The Nashville and Middle Tennessee Community Visioning Project (2019)

AN INITIATIVE OF

INTRODUCTION

The LGBTQIA+ movement has witnessed wins that an earlier generation would have thought impossible, from the legalization of same-sex marriage to a U.S. President acknowledging LGBTQIA+ rights in his inaugural address to the nation. However, as the push for full legal equality for LGBTQIA+ people in the United States continues to advance, the movement still faces a series of questions about the future in Tennessee, our nation, and around the globe. The truth of the matter is: growing up and living authentically in the South is still as terrifying as ever for many people in our community.

The centerpiece of the Nashville + Middle Tennessee LGBTQIA+ Community Visioning Project is to create an ongoing dialogue and develop a collective vision for the future of the community. Ensuring that all LGBTQIA+ people in Middle Tennessee can thrive as full and functioning members of society is a simple idea, but it is also a revolutionary one. As we work toward this goal, we acknowledge that equality must include the most marginalized members of our LGBTQIA+ community, including indigenous, poor, disabled, and people of color.

The desire and message is simple: In our human diversity, we all deserve acceptance and the opportunity to prosper. No matter what, who you love and where you live should never determine your rights, access to services, or ability to thrive.

We acknowledge that the survey meetings, data collection, and report process were completed on the traditional, ancestral, and unceded territory of the Cherokee and Shawnee people. We also acknowledge that the state of Tennessee was heavily involved in the exploitation of enslaved black people, which is a crime against humanity, and reparations to members of this community are due.

ACKNOWLEDGEMENT OF PRIVILEGE

Across the world, those who are minoritized face discrimination, persecution and stigma. LGBTQIA+ people encounter this every day as they attempt to live authentically. As LGBTQIA+ people push back against heteronormativity, they often face emotional and physical violence. Narrow-minded people who refuse to acknowledge the change and progress in our society often take their ignorance and discomfort out on members of the LGBTQIA+ community, whose mere existence might challenge their outlook. As it relates to LGBTQIA+ history, the very beginnings of the movement for equity were sparked by riots led by transgender activists of color. However, white supremacy has created a system by which those who were often most visible within the fight for LGBTQIA+ rights were gay, white males. Of course, this isn’t to say that racial and sexual minorities within the community weren't organizing and leading movements – they were often unacknowledged trailblazers in various aspects of the equal rights movement. The power structures within society extend the most privileges to affluent, white cis-men, which has led to marginalization and omission of the complex and important histories of LGBTQIA+ people of color.

Throughout this research process, our team was aware of how our various privileges influenced how others perceived and interacted with us, and more importantly, made our participation in this research possible. Because the research team was almost entirely volunteer, it did not reflect the diversity of our broader community; the members of our research team are all white, cis-gender passing, and socioeconomically stable. Although we made concerted efforts to include trans and gender expansive members, as well as LGBTQIA+ people of color and poor people, our final research team did not reflect these efforts, and our research is weaker because of it. Moving forward, we pledge to work harder and allocate the resources to include all voices from our community in this work, especially in leadership roles.

WHY LGBTQIA+ ?

The acronyms and terminology used to describe the lived experience of members of our community are constantly evolving. Because the language that we use can shape our movement, everyone should be reflected and acknowledged as we discuss the members of our community. We believe that the term ‘LGBTQIA+’ reflects a fuller and more complete picture of our lived experiences. We hope that using the term ‘LGBTQIA+’ allows for the most unity within our community and raises awareness of those who may otherwise not be seen. Our strength is found when the community works together. Rather than taking umbrage over a single term, let’s focus on ensuring inclusion and working together to make the world better for every member of our community.

REASONING

WHY WAS THIS NEEDED?

As GLAAD President Sarah Kate Ellis said, “Forward progress ebbs and flows in every social justice movement. Progress for marginalized communities is a pendulum that swings in both directions, but ultimately lands on freedom.” We LGBTQIA+ people are already everywhere. We are born at the same unstoppable pace in every state—North, South, red, blue—and to every household, religious or not. The fact is, there is vitality in the lives of gay, lesbian, bisexual, transgender, and gender-expansive people, especially in the South where it is often least expected. We are bonded together by the pressure of bigoted policies and legislative threats on a state and national level, most notably under the current administration. We need each other because we are still climbing up from the bottom. Over the next few years, laws will come, and laws will go. It is certainly possible that things may get worse for LGBTQIA+ people before they get better, especially when tolerance of LGBTQIA+ people has slipped over the last yearA. What we must remember is that being a member of this beautiful community is itself forever. It is also everywhere—and irrefutably American.

There is no denying that Tennessee has earned a reputation as one of America’s friendliest states in many respects. Still, it is also the state responsible for draconian “Slate of Hate” bills in the most recent legislative session. We LGBTQIA+ people refuse to be complacent. Our communities welcome new residents, workers, and visitors hailing from destinations worldwide because a Tennessee that is diverse and accepting of all people thrives. Specifically, Nashville and Middle Tennessee have seen continual growth over the last decade, adding 400,000 residents from 2007 - 2017. By 2020, the area is expected to have 2,000,000 people, with another 1,000,000 projected to move to the region over the next two decadesD. The LGBTQIA+ community in Davidson County and the immediate surrounding counties is estimated to be between 6.5 - 10% of the population according to the Williams InstituteB. With the growth the region has experienced and will continue to experience, understanding the needs of our community is of paramount importance.

In the fifty years of tracked history of the Nashville LGBTQIA+ communityC, there has not been a community-wide conversation that tracked the specific needs of the residents who identify as gender or sexual minorities. The goal of this program was to understand what members of our community need to thrive. By engaging in conversation that was far-reaching, meaningful, transparent, and action-oriented, we can create revolutionary change for our community members. As Gloria Steinem said, “Revolutions, like trees, grow from the bottom up.” The movement for full acceptance and full equality for LGBTQIA+ people is the revolution that we must fight now. To liberate our LGBTQIA+ community throughout the region, so that we can all thrive, we must understand the needs of our community.

PROCESS & METHODOLOGY

Over the course of five months, our research team hosted a series of conversations throughout Middle Tennessee at a variety of times, spaces, and regions to hear from members of the LGBTQIA+ community. We conducted outreach for participants in the conversations and survey in a variety of ways, including paid, print, and online media; email; word of mouth; and traditional marketing methods.

WORLD CAFE

Over the course of the research phase, we hosted a total of ten World Cafe sessions. These sessions were a combination of public and invite-only conversations to ensure maximum diversity of participants. These conversations consisted of small group and facilitated conversations. Average attendance at these conversations was forty-five.

