amazing amount of talent in this room. It's only with all of us screaming and pushing persistently that we're going to make any difference."

On Thursday, Secretary Sebelius also called for reinvigorating domestic HIV/AIDS prevention efforts, remarking that given the continued steady infection rate nationwide, "frankly, what we've been doing is not very good." The president's 2013 budget, released earlier this week, calls for modest increases in HIV prevention efforts for high-risk groups, including gay men and African-Americans.

"The most frustrating thing is that there's now very good data about how prevention can work, about how to reduce partner-to-partner transmission, early identification and treatment," Sebelius said in the January interview. "And yet we have 50,000 new infections popping up. It just doesn't make any sense. So we've got to redouble our efforts on the education front and outreach front to really drill down into the communities most at risk."

The Obama budget also calls for an additional $75 million for care and treatment through the Ryan White HIV/AIDS program.

Off-the-record sessions for attendees during the Thursday conference focused on aging, LGBT youth, transgender health, cultural competency, and "engagement opportunities with the White House and HHS."

Dr. Scout, a transgender health advocate with The Fenway Institute in Boston, said the conference "didn't have so much new information," though "its real value is in the fact that it exists."

"We can grumble about how much needs to be done on LGBT health at HHS, and we should, but today the Administration really showed up for us," said Dr. Scout, whose organization received a $250,000 grant last year from the Health Resources and Services Administration to create a national training center for improving LGBT health. "If more healthcare policymakers showed the commitment the people here did, LGBT health disparities could be practically eliminated. Our huge smoking disparity, our access to care problems, our mental health disparities, all of it could be virtually wiped out with smart policies like the ones we heard talked about today."

However, to his disappointment, Dr. Scout said that agencies with substantial power over LGBT health issues, such as the Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality, didn't have staff in attendance, "which frankly is what I expected considering their lackluster performance in this area. I really do love what was being said today, but we need to start noticing what's not being said too, and who didn't even show up."

Sebelius, who has been tapped by Obama campaign officials to speak at super-PAC events for the reelection effort, attended a Washington, D.C., fund-raiser last week with the president that drew a who's who of major LGBT Democratic donors paying $35,800 each for a $1.4 million overall haul. Cohosts of the event included GeoCities founder David Bohnett, Gill Foundation founder Tim Gill, and Laura Ricketts, co-owner of the Chicago Cubs.

After the jump, the Secretary's full remarks to the conference as prepared for delivery.