New research out of the University of Minnesota reveals rural LGBTQ folks face unique, and often unmet, mental- and physical-health needs.

The Minnesota research, published last month, indicates social cohesion can play a major role in the health and well-being of LGBTQ people, and it documents how some organizations are trying to meet that need.

Marianna Tuttle, a research and communications fellow at the University of Minnesota's Rural Health Research Center, said community organizations can play a major role in supporting that sense of belonging.

"So the organizations we spoke with were doing a range of work," said Tuttle, "including support groups and relationship-building activities that may fall under the social and emotional support needs, to anti-bullying efforts and education for their entire community that could more broadly impact the environment folks live in."

One of the groups profiled in Tuttle's research is the Virginia Rural Health Association, which aims to improve health access and quality of care for the commonwealth's rural communities.

That association offers LGBTQ-specific programs through its Pride of Rural Virginia initiative, which has its next in-person program scheduled for August 6 at the Edinburg branch of the Shenandoah County Public Library.

Tuttle said prior research revealed rural LGBTQ folks saw a significant decrease in their social and emotional support during the COVID-19 pandemic.

She said Pride events, and other community gatherings, can provide an important mental-health boost by increasing visibility and providing a sense of belonging.

"They're not the end-all, be-all, but they're a really important and positive start," said Tuttle. "Having the entire town or the entire region come together to celebrate LGBTQ+ folks' presence, their membership in the community, is a really good place to start."

Nearly half of all LGBTQ youths in rural areas say their community is unaccepting of LGBTQ people, according to a 2021 Trevor Project report. Similarly, those same kids reported higher rates of discrimination against LGBTQ folks.

For some LGBTQ+ voters in Nebraska, the state's new voter ID law brought up issues in the May primary election and could again in November's General Election.

Johnny Redd, communications manager for OutNebraska, said the group has used Pride Month to focus on voter registration and what the voter ID law does and does not mean. Redd explained one concern they have heard is, what happens if the person's ID picture does not match their appearance or gender expression?

"There is no requirement that requires you to look like your photo. It just has to be a photo ID," Redd noted. "I mean, obviously, if it's like someone of a different race, or something like that, then there's a problem."

Redd pointed out it is not unusual for people to look different from their photo ID, often because of a different hair color or style, or weight gain or loss. But for those who have changed their name, she stressed the name on their ID and their voter registration must match for them to be eligible to vote.

Redd urged people to make sure their voter registration is up-to-date. At the Secretary of State's Voter Registration Portal, people can register, change their address and even change their name in some cases.

Redd added voter roll purging is another reason people should double-check their registration. She said although it is usually billed as "upkeep," in some cases it may be more targeted.

"Specifically, BIPOC and LGBTQ people end up being a huge number of those folks that are purged from voter rolls, for whatever reason," Redd observed. "That's another big one, just showing up and realizing, 'Wait, I'm not even on the list because I haven't voted since 2017,' or something like that."

Nebraska law requires people who've moved to update their voter registration by the deadline indicated by their county election commissioner or county clerk, or they will be dropped from the voter rolls.

A 2022 study identified members of the LGBTQ+ community and their supporters as one of the fastest growing voting blocs in the country.

Twenty years after the first state permitted marriage equality, a majority of same-sex married couples said it had a profound positive effect on their lives.

A new report finds it strengthened couples' relationships, provided legal protections, financial security and greater acceptance among family and friends.

Abbie Goldberg, professor of psychology at Clark University, said marriage equality is part of a public health agenda.

"They have access to health insurance. They are physically and mentally healthier. They're able to share the sort of challenges and work of raising children," Goldberg outlined.

Still, Goldberg said nearly 80% of couples surveyed worry about the future of marriage equality. Supreme Court Justices Samuel Alito and Clarence Thomas have both suggested the high court revisit Obergefell v. Hodges, the decision which legalized same-sex marriage in 2015.

The report reveals same-sex married couples are also concerned about what they call an increasingly hostile environment in the U.S. More than 500 anti-LGBTQ+ bills have been introduced since last year, including in New Hampshire, where lawmakers have advanced measures targeting transgender youth.

Goldberg noted concerns are forcing couples to consider relocating to more accepting states, or even outside the U.S.

"It's creating not just legal uncertainty but propelling them to think about the future in ways that require time, money, planning," Goldberg explained.

Goldberg added marriage equality created families and the report details the positives to ensuring people are protected. Almost 60% of participants said marriage provided more stability or security for their children, and often created new in-laws who could help.


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As Pride Month winds down, health advocates want members of the LGBTQ+ community to know about health care options, despite any challenges to obtaining them.

Nearly 8% of U.S. adults identify as lesbian, gay, bisexual, transgender, queer or some other sexual orientation besides heterosexual, according to 2023 data, which is more than double the number in 2012.

Despite the increase, the group still faces health care disparities. According to a 2023 survey from the health policy organization KFF, LGBTQ+ people are more likely to self-report poorer health, experience higher rates of disability and have more need for mental health services. Those living in rural places face additional challenges.

Kenny Starling, owner of Wyoming's debut drag and theater production company, said health care can feel like a taboo topic, especially for queer people.

"On top of that, the actual health care providers themselves being up-to-date on the information about queer individuals and the resources that should be available to us," Starling pointed out.

Starling noted it took them four months to find a local doctor willing to work with them to obtain Pre-Exposure Prophylaxis, or PrEP, an HIV preventive Starling's original doctor had not even heard of. According to KFF, nearly half of LGBTQ+ people have reported a negative experience with a health care provider in the last two years, as opposed to one-third of people outside the group. It includes the provider dismissing patient concerns, making assumptions, thinking the patient was lying and more.

Starling emphasized their theater and drag company has been busy during Pride month. The company uses performances to address health care, talking about it during shows and providing resources in the lobby.

"We alternate between the resources," Starling added. "Be they mental health services or free rapid HIV and STD testing, suicide prevention, access to Enroll Wyoming and health insurance resources."

Open enrollment for health insurance begins Nov. 1 in most states but special enrollment periods apply for those experiencing certain life changes.


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