SMALL GROUP

Starting in late June, we hosted a total of 70 different small group conversations throughout Middle Tennessee. A majority of these conversations targeted individuals with specific identities, age ranges or interests. Each conversation was facilitated. The average attendance of these conversations was twelve.

ONLINE

At the start of Nashville Pride Week (6/22/19), the online version of the Community Visioning Project survey went live and over the course of three months engaged 1,236 respondents. This survey asked very similar questions to the in-person conversations and respondents were able to indicate their top priorities and issues.

WHAT DOES THE NASHVILLE & MIDDLE TENNESSEE LGBTQIA+ COMMUNITY NEED TO THRIVE?

84% 82%

of participants indicated that the creation of a centralized, safe, sober space for the LGBTQIA+ community is a priority.

65%

of participants reported that specific programming and resources for LGBTQIA+ older adults (55+) is a priority for Middle Tennessee.

71%

of participants reported that access to affordable and affirming healthcare is a priority.

of participants reported that specific programming and resources for LGBTQIA+ young adults (13-26) is a priority for Middle Tennessee.

of participants expressed a need for a centralized collection of resources.

of participants expressed a need for more visibility year-round for LGBTQIA+ life throughout the region.

OUR COMMUNITY

could name resources in our community and indicate visible supports in Middle Tennessee. Participants noted many successes in terms of increased LGBTQIA+ visibility in Middle Tennessee, including the 75,000 people in attendance of the most recent Nashville Pride Festival & Parade, the positive steps that ensure an equal playing field for LGBT owned businesses in Metro Nashville contracting, and the inclusion of LGBT liaisons within Metro Nashville Police and Fire Departments. Over the last decade, Nashville has become a destination of equality for many LGBTQIA+ people throughout the region and nearby states.

PARTICIPANT DEMOGRAPHICS

2,276 WE HEARD FROM LGBTQIA+ PEOPLE

PARTICIPANT LOCATIONS

MIDDLE TENNESSEE

52% DAVIDSON COUNTY

19% WILLIAMSON COUNTY

11% RUTHERFORD COUNTY

5% WILSON COUNTY

5% MONTGOMERY COUNTY

6% CHEATHAM | ROBERTSON | SUMNER COUNTIES

2% SHELBY | MAURY | MARSHALL | BEDFORD COUNTIES

LGBTQIA+ organizations currently serving Middle Tennessee should work together in unity towards full acceptance & equality of our community.

SECONDARY RECOMMENDATIONS

Participants recommend the creation and management of an online and in-print centralized collection of regional LGBTQIA+ affirming services and resources.

Participants recommend the creation of programming and services that specifically target LGBTQIA+ older adults and their needs .

Participants recommend the creation of programming and services that specifically target LGBTQIA+ young adults under the age of 26.

Participants recommend the alignment of resources that would address the unique health needs of the LGBTQIA+ community.

Our community recommends establishing a safe and centralized space that is accessible to all members of the LGBTQIA+ community, especially those most marginalized.

RECOMMENDATION ONE

LGBTQIA+ organizations currently serving Middle Tennessee should work together in unity towards full acceptance & equality of our community.

35+ organizations specifically address LGBTQIA+ issues in Middle Tennessee. These range from small nonprofits and large local groups to statewide organizations and chapters of national organizations.

73% nearly

of conversation participants expressed the desire for more unity in our community and between our nongovernmental organizations.

90% nearly

of conversation participants shared a need for a centralized asset to learn about and connect to all LGBTQIA+ events, resources, affirming (and LGBTQIA+ owned) businesses, and programming.

Collaboration and unity among LGBTQIA+ organizations is not a new idea; it is intrinsic to the very nature of the movement for progress. Unity led the charge at the Stonewall Riots, the Compton’s Cafeteria Riots, and the movement to achieving marriage equality. The modern day LGBTQIA+ movement has certainly increased in size and strength since then, but today too many of our organizations are working in isolation. In order to achieve the radical social change and unity that our community desires, we must focus on how we can make a collective impact. The key to unleashing the power of the LGBTQIA+ movement in Tennessee and throughout the southern United States is to focus on solidarity, full inclusion, and engagement. Our organizations must not only work in concert with one another, but also ensure that our movement is intersectional by finding every opportunity to engage other marginalized groups.

The movement that we are engaged in has already determined a common agenda—to achieve full and complete equality for all members of the LGBTQIA+ community. In order to do that, we must have a shared vision on how we address the issues that we face.

Collective impact takes us from common goals to uncommon results.

Following the PULSE nightclub massacre in Orlando in June of 2016, Central Florida experienced incredible unity, which led to the birth of the One Orlando Alliance. In many ways, that senseless tragedy was the seeds from which the alliance grew, as it motivated community members and leaders to come together to address the community’s needs. While Nashville and Middle Tennessee have thankfully not experienced such a tragedy, the model that was created by the One Orlando Alliance has transformed the region and created a more accepting and unified community for all LGBTQIA+ people.

In the Middle Tennessee region, the Center for Nonprofit Management has created a number of programs that focus on solving complex problems through collective impact. In order to fulfill the recommendation from the Community Visioning Project, participants recommend the creation of a council or alliance of our LGBTQIA+ organizations that engage in this work throughout Middle Tennessee.

AN APPROACH TO COLLECTIVE IMPACT

Come together to address our concerns. Establish shared goals for our regional movement. Coordinate collective efforts to maximize the end result. Build a culture that fosters relationships, trust, and respect. Customize strategies and build plans that are local first.

Our community recommends establishing a safe and centralized space that is accessible to all members of the LGBTQIA+ community, especially those most marginalized.

of participants indicated that the creation of a centralized, safe, and sober space for the LGBTQIA+ community should be a top priority.

70% 75% 50%

of participants report a need for an LGBTQIA+ safe space that isn’t predominantly associated with drinking and nightlife.

of participants expressed a need for tailored services for those most marginalized in the LGBTQIA+ community, including youth under 26, older adults, queer people of color, transgender and gender non-conforming people, and disabled members of our community.

of participants indicated a need for services and programs that were accessible by a comprehensive public transit system.

Every community relies on services to help meet social, political, and economic needs. Many communities have centralized these services in a single community center that provides wrap-around support and solves a variety of problems. Every community is made up of unique individuals, situations, desires, and hopes, and in order for a community to move forward together, those desires must be fully realized with an actionable plan to fulfill their needs.

