LGBTQ Health

Dr. Warren J. Blumenfeld details a demonstration in which he participated protesting the American Psychiatric Association's designation of homosexuality as a so-called "Ego-Dystonic Disorder," a mental illness in a similar category with schizophrenia and manic depressive disorder.  The article investigates how the psychiatric profession constructed and then deconstructed homosexuality as a mental disease.

Este material ofrece conceptos y herramientas teóricas y metodológicas para el abordaje de las adolescencias y la diversidad sexual e identidad y expresión de género, desde una perspectiva de salud integral y derechos. Está destinado a equipos de salud y otros actores que trabajen tanto en el ámbito asistencial como en prevención y promoción comunitarias.

Over the past decade, evidence has accumulated to suggest that bisexual people experience higher rates
of poor mental health outcomes compared to both heterosexual and gay/lesbian individuals. However,
no previous meta-analyses have been conducted to establish the magnitude of these disparities. To
address this research gap, we conducted a systematic review and meta-analysis of studies that reported
bisexual-specific data on standardized measures of depression or anxiety. Of the 1,074 full-text articles
reviewed, 1,023 were ineligible, predominantly because they did not report separate data for bisexual
people (n = 562 studies). Ultimately, 52 eligible studies could be pooled in the analysis. Results indicate
that across both outcomes, there is a consistent pattern of lowest rates of depression and anxiety among
heterosexual people, while bisexual people exhibit higher or equivalent rates in comparison to lesbian/
gay people. On the basis of empirical and theoretical literature, we propose three interrelated contributors
to these disparities: experiences of sexual orientation-based discrimination, bisexual invisibility/erasure,
and lack of bisexual-affirmative support. Implications for interventions to improve the
health and well-being of bisexual people are proposed.

Pregnancy is considered a feminine experience in mainstream Canadian culture. Babies identified as female at birth are expected to grow up to become feminine heterosexual mothers. This research considers the desires, choices, and experiences of individuals who were identified as female at birth, but who do not identify as feminine heterosexual women; this dissertation focuses on the reproductive desires, choices, and experiences of butch lesbians, transmen, and genderqueer individuals in British Columbia. Three methods and two distinct populations formed this research. Participant observation was conducted in 21 cities across southern BC. Questionnaires were completed by 28 health care professionals (HCPs), and by 46 butch lesbian, transmen, and genderqueer (BTQ) individuals. Face-to-face interviews were conducted with 10 HCPs, 8 BTQ individuals who had experienced at least one successful pregnancy, and 4 BTQ individuals who had either experienced or been diagnosed with a condition linked to infertility. What I found, is that for many BTQ individuals, reproduction associated with the female body (ie: pregnancy and breastfeeding) is not exclusively considered a feminine desire or experience. In fact, what I discovered is that BTQ individuals who experience pregnancy and breastfeeding explicitly challenge the cultural fetish associating femininity with reproduction (including pregnancy, breastfeeding, mothering, and fertility). Thus, I highlight not only the typically ignored desire and achievement of pregnancy of BTQ individuals, but also how BTQ individuals have experienced breastfeeding, how some BTQ parents raise queerlings, and how some BTQ individuals have negotiated diagnoses and experiences of infertility. Overall, I highlight the unique and various expectations and experiences that butch lesbians, transmen, and genderqueer individuals have regarding their ‘female’ (and potential) biological reproduction. In the end, I hope that by presenting the diverse reproductive experiences, desires, and choices of BTQ individuals, that I can foster more of an understanding of these experiences, desires, choices, and individuals, and thus challenge the cultural fetish that links femininity with ‘female’-associated reproduction. Moreover, I offer recommendations for health care professionals in an effort to foster more understanding in BTQ health care, as well as help to facilitate more queer competent health care professionals.

Historically there has been an ambivalent relationship between the mental health sciences and homosexuality. While the view, that homosexuality is some form of a mental disorder, a distortion in the normal course of human growth and development has changed in most parts of the world, several mental health professionals in India continue to stigmatize homosexual persons. There is a an urgent need to stop this discrimination in counselling practice and sensitise and train all mental health care providers to adopt an LGBTQ-affirmative stance in their practice. This manual provides several pointers and guidelines on ways in which mental health practice can be made better responsive and affirming of LGBTQ lives in India.

