Among the accomplishments, HHS Secretary Sebelius lists the development of an Institute of Medicine report on LGBT health, a rule requiring hospitals to accept patients’ wishes for who can visit them “regardless of sexual orientation, gender identity, or any other non-clinical factor,” inclusion for the first time of LGBT health concerns in the nation’s Healthy People goals, anti-bullying efforts, and policies and funds to encourage shelters for homeless young people to be properly equipped to provide services to LGBT youth.

Several items for future action were also listed, including promoting “cultural competence” training for healthcare providers to improve care to LGBT patients, guidance to state child welfare agencies on how to better support LGBT young people, and better data collection on sexual orientation and gender identity in health data collection processes in order to better understand and approach health disparities.

There’s a long way to go – a 2010 report indicated that nearly 1/3 of transgender men and women had avoided getting medical care because of discrimination, and about 1 in 5 had been refused care due to their transgender or gender non-conforming status. Lesbian and bisexual women are thought to be at higher risks of heart disease because of higher rates of obesity, smoking, and stress – which may in turn be related to discrimination faced in healthcare systems and society in general. The IOM report mentioned above reminds us that LGBT folks face “a profound and poorly understood set of additional health risks due largely to social stigma.”

Let us hope that in the coming year, as President Obama stated last night about the nation, the state of our LGBT health will be getting stronger.

For an overview of LGBT human rights and discrimination around the globe, see this United Nations report published last November.

The story starts by comparing identical twins, two boys who grew up with distinctly different personalities and interests. As Bella English writes:

Jonas was all boy. He loved Spiderman, action figures, pirates, and swords.

Wyatt favored pink tutus and beads. At 4, he insisted on a Barbie birthday cake and had a thing for mermaids. On Halloween, Jonas was Buzz Lightyear. Wyatt wanted to be a princess; his mother compromised on a prince costume.

You see where this is going. What makes it a must-share read is the family’s forthrightness in discussing the difficult decisions they made to ensure Wyatt, now 14 and named Nicole, is able to grow up in a world in which she feels loved, safe and welcomed.

Having read so many superficial or gee-whiz stories on transgender children and adults, this one will be remembered for its honesty and emotion, especially coming from Nicole’s father, Wayne, 53. Here’s just one example:

Last winter, Maine state representative Kenneth Fredette, a Republican from Penobscot County, sponsored a bill that would have repealed protections for transgender people in public restrooms, instead allowing schools and businesses to adopt their own policies. The bill was a response to the Maines’ 2009 lawsuit against the Orono School District.

Last spring Wayne and Nicole roamed the halls of the State House, button-holing legislators and testifying against the bill. “I’d be in more danger if I went into the boys bathroom,’’ Nicole told the lawmakers, who ultimately rejected the bill.

“She knows how to work a room,’’ her father says proudly. “She even convinced a cosponsor to vote the other way.’’

In October, the family was honored for its activism in helping defeat the transgender bathroom bill. The Maineses received the Roger Baldwin Award, named for a founder of the American Civil Liberties Union, from the Maine chapter of the ACLU.

Surrounded by Kelly and the kids, Wayne told the audience that he and his wife have had top-notch guides as they confronted the unknown.

“As a conventional dad, hunter, and former Republican, it took me longer to understand that I never had two sons,’’ he told them. “My children taught me who Nicole is and who she needed to be.’’

Go read the whole thing. And also see “What If Your Child Says, I’m In The Wrong Body?” — an NPR interview with endocrinologist Norman Spack, co-founder of the Children’s Hospital Gender Management Services Clinic at Boston’s Children’s Hospital. Spack has worked with 30 transgender youth (including Nicole) and their families on the emotional and medical issues, particularly in adolescence.

Plus: In related news this year, the Massachusetts Legislature passed and the governor signed into law the Transgender Equal Rights Bill, extending civil rights and hate crimes protections to transgender residents of that state. At left is a photo of Gunner Scott, executive director of the Massachusetts Transgender Political Coalition, an advocate of the bill, and Craig Norberg-Bohm, coordinator for the Men’s Initiative for Jane Doe.

Both men contributed to the new edition of “Our Bodies, Ourselves“; Scott’s piece, an adaptation of his remarks at the Jane Doe organization’s White Ribbon Day rally in 2010, explains how violence against transgender people is related to violence against women.