Nashville has a history of community centers that provide a variety of services; however, only two have specifically focused on LGBTQIA+ issues. Unfortunately, for a number of reasons, our most recent LGBTQIA+ center, OutCentral, closed in the Spring of 2018. In the year leading up to closure of OutCentral, numerous issues plagued the facility that dramatically affected its operations. The lessons learned from the final years of OutCentral's operations must actively inform the planning and development of a new community space. A new community space must be built with sustainability in mind. Models for effective service provision abound in Middle Tennessee-Nashville CARES, Street Works, and Neighborhood Health have partnered to provide a one-stop health and wellness community center for same gender loving men of color and gay/bisexual men at My House Nashville. Support services include a drop-in and event space with programming, HIV and STI testing, prevention education, medical care, access to PrEP, and other integrated activities.

Throughout the engagement period of the Community Visioning Project, it became clear that the participants felt a need for a comprehensive facility that would provide a variety of services and act as a clearinghouse for the needs of LGBTQIA+ people throughout Middle Tennessee. It was also evident that these needs are not only present within Nashville, but also in the nine county region of Middle Tennessee. As we move forward as a community, we learn from past and current projects in the hopes of creating an accessible space that serves all of LGBTQIA+ Middle Tennessee.

In their own words…

DATA ON LGBTQIA+ CENTERS

• There are approximately 130 LGBTQIA+ centers around the United States.

• On average, LGBTQIA+ centers around the United States serve 40,000 people a week.

• 9 out of 10 LGBTQIA+ centers operate a physical space.

• Of these centers, 45% have an annual budget under $150K and 55% have an annual budget over $150K.

We badly need a primary community space/center. There are events like Pride and several smaller groups within Nashville that unite parts of the community, but a LGBTQ+ community center is what's been missing since OutCentral closed. Nashville is growing by leaps and bounds as a city, and still we truly lack a "community" base in Nashville. So many other metropolitan areas through out the U.S have these areas/spaces that we should mirror and learn from. Participant, Age 35

PROGRAMS

Throughout the data collection of the Community Visioning Project , community members shared a variety of programs and services that should be available in a community space. Participants indicated a desire for a wide range of programming-including social and recreational activities, arts and culture, health and wellness, legal services, and policy and advocacy for community members. Community centers that thrive are those that regularly engage community members to determine their desired services and tailor programming to the needs of their communities.

DESIRED PROGRAMS

Social + Recreational Arts + Cultural Health + Wellness Legal Services Policy + Advocacy Education

Safe + Affirming Fitness Opportunities

Art Gallery + Display Space

Affirming Physical + Mental Healthcare

Friendly Legal Referrals

Increased policy awareness and messaging

Employment

Counseling + Training

LGBTQIA+ specific support groups

Film Screenings (Film Festival)

Affirming Family Planning + Parenting Resources

End of Life and Healthcare Planning

Opportunities for involvement in local + state politics

Financial Literacy +

Financial Planning

Referrals to

LGBTQIA+ businesses Performance Spaces

HIV/AIDS Prevention + Treatment

Hate Crime Reporting

Advocacy training for community Computer Training + Computer Lab

Wide ranging Youth +

Older Adult programs

Book Clubs

Transgender +

Gender Affirming Healthcare Legal Document Preparation

- -

SPACE + LOCATION

During the engagements that took place in person, participants were given opportunities to share specific ideas about what a community center or space should include, along with ideal locations within Davidson County, as the conversation dictated. While a majority of our participants live within the county, participants expressed the desire to see services extend beyond Davidson County into the nine county region of Middle Tennessee, specifically in Murfreesboro, Goodlettsville, Hendersonville, Mount Juliet, Franklin, and Clarksville.

Across the country, 90% of LGBTQIA+ Community Centers have a physical space. Many centers are also developing “pop-up” and "portable" facilities in a number of locations.

Middle Tennessee is large, diverse, and geographically spread out, so we must be thoughtful about how we can have the greatest impact and reach the greatest number of community members. An additional concern was the accessibility of the space; over 50% of participants stated that it was important to have access to a transit system that allows them to reach vital services. Participants also indicated a desire for services that are accessible to those who live in the surrounding nine country region, as well as those in more remote or rural areas of Tennessee.

Participants in conversations often indicated a need for spaces where community members could congregate, including coffee shops, bookstores, libraries, restaurants, galleries and event spaces. With further reflection and analysis, our research team determined that a community center would best meet the needs and most clearly align with the desires of the community at large.

SECONDARY RECOMMENDATIONS

RECOMMENDATION ONE

The Community Visioning Project participants recommend the creation and management of an online and in-print centralized collection of regional LGBTQIA+ affirming services and resources.

Ideally, this would include detailed information about physical and mental healthcare services, open and affirming faith communities, events and social gatherings, and LGBTQIA+ businesses and spaces in the community.

Middle Tennessee has a variety of friendly, affirming, and accessible resources and services that are open to all members of the LGBTQIA+ community, but participants repeatedly shared the need for a centralized collection of these resources. While vital resources continue to be available to members of our community, many of these resources are shared only via word of mouth and are difficult to locate online or in print. Participants also stressed the difficulty of finding current, up-to-date lists of resources.

Major metropolitan markets nationwide have a variety of methods to share resources with members of the community, from Pink Pages to directories with LGBT Chamber of Commerces to local websites and mobile applications. LGBTQIA+ Nashvillians do not have a centralized resource that provides a listing of these services in one place; instead lists are piecemeal based on specific interests, organizations, topics, or concerns.

Nearly 90% of our in-person conversations, including the World Cafe programs and small group meetings, touched on a need for a centralized database of services and resources. Although the survey did not specifically ask about a directory, many respondents added comments about the need for such a collection of resources. The creation of a database of LGBTQIA+ identified services, locations, resources, and businesses would allow members of our community to be in the know. Additionally, organizations would benefit as they would have further reach and could serve more participants. With community participation and organizational support, the collection could serve as a comprehensive resource for our community.

DETAIL

Throughout the research phase of the Community Visioning Project, participants shared numerous resources and assets that would allow our community to successfully navigate LGBTQIA+ life. Participants suggested everything from applications to mobile responsive websites to even print magazines as potential solutions that would consolidate and coordinate resources.

PRINT ONLINE MOBILE

Print still plays a very important role in our culture and community. Larger metropolitan areas around the country have resources like the Gay Yellow Book, the Pink Pages, and print directories in their regional LGBTQIA+ publications. Nashville currently has two publications that serve the LGBTQIA+ community. Participants suggested that our current printed publications could act as a resource or a guide for LGBTQIA+ people living in Middle Tennessee, similar to the Austin, TX, Field Guide.