: Intolerance and discrimination towards sexual minorities are a worldwide phenomenon. India’s transformation from a prejudiced and stigmatized country to a minority friendly society is a worth speculating. People of sexual minorities, and their rights, once recognized in past are more likely to face harassment, threat of violence, moral policing because of the lack of social acceptance and legal recognition. LGBT people, as members of a social minority group, are suffering from various forms of socio-economic and cultural injustices which in turn make them vulnerable to mental health problems. But this highly significant aspect is understudied by the academia and the policy makers. This article is the first attempt to explore the impact of law, society and culture on the mental health of LGBT community in India.

This paper discusses a review of the literature on how gender and sexuality impact healthyaging in relation to Lesbian, Gay, Bisexual, and Transgender (LGBT) seniors. Despite the recognitionof the importance of gender and sexuality in relation to health outcomes, the health needs of LGBT  seniors have largely been ignored by health policy and program developers and are rarely considered within the scope of practice of many health care professionals. Recent research in the area of LGBT  seniors and health care has established the need for greater inclusivity and diversity education among health care workers. While many seniors are comfortable with their sexuality later in life, others maybe unable or unwilling to disclose their sexual orientation due to fear of homophobic reactions(Brotman, Ryan, & Cormier, 2003). This review of the literature frames further investigation into the experiences of LGBT seniors and the challenges for care givers as essential to producing more effective health promotion policies and programs.

In recent years, many studies have focused on the body of sexual minority women, particularly emphasizing their larger size. These studies rarely offer theoretically based explanations for the increased weight, nor study the potential consequences (or lack thereof) of being heavier. This article provides a brief overview of the multitude of factors that might cause or contribute to larger size of sexual minority women, using an ecological framework that elucidates upstream social determinants of health as well as individual risk factors. This model is infused with a minority stress model, which hypothesizes excess strain resulting from the stigma associated with oppressed minority identities such as woman, lesbian, bisexual, woman of color, and others. We argue that lack of attention to the upstream social determinants of health may result in individual-level victim blaming and interventions that do not address the root causes of minority stress or increased weight.

Objectives: We aim to provide an understanding of the psychological sequela of androgen insensitivity syndrome (AIS) in phenotypic females in order to begin to inform psychosocial health care services.

Design: Eight adult women with AIS were recruited through the Androgen Insensitivity Syndrome Support Group-United Kingdom (AISSG-UK). Data was collected via two semi-structured interviews with each woman.

Methods: Transcripts were analysed using grounded theory and a conceptual model was developed which suggests a way of understanding the AIS distress experienced by the participants.

Results: The pivotal concept is a woman's fear of devaluation. This is connected to her level of adaptation and perception of having a compromised womanhood. These, in turn, are related to her medical management and involvement with others via a support group and in talking about AIS.

Conclusions: Participants showed a clear preference for open communication about their condition throughout the process of medical management. We recommend sensitive, pacing of information to allow young women and their families to make informed decisions about treatment and a realistic adaptation to life with AIS.

Background and Purpose. The public health perspective regarding sexual and gender minority health has continued to expand beyond the hallmark AIDS crisis in the 1980s. Sexual and gender minorities experience various health and healthcare disparities for a variety of reasons. A 2017 national survey indicated that 8% of lesbian, gay, bisexual, and queer (LGBQ) respondents had been refused care by a health care provider in the last year because of their sexual orientation, and 29% of transgender-identified individuals were refused care.1 Healthcare provider attitudes and behaviors contribute significantly to some of these disparities. This perspective piece provides a synopsis of the public health/population health challenge with health disparities in these populations and a call for action to have professional health education be more inclusive of content pertinent to the health and treatment of sexual and gender minorities. This perspective also provides a summary of educational recommendations and sample curricular objectives to assist ease of integration into health professional education, regardless of discipline. A framework of pedagogy and delivery of curricula is beyond the scope of this perspective piece.
Position and Rationale. In seeking solutions to impactful ways of achieving health and healthcare equity in these communities, one solution has to be on the educational and academic side of health professions. In its broadest sense, the literature suggests a strong positive association between education and health from a socio-ecological model perspective. This perspective piece speaks directly to the subset of how education can have a direct impact on health disparities through the health care provider’s interpretation and use of information learned/not learned.
Discussion and Conclusion. Based on pedagogical principles in education and literature suggesting positive associations between impact on health disparities and health professional education,2 it is concluded that health professional education - regardless of discipline - should be inclusive of sexual and gender minority content to address this significant gap in knowledge, awareness, and skill in health delivery for these populations.

