Young people who are LGBT often grow up isolated, without family support, without inclusion in history & literature taught at school, and invisible. Until recently, when the HIV/AIDS crisis made the LGBT community more visible, health messages had reflected the assumption that everyone is heterosexual. This isolation creates the conditions for mental health difficulties, including depression and increased risk for suicide, and also increased alcohol and other drug (including tobacco) use.

Keep in mind that many LGBT people are resilient and strong, having weathered being treated poorly, and have developed strengths, such as culture, humor, community organizing. We see these strengths in our students who are now celebrating 30+ years of activism here at Rutgers.

Coming out is an ongoing health issue, as that process continues throughout life. Identifying a support network is important for college students planning to come out to their families. If a family member throws the student out of the house, where will they live? What kind of economic support might they lose, or have from other sources? Student organizations and LGBT positive counselors/therapists can be helpful.

What are LGBT health issues? On the one hand, they are the same issues as everyone else's. At the same time, prejudice, ignorance, and fear may mean that a LGBT student has avoided using health services and may have later diagnosis for a health condition. Women often access health services through gynecology, seeking birth control. For women who partner only with women, birth control is of course not needed, and therefore a student may not have a routine gyn exam, missing out on her Pap smear and clinical breast exam. Further, if a woman who partners with women has had a negative experience with a provider who assumes she needs birth control, or even if she has heard a friend's story to that effect, she may be reluctant to confront the provider or request another provider; she may "tune out," and avoid preventive care.

Gay or bisexual men, and transgender people, also often avoid using health services, until it is clear that services are culturally and clinically competent. At the RHS we provide periodic training, designed and implemented by staff and students, to improve upon our care and services.

We can all support the health of LGBT students by being active as members of the community or as allies, working to change the culture, prejudices, and institutional barriers to health. Working with legislators to pass Hate Crimes legislation, and working for benefits equal to those provided to heterosexual colleagues is crucial to health. Also important is working with public schools to ensure that they include LGBT history and culture in their curricula and equally importantly, initiate educational interventions that proactively address racism, sexism and heterosexism, dealing appropriately and effectively with bias-related language and violence in the schools.

HIV/AIDS is still a major concern for young people under the age of 25. Risky behavior is the risk factor, e.g., sharing needles or having unprotected sex with an infected partner, not sexual orientation or gender of partners. Of course some gay and bisexual men are not at risk, successfully using abstinence or safer sex, while others are ignoring safer sex messages, or sharing injection drug equipment. Lesbian and bisexual women are also potentially at risk for the same reasons. Sexually transmitted infections are easily passed between people of the same/other genders as well, through oral, vaginal and anal penetration, or potentially through the exchange of blood/semen/vaginal secretions. The message must go out to all that we are still in the HIV/AIDS epidemic, and that choosing same and/or other gender sex is fine; and condoms, lube, dental dams/plastic wrap are necessary to protect oneself and partners. Part of our health education message is that we value our LGBT students, we care about their health, we look forward to seeing them achieve their dreams and goals.

Violence is another issue for LGBT students. Bias-related violence is a real threat to those perceived to be LGBT, and that threat contributes to the fear of those unwilling to leave the "safety" of the closet. The LGBT community has rallied to address and prevent this violence. More insidious is same gender relationship violence, which is also a problem. Increasingly, community anti-violence projects are not only providing services to the battered/abused partner, but reaching out to abusers as well.

When heterosexism and homophobia are greatly diminished, LGBT health concerns will return to being college health concerns. Until then, we must all let our students know that there are health education, counseling, and clinical services that are well suited to their specialized needs. Some of these resources are listed below:

RESOURCES

Rutgers University:

Rainbow Community Advisory Board
c/o Ellen Zaltzberg, Coordinator, Sexual Health Education and Training Program

Department of Health Education
Hurtado Health Center, 11 Bishop Place, New Brunswick, NJ 08901
(732) 932 7710
zaltzber@rci.rutgers.edu
http://health.rutgers.edu

RU Health Services
Richard Piech, MD, Health Services Director
(732) 932-8429

Busch-Livingston Health Center
445-3250
Edward Lifshitz, MD, Acting Director

Hurtado Health Center
932-7402
Carolynne Murphy, Acting Director

Willets Health Center
932-9805
Dorothy Kozlowski, Director

RHS Insurance Office
932-8285

Alcohol and Other Drug Assistance Program
932-7976
Lisa Laitman, Director

New York City:

Michael Callen Audre Lorde Community Health Center
356 West 18^th Street, NYC 10011
(212) 271 7200
http://www.callen-lorde.org/
Comprehensive and tailored health services; particularly sensitive to LGBT people. Insurance accepted.

NYC Gay and Lesbian Anti-violence Project
240 West 35th Street
New York, NY 10001
(212) 714-1184 (phone)
(212) 714-1141 (24-hours)
(212) 714-1134 (TTY)
http://www.avp.org/

Websites:

Gay and Lesbian Medical Association

Gay Men's Health Crisis