As the internet has become more accessible for most members of our community, a comprehensive website could be built to serve as a database for all of the resources available to LGBTQIA+ people in the region. Participants shared examples where they can find select information about local LGBTQIA+ resources in the community, but indicated a need for a more comprehensive, online resource that would aggregate the disparate offerings currently available.

Mobile applications have made an impact on the LGBTQIA+ community over the last decade. This, in part, has been spurred on by younger generations who are early adopters of technology. A mobile app or mobile responsive site could be a great resource by including a database to further connect the members of our community. One model is They2Ze, which provides resources for transgender and gender-expansive youth.

RECOMMENDATION TWO

The Community Visioning Project participants recommend the creation of programming and services that specifically target LGBTQIA+ older adults and their needs.

This includes affirming retirement and nursing homes, housing access and year-round homeless services, endof-life planning and advocates, intergenerational connections, and social initiatives

LGBTQIA+ older adults face unique challenges when seeking home- and community-based services, social services, and long term care. Many LGBTQIA+ older adults have experienced a lifetime of systematic discrimination and prejudice. Based on their gender, socioeconomic status, race, health and/or sexual minority status, many older adults spent much of their lives without access to the social institutions that would provide them critical support later in life—including access to healthcare, the right to marriage, family, and affirming employment and housing. Our community organizations must actively engage with LGBTQIA+ aging adults to meet their specific needs and better serve our Stonewall Generation.

65% 60%

of all respondents reported the need for more comprehensive programming for LGBTQIA+ older adults.

55% over nearly over of LGBTQIA+ older adult participants reported that affordable and welcoming housing within the region should be a priority.

of LGBTQIA+ older adult conversation participants reported feeling a lack of companionship; while over 50% reported feeling isolated from others.

DETAIL

According to the AARP, there are an estimated 3 million LGBTQIA+ older adults aged 50+ throughout the United States. The five plus decades of the LGBTQIA+ movement have brought unimaginable triumphs, from the birth of the Pride movement to marriage equality nationwide. Many members of the Stonewall Generation never expected they would galvanize the modern day movement for LGBTQIA+ equality and visibility, but their unapologetic dedication to our community cannot go unacknowledged. The movement for full equality would not be where it is today without this generation. However, as LGBTQIA+ older adults attempt to age with dignity and grace, they are met with new challenges.

According to Sage, aging LGBTQIA+ people are two times more likely to be single and three to four times less likely to have children. These issues directly affect the lives of older adults. According to AARP’s ‘2018 Maintaining Dignity’ survey, three out of four LGBT older adults (45+ for this survey) are concerned that they will not have support from family or friends when they grow older, and an overwhelming majority are concerned about how they will be treated in long-term care facilities.

Locally, groups like Fifty Forward, the Council on Aging of Middle Tennessee, the Tennessee Commission on Aging, and others have worked to identify the needs for older adults. Through a thoughtful and intentional collaboration with these groups, we can ensure that the Stonewall Generation is honored, respected, and able to thrive throughout their lives.

It is important to note that concerns about programming and resources for LGBTQIA+ older adults were raised by nearly 65% of respondents across all age groups. Participants, regardless of their age, indicated interest in services for older adults, including establishing affirming retirement and nursing homes, creating access to affordable housing and year-round homeless services, providing end-of-life planning and advocates, and fostering intergenerational connections and social initiatives.

In their own words…

The single issue that concerns me the most is access to LGBTQ affirming elder care that honors and respects my relationship with my wife as we continue to age without the benefit of children to act as advocates for us.

A topic of interest for many participants was the opportunity to make intergenerational connections with members of the LGBTQIA+ community of different ages. This desire for community aligns with concerns of loneliness and the lack of a safe, sober, accessible space to meet and make friends. Respondents under 40, in particular, indicated a desire for these intergenerational connections. An opportunity for this kind of connection would give members of the Stonewall Generation, who have paved the way for younger adults, the opportunity to engage and create meaningful friendships.

Participant, Age 55

According to SAGE, nearly 60% of LGBT older adults report feeling a lack of companionship, and over 50% reported feeling isolated from others. Recent research by Holt-Lundstad and colleagues (2015) indicates that the health risks of prolonged isolation have been shown to be similar to smoking 15 cigarettes a day. Therefore, providing social connections for our aging LGBTQIA+ community is vital. Aging in America can be filled with uncertainty for older adults of every identity, but it is particularly challenging for LGBTQIA+ older adults, who face issues including stigma, isolation and discrimination.

In their own words…

I would love to be more involved in every aspect of the LGBTQIA+ community in Nashville, but unfortunately I cannot attend the events if they are not accessible. It seems to me like the LGBTQIA+ organizations only care about and cater to their ablebodied members. We need our community to acknowledge and do more to welcome people with disabilities to be full members of our community.

Participant, Age 56

According to the National Resource Center on LGBT Aging, “A vast majority of LGBTQIA+ older adults have lived through discrimination, social stigma, and the effects of prejudice both past and present, including a history of being labeled as criminals, sinners and mentally ill.” Challenges related to these experiences put this population at significantly greater risk in a myriad of ways including access to health, safety, and public accommodation. Throughout the data collection phase during the Community Visioning Project, participants provided a number of recommendations that layer in the needs that LGBTQIA+ older adults need in order to thrive.

ADVOCACY

LGBTQIA+ older adults are far more prone to experience or have faced discrimination, social stigma, and the effects of prejudice according to studies completed by SAGEA. Additionally, it is more than likely that they will face poverty and homelessness, and have poor physical or mental health. Older adults are also four times more likely to not have children and twice as likely to live alone. These experiences show that there is a clear need for advocacy for older adults in our community. Over 70% of our conversation participants shared concerns that older adults do not have adequate programs and services that support their lived experience. In order to help our Stonewall Generation age with dignity, they deserve advocacy programs that allow them to live the highest quality of life possible.

In their own words…

We need a community space for LGBTQIA+ members of all ages to meet and develop friendships outside of a bar. It is so important to increase the casual sociability of the queer residents of Middle TN. We need programs and activities to educate and A place around me where I can meet other LGBT people my age.

Participant, Age 62

CONNECTION

LGBTQIA+ older adults are prone to a lack of companionship, as there are a serious lack of services and programs that provide opportunities for them to connect. According to a recent study from AARPA, nearly 3/4 of LGBTQIA+ older adults do not have access to specific social services, while over 75% of older adults are concerned about having these supports as they age further. Furthermore, transgender and gender expansive individuals are least likely to engage with social support services. An overwhelming majority of LGBTQIA+ older adults in the region who participated in our research shared the desire to have opportunities to engage in mentorship programs with youth and participate in specifically targeted programming focused on combating loneliness and isolation.

