Real Health Focus LGBTQ Health

Supplement to Real Health magazine

LGBTQ Health Matters Too Total wellness for transgender people demands an end to the violence and discrimination they face daily.

Actress-activist Laverne Cox

RH_FOCUS_LGBTQ_pCOV1_REV_HY.indd 1

10/14/21 1:42 PM

IMPORTANT FACTS FOR BIKTARVY®

(bik-TAR-vee)

This is only a brief summary of important information about BIKTARVY and does not replace talking to your healthcare provider about your condition and your treatment.

MOST IMPORTANT INFORMATION ABOUT BIKTARVY

POSSIBLE SIDE EFFECTS OF BIKTARVY

BIKTARVY may cause serious side effects, including:

BIKTARVY may cause serious side effects, including:  Those in the “Most Important Information About BIKTARVY” section.  Changes in your immune system. Your immune system may get stronger and begin to fight infections that may have been hidden in your body. Tell your healthcare provider if you have any new symptoms after you start taking BIKTARVY.  Kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys. If you develop new or worse kidney problems, they may tell you to stop taking BIKTARVY.  Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat.  Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.  The most common side effects of BIKTARVY in clinical studies were diarrhea (6%), nausea (6%), and headache (5%).

 Worsening of hepatitis B (HBV) infection. Your

healthcare provider will test you for HBV. If you have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking BIKTARVY. Do not stop taking BIKTARVY without first talking to your healthcare provider, as they will need to check your health regularly for several months, and may give you HBV medicine.

ABOUT BIKTARVY BIKTARVY is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in adults and children who weigh at least 55 pounds. It can either be used in people who have never taken HIV-1 medicines before, or people who are replacing their current HIV-1 medicines and whose healthcare provider determines they meet certain requirements.

BIKTARVY does not cure HIV-1 or AIDS. HIV-1 is the virus that causes AIDS. Do NOT take BIKTARVY if you also take a medicine that contains:  dofetilide  rifampin  any other medicines to treat HIV-1

BEFORE TAKING BIKTARVY Tell your healthcare provider if you:  Have or have had any kidney or liver problems,

including hepatitis infection.  Have any other health problems.  Are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby.

Tell your healthcare provider if you become pregnant while taking BIKTARVY.  Are breastfeeding (nursing) or plan to breastfeed.

Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

Tell your healthcare provider about all the medicines you take:  Keep a list that includes all prescription and over-the-

counter medicines, antacids, laxatives, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist.

 BIKTARVY and other medicines may affect each other.

Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.

These are not all the possible side effects of BIKTARVY. Tell your healthcare provider right away if you have any new symptoms while taking BIKTARVY. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

Your healthcare provider will need to do tests to monitor your health before and during treatment with BIKTARVY.

HOW TO TAKE BIKTARVY Take BIKTARVY 1 time each day with or without food.

GET MORE INFORMATION  This is only a brief summary of important information

about BIKTARVY. Talk to your healthcare provider or pharmacist to learn more.

 Go to BIKTARVY.com or call 1-800-GILEAD-5  If you need help paying for your medicine,

visit BIKTARVY.com for program information.

BIKTARVY, the BIKTARVY Logo, GILEAD, the GILEAD Logo, KEEP LOVING, and LOVE WHAT’S INSIDE are trademarks of Gilead Sciences, Inc., or its related companies. Version date: February 2021 © 2021 Gilead Sciences, Inc. All rights reserved. BVYC0370 04/21

PZA529987_1-1.pgs 04.20.2021 01:56

ESA

NIKKI LIVING WITH HIV SINCE 2008 REAL BIKTARVY PATIENT

KEEP LOVING.

Because HIV doesn’t change who you are.

BIKTARVY® is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in certain adults. BIKTARVY does not cure HIV-1 or AIDS.

Ask your healthcare provider if BIKTARVY is right for you.

See Nikki’s story at BIKTARVY.com.

Featured patient compensated by Gilead.

Please see Important Facts about BIKTARVY, including important warnings, on the previous page and visit BIKTARVY.com.

PZA529987_2-2.pgs 04.20.2021 01:56

ESA

CONTENTS this month on

REALHEALTHMAG.COM Rapper Lil Nas X Gives Birth

Health Basics A—Z Want to lose weight, exercise smart, eat right, find good health care, sleep better or just get healthy?

For tips, click on “Health Basics A–Z” on the realhealthmag.com home page.

About LGBTQ Sexual Health Two queer New Yorkers discuss their sexual lives and health and how important it is for people to embrace and enjoy their sexuality.

Eat Healthy, Eat Well How about roasted fall veggie vegan tacos stuffed with sweet caramelized cauliflower and tasty butternut squash?

Digital Real Health

Laverne Cox

10

3 EDITOR’S LETTER

8 PROFILE

4 Q&A

9 TREATMENT NEWS

LGBTQ people face unique stressors that affect their overall physical and mental health. Social acceptance and life-affirming care can help.