A theoretical model was tested, in which better perceived social network support specifically for a romantic relationship was hypothesized to predict higher relationship well-being which, in turn, would predict more positive mental and physical health outcomes for relationship partners. Furthermore, the model was tested on participants in both same-sex (i.e., homosexual, n = 183) and mixed-sex (i.e., heterosexual, n = 275) relationships. Structural equation modelling indicated that the hypothesized model did fit the data very well; furthermore, no differences in model fit were found between the two relationship groups. Support specifically for the relationship remained a highly significant predictor of the outcome variables, even when general social support and support for one's sexual orientation were controlled. KEY WORDS: gay/lesbian relationships • health • mental health • networks • social support Journal of Social and Personal Relationships

The health of minority populations has been a priority for the nation since the 1985 landmark report released by the Department of Health and Human Services (DHHS). The report,
prepared by the DHHS Secretary’s Task Force on Black and Minority Health, documented disparities between minority populations and whites and began what has become a national
discourse on health disparities and, ultimately, health equity. This paper presents an overview of a panel presentation titled “The Minority Health Perspective” which was held during the
2015 Commemorative Booker T. Washington Public Health Forum in Atlanta, GA. Panelists represented American Indian/Alaska Native, Native Hawaiian/Pacific Islander, Hispanic/Latino, African American and Lesbian Gay Bisexual Transgender Queer (LGBTQ) populations. Challenges experienced by minority populations were discussed, as well as collective solutions to address some of the challenges.

Students pursuing post-secondary education should never face discrimination, harassment, or exclusion
on their campuses. Yet on many Ontario university campuses, Two Spirit and LGBTQ+ students face such realities and are marginalized because of who they are. In some cases, these students become the targets of deliberate, hate-motivated actions, and in other instances, the blame lies in ignorance or apathy. It is OUSA’s hope that the recommendations provided in this paper will contribute to improving access to and safety in postsecondary education for Two Spirit and LGBTQ+ students.

Empirical studies in lesbian, gay, bisexual, and transgender (LGBT) health have documented significant disparities in risk behaviors and health outcomes across sexual orientation and gender identity. One such disparity lies in tobacco use. Surveys based on representative samples (Jabson, Farmer, & Bowen, 2014; Manalastas, 2012; tang et al., 2004) as well as meta-analyses (Lee, Griffin & Melvin, 2009; Marshal et al., 2008) indicate that gender and sexual minorities generally have disproportionately higher rates of smoking than heterosexuals. This paper builds on previous research in the Philippines that presented initial evidence for cigarette smoking disparities among sexual-minority youth (Manalastas, 2012). We examine this issue again using a different nationally representative sample of Filipino men. Analysis of archival data from the National Demographic and Health Survey showed evidence for disparities in tobacco use based on sexual-minority status. Current smoking was disproportionately higher among sexual-minority men (67%) than heterosexual men (54%). Filipino sexual-minority men also began smoking significantly earlier—about a year—than heterosexual men. No differences in smoking volume was found—both sexual-minority and heterosexual Filipino male smokers smoked an average of 10-11 sticks a day. The findings point to one important disparity in Filipino LGBT health risks: the need to address the disproportionately higher uptake of tobacco use, one of the leading preventable causes of morbidity and mortality in the world, among sexual-minority Filipino men.