Finally, we’re looking forward to hearing more in 2012 about the forthcoming book “Trans Bodies, Trans Selves,” a resource guide for the transgender population, covering health and legal issues, along with cultural and social questions, history and theory. Check out the list of contributors and topics.

The United Nations’s UN Women group released a report, “Progress of the World’s Women: In Pursuit of Justice,” which looks at the legal rights of women around the world, barriers to accessing and navigating the justice system, and the impact of war/conflict on women, among other issues. It also includes ten recommendations for making justice systems work for women.

The University of South Florida has begun offering students gender-neutral housing options in response to a transgender student who reported hostility and harassment in campus housing. The school is going to offer several housing options and allow students to indicate male, female, or transitioning on their campus housing applications.

NPR’s All Things Considered ran a piece yesterday on mother-to-child transmission of HIV in Mozambique; there is a related piece on breastfeeding and HIV in developing nations.

Childbirth Connection has launched the Transforming Maternity Care blog with Amy Romano, formerly of Science & Sensibility and part of the editorial team for the forthcoming edition of “Our Bodies, Ourselves.” It looks like the blog will focus on quality improvement, patient advocacy, and shared decision-making in maternity care.

As I read the legislation, it includes coverage for both certified professional midwives and certified nurse-midwives.

The Governor remarked, “Access to midwifery care and home birth should not be limited only to those who can afford those services out of pocket. This law will ensure that all expectant mothers get the coverage and care they want and deserve.”

The legislation establishes a maternal mortality review board made up of an obstetrician, maternal-fetal medicine specialist, neonatologist, CNM, CPM, and other relevant specialists, along with a member of the public. This board will review maternal deaths in Vermont for factors associated with the deaths, and will make recommendations for systemic changes and legislation to address those factors.

Although it seems to have received less media attention, the law also includes a provision to allow transgender individuals to acquire new birth certificates reflecting their gender rather than the one assigned at birth. This will require a doctor’s note submitted to a court “stating that the individual has undergone surgical, hormonal, or other treatment appropriate for that individual for the purpose of gender transition.”

This reportedly makes Vermont the only state with a law that explicitly specifies that surgery is not required in order to obtain a new birth certificate. The law also provides that the original birth certificates will not be available for public inspection in order to protect individual privacy.

Saying that it discriminates against gay men and women, a federal judge in San Francisco struck down California’s voter-approved ban on same-sex marriage on Wednesday, handing supporters of such unions at least a temporary victory in a legal battle that seems all but certain to be settled by the Supreme Court.

Wednesday’s decision is just the latest chapter in what is expected to be a long battle over the ban — Proposition 8, which was passed in 2008 with 52 percent of the vote. Indeed, while striking down Proposition 8, the decision will not immediately lead to any new same-sex marriages being performed in California. Vaughn R. Walker, the chief judge of the Federal District Court in San Francisco, immediately stayed his own decision, pending appeals by proponents of Proposition 8, who seem confident that higher courts would be less accommodating than Judge Walker.

But on Wednesday the winds seemed to be at the back of those who feel that marriage is not, as the voters of California and many other states have said, solely the province of a man and a woman.

“Proposition 8 cannot withstand any level of scrutiny under the Equal Protection Clause,” wrote Judge Walker. “Excluding same-sex couples from marriage is simply not rationally related to a legitimate state interest.”

Continue reading …

Related:

* Judge Vaughn Walker’s 136-page ruling against Prop. 8. One of my favorite sections:

The evidence shows that the movement of marriage away from a gendered institution and toward an institution free from state-mandated gender roles reflects an evolution in the understanding of gender rather than a change in marriage. The evidence did not show any historical purpose for excluding same-sex couples from marriage, as states have never required spouses to have an ability or willingness to procreate in order to marry.

Rather, the exclusion exists as an artifact of a time when the genders were seen as having distinct roles in society and in marriage. That time has passed.

* More on the judge’s “findings of fact” at ColorLines.

* Lots of links and good info at Pam’s House Blend (start with this open discussion).

* NYT editorial: “The decision [...] is a stirring and eloquently reasoned denunciation of all forms of irrational discrimination, the latest link in a chain of pathbreaking decisions that permitted interracial marriages and decriminalized gay sex between consenting adults.