Maven Lee: How he connects HIV advocacy with kiki ballroom events

6 NEWS

DaBaby matures after a parley with grassroots HIV organizations. Motherand-son LGBTQ ministers Gwen and Davin Clemons unleash their voice.

Sarah R. Shaw is a Black queer woman whose chronic migraines drove her to become a passionate health advocate for those in marginalized communities.

Mental health therapists are now starting to realize that LGBTQ people need affirming care to thrive.

10 FEATURE

Laverne Cox is on a personal mission to help trans people transform shame and fear into resilience and self-love.

REACH OUT & CLICK! Read Real Health magazine online exactly as it appears in print. Go to realhealthmag.com/digital to view the current issue and the entire Smart + Strong digital library.

RH_FOCUS_LGBTQ_p2_TOC_HY.indd 2

At realhealthmag.com, you can read more articles; access exclusive, online-only special reports; and subscribe ($9.97 for four quarterly issues; or call 212.242.2163). Plus, sign up for the Real Health email newsletter to get the latest news on issues relating to Black health!

COVER: MARK SAGLIOCCO/GETTY IMAGES; THIS PAGE: (COX) JARED SISKIN/GETTY IMAGES; (LIL NAS X) COURTESY OF WELCOMETOMONTERO.COM/BABYREGISTRY; (DOCTOR/PATIENT) ISTOCK; (SEXUAL HEALTH) COURTESY OF SABRINA SARRO; (ROASTED VEGETABLES) COURTESY OF COOK FOR YOUR LIFE/JOE GAFNEY; (MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY)

The hoopla around the hip-hop artist’s recent debut album targets stigma in all places but focuses in particular on how misinformation and fear continue to drive the HIV epidemic in the South.

10/21/21 8:35 AM

EDITOR’S LETTER

EDITOR-IN-CHIEF

Kate Ferguson

MANAGING EDITOR

Jennifer Morton DEPUTY EDITOR

Trent Straube

SCIENCE EDITOR

Liz Highleyman COPY CHIEF

Joe Mejía

NEWS WRITER

Jeanette L. Pinnace ART DIRECTOR

Mark Robinson ART PRODUCTION MANAGER

Michael Halliday ADVISORY BOARD

Goulda Downer, PhD, RD, CNS; Lovell Harris, MD; Dorothy Horton, PsyD; Lee SaintMartin, MS, IIPA, CN, ND; Yuan Wan, LAc FEEDBACK

Real Health, 157 Columbus Avenue, Suite 525, New York, NY 10023, or email info@realhealthmag.com

SMART + STRONG PRESIDENT AND COO

Ian E. Anderson

EDITORIAL DIRECTOR

Oriol R. Gutierrez Jr. EXECUTIVE EDITOR

Bob Barnett

CHIEF TECHNOLOGY OFFICER

Christian Evans

VICE PRESIDENT, INTEGRATED SALES

Diane Anderson

INTEGRATED ADVERTISING MANAGER

Jonathan Gaskell

INTEGRATED ADVERTISING COORDINATOR

Sarah Pursell SALES OFFICE

212-938-2051 sales@realhealthmag.com BULK SUBSCRIPTIONS

order.realhealthmag.com or subs@realhealthmag.com

CDM PUBLISHING LLC CHIEF EXECUTIVE OFFICER

Jeremy Grayzel CONTROLLER

JOAN LOBIS BROWN

Joel Kaplan

Real Health (ISSN 2688-7258) Copyright © 2021 CDM Publishing LLC. All rights reserved. No part of this publication may be reproduced, stored in any retrieval system or transmitted, in any form by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher. Smart + Strong® and Real HealthTM are trademarks of CDM Publishing, LLC.

Stressing a Point

S

everal years ago, I learned that Kelly, a childhood friend of my former husband, had died. Her body was found curled up in a corner of a Philadelphia bus station. Kelly had spent most of her early adolescence living as a transient in the mazelike corridors of the city’s bus and rail system known as SEPTA. When she came out as transgender in her early teens, Kelly didn’t fully understand the meaning of the colorful flag she’d unfurled. All she knew was that her family rejected her for the way she talked, looked and acted, ways that felt right and natural to her.

After one of her parents’ many putdown sessions about how ashamed she made them feel, Kelly ran away.

With nowhere else to go, she made her way to the transportation hub she would come to call home.

There, Kelly tasted a freedom she’d never experienced and grew up on her own. She panhandled for food, clothing and, when the station wasn’t an option, shelter.

As the years passed, Kelly became increasingly street smart. She teamed up with another homeless teen, and the two devised a scheme to make money. Kelly would bait men looking

for sex, and her partner in crime would rob them. The hustle was good while it lasted, but when word spread in certain circles, Kelly and her accomplice were forced to quit their dangerous con game.

In her 20s, Kelly began having medical problems from untreated anal fissures. Kelly had assiduously avoided doctors ever since the family pediatrician had spoken with her parents about the gender identity she embraced.

Then, she met a man she thought truly cared for her. At first, he paid for medical treatment. Then, he promised to help pay for the gender-affirming hormone treatments she needed.