In psychotherapeutic and lesbian popular culture literatures, there is an assumption that female same-sex couples are overly close and lack boundaries, a concept called ''fusion.'' Empirical efforts have yet to demonstrate whether fusion is experienced more often among women in same-sex relationships than among men in same-sex relationships or among men and women in heterosexual relationships. Furthermore, research on the topic has yet to fully incorporate feminist perspectives that challenge assumptions that high levels of closeness in and of themselves are problematic. Our study employed measures of Inclusion of Other in Self (Aron, to examine the distribution of indicators of fusion among 76 women and 58 men in same-sex relationships and 1,221 women and 285 men in heterosexual relationships. Women in same-sex couples differed from the other groups on only one indicator of fusion-they were more likely to desire less closeness in their relationships, even though their current relationships were rated as close as other types of relationships. Our study suggests that widely held assumptions that women in same-sex couples experience and idealize pathologically high closeness are not accurate.

Purpose: To assess the health and well-being of sexual minority women (SMW) with disabilities. Methods: A survey assessing physical and mental health and quality of life was administered to a convenience sample of 52 women with disabilities and 74 without disabilities. All had been recruited for an SMW's health intervention targeting women over 40 with potential for weight-related health problems. Results: Women with disabilities experienced more discrimination, had more posttraumatic stress disorder and anxiety disorders, were less connected to SMW's communities, had more physical health limitations, and reported poorer quality of life, mostly related to physical factors such as energy level and pain. Conclusions: SMW with disabilities have rarely been studied, and may have significant challenges with health, including greater need for community support. Studies are needed to further explore the influences on the health and well-being of SMW with disabilities.

Abstract: L'Intimate Partner Violence (IPV), un tempo chiamata violenza domestica, comprende un qualsiasi comportamento o atteggiamento di un membro della relazione intima volto a causare danno (fisico, sessuale, psicologico) a un altro membro della stessa relazione. L’IPV è stata spesso studiata all’interno di relazioni tra uomini e donne cisgender .
Così facendo le persone che si identificano come lesbiche, gay, bisessuali e/o transgender (LGBT) sono state per lungo tempo escluse dalle indagini. L'IPV che avviene in relazioni intime in cui almeno uno dei partner si definisce LGBT ha specifiche dinamiche sociali e psicologiche derivanti proprio dall'appartenere a minoranze sessuali in un contesto cisgender- e etero-normativo. Lo stress vissuto dalla comunità LGBT+  , chiamato Minoriy Stress, potrebbe giocare un ruolo nella messa in atto di IPV e al contempo ostacolare la ricerca di aiuto da parte delle vittime di IPV.
Nel seguente elaborato presenterò una breve panoramica della letteratura nazionale e internazionale riferita al fenomeno dell’IPV nella comunità LGBT, facendo luce sulle possibili differenze tra i vari sottogruppi: uomini gay e bisessuali, donne lesbiche e bisessuali e uomini e donne transgender. Lo scopo è quello di poter fornire spunti di riflessione utili per l’eventuale realizzazione di interventi di prevenzione del fenomeno e interventi da un punto di vista clinico nonché possibili idee per la ricerca.



Abstract:
The Intimate Partner Violence (IPV), once called domestic violence, includes any behavior or attitude of a member of an intimate relationship that cause harm (physical, sexual or psychological) to another member of the same relationship. IPV has often been studied in heterosexual relationships between cisgender men and cisgender women.
People who identify themselves as lesbian, gay, bisexual and / or transgender (LGBT) were excluded frm research. The IPV in intimate relationships in which at least one of the partners defines him/herself as LGBT, has specific social and psychological dynamics deriving precisely from belonging to sexual minorities in a cisgender- and hetero-normative context. The stress experienced by the LGBT + community is called minoriy stress, and it could play a role in the implementation of IPV and at the same time hinder the victims’ search for help.
In the following paper I will present a brief overview of national and international literature referring to the IPV phenomenon in the LGBT community, shedding light on the possible differences between the various subgroups: gay and bisexual men, lesbian and bisexual women and transgender men and women. The purpose is to provide useful references for the possible implementation of interventions for the prevention of the IPV phenomenon and interventions from a clinical point of view as well as possible ideas for future  research.