“As the case heads toward appeals at the circuit level and probably the Supreme Court, Judge Walker’s opinion will provide a firm legal foundation that will be difficult for appellate judges to assail.”

* San Francisco Chronicle’s archive of the November 2008 California ballot measure and the state Supreme Court challenge to Prop. 8.

* Timeline of the 10-year battle over same-sex marriage in California.

* Finally, for your viewing pleasure, a look back at “Prop 8: The Musical” …

What are you reading on Prop 8?

The proposed rule is now posted for public comment at Regulations.gov. Comments are being accepted until 11:59 pm Eastern time on August 27, 2010. Click on “Submit Comment” at the top of the page to weigh in on the proposed rule.

Once comments are submitted and uploaded, you’ll be able to view them here. (You won’t see any just yet, as none have been uploaded as of this writing.) You can also sign up for email alerts on this item and use the “Share” options to post to Twitter, Facebook, and other services.

The proposed rule change follows up on an April 15 presidential memorandum requesting, in part, that critical access hospitals and hospitals participating in Medicaid or Medicare allow patients to designate visitors who would receive the same access as “immediate family members.” These participating hospitals “may not deny visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability.”

As the memorandum explains:

[E]very day, all across America, patients are denied the kindnesses and caring of a loved one at their sides — whether in a sudden medical emergency or a prolonged hospital stay. Often, a widow or widower with no children is denied the support and comfort of a good friend. Members of religious orders are sometimes unable to choose someone other than an immediate family member to visit them and make medical decisions on their behalf. Also uniquely affected are gay and lesbian Americans who are often barred from the bedsides of the partners with whom they may have spent decades of their lives — unable to be there for the person they love, and unable to act as a legal surrogate if their partner is incapacitated.

Marilyn Tavenner, acting administrator of the Centers for Medicare & Medicaid Services (CMS), called the rule “an important step forward in the rights of all Americans to expect equal rights and privileges from the health care system, regardless of their personal and familial situations.”

The proposed rule will be available for public comment for 60 days, after which CMS will review the comments before finalizing the rule. It does not seem to be posted for comment yet at Regulations.gov, but we’ll update this post with the link when it is.

The ACLU and Planned Parenthood have further commentary.

Rachel Maddow invited Richard Cohen, who claims he can “cure” homosexuals, on her show Tuesday night. Passages of his book “Coming Out Straight” — unscientific, debunked, ridiculously accusatory passages — are being used to justify proposed legislation in Uganda  that calls for executing gay men and women either living with HIV or who are “serial offenders” (whatever that means).

Anyone convicted of a homosexual act faces life in prison under the Uganda bill, and anyone who ”aids, abets, counsels or procures another to engage of acts of homosexuality” faces seven years in prison.

Cohen insists that he is not a proponent of the legislation, but Maddow doesn’t let him off the hook:

“I realize I was taking the risk of helping promote you and the way that you think about these things by putting you on the air,” says Maddow, “but I do think that you’ve actually got blood on your hands.”

For more background on what’s going on in Uganda and the connection to influential right-wing members of Congress, read the transcript of this “Fresh Air” (NPR) interview with Jeff Sharlet,  author of “The Family: The Secret Fundamentalism at the Heart of American Power.”

Visit msnbc.com for breaking news, world news, and news about the economy

Feministing’s Jessica Valenti is quoted in this Associated Press story on the election and NOW’s generational divide.

Plus: I don’t think I’ve linked yet to Katha Pollitt’s excellent piece in The Nation on feminism’s false waves. It begins:

Can we please stop talking about feminism as if it is mothers and daughters fighting about clothes? Second wave: you’re going out in that? Third wave: just drink your herbal tea and leave me alone! Media commentators love to reduce everything about women to catfights about sex, so it’s not surprising that this belittling and historically inaccurate way of looking at the women’s movement — angry prudes versus drunken sluts — has recently taken on new life, including among feminists.

Losing Celebrity Weight Battles: When famous dieters like Kirstie Alley or Oprah Winfrey talk about being “disgusted” with their bodies, the comments have an effect beyond selling magazines.