Everything was fine for almost 10 years. Then, one night Kelly’s lover brought several strangers to the West Philly apartment they shared. He’d invited them there to have sex with her.

After an ugly scene that became disturbingly physical, Kelly felt lucky to exit the apartment with her life.

Her whereabouts remained unknown for almost 15 years, until a brief news item surfaced about the discovery of the body of an unidentified homeless trans woman in a bus station.

It was Kelly; she was just 45 years old.

Kelly’s death illustrates the vulnerability many transgender women face.

Indeed, recent findings show that trans women are twice as likely to die prematurely—of either illness or nonnatural causes—compared with their cisgender counterparts.

At the risk of sounding simplistic, increased acceptance of trans women in society and access to life-affirming health care might have changed the outcome for Kelly, a woman who died far too soon.

Here’s to your health,

Real Health is BPA audited.

Kate Ferguson, Editor-in-Chief katef@realhealthmag.com

realhealthmag.com

RH_FOCUS_LGBTQ_p3_EdLetter_HY.indd 3

I

W I N T E R 2 0 21 R E A L H E A LT H F O C U S 3

10/12/21 4:26 PM

Q&A

Kiki With a Legendary HIV Advocate

Maven Lee shares his HIV story while promoting balls, serving runway and starring on reality TV.

T

he house and ball scene is back in style. Although they shot to world fame over three decades ago with Madonna’s megahit “Vogue” and the documentary Paris Is Burning, ballroom dance competitions and their communities have returned to the cultural spotlight by way of the reality show Legendary (Megan Thee Stallion is a judge) and the drama Pose, which is set in AIDS-ravaged 1990s New York City and follows a large cast of Black and brown queer characters. (The series aired its final season this past summer.)

Since balls remain popular among minority LGBTQ folks—a population that

4 R E A L H E A LT H F O C U S W I N T E R 2 0 21

RH_FOCUS_LGBTQ_p4-5_QA_HY.indd 4

I

sees disproportionate rates of HIV— the events offer a unique opportunity for HIV outreach. To learn more, we spoke with Maven Lee, 31, an HIV advocate in St. Louis who has been living with the virus for a decade and has been involved in ballroom and kiki events across the nation. (Kiki is a more youth-oriented twist on ballroom that

(POSING) COURTESY OF MAVEN LEE/ CHRYS WILLIS PHOTOGRAPHY; (SPEAKING) VIMEO/THE KIKI SHOW; (AIDSWATCH GROUP) COURTESY OF MAVEN LEE

Clockwise from left: Maven Lee promotes numerous ballroom and kiki events in St. Louis; Lee shares his HIV story during the latest season of reality series The Kiki Show; and Lee represents Missouri and Georgia during an AIDSWatch advocacy event in Washington, DC. Pictured at our nation’s capital are, from left to right, Richard Hutchinson, Tori Cooper, U.S. Senator Tammy Baldwin (D–Wis.), Maven Lee and Keiva Lei Cadena.

realhealthmag.com

10/12/21 5:31 PM

allows for more experimentation.) Lee also stars in season 2 of the reality series The Kiki Show, now available (for free!) on Vimeo.

COURTESY OF MAVEN LEE

(SPEAKING) VIMEO/THE KIKI SHOW; (AIDSWATCH GROUP) COURTESY OF MAVEN LEE

How did you get into HIV advocacy?

I was part of a house here in St. Louis called the House of Efficacy, and it was centered around HIV prevention and outreach more than on walking balls, which is a little bit unusual. I started volunteering at an HIV organization called Project ARK on behalf of my house, and I started learning about HIV. I ended up getting a job at the organization as a peer advocate.

I thought I knew it all and was protecting myself. I was dating around and things like that, and there was a situation when everything I knew went out the door. I trusted someone, and I was vulnerable, and, honestly, that’s how I ended up becoming positive.

It was an interesting situation, because I was working at an organization that tells you this is what you’re supposed to do [to stay HIV negative] and how you handle situations. But none of that mattered when my feelings and emotions and heart came into the conversation and I trusted someone. I then realized that I had to nuance what I was being taught when I said it to other people because it’s not that simple. We need to speak to folks like they’re real human beings because it’s not as easy as “Protect yourself. Use a condom.” When you talk from real experience, you start to say things differently.

Did working in the HIV field prepare you for the diagnosis?

Absolutely. At one point, I was disappointed in myself and angry. And folks made me feel this way. They were like, “How dare you make this mistake?

You’re supposed to know better.” I also felt like me becoming positive opened the door [for me to] be a positive light for so many people. I’m able to live a very healthy life, I’m undetectable and I’m doing well. Who’s to say this was not something I’m supposed to experience?

How long did it take before you started disclosing your status?

When I was told my results, honestly, the

first thing I did was call my house father and call my grandmother and biological father—actually, he’s my uncle, but he raised me as his son. I told them immediately. But I don’t think my family really understood. They didn’t necessarily judge me, but they haven’t talked about it since.