Background: Over the past 20 years, a growing literature has demonstrated that sexual minority women have greater weight than heterosexual women, prompting concern that they may be at high risk for disparities in physical disorders. In 2008, Bowen et al. published a review of the existing research on sexual minority women and obesity, finding no methodologically strong studies with representative sampling procedures. Method: We conducted a systematic review of the literature covering the period of July 2006 to February 2014 on the relationship between sexual orientation and weight. The review includes 20 population-based and 17 nonprobability sample studies.

Adult lesbian and bisexual (LB) women are more likely to be obese than adult heterosexual women. Achieving a healthy weight reduces health risks and improves quality of life, but the evidence based on successful weight interventions is limited. To inform a national initiative, a metasynthesis (a form of qualitative meta-analysis) of focus group data was conducted to gather lesbian and bisexual womens' perspectives. Analysis used de-identified transcripts and narrative reports from 11 focus groups guided by different semi-structured discussion guides with 65 participants from five locations. A literature search was conducted to identify existing themes in published literature and unpublished reports. Six key themes were identified: aging; physical and mental health status; community norms; subgroup differences; family and partner support; and awareness and tracking of diet and physical activity. Participants expressed feeling unprepared for age-related changes to their health and voiced interest in interventions addressing these issues. Their perspectives on community acceptance of body size shifted as they aged. Participants cited age, class, race, ethnicity, sexual identity, and gender expression as potential characteristics that may influence participation in interventions. Families were both a barrier to and a facilitator of health behaviors. Awareness and tracking of dietary habits, stressors, and physical activity levels emerged as a theme in more than half of the groups. An unsolicited, overarching theme was aging and its influence on the participants' perspectives on health and weight. Interventions should be tailored to the needs, goals, and community norms of LB women.

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In psychotherapeutic and lesbian popular culture literatures, there is an assumption that female same-sex couples are overly close and lack boundaries, a concept called ''fusion.'' Empirical efforts have yet to demonstrate whether fusion is experienced more often among women in same-sex relationships than among men in same-sex relationships or among men and women in heterosexual relationships. Furthermore, research on the topic has yet to fully incorporate feminist perspectives that challenge assumptions that high levels of closeness in and of themselves are problematic. Our study employed measures of Inclusion of Other in Self (Aron, to examine the distribution of indicators of fusion among 76 women and 58 men in same-sex relationships and 1,221 women and 285 men in heterosexual relationships. Women in same-sex couples differed from the other groups on only one indicator of fusion-they were more likely to desire less closeness in their relationships, even though their current relationships were rated as close as other types of relationships. Our study suggests that widely held assumptions that women in same-sex couples experience and idealize pathologically high closeness are not accurate.

Background. In response to the need for health and human rights education in undergraduate medical curricula, the Faculty of Health Sciences at the
University of Cape Town, South Africa, has included human rights learning in its reformed programme. Drawing on experiences in several curricular
initiatives within the Faculty and beyond, I introduce the Human Rights Key as a new heuristic learning tool.
Objective. To share a teaching innovation in an area of need in medical education.
Method. The Key scaffolds and facilitates students’ learning through a sequential process of guided self-reflection with probing questions. It
illuminates the inter-relationship of key human rights concepts, enabling students to create and make connections between human rights principles,
legal mechanisms, their own personal realities and their developing clinical practice.
Discussion. Feedback reflects the effectiveness of the Human Rights Key in supporting transformative learning, suggesting that the Key will remain
prominent in students’ memory. Online publication of the Key as an open educational resource (OER), with extensions to specific themes, has
increased its impact and demonstrated the generalisability of the tool.
Conclusion. I propose the Human Rights Key as a useful visual communication tool to guide students in connecting their classroom learning with the
reality of local, regional and international health and human rights issues. As an OER with a Creative Commons licence, the Key is available online
for both educators and students to use as a resource with downloadable components.