In their own words…

I need more opportunities to engage with members of the community, where I can meet new people and feel comfortable in the space. As a senior who can only drive at certain times of day, I want to find new opportunities for connection that are meaningful.

AFFIRMATION

Older LGBTQIA+ adults in particular fear discrimination in senior housing. In a 2018 survey by AARPB, more than a third of respondents said they were at least “somewhat worried” that they would have to hide their sexual identity in order to find new housing as they age. Nearly 60% of participants in the Community Visioning Project, over the age of 50 expressed that having access to affordable housing is a priority for them and something that they are concerned about as they age. As LGBTQIA+ older adults age, we found that our research follows the trends of national data expressing that more than 60% of participants would be interested in a LGBTQIA+ welcoming housing development if they could afford it.

76% 74% 85% 48%

of LGBTQIA+ older adults are concerned about having adequate family/social supports as they age.A

of LGBTQIA+ older adults do not have access to LGBTQIA+ specific senior services in their area.B

of nonprofit continuing care retirement communities are religiously affiliated.C

of LGB older adults have experienced adverse treatment when seeking senior homes.C

*The percentage is higher for transgender & gender expansive older adults.

Participant, 66

RECOMMENDATION THREE

The Community Visioning Project participants recommend the creation of programming and services that specifically target LGBTQIA+ young adults under the age of 26.

Ideal programming includes mentorship and job training, affordable housing access, year-round homeless services, developmentally appropriate resources for coming out and thriving, inclusive sexual and reproductive education, and evolving advocacy that responds to the political needs of the moment.

For the last decade, the LGBTQIA+ movement has made tremendous strides toward equality and inclusion. However, in national, statewide, and local studies, young people report serious and persistent challenges to their safety, happiness, and success. Despite these challenges, we continue to hear stories of youth empowerment, resilience, and activism. These stories share a bright hope for the future and demonstrate that LGBTQIA+ youth who are supported and provided proper programming can live full and meaningful lives.

72% nearly

of respondents reported a need for more programming for LGBTQIA+ youth and young adults ages 12-26.

60% nearly 63% over

of respondents under the age of 26 expressed the need for a safe and sober community space.

of respondents under the age of 26 expressed the need for job training, mentorship & educational opportunities.

Throughout the United States, LGBTQIA+ youth face a number of challenges that impact their existence and ability to thrive. In the southern United States, youth face specific challenges including lack of support from family, counseling and mental health support, and safety in schools. Further, LGBTQIA+ youth of color experience additional stressors due to the combined effects of racism, homophobia, and transphobia. Transgender and gender-expansive youth also face challenges that prevent them from thriving in our region, where many youth find limited support.

In their own words…

As a high school student in public school, my fellow trans students and I are subject to a lot of purposeful misgendering and disrespectful treatment from teachers/staff. We need our educators to have more workshops the address the importance of respecting identity, no matter how young the student.

The lack of support from educators and family, as well as the burden of rejection that many LGBTQIA+ youth face, impacts the way in which they move throughout this world. In order to live authentically, youth in our community need access to supportive services within the education system, the broader healthcare system, and within the family structure. In the state of Tennessee, no lawsA enumerate protections for LGBTQIA+ youth in schools in terms of bullying or discrimination. Despite positive steps within Metro Nashville Public Schools, thanks in large part to partnership with GLSEN and Oasis Center, there are still widespread issues related to school climate throughout the region that take a toll on the well-being of LGBTQIA+ youth in our region.

LGBTQIA+ youth with unsupportive families also face a host of issues including suicidal ideation, depression, drug use, and other risky behaviors. As a result of family rejection, discrimination, and criminalization, LGBTQ youth represent as much as 40% of the homeless youth populationB. According to Missed Opportunities: LGBTQ Youth Homelessness in America, “LGBTQIA+ youth and young adults are at more than double the risk of experiencing homelessness as their straight and cisgender peers, and those rates are even higher for LGBTQIA+ youth of color.”C

Throughout the Community Visioning Project, three themes came to the forefront of discussions concerning the programs and supports needed for LGBTQIA+ youth: mentorship and job training, housing and homeless services, and inclusive education. We understand the importance of providing necessary supports for the next generation to ensure that all members of our community can live full and meaningful lives.

Participant, Age 16

In Nashville and Middle Tennessee, there are a number of services and programs for LGBTQIA+ youth. Although participants did acknowledge these resources, they expressed a deep desire for more connections for youth under the age of 26 throughout the region. In addition, participants expressed a need for wrap-around services for members of the LGBTQIA+ community between the ages of 18-26, especially those most marginalized and without family support.

In their own words…

There is a desperate need for pro-active, bullying prevention programs in schools. Education in schools to educate the general student population about LGBTQ+ and promote acceptance. We also need more opportunities to meet other members of the community, outside of nightlife and expensive benefit dinners.

Participant, Age 19

MENTORSHIP & JOB TRAINING

LGBTQIA+ youth typically begin to disclose their sexual and gender identity during adolescence. The coming out process varies widely for each young person, and a number of factors that influence the experience. Studies have shown that youth who experience identity affirmation from family and receive strong external support report better academic performance, higher self esteem, and lower anxiety and depression. Further, family rejection is associated with substance abuse, mental health concerns, and social exclusion.

In order for young adult members of our LGBTQIA+ community to fully thrive, services and programs must be developed to help them achieve financial security and take advantage of new opportunities. While there are a number of job training, placement, and vocational programs throughout the region, young people expressed difficulty finding resources that will allow them to participate authentically as an out LGBTQIA+ person. Tennessee is one of 30 states that do not protect LGBTQIA+ people from discrimination, and local communities cannot pass their own non-discrimination laws. In addition to job training, a majority of youth participants indicated a desire for mentorship and connection with others. It is important to note that LGBTQIA+ young people often experience isolation because their families and community environments may not reflect their gender or sexual identities, so mentorship and connections with others in the community are vitally important.

In their own words…

My teachers never address any sex education when it comes to the LGBTQ+ community. The most oppressed group in the LGBTQ+ community is the transgender community who are ignored and alone and yet still receive even less information on their identities and how they can be safe in a sexually active environment.