Like a week later, I participated in a retreat for Black and brown men who have sex with men, and we were all sitting around and sharing information, and for some reason, I felt compelled

each other in three categories: runway, vogue and tag-team performance.

Tell us about your history in the balls, especially in the Midwest.

I’ve been walking balls for 12 years.

I’m legendary for the category of runway. To be a legend or icon, you have to be deemed as such. I’ve walked in every major ballroom city in the country and abroad.

Ballroom is everywhere. It has grown so much in the last few years. I’ve been

“I’m able to live a very healthy life. I’m undetectable.

I’m doing well.” to say, “Hey, y’all, last week, I found out I was positive.” This was 2011. So I disclosed that day. I saw how difficult it was for folks I know who had HIV—the hurt and confusion of having that conversation every time they met someone— so for me, I wanted to get that [stress out of my life] immediately. It was a relief to me.

Do you get to tell your HIV story on the second season of The Kiki Show?

I do. In the beginning, it’s what they focus on. And there are like four others who are HIV positive on the show.

What is the new season about?

It was filmed in Philly—the first season was in Atlanta, when I lived there. That year, I represented both Georgia and Missouri at AIDSWatch [an annual event when HIV advocates head to Washington, DC, to meet lawmakers]—the second season is individuals battling against each other, unlike regular balls, where it’s house against house. And it’s folks from different regions competing against

to balls in Minnesota, Wisconsin, Kansas, Nebraska, Chicago and Detroit. We have had some very successful balls in St. Louis. We have a mainstream ballroom scene and a kiki ballroom scene. In St. Louis, we treat the kiki ballroom scene more as a practice for the mainstream scene. Our kiki balls are like 50 to 70 people. In some cities, the kiki scene is almost bigger than the mainstream ball.

New York’s kiki ballroom scene gets 500 to 700 people. Our mainstream ballroom events get like 200 to 400 folks.

You organized a ball in St. Louis during Black Pride this summer, and you’re planning events at historically Black colleges and universities. Does this overlap with your HIV advocacy?

I consult with several LGBT centers and HIV service centers here in St. Louis.

Some of the HIV agencies like to throw balls because lots of young LGBTQ folks of color come out to balls and pageants, so [it’s an opportunity] to get people tested for HIV and connected to services.

—Trent Straube

realhealthmag.com

RH_FOCUS_LGBTQ_p4-5_QA_HY.indd 5

I

W I N T E R 2 0 21 R E A L H E A LT H F O C U S 5

10/13/21 12:07 PM

BUZZ

Dialogue With DaBaby STICKS AND STONES MAY BREAK MY bones, but words will never hurt me.

Remember that saying we all learned as children? Turns out, despite the implied message of resilience, words can indeed cause harm—and destroy careers.

Words also have the power to heal. Just ask DaBaby.

Our saga begins in July at the Rolling Loud Miami 2021 music festival, where the rapper let loose a string of stigmatizing remarks that went viral. Just a taste: “If you didn’t show up today with HIV, AIDS or any of them deadly sexually transmitted diseases that’ll make you die in two to three weeks, then put your cell phone lighter up!” DaBaby also disparaged women and gay men.

The clapbacks on social media arrived with a swiftness and included calls for concert venues to cancel his future appearances (many did).

Some people, like Hamilton star Javier Muñoz, who is living with HIV, urged DaBaby to educate himself, adding, “I stand here as living proof that all you

6 R E A L H E A LT H F O C U S W I N T E R 2 0 21

RH_FOCUS_LGBTQ_p6_News1_HY.indd 6

I

say AND imply are false. I am LIVING proof. Do better.”

On August 4, a group of HIV organizations with strong ties to Black LGBTQ people in the South penned an open letter to the rapper; eventually, over 126 groups signed on in support.

“2021 marks the 40th year of the HIV/AIDS epidemic,” the advocates wrote, “and the greatest obstacles in our work to end HIV are the compounded stigmas attached to anti-Blackness, living with HIV, misogyny and antiLGBTQ attitudes and stereotypes, all of which are fueled by misinformation.

It’s fear and stigma that keep people, particularly Black Americans, from accessing HIV prevention or care that White Americans have historically and continue to access more easily.”

The advocates’ letter included vital information, such as the facts that Black Americans accounted for 43% of new HIV diagnoses in 2019 (although they made up only 13% of the population), that daily pre-exposure

prophylaxis (PrEP) tablets can keep people from contracting the virus and that those living with HIV who are on treatment and fully suppress the virus do not transmit HIV sexually, a fact often referred to as Undetectable Equals Untransmittable (U=U).

The letter also invited DaBaby to meet with them for further dialogue— “our goal was to ‘call him in instead of calling him out,’” they wrote—and he accepted.

In a post on a blog for the LGBTQ group GLAAD, the HIV advocates reported on the meeting’s success and described DaBaby as being engaged and respectful. “DaBaby acknowledged that the HIV facts we presented—many of which he himself was unaware of— are what every American needs to know.