This paper was offered at the 2013 Annual Meeting of the American Academy of Religion as part of session on African Homosexualities co-sponsored by the African Religions Group, the Gay Men’s Issues in Religion Group, and the Lesbian-Feminist Issues in Religion Group. I presented theoretical background and my co-presenter, Peter Irungu, presented on his work with men who have sex with men in Mombasa as part of his graduate studies in theology.

“All people are born equal, their rights and dignities are equal.”
(PembeHayat ve Kaos GL, 2014:4). In the context of the first sentence of
the Yogyakarta Principles, LGBTI + people should benefit from health
institutions equally and fairly. Indeed, there are still problems in practice
within countries that have adopted and have not adopted these principles.
Turkey is among the countries that do not accept the Yogyakarta
Principles. Therefore, LGBTI+’s in Turkey face many problems because
of insufficiency of health policies and fobic attitudes by people working
in health institutions. Transsexual women who are one of the people who
cannot get enough services in the transition process due to the health
policies implemented by the state, cannot receive an equal and fair service
due to their invisibility under the Constitution and the Law and othering
attitudes they face in health institutions. As is known, the policies which
is oriented LGBT people in Turkey as long as it continued to be ignored
in the framework of the Constitution and the law; this situation causes
LGBTI + people to face many problems in practice. As one of these
problems, the right to health is neglected by health institutions in the
context of services and policies when it comes to LGBTI + people.
Turkey is among the countries that signed the European Declaration of
Human Rights and it is known that Turkey did not make concrete
statements in the Constitution and laws and left the comments to the
courts(Yeşiltepe,2015:19-20). Due to the gaps in the Constitution and
Law articles, LGBTI + people have problems in many issues.
LGBTI + people are not under the guarantee of the Constitution and Law,
causing transsexual women to face various problems in the health sector.
For this purpose, the study addresses the problems that transgender
women face in the health sector in practice. First of all, the health policies
of LGBTI + people within the framework of the Constitution and Law
were discussed. Afterwards, how much LGBTI + people can benefit from
health institutions and their experiences are transferred. In the next part of
the study within the scope of the Constitution and the Law frame
specified and transgender women's health policies in Turkey; Problems
experienced by these people in health institutions were explained and
solutions and suggestions were presented.

The main purpose of this article is to analyse how healthcare providers in Portugal perceive asexuality. To do so, the author makes use of qualitative data from both the CILIA LGBTQI+ Lives project and The Asexual Revolution doctoral research on asexuality in Portugal, namely, a focus group conducted with healthcare providers, drawing from their assessment of interview excerpts with people identifying as asexual. The data were explored according to thematic analysis and revealed three major tendencies: (1) old tropes at the doctor’s office; (2) narratives of willingness to learn about the subject; and (3) constructive and encouraging views of asexuality. From this analysis, valuable lessons can be drawn concerning the respect for gender and sexual diversity. The author argues that both formal and informal learning play an important role in building cultural competence among healthcare providers. This could be achieved both by introducing sexual and gender diversity in curricula in HE and through media exposure on these subjects. Overall, it will lead to building knowledge and empathy about marginalised groups, and will help fight inequalities of LGBTQI+ people in healthcare. As such, LGTBQI+ activism that puts the topics of asexuality and LGBTQI+ in the media agenda, is a powerful strategy. Hence, because healthcare providers show willingness to learn, the media becomes a source for learning about asexual and LGTBQI+ experiences, which they can incorporate in their medical practice.

Transgender women (women whose assigned sex at birth [ie: male] based on genitalia, does not match/correspond with their innate gender identification as female) nationwide face discrimination, violence, harassment and unjust treatment in most societal systems and aspects of life more so than cisgender people . This discrimination, violence, harassment and unjust treatment is further compounded for transgender women of color (predominately black and Latina transgender women) because of their intersecting identities as transgender women and women of color. The heightened marginalization of transgender women of color (TWOC) is most visible when discussing healthcare, specifically HIV infection rates amongst transgender women of color and access to culturally competent, affordable, quality care for transgender women of color.