Participant, Age 17

HOUSING & HOMELESSNESS SERVICES

LGBTQIA+ young people are 2.2x more likely to experience homelessness than their straight peers, and young people of color are even more likely than their white counterparts. Middle Tennessee must ensure that LGBTQIA+-sensitive outreach, drop-in centers, services, and housing options are located in or near communities most affected by homelessness. Data from the Missed Opportunities: LGBTQ Youth Homelessness in America report show a nationwide trend that young LGBTQIA+ people who experience homelessness have endured especially high levels of adversity. (See right) According to the report, “it is critical that new efforts integrate safe spaces, rapid and sustained exits from homelessness, positive adult connections, and culturally attuned mental and physical health supports into service plans for LGBTQIA+ young people.” We must push for the coordination of resources among the many service providers who aim to support LGBTQIA+ youth, especially those in crisis, including healthcare providers, houses of faith, and schools. In Nashville, LaunchPad works to address the crisis of LGBTQIA+ youth homelessness in the winter months. Additional resources are needed to ensure that year-round services are available for the many unhoused LGBTQIA+ youth in Middle Tennessee so that these young people can grow and thrive. We recommend the establishment of year-round homelessness services including affirming shelters and food pantries, affordable housing opportunities, and a queer roommate exchange to support, keep safe, and better the lives of LGBTQIA+ youth in Middle Tennessee.

INCLUSIVE EDUCATION

The state of Tennessee lacks both enumerated protections for LGBTQIA+ youth in schools and comprehensive, appropriate education about/for LGBTQIA+ students. According to the GLSEN Tennessee 2018 School Climate Report, only nine school districts out of 146 in Tennessee have enumerated protections for students based on sexual orientation, gender identity, and gender expression within their anti-bullying policies. GLSEN Tennessee also reported that 90% of LGBTQIA+ students reported regularly hearing homophobic remarks in school, over 80% reported regularly hearing negative remarks about transgender students, and 82% also reported harassment based on sexual orientation. With such devastating numbers of LGBTQIA+ youth enduring discrimination within the Tennessee school system, we must work harder to ensure enumerated protections, educational outreach, and youth services that help our students to thrive.

We recommend the establishment of queer sexual health and reproductive education programs outside of the public school system, training for school administrators and personnel around LGBTQIA+ inclusion, and advocacy to local school systems (public, private, and charter) to create and enforce LGBTQIA+ affirming policies and curricula. We understand that some of this work already occurs in Metro Nashville, however the need is great throughout the region. While this work is vital for all LGBTQIA+ students, we must be especially attentive to the needs of transgender and gender-expansive students and ensure that all programming and workshops address the unique needs and issues our school systems present for them. only only only only

27% 13% 12% 26%

of youth can DEFINITELY be themselves in school as an LGBTQIA+ person.A

of LGBTQIA+ youth can report hearing POSITIVE messages about being LGBTQIA+ in school.A

report receiving information about safe sex that was relevant to them as an LGBTQIA+ young person.A

of LGBTQIA+ youth report that they ALWAYS feel safe in their classrooms at school.A

of LGBTQIA+ youth reported REGULARLY hearing homophobic remarks in school.B

90% 82% 71% 69% of LGBTQIA+ youth reported harassment based on their sexual orientation.B

of transgender students were not able to use the restroom aligned with their gender.B

RECOMMENDATION FOUR

The Community Visioning Project participants recommend the alignment of resources that would address the unique health needs of the LGBTQIA+ community.

This can be accomplished by ensuring access and navigation to affirming and inclusive mental and physical healthcare, gender confirmation counseling and medical support, and by engaging in outreach and education to community healthcare providers.

LGBTQIA+ individuals worldwide encompass all races, ethnicities, religions and social classes—comprising the most diverse and beautiful fabric that we call community. Research at the national, statewide, and regional level all indicates that our community faces health disparities linked to social stigma, institutional discrimination, and the denial of civil and human rights. Understanding LGBTQIA+ health starts with understanding the history of oppression and discrimination that our community has faced and continues to experience.B Publicly available data show that discrimination against LGBTQIA+ people has been associated with higher rates of poor mental health, substance abuse, and suicide. Eliminating LGBTQIA+ health disparities and enhancing efforts to improve the health of our community is necessary to ensure that we all can thrive. Within our community, there are many resources and affirming healthcare providers, but many respondents indicated that they did not know how to access these services or were not aware of the breadth of opportunities available.

70% over

of transgender people believe that they would experience discrimination in healthcare because of their identityA

55% over

of LGB people believe they would experience discrimination in healthcare because of their identityA

60% over

of respondents indicated that LGBTQIA+ affirming healthcare services is a priority

Just over a decade ago, there were few options for comprehensive and affirming LGBTQIA+ healthcare throughout the United States, and even fewer options in the southern United States. The positive news is that there have been incredible advances to ensure more access for our community throughout the country, and particularly in our region. However, LGBTQIA+ people still experience a wide variety of disparities in access to care. Historically, limited research has explored healthcare access in our community; most recently, though, a combination of studies from NashvilleHealth, the Metro Health Department, and Vanderbilt University Medical Center’s LGBTQI Health Program have explored health behaviors within the LGBTQIA+ community.

In their own words…

There are a lot of members in this community who struggle with not only their identity, but also mental health. Many of my friends have been forced to undergo conversion therapy under a therapist who was meant for depression, anxiety disorder, PTSD, and other actual disorders they suffered with. Your identity can put you in situations that cause will aggravate these mental illnesses but your identity is not the illness. Safety is access to mental health specialists who are LGBTQ+ friendly.

Participant, Age 37

When NashvilleHealth surveyedA the health literacy and other measures of wellbeing in both LGB and heterosexual populations, LGB individuals indicated higher health literacy, but reported engaging in nearly half the rate of some preventative medicine practices. They also reported twice as many days of bad health per month than heterosexual respondents and had lower rates of healthful behaviors like consistent exercise and healthy eating habits. These findings hold despite the fact that LGB people have nearly even rates of chronic health conditions like diabetes, hypertension, and COPD, and have better access to stores where healthy food is sold.

While the Community Visioning Project only addressed trends in healthcare needs, and did not address specific or personal health data, a majority of respondents indicated a lack of access to affirming physical healthcare. In conversations, some respondents reported discomfort in discussions of sexuality and gender with their providers, expressing fears that their providers may not be prepared to respond to LGBTQIA+ concerns. In order for patients to be open and honest in their communication with healthcare professionals, providers must focus on building trust with their patients, and patients must understand that their providers are supportive and affirming. Several respondents indicated that a database of affirming healthcare providers, as well as a consolidation and streamlining of resources, would improve their healthcare access in Middle Tennessee.