Now, we wish for him to use his platform to relay that critical information to his fan base and encourage people to get tested and know their status.”

Let’s hope he spreads the word.

— Trent Straube

RICH FURY/GETTY IMAGES

After the rapper made stigmatizing remarks, HIV advocates wanted to “call him in instead of calling him out.” The outcome may surprise you.

realhealthmag.com

10/12/21 5:39 PM

BUZZ

Like Mother, Like Son

COURTESY OF WILEY BROWN PHOTOGRAPHY

HIV advocates Gwen and Davin Clemons, both LGBTQ ministers, got a shout-out from Lil Nas X.

AS THE MOM-AND-SON DUO BEHIND the Memphis-based, Black-led LGBTQ nonprofit Relationship Unleashed, Gwen and Davin Clemons have survived tumultuous times and are enjoying some well-deserved national triumphs.

“We live in the so-called Bible Belt,” Davin explains. “The Black church and the Black community have traditionally held a non-tolerant stance toward the LGBTQIA community. One of the reasons that Relationship Unleashed was founded was to help those trapped by religious dogma. Our goal is to liberate Black and brown people through education, empowerment and enrichment.” It’s an important mission, he says, because factors such as intolerance can foster self-hate among many minority LGBTQ folks, and this in turn leads not only to higher HIV rates— the South is the epicenter of today’s epidemic—but also to “other disparities in life that ultimately cause death to us spiritually, mentally and physically,” says Davin.

When COVID-19 forced the group’s impactful in-person events to go virtual, depriving members of one another’s healing presence, as Davin recalls, it took a toll on the nonprofit’s services as well as on the duo personally.

“COVID has been one of the worst experiences of my advocacy work,” Gwen explains. “I lost my mother (Davin’s grandmother) August 20, 2021, to COVID pneumonia. Although my mother was vaccinated, she was considered high risk with a host of comorbidities, and a large portion of my family members were not vaccinated, potentially placing her at risk. In Memphis,” she says, “there is a large population of African Americans who are not vaccinated and are dying unnecessarily.”

This wasn’t Gwen’s first experience with a deadly epidemic. In 1991, she lost her beloved transgender sister, Jewel, to AIDS, which led to Gwen’s calling in HIV and LGBTQ advocacy.

Gwen, a minister with an MBA who has worked in criminal justice for over three decades, identifies as a lesbian, and Davin, who has a doctoral degree in leadership in ministry, is a gay man. Since launching Relationship Unleashed in 2014, they’ve expanded their reach through The Unleashed Voice Media Marketing Firm, which has produced a radio show, a podcast and a national LGBTQ magazine. Earlier this year, when DaBaby made national headlines for homophobic and misogynistic remarks, Relationship Unleashed joined other agencies to pen an open letter to the The duo founded a nonprofit for Black LGBTQ people.

rapper (see page 6). Stated Gwen at the time: “We are committed to…helping anyone learn the facts about HIV/AIDS.” Their tireless work is paying off. The nonprofit received a grant from the COMPASS Initiative—the name stands for “COMmitment to Partnership in Addressing HIV/AIDS in Southern States”— which is funded by pharma giant Gilead Sciences. And in the fall, when Lil Nas X released his debut album, Montero, he encouraged fans to donate to HIV causes in the South, specifically linking his track “Scoop (featuring Doja Cat)” to the Clemons’s Relationship Unleashed.

“This is a once-in-a-lifetime opportunity for us,” Gwen says of the endorsement. “Lil Nas X is a true example of activism and philanthropy for grassroots organizations. [His] efforts to use his image and platform for political and social awareness should become the norm for celebrities.” —Trent Straube

realhealthmag.com

RH_FOCUS_LGBTQ_p7_News2_HY.indd 7

I

W I N T E R 2 0 21 R E A L H E A LT H F O C U S 7

10/19/21 8:42 AM

PROFILE

GOOD HEALTH CARE FOR ALL HALLOWEEN WAS A FEW DAYS OFF, AND SARAH RENEÉ SHAW, age 32, was waiting in line to enter a corn maze with a group of friends when a sharp, jagged pain shot through her right eye to the back of her skull. The pounding pain took her breath away.

“Everything felt too loud and looked too bright,” she says.

Shaw managed to get through the night. But for the next three days, excruciating pain confined her to bed. She was severely nauseated and barely able to eat. “At that point, I didn’t know what I was experiencing was a migraine attack,” she says.

The first few doctors Shaw visited diagnosed her with anxiety and stress from overwork. Over time, she began attending pain support groups online in search of any information she could find. A chance conversation with an employee at her neighborhood pharmacy offered a possible explanation.

“When I mentioned that I experienced nausea and light sensitivity, she said, ‘Oh, that sounds like you’re having a migraine.

Here’s some over-the-counter medication that I think would help. But I really think you need to see a neurologist.’ That was the first time anyone had mentioned the word migraine,” Shaw says. “That’s when I started to make a little more progress in finding out what was going on with me.”