“Kirstie looks the same as me, to the inch, height and weight,” Emily Schaibly Greene, 29, recently told The New York Times. “It took me a long time to get there, but I’m feeling good with how I look. But it’s difficult to keep liking the way I look when I’m reading that it’s gross.”

Lesley Kinzel, who writes for the blog Fatshionista, said, “When you have famous people turning their weight tribulations into mass-media extravaganzas, they’re contributing to a culture where passing comments on strangers’ bodies is considered O.K.”

Plus: Nia Vardalos, who rose to fame after starring in “My Big Fat Greek Wedding,” says her recent weight loss is all people want to talk about these days, pushing aside her personal and professional achievements. Her column is awesome.

And if you haven’t yet bought “Lessons From the Fat-O-Sphere,” go. Author Kate Harding – founder of Shapely Prose and contributor to Broadsheet — is still on the book tour this month and is looking forward to speaking at colleges in the fall. 

Summer Reading List: From Women’s eNews: From sensational memoirs to serious sociology, check out what women are writing about and the prizes they’ve been snapping up so far in 2009. Sarah Seltzer has the goods.

Women’s Health Clinic to Close: The University of Chicago Medical Center is closing its women’s health clinic, an essential community health resource, at the end of the month. Ironically, this is being done under the Medical Center’s Urban Health Initiative; U.S. Rep. Bobby Rush has called for a congressional investigation into whether the Medical Center has engaged in “patient dumping” by steering the poor to other health facilities.

“Medical center executives have said the steep downturn in the economy has forced them to trim $100 million from the hospital’s budget to maintain running a prestigious hospital, research center and medical school. They also have said the Women’s Health Center, which cares for thousands of Medicaid patients, is a money loser,” reported the Chicago Tribune last month, in a story on protests against the closing.

Plus: While looking up information about the closing, I came across a 2008 New York Times story on Michelle Obama, who at that time was on leave from her job as vice president of community affairs at the University of Chicago Medical Center. Stories like this made me wonder what she could/would have done about the closing:

When the human papillomavirus vaccine, which can prevent cervical cancer, became available, researchers proposed approaching local school principals about enlisting black teenage girls as research subjects.

Obama stopped that. The prospect of white doctors performing a trial with black teenage girls summoned the specter of the Tuskegee syphilis experiment of the mid-20th century, when white doctors let hundreds of black men go untreated to study the disease.

Too Poor to Make the News: Over on The New York Times op-ed page, Barbara Ehrenreich has written the first in a series on how the recession affects people who don’t neatly fit the downwardly mobile narrative: the already poor.

“This demographic, the working poor, have already been living in an economic depression of their own,” writes Ehrenreich. “From their point of view ‘the economy,’ as a shared condition, is a fiction.” She continues:

The deprivations of the formerly affluent Nouveau Poor are real enough, but the situation of the already poor suggests that they do not necessarily presage a greener, more harmonious future with a flatter distribution of wealth. There are no data yet on the effects of the recession on measures of inequality, but historically the effect of downturns is to increase, not decrease, class polarization.

The recession of the ’80s transformed the working class into the working poor, as manufacturing jobs fled to the third world, forcing American workers into the low-paying service and retail sector. The current recession is knocking the working poor down another notch — from low-wage employment and inadequate housing toward erratic employment and no housing at all. Comfortable people have long imagined that American poverty is far more luxurious than the third world variety, but the difference is rapidly narrowing.

Health Care & the Arts: NPR interviews Anna Deveare Smith about her show “Let Me Down Easy,” which is based on interviews with doctors and patients (previously discussed here). Her newest role: artist in residence at the Center for American Progress, which Smith will use as a perch for studying changes in Washington. Smith also plays a doctor in the new Showtime series “Nurse Jackie.”

Speaking of “Nurse Jackie,” David Bauder of the Associated Press notes that the ethically challenged nurse at the head of the show (wonderfully played by Edie Falco) has appalled some nurses — but is that a bad thing for Showtime? Well, no.

Apologies from California: I meant to post this next one when it first came out, but I still think it’s amusing — San Francisco Chronicle columnist Mark Morford would like you to know California is really, really sorry about the whole Prop 8 thing.

Meanwhile, tony Greenwich, Conn., has become wedding central for same-sex New York couples who no longer have to drive as far as Massachussetts. California sure could have used money spent on wedding bliss.