The Nashville Community Health & Well-being SurveyA indicated that LGB people were more likely to report lower social support and more days of bad mental health, even though LGB people in Nashville have higher treatment rates for mental health concerns. Similarly, many Community Visioning Project respondents indicated concerns about mental healthcare in Middle Tennessee, expressing a need for affirming providers and accessible services. Participants shared concerns about their own ability to receive treatment and the resources they needed to deal with the discrimination and trauma they have faced living in the South.

DETAIL

Roughly a third of individuals reported that they lack access to LGBTQIA+ affirming healthcare. Importantly, this need was present in all three age groups (<26, 26-54, >55) and across all demographic factors. Conversation participants of every age group expressed that access to affirming and knowledgeable mental and physical healthcare providers for LGBTQIA+ people was a necessity in our region. Some respondents highlighted the recent attempts to enact ‘religious freedom’ laws that would allow counselors and healthcare providers to discriminate based on LGBTQIA+ status, expressing fears that their providers may not be open or affirming.

ACCESS TO PHYSICAL + MENTAL HEALTHCARE

Participants repeatedly mentioned that one of their greatest concerns was the affordability of health insurance and healthcare. According to the recent NashvilleHealth survey, roughly 30% of LGB people live without health insurance, compared to 7.5% of their heterosexual counterparts. Additionally, LGB people in the region have experienced an average of 10 poor mental health days out of a month, compared to only 4 for heterosexual counterparts.

Over 75% of our participants expressed that having access to LGBTQIA+ affirming healthcare was a critical need for the community. In many conversations, participants pointed to a lack of cultural awareness of LGBTQIA+ people in the healthcare system, which often manifested in prejudice, discrimination, and stigma. Many respondents shared that they had to teach their healthcare providers about their lived experience—for example, mentioning PrEP to a healthcare provider who had never heard of it—and transgender or gender expansive respondents indicated their frequent need to provide basic education to their healthcare providers. Unsurprisingly, many members of our community anticipate that they will face discrimination when seeking care, especially LGBTQIA+ youth.

In our conversations that specifically engaged members of the transgender community, we heard time and again that the healthcare system has failed them. While certain medical organizations such as Vanderbilt University Medical Center have made important strides in providing competent and comprehensive care, many participants expressed that they did not have the necessary insurance to seek such care and therefore could not access an informed provider.

In their own words…

There is a desperate need for access to mental healthcare in our community. While I have insurance, I need help navigating. As someone who was put through religious based reparative therapy as a teenager, there needs to be someone who can help me determine who is the best therapist without having to wait 6 months for a first time appointment.

Participant, Age 36

HIV PREVENTION + TREATMENT

HIV/AIDS continues to be a major health crisis that impacts the LGBTQIA+ community throughout the United States. While there have been incredible strides scientifically, politically, and socially towards managing and ending this crisis, thousands of people in the United States contract HIV every year. Gay, bisexual, and men who have sex with men are most affected by HIV/AIDS in the United States. Importantly, Black Americans have been disproportionately affected by HIV/AIDS since the epidemic’s beginning, and that disparity has deepened over time. Black and African Americans accounted for 43% of new HIV diagnoses in 2017 and are an estimated 42% of people living with HIV. Regionally, the South accounts for the majority of Black people newly diagnosed with HIV (63% in 2017).A

As noted in the HRC’s study, ‘How HIV Impacts LGBTQ people’, “Federal and state programs are also hampered by policy decisions grounded in ideology rather than science such as the allocation of more than $1 billion to failed abstinence-only sex education programs or the enactment of outdated HIV criminalization statutes. In more than 30 states, people living with HIV can be tried and imprisoned simply because a partner accuses them of withholding their HIV status. There’s no proof these laws work, and they run counter to public health by perpetuating stigma and subsequently deterring people from getting tested or treated for HIV.”

On a regional level, the Tennessee enhanced HIV/AIDS Reporting System indicates that in Davidson County, modeling predicts that 4,100 residents live with HIV/AIDS. Further, in the nine surrounding counties of Davidson, approximately 0.5% - 1.2% of people are living with HIV/AIDS. In line with national trends, certain subpopulations continue to be disproportionately affected by HIV in Nashville. Out of the 146 people in Davidson County who were diagnosed with HIV in 2017, more than half were Black/African American and more than 63% of people diagnosed were between 15 and 34 years of age. Within the HIV epidemic there are hidden populations, which include transgender and homeless individuals that are particularly vulnerable to HIV infection.

In Nashville / Davidson County specifically, former Mayor David Briley convened an “Ending the HIV/ AIDS Epidemic in Nashville” Task Force in 2018. Participants in this Task Force, have made the commitment to ensuring health equity and social justice in our community by working to eradicate the epidemic. It is the responsibility of every organization to unify and work together to “create, manage, and distribute resources that directly impact the health of the Nashville community. These same institutions are charged with the important responsibility of ensuring equitable resource allocation; efforts and assets need to be directed towards populations that have historically been disproportionately impacted by HIV.”

U=U | Treatment as Prevention

“In recent years, an overwhelming body of clinical evidence has firmly established the HIV Undetectable = Untransmittable (U=U) concept as scientifically sound, according to the National Institutes of Health. U=U means that people living with HIV who achieve and maintain an undetectable viral load — the amount of HIV in the blood — by taking and adhering to antiretroviral therapy (ART) as prescribed cannot sexually transmit the virus to others. Validation of the HIV treatment as prevention strategy and acceptance of the U=U concept as scientifically sound have numerous behavioral, social and legal implications. U=U can help control the HIV pandemic by preventing HIV transmission, and it can reduce the stigma that many people with HIV face.”

Throughout the engagement of the Community Visioning Project, an overwhelming majority of respondents across all ages and racial groups, sexual orientations and gender identities, education levels, and zip codes ranked HIV prevention and treatment as a priority. In order to address this priority, community members and participants provided five specific recommendations:

• Educate medical providers around PrEP/PEP to reduce stigma.

• Reduce the cost associated with PrEP/PEP.

• Promote education of U=U and what that means for our community.

HEALTH NAVIGATION

• Promote positive and realistic safe sex education in schools.

• Coordinate efforts between all LGBTQIA+ organizations to share information about ending the epidemic.

Although many respondents indicated that they lacked access to affirming healthcare, it is important to note there are several world-class options for LGBTQIA+informed providers in Middle Tennessee. The Vanderbilt Program for LGBTQ Health, for example, offers comprehensive healthcare services, including a database of affirming providers and resources for members of our community. Additionally, non-profit organizations like Neighborhood Health, Connectus Health, and Planned Parenthood offer a wide range of LGBTQIA+ services and serve many needs for those in our community.

