Online Extra: LGBTQ Agenda: State, city criticized for not counting sexual orientation of COVID-19 patients
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LGBT leaders and medical professionals are worried that a lack of data on the LGBT identities among novel coronavirus patients means that they won't know the particular ways in which the community is being affected.
Both the city of San Francisco and the state of California are not collecting data on sexual orientation, but the city is collecting data on whether patients identify as transgender.
As the Bay Area Reporter reported March 17, LGBTs may be at heightened risk of getting — and dying from — COVID-19, the disease caused by the novel coronavirus, due to a number of factors, including heightened levels of tobacco use, cancer and HIV infection, as well as discriminatory attitudes within parts of the medical field.
And as the B.A.R. reported April 7, the economic impact of shelter-in-place orders in almost every state disproportionately impact industries where LGBTs work, which will almost certainly exacerbate the pre-existing pay gap between LGBT people and their cisgender/heterosexual neighbors. And as the Washington Blade reported April 1, many states and local jurisdictions are not collecting data on whether COVID-19 patients are LGBTs.
Scout, who goes by one name, is a bisexual and trans man who is the deputy director of the National LGBT Cancer Network. He rebuffed statements, such as one sent from the office of New York Governor Andrew Cuomo (D) to the Blade, that because the virus does not discriminate on the basis of identity groups, it is not necessary to collect data on whether patients are LGBT.
"The virus doesn't discriminate but pre-loaded health disparities create discrimination," Scout, a Ph.D., said in an April 7 phone call.
The Centers for Disease Control and Prevention asks for data based on age, sex, and ethnicity but not on sexual orientation or gender identity, Scout said.
"We have been on a campaign for federal data collection for many years now," Scout said. "Until your doctor asks if you are LGBT on an intake form, we are going to keep hiding the extent of this."
SF, CA response
The San Francisco Department of Emergency Management, which is overseeing the city's response to COVID-19, told the B.A.R. via email on April 7 that "we are collecting trans status in order to inform clinical understanding and management of each case, but not sexual orientation."
The department has not responded to a request for comment asking why this is the case.
No cases have been reported among trans men or women on data charts released by the city as of April 10. The department said that the city will report those if the number of trans people affected exceeds five, a minimum that is in place to protect patient privacy.
Scout said that it worries him that only data on gender identity is being collected.
"There are some legacy-trans data surveillances, such as for cancer, that keep track of that under sex," Scout said. "But just because it exists doesn't mean it's being used. Now, it is San Francisco, so maybe it'll be much better, but I'd be concerned about getting accurate data. The trans option (on the national cancer registry) has yielded little factual info."
Scout told the B.A.R. in an April 9 email that he has reached out to several states to see the status of their collecting efforts.
"While I talked with California folk, I haven't heard anything definitive," Scout said. "I've asked my contact if they can send me to someone who could answer."
Gay state Senator Scott Wiener (D-San Francisco) told the B.A.R. April 10 that the state is not collecting data on sexual orientation or gender identity but that he will be sending a letter to Governor Gavin Newsom (D) requesting it do so.
Later that day, Wiener's office announced it had sent the letter, which was co-signed by Assemblyman Todd Gloria (D-San Diego). Wiener is the chair of the legislative LGBTQ caucus and Gloria is the vice-chair.
"We believe that unless the state makes a concerted effort to collect data on LGBTQ people affected by COVID-19, we will not be able to adequately respond to the needs of our community," the letter, released around 3 p.m. Friday, states. "Thank you for your time and please do not hesitate to reach out to either of us directly should you need more information."
The California Department of Public Health had not responded to multiple requests for comment at press time. The governor's office did not immediately respond to a request for comment. Wiener broached the issue in an April 8 virtual news conference hosted by the California LGBTQ Health & Human Services Network.
"We don't have the data we need," Wiener said. "This pandemic is particularly harming communities with underlying health and economic inequalities. We know our community is likely to have underlying health challenges.
"That makes COVID-19 worse, and as California moves forward we need to make sure that is taken into account and we have the resources to survive and protect our communities. The last thing we need is to have LGBTs not represented," he added.
Wiener said there are other factors for older people in the LGBT community that could put them at particular risk for COVID-19.
"A lot of LGBT people have no children and don't have the support system other seniors have," he said.
Wiener, who has been a prominent statewide voice on housing issues, also discussed the housing challenges that will occur when emergency declarations are lifted unless further governmental action is taken.
"We don't want people to hang on to housing during the state of emergency only to be evicted afterward," Wiener said. "We don't want our community to fall through the cracks."
Scout said that smoking, more than HIV-status per se, is a prime indicator of risk from COVID-19.
"There are 2.3 million LGBT tobacco users," Scout said. "All of those people are at high risk for getting COVID, and definitely at higher risk for extremely adverse outcomes."
Nationwide, it's been reported that African Americans have been dying of COVID-19 in numbers greater than their presence in the general population.
While black people make up 30% of the population of the city of Chicago, for instance, 67% of COVID-19 deaths reported there have been in that group.
In San Francisco, 5% of COVID-19 cases have been among black people, and about 5% of the population is black, according to U.S. Census Bureau estimates. There is a racial disparity, however, among people who are either Hispanic and/or Latino, with 24% of the city's COVID-19 cases in that population, while Hispanic and/or Latino people make up 15% of the city's population, according to census estimates.
Congresswoman Barbara Lee (D-Oakland) announced a petition April 10 demanding congressional action to require national reporting of COVID-19 CDC data relating to race.
Lee's office did not respond to a request for comment at press time.
Dr. Anthony Fauci, who has been the director of the National Institute of Allergy and Infectious Diseases since 1984, said in a White House news conference April 7 that the disproportionate effects of COVID-19 lay bare the marginalization of the African American community.
"I see a similarity here because health disparities have always existed for the African American community," Fauci said. "It's shining a bright light on how unacceptable that is because when you have a situation like the coronavirus, they are suffering disproportionately."
Fauci drew a comparison to his memories of his work on the AIDS epidemic during the 1980s and 1990s. Standing beside Vice President Mike Pence (R), who has been a decades-long opponent of LGBT rights, Fauci said other communities can learn from the LGBT community's response to HIV/AIDS.
"If you go back then during that period of time when there was extraordinary stigma particularly against the gay community," Fauci said. "It was only when the world realized how the gay community responded to this outbreak with incredible courage and dignity and strength and activism: I think that really changed some of the stigma against the gay community."
LGBTQ Agenda is an online column that appears weekly, usually on Tuesdays. Got a tip on queer news? Contact John Ferrannini at email@example.com
Updated, 4/10/20: This article was updated to include the fact that state Senator Scott Wiener did send his letter to Governor Gavin Newsom.
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