Biden must earn the LGBTQ community's trust on vaccinations, experts say

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Advocates say the Biden administration must do what it can to reach out to marginalized communities proactively.

LGBTQ advocates and policy experts say the Biden administration must take steps to ensure queer, transgender, and/or nonbinary people have access to COVID-19 vaccinations and testing, free of discrimination.

The Center for American Progress's LGBTQ project on Monday called on the White House and federal agencies, as well as state and local governments, to develop "a strategically coordinated effort to implement policies in the areas of public health and health care," among other things.

They also recommended better data collection on sexual orientation and gender identity in COVID-19 testing and the release of people in immigration detention who are particularly vulnerable during a pandemic, including LGBTQ people and individuals living with HIV.

The Biden administration has already taken several steps to advance LGBTQ equality and signal its support of the community. President Joe Biden recently signed an executive order to implement a landmark Supreme Court decision that says federal agencies cannot discriminate against LGBTQ people based on sex and took steps to reverse the transgender military ban.

Biden's pick for assistant health secretary, Dr. Rachel Levine, who headed Pennsylvania's health department previously, has also demonstrated that her priorities include addressing health disparities for LGBTQ people. Levine is expected to be the first transgender official to be confirmed by the Senate.

Biden also set up a COVID-19 Health Equity Task Force for "mitigating the health inequities caused or exacerbated by the COVID-19 pandemic," that included considerations for "sexual and gender minority groups."

Caroline Medina, a policy analyst for the LGBTQ research and communications project at the Center for American Progress, said that the Biden administration can continue the work it began with the executive order on Bostock v. Clayton County and communicate to states, grant recipients, and federally funded providers that discrimination based on gender identity and sexual orientation is illegal and that they will be enforcing the law in all areas of health care.

LGBTQ people regularly face medical discrimination, with 15% of all LGBTQ respondents and 28% of transgender respondents in a 2020 Center for American Progress survey saying they put off or avoided getting necessary health care because of disrespect and discrimination.

Medina said there is reason to believe that this discrimination has presented itself in health care related to the pandemic as well. Guidance from the federal government would help to protect LGBTQ people from discrimination in the vaccine distribution process, among other things.

"I think a good example of what discrimination could look like in a [vaccination] setting would be related to ID requirements and incidents where a trans person is denied access to the vaccine because their government-issued ID doesn't reflect their gender identity," Medina said. "... So I think guidance ensuring nondiscrimination in those settings would be super important."

The group also called on the federal government to require data collection on LGBTQ people for COVID-19 testing and vaccination by the U.S. Department of Health and Human Services and to do an audit of the population in immigration to detention so that people at the highest risk serious illness from COVID-19 can be released.

LGBTQ advocates said it is key for the federal government and state and local governments to prioritize outreach to the community through groups that advocate for and provide health care for queer, transgender, and/or nonbinary people

Mardi Moore, executive director of OutBoulder County in Colorado, said that for many LGBTQ people, including transgender people who experience discrimination at the doctor's office or lesbian, gay, and bisexual people who remember how they , it is understandable to have distrust of the medical community.

Mardi Moore, executive director of OutBoulder County in Colorado, said it was understandable that many LGBTQ people, specifically transgender people who experience discrimination at the doctor's office or lesbian, gay, and bisexual people who were listed as having a mental disorder until the 1970s, were distrustful of the medical systems that have historically mistreated them.

She said it was incredibly important for governments to work with organizations like OutBoulder to convey to LGBTQ communities that they could trust the vaccines.

"We will advertise [them] as trusted messengers and get the message out [...]," Moore said.

The Biden administration largely agrees with this approach.

Dr. Marcella Nunez-Smith, a professor at Yale University who is the head of Biden's COVID-19 equity task force, told the New York Times last month that it was important to make sure groups that have experienced discrimination and distrust the health care system, including LGBTQ people, have "trusted messengers" who "have answers and consistent messaging."

"It is completely rational for [marginalized groups] to have a healthy degree of skepticism. We have to start the conversation there and acknowledge that there are groups in our country that have not really received the respect and the fair treatment that they deserve," she said.

She added, "It is very frustrating when people are like, 'Oh these folks aren't educated.' We need to understand why people have this apprehension."

Published with permission of The American Independent Foundation.