Despite these resources, the community reports that there is a significant need for support around health navigation for members of our community. We see this navigation as a resource that will help LGBTQIA+ Middle Tennesseans find appropriate care without relying on word of mouth and social groups to connect into services. Furthermore, coordination of services for medical care is something that members of the community share to be a common need. Middle Tennesseean LGBTQIA+ people of every socioeconomic background, but most importantly our poor and low income community, need help to navigate the best possible healthcare.

Community Visioning Project participants shared that other major cities around the country have effective LGBTQIA+ health navigator programs which provide a range of programming, services, and counseling options for the whole community. Members of our community from a variety of experiences expressed a need for assistance navigating the complex health insurance marketplace. In order to help meet these needs, we recommend the development of a comprehensive LGBTQIA+ focused health navigator program.

In their own words…

Throughout Middle Tennessee we need a more centralized system to access to LGBTQIA+ healthcare services. Even if it's just simply a list of physicians/offices that are educated on LGBTQIA+ health needs. What I could really use to thrive is someone who can help me navigate the health resources available in this community.

Participant, Age 30

NEXT STEPS

The Nashville + Middle Tennessee LGBTQIA+ Community Visioning Project was built on a data driven decision model to determine the needs of the region. Through this process, we focused on collecting data to assess needs and develop programs and partnerships that would improve the lives of LGBTQIA+ people throughout Middle Tennessee. Our process has been iterative in nature, and we have worked to be flexible and responsive to the needs of the community.

With the completion of this report and the sharing of these results to the community at large, our hope is that these recommendations do not stay on paper, but that a unified attempt to create action begins to address these recommendations. Through cross-sector partnerships with key organizations in the community, we can move into a collective impact model to that addresses both the top line and secondary recommendations. These impact initiatives are a critical and valuable lever for social change. The next phase of our reporting, which will include recommendations for a community-wide strategic initiative using a collective impact framework, will be delivered on December 4, 2019 at a live event hosted by Nashville Pride.

Systematic change for LGBTQIA+ people throughout Middle Tennessee will only come through a strong foundation of intersectional accountability that acknowledges and celebrates the differences within our community. Moreover, this work must be attentive to the multiple oppressions many members of our community face, especially those most marginalized in a patriarchal, white supremacist, ableist society. Moving forward, all work must be rooted in equity, focused on action, and driven by meaningful, authentic inclusion.

COMMUNITY MEMBER TESTIMONIALS

DEL RAY ZIMMERMAN | HE/HIM

“This past summer, Vanderbilt University Medical Center conducted listening sessions as part of the organization’s Community Health Needs Assessment, documenting health disparities for a number of diverse Middle Tennessee communities. Among key findings, LGBTQ participants told us they lack a sense of community and want safe, affirming gathering spaces to socialize and serve as a hub of helpful resources. Community spaces are vital to fostering connections and emotional support and play a critical role in reducing mental health issues like anxiety and depression, particularly among older adults. Our findings are very much in concert with the results of Nashville Pride’s Community Visioning Project. The Vanderbilt Program for LGBTQ Health is excited to partner with Nashville Pride to plan for a future for everyone, as well as programming that will help keep our LGBTQ community healthy and vibrant. We wholeheartedly endorse the work they are doing.”

MEREDITH FORTNEY | SHE/HER

"The Nashville + Middle Tennessee LGBTQIA+ CommunityVisioning Project is imperative to the growth and development of our local LGBTQ+ community. Engaging in meaningful conversations with our amazingly diverse community is the only way to truly understand the most effective and beneficial ways to support progress in our city. The Nashville Human Rights Campaign Board of Governors are thrilled to engage in these recommendations to help our community thrive.”

CHARLES PATRICK BROWN | HE/HIM

“I’m both grateful and proud to have been able to participate in the Nashville + Middle Tennessee LGBTQIA+ Community Visioning Project. It gave us the opportunity to learn more about our existing resources, dialogue with community members and co-stakeholders, drill down to the real needs, and explore the opportunities for growth—all in a dynamic, intentional, proactive way. This a rare occurrence. I certainly feel more connected to the LGBTQIA+ community as a result of this project and look forward to what’s to come.”

ACKNOWLEDGEMENTS

RESEARCH TEAM

ROBERT MARX HE/HIM

PHIL COBUCCI HE/HIM

CHARLES WHITMORE HE/HIM

KASS PATTERSON-SMITHMIER SHE/HER/THEY

COOPER MARSH HE/HIM

STEVE WEISSENBURGER HE/HIM

RESOURCES

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Ending the Epidemic Nashville,. (2018). A Five Year Community Plan to End the HIV Epidemic in Nashville. http://bit.ly/bnaete1

ORSImpact & Spark Policy Institute,. (2018). When Collective Impact has an Impact.

SAGE,. (2011). Inclusive Services for LGBT Older Adults. http://bit.ly/servlgbta-cvp

Langford, J. (2018). The Pride Guide. A Guide to Sexual and Social Health for LGBTQ Youth.

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Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on psychological science, 10(2), 227-237.

Fish, J., Moody, R., Grossman, A., Russell, S., (2019). LGBTQ Youth-Serving Community-Based Organizations: Who Participates and What Difference Does it Make

GLSEN,. (2018). School Climate Survey, Tennessee. https://www.glsen.org/schoolclimate-survey

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NashvilleHealth,. (2019). Nashville Community Health and Wellbeing Survey. http:// bit.ly/nhwcs19

Vanderbilt University Medical Center,. (2019). Vanderbilt LGBTQ Health. Community Needs Assessment for the Greater Nashville LGBTQ Community.

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SAGE,. (2018). The Facts on LGBT Aging. http://bit.ly/2D3ge5C

Pannu, K. (2017). Privilege, Power, and Pride: Intersectionality within the LGBT Community. http://bit.ly/2ra9lMY

Jones, C. (2016). When We Rise: My Life in the Movement

Signorile, M. (2015) It's Not Over: Getting Beyond Tolerance, Defeating Homophobia & Winning True Equality.

Morton, M. H., Samuels, G. M., Dworsky, A., & Patel, S. (2018). Missed opportunities: LGBTQ youth homelessness in America. Chicago, IL: Chapin Hall at the University of Chicago.

The mission of Nashville Pride is to maintain a sense of community or awareness of, about, and for LGBTQIA+ people and culture throughout Middle Tennessee. As an organization that is focused on celebrating and acknowledging the lived experiences of our beautifully diverse community, we were focused on undertaking this effort to understand what members of the Middle Tennessee LGBTQIA+ community need in order to thrive.

SPECIAL THANKS

NASHVILLE