Currently there is not enough programming, funding, or culturally competent resources to fully tackle the spectrum of social, economic and health needs that put transgender women of color at a higher risk for testing HIV positive, and to treat those transgender women of color who are already HIV positive. A July 2004 report published in the American Journal of Public Health found that “few evidence-based transgender-specific HIV interventions exist” . Because of the lack of evidence based HIV interventions for transgender women of color, and the extreme social, political and economic factors that many transgender women of color face a recent survey showed that more than 56% of black transgender women are HIV positive, and 16% of Latina transgender women are HIV positive .

In order to best serve transgender women of color and their health needs more programming and funding must be allocated to targeting their specific needs and challenges relating to HIV.

To improve cancer disparities among under-represented minority (URM) populations, better representation of URM individuals in cancer research is needed. The San Diego State University and University of California San Diego Moores Cancer Center Partnership is addressing cancer disparities through an educational program targeting undergraduate URM students. The Partnership provides a paid intensive summer research internship enriched with year-round activities that include educational sessions, a journal club, mentorship, social activities, and poster sessions and presentations. Program evaluation through follow-up surveys, focus groups, and other formal and informal feedback, including advisory and program steering committees, are used to improve the program. Long-term follow-up among scholars (minimum of 10 years) provides data to evaluate the program's long-term impact on scholars' education and career path. Since 2016, 63 URM undergraduate students participated in the scholar program. At the year-2 follow-up (2016 cohort; n = 12), 50% had completed their Graduate Record Examination (GRE) and/or applied to graduate or medical school. Lessons learned during the course of the program led to implementation of changes to provide a better learning experience and increase overall program satisfaction. Updates were made to recruitment timeline, improvements of the recruitment processes, refinement of the program contracts and onboarding meetings, identification of essential program coordinator skills and responsibilities, adjustments to program components, and establishment of a well-mapped and scheduled evaluation plan. The Partnership identified best practices and lessons learned for implementing lab-based internship scholar programs in biomedical and public health fields that could be considered in other programs.

On February 12, 2010 in Mtwapa, Kenya, five men were taken into custody by the Mombasa police for "having unnatural sex against the order of nature." Two of the men had been pulled out of the offices of the Kenya Medical Research Institute (KEMRI) by a group of an estimated 200 to 300 protesters and were being beaten by the crowd until the police intervened. Three other men in the KEMRI offices were also arrested. In an interview with Kenyan media, a police spokesperson reaffirmed the arrests: "We are grateful to the public for alerting the police. They should continue cooperating with the police to arrest more. It is an offence, an unnatural offence, and also their behaviour is repugnant to the morality of the people. These men will undergo a medical examination before we charge them with homosexuality." 1 The crowd who marched on the offices of KEMRI did so following rumors of a gay wedding scheduled to take place in a private residence on the Kenyan coast. They were exhorted to march by select Christian and Muslim leaders. Rather than condemning the violence and repudiating the messages of these religious leaders, broader coalitions of Christian and Muslim leaders-including representatives of the National Council of Churches of Kenya, the Council of Imams and Preachers of Kenya, and Supreme Council of Kenya Muslims-spoke out in support of these actions. How did KEMRI-a research institution with ties both to the Kenyan government and to nongovernmental and academic international relief, development, and public health initiatives-become the target of a public protest against a rumored gay wedding

This publication was based on the main findings of “Bring-In” project’s field research with social and health care professionals in Bulgaria, Greece, Hungary and the UK. Its purpose is to support and guide adult trainers in order to build the capacity of the aforementioned professional groups so that they may provide high quality supporting services to intersex people. The 2-days basic training programme incorporates adult training techniques, thus facilitating active learning and interaction between the trainer(s) and the trainees as well as among the trainees themselves. Adult trainers are welcomed to make necessary adjustments and adaptations based on their personal skills, experiences and/or the topics they want to focus more, the profile and background of their trainees as well as the national/social context. Useful resources that will help them better prepare are also included in this publication.