An adopted child, Shaw was unaware of her family’s medical history. “I didn’t know if I was predisposed to migraine attacks, so this unknown didn’t help me get a quick diagnosis,” she says.

Shaw thinks that getting a proper diagnosis was also made harder by the fact that she was a Black queer woman in pain who got no relief from any of the medications doctors gave her.

“I was often called ‘a problem patient’ because whatever they were doing wasn’t working,” she says. “I also noticed I was treated differently if I came to a doctor’s appointment in sweatpants and a sweatshirt versus if I came straight from work wearing professional attire,” she says.

“I definitely feel that there are different misconceptions physicians believe, not only based on a patient’s gender,” Shaw continues. “For example, as a queer woman with a partner who comes with me to my sessions, I’ve sometimes noticed a sort of unspoken discomfort on the part of doctors when I introduce her. I can’t say that it’s affected my treatment plan, but this sometimes made it uncomfortable for me to go to the doctor.”

Doctors’ implicit biases can be particularly destructive to their patients’ health outcomes. But advice Shaw received from other people of color helped. “They told me that I really needed to find an affirming doctor who is either a person of color or a physician who gets it,” she says.

Shaw did just that and for a while was satisfied with her care.

Then she was laid off work. “I lost all my insurance, so I had to quit that doctor. Then I was put back into a ‘more affordable level of care,’” she says. “That’s when I ran into the same problems with providers that I had before.”

Eventually, Shaw sought care outside New Jersey, her home state. “I found a Black queer neurologist in Pennsylvania who aligns with me and just advocates more for me and really validates my experiences,” she says. “I find having that affirming doctor that gets it just makes a world of difference.”

Shaw shares more of her story in a Global Healthy Living Foundation podcast called Talking Head Pain, available anywhere podcasts are streamed.

—Kate Ferguson

8 R E A L H E A LT H F O C U S W I N T E R 2 0 21

RH_FOCUS_LGBTQ_p8-9_Profile_Treatment_HY.indd 8

I

realhealthmag.com

10/13/21 11:46 AM

TREATMENT NEWS

Care That Lets You Be You (SHAW) COURTESY OF CREAKYJOINTS/GLOBAL HEALTHY LIVING FOUNDATION; (THERAPIST AND PATIENT) ISTOCK (MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY)

Sarah Reneé Shaw

The best mental health treatment for LGBTQ people begins with therapy that supports each person as an individual.

ACCORDING TO EXPERTS, LESBIAN, gay, bisexual, transgender or queer people experience a higher rate of depression and anxiety than their straight counterparts. What’s more, suicidal thoughts and attempts among LGBTQ people are significantly higher compared with other population groups in the United States.

But treatment of these issues requires that psychiatrists fully understand and appreciate the comprehensive nature of the real-life challenges LGBTQ people face—whether at work, at home or at play.

In a special report he wrote for Psychiatric News, Eric Yarbrough, MD, the

medical director at GMHC (Gay Men’s Health Crisis) in New York City, observes that mental health practitioners must focus on individuals’ “acceptance of not who they wish to be but of who they are.”

Therapists “can play a major supportive role by providing emotional relief,” Yarbrough stresses, because “even those who are lucky enough to have an extremely accepting support system can still struggle with the process beTherapy for LGBTQ cause of what they people must read and hear about affirm who from the larger world.” they are.

—Kate Ferguson

realhealthmag.com

RH_FOCUS_LGBTQ_p8-9_Profile_Treatment_HY.indd 9

I

W I N T E R 2 0 21 R E A L H E A LT H F O C U S 9

10/12/21 5:49 PM

(POGUE) DUSTIN FENSTERMACHER; (CHILDREN) COURTESY OF ERIC POGUE

Truly fierce beyond her appearance, Laverne Cox advocates for health equity and social justice for LGBTQ people everywhere.

RH_FOCUS_LGBTQ_p_10-13_Feature_HY.indd 10

10/12/21 4:50 PM

WELLNESS

WARRIOR THE PATHBREAKING ACTRESS, PRODUCER AND ACTIVIST LAVERNE COX WANTS BLACK LGBTQ PEOPLE TO BE WHOLE—PHYSICALLY, MENTALLY AND IN THE WORLD.

JARED SISKIN/GETTY IMAGES

By Tim Murphy

R

ather than a scolding call-out, it was the gentle call-in heard round the world. In early 2014, while interviewing transgender reality-TV star and model Carmen Carrera on her then talk show, Katie, longtime TV journalist Katie Couric asked Carrera the question every trans person dreads hearing from a cisgender (non-trans) person: “Your private parts are different now, aren’t they?”

Carrera, visibly embarrassed, actually shushed Couric, saying, “I don’t wanna talk about it because it’s really

personal.... I’d rather talk about my modeling stuff.”

Couric looked like she suddenly realized she might have misspoken.

But she likely didn’t fully understand why until moments later, when Carrera and Couric were joined by Laverne Cox, who was at the time perhaps the most famous trans person in America by way of her groundbreaking role on the hit women’s-prison TV show Orange Is the New Black (OITNB).

Referencing Couric’s inappropriate question, Cox calmly said: “The preoccupation with transition and with surgery objectifies trans people...and then we don’t get to really deal with the real lived

experiences, and the reality of trans people’s lives, is that, so often, we’re the targets of violence. We experience discrimination disproportionately to the rest of the community. Our unemployment rate is twice the national average— if you’re a trans person of color it’s four times the national average. The homicide rate in the LGBTQ community is highest among trans women.”

Cox then told the story of 21-yearold Islan Nettles, a Black trans woman who the previous year had been brutally beaten into a coma (she later died) on the street in Harlem by a young man who had catcalled her and then erupted in rage when he learned she was trans.

realhealthmag.com

RH_FOCUS_LGBTQ_p_10-13_Feature_HY.indd 11

I

W I N T E R 2 0 21 R E A L H E A LT H F O C U S 1 1

10/13/21 11:11 AM

“This is the reality of so many trans women of color’s lives, whose lives are in danger simply from being who they are,” continued Cox. “And by focusing on bodies, we don’t focus on the lived realities of that oppression and discrimination.”

To Couric’s credit, she owned her gaffe, later calling herself “an insensitive buffoon.” She even went on to produce a documentary showing the full scope of trans lives and invited Cox back on her show to apologize to her and continue the conversation.

But more important, the moment with Couric was among the first of many times the Alabama-born Cox would use her new platform not just to show off her fierce hair, wardrobe and shoes but to eloquently and passionately advocate for the physical and mental well-being of LGBTQ folks.

Since finding fame in her early 40s, Cox has evolved into a high-profile advocate for transgender people, especially trans women of color.

But she doesn’t advocate just for transgender folks. The Emmy-winning Cox, who recently executive-produced the acclaimed trans documentary Disclosure and starred in the films Promising Young Woman and Jolt, has continuously stepped up for issues of health equity and justice for all LGBTQ folks.

Rare is the Hollywood glamazon who can also discuss health care policy like your favorite friendly public health professor. But that’s Cox, whether it’s on her iHeart podcast, The Laverne Cox Show, in her Twitter or Instagram feeds, in live interviews or even in perfect sound bites while twirling on the red carpet.

Certainly, she’s become rich enough for her own health care access not to be the issue it might have been for her in earlier, struggling days. So why the continued passion? The answer may lie in something she told Johnson & Johnson in late 2019 about appearing on the reality show I Want to Work for Diddy in 2008 (well before OITNB made her a household name).

“For the first time, I had a national platform,” she said. “I remember saying to my brother, ‘Well, I’m already Black 12 R E A L H E A LT H F O C U S W I N T E R 2 0 21

RH_FOCUS_LGBTQ_p_10-13_Feature_HY.indd 12

I

and trans, and that’s a lot for people.’ He said, ‘If you have this platform, why have it—if you’re not going to use it to say something meaningful and be about something that is bigger than you?’”

She’s been doing just that ever since.

FROM HIV/AIDS TO RESILIENCE TO TRANS JUSTICE Cox was talking to Johnson & Johnson on the occasion of her becoming the first spokeswoman for the Band-Aid RED campaign to end the HIV/AIDS epidemic. Proceeds from purchases of J&J’s distinct red Band-Aid bandages were donated to The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Although HIV negative, Cox spoke passionately about how the epidemic was “a human health crisis that has greatly impacted my life.”

Of course, the disease for years has hit hardest the very communities Cox is a part of—LGBTQ , Black, transgender. Indeed, Black gay men and trans women have the highest rates of HIV in the United States.

“It’s always affected people I know,” she continued. “And my entire life, there’s been so much stigma around it.

As I came of age, I remember thinking that I was going to get AIDS and die.

I always thought, If I feel this way, I must not be the only one who feels this way. The way to deal with the shame and trauma, in part, is to talk about it and find ways to heal.”

LGBTQ mental health is another advocacy priority for Cox. She has been extremely vocal about being in therapy herself, largely to work through what she has called the trauma of internalized shame and self-hate related to the bullying she endured as a child for being effeminate and has often suffered simply for being a trans woman walking the streets of New York.

On Instagram Live in May, Cox talked about working on “trauma resilience” in therapy, which, in her words, is “the process of moving from what’s wrong with me to what happened to me to what’s right with me. And what’s right with me is the resilience piece.” It had been healing and strengthening for her, she said, after processing what she’d been through, to focus on the

ways she’d been strong and resourceful through it all.

And on her podcast, Cox often has deep conversations with leading Black therapists, thinkers and writers, such as professor Cornel West, PhD, and #MeToo founder Tarana Burke, about putting trauma in the context of larger forces, such as multigenerational racism, misogyny and transphobia. Her aim is to help Black LGBTQ folks understand that therapy and support groups can help empower them to rewrite messages from the outside world that they have internalized.

STANDING UP FOR LGBTQ PEOPLE—TRANS FOLKS, ESPECIALLY Cox has often championed the health and well-being of the entire LGBTQ community. She testified on Capitol Hill in support of the LGBT Data Inclusion Act, which would require government surveys, including the Census, to collect data on people’s sexual orientation and gender identity alongside other demographics. “LGBT people exist, we are a vital part of the fabric of this country, and we just want to be counted,” she said in her testimony.

Cox spoke out again last year on the morning show The View after the Supreme Court, newly slanting conservative in the wake of appointments under ex–President Trump, surprisingly outlawed LGBTQ employment discrimination.

“I’m shocked,” she said, smiling, noting that the ruling also reflected similar protections in health care. (This was at a moment when the Trump administration was simultaneously attempting to roll back health care and housing protections for trans people.)

But she also noted, “I would like to remind people that just because we have policies in place that protect folks, it doesn’t necessarily mean that the hearts and minds of citizens are changed. We have to do that work within ourselves, within our communities, with our friends and families and in the media.”

Yet given that trans folks, especially Black trans women, remain the most economically and physically vulnerable

realhealthmag.com

10/13/21 11:13 AM

people in the LGBTQ community, it’s no wonder that Cox becomes most passionate when she’s talking about the health and welfare of her own trans sisters of color.

She has become perhaps the most vocal and consistent voice against the global epidemic of often fatal violence against mostly Black and Latina trans women, unyielding in her convic­ tion that the brutality is rooted in a society that tells straight men they are “less than a man” if they are attracted to a woman who turns out to be trans.

In 2019, on the news show Democracy Now, she said, “It’s really hard for me to continue to talk about the murders of trans women of color.... This was a reality in my life in 1998 [when she began medically transition­ ing], that there were trans people being murdered all around me and this insane fear, Will I be next?... And for my entire life as a trans woman, for 21 years, I have been hearing about, wit­ nessing, going to memorials, going to Trans Days of Remem­ brance...I don’t even actually have words for the trauma of that….

And we live in a culture that con­ sistently stigmatizes trans people, tells us that we aren’t who we say we are.”

In the past year alone, despite a new presidential administration that is thankfully LGBTQ­ affirming in the Obama­era tradi­ tion, Republican­driven bills in several states have attempted— sometimes successfully—to make it illegal for health providers to give young people trans­affirming care.

Such care includes puberty block­ ers, which delay the onset of devel­ opments that trans kids often find deeply upsetting, such as breast growth in cisgender girls or body hair and deeper voices in cisgender boys.

One such bill passed in Arkansas this year but was blocked by a federal court before it was set to go into effect by the end of July.

In addition, other bills aim to block trans students from playing on sports

teams that match their gender identity.

Cox has spoken out powerfully against such legislation. Talking to Variety in June 2021, she said of the people behind such bills, “What they’re trying to do is dehumanize these children, which is so heartbreaking...the fervor with which they’re going after the[m].”

She indicated the illogic of oppos­

COX IS VOCAL ABOUT THE OFTEN FATAL VIOLENCE AGAINST MOSTLY BLACK AND LATINA TRANS WOMEN. ing both the right of trans kids to play on the team of their choice and their right, in consultation with their parents, to access puberty blockers. “They’re saying trans girls can’t play sports and also trying to deny those girls and boys access to the...care that would actually halt puberty. So it’s like,

make it make sense!”

Then she added: “Those folks who say they’re allies of trans people who don’t have all the information, I say [to them] with love, let’s get the information.”

ALWAYS LEADING WITH LOVE Maybe Cox has proved such an effective advocate for LGBTQ justice because she truly believes in the best in people, the idea that if folks are approached with kindness rather than shamed and canceled on social media, there really is a chance that hearts and minds will change—and legislation will follow.

As she said on The View, “So often when folks feel called out and accused of being racist or transphobic…[they] are on defense...and not in a place where we can fully hear each other. And so as corny...as it sounds, we have to create [a] safe space so that each human being feels...that they’re safe, so that we can have conversations with love and empathy. So I’m not a fan of cancel culture. I’m a fan of giving people space...so they can take risks and make mistakes— and be transformed.”

Maybe that’s the word that best sums up Cox—transformation. There’s her own personal transformation from fear and shame to resilience and self­love, which she has shared so gener­ ously with her fans. Then there’s that same individual transforma­ tion that she champions for her LGBTQ brothers and sisters, particularly her fellow trans women of color.

And finally, with both com­ passion and sheer passion, Cox lobbies ceaselessly for the kind of political and societal transfor­ mation Black folks need to thrive— regardless of what gender they identify as or who they love and desire. ■ Look for Cox in the forthcoming series Inventing Anna and Clean Slate. Follow her on Twitter @Lavernecox and Instagram @lavernecox.

realhealthmag.com

RH_FOCUS_LGBTQ_p_10-13_Feature_HY.indd 13

I

W I N T E R 2 0 21 R E A L H E A LT H F O C U S 1 3

10/19/21 9:00 AM

RHA534592.pgs 10.19.2021 13:59

ESA