STATE OF THE STATE REPORT ON LESBIAN AND GAY NEW YORKERS AND THEIR FAMILIES

[In this report you will see the words lesbian and gay, as well as bisexual and transgendered. Lesbian, gay, bisexual, and transgendered individuals may be identified in this report with the letters LGBT.]

hether we live in the rural communities of upstate New York, the outer boroughs of New York City, or the suburbs of Long Island, lesbians, gay men, and bisexual and transgendered men and women share many of the concerns of our fellow New Yorkers. Like our neighbors, we worry about finding and keeping a good job, providing for our partners, our families, and ourselves, finding safe and affordable housing, and dealing with the normal range of health problems, from heart disease to breast cancer. Like our neighbors, we worry about making ends meet, and about having access to adequate medical care and health insurance.

But while lesbian and gay New Yorkers have many of the same aspirations as our neighbors, we don't always have the same basic opportunities.

• Economically, lesbian, gay, bisexual, and transgendered New Yorkers are vulnerable to job discrimination, workplace harassment, and lack of access to standard family health benefits. Unlike other New Yorkers, we can lose our jobs or our housing, with no legal recourse, simply because we are lesbian, gay, bisexual, or transgendered.

The recent murder of Mathew Shepard in Wyoming bears stark testimony to these horrible statistics. The fact that New York State lacks statewide hate crimes legislation that includes lesbians and gay men exacerbates the epidemic of violence.

The Purpose of the Report

he purpose of the State of the State Report on Lesbian and Gay New Yorkers and Their Families is to increase awareness among our elected and appointed officials to the real life concerns and struggles of LGBT people and their families in New York State, and to inform our representatives about the most pressing needs of our community, including the need for:

• Access to appropriate and sensitive primary medical care, including preventive care for illnesses such as breast and gynecological cancers,
• Appropriate mental health counseling and support, especially for our elderly at risk of isolation and for lesbian and gay youth, who may be at increased risk for depression, drug abuse, and suicide,
• Support services to counter the effects of violent crime directed at gay men and lesbians, and
• Increased funding for LGBT community-based organizations.

While we recognize the devastating impact of HIV/AIDS on the LGBT community, this report extends the discussion of lesbian and gay health needs beyond the epidemic. At the same time, it recognizes the crucial role the epidemic has played in building both a community and the organizational infrastructure capable of meeting the diverse health and human service needs of lesbian and gay men across the state.

Historic Funding for Lesbian and Gay Health and Human Services

ew York State has a long history of investing in the health and well-being of lesbian and gay men. Through the Department of Health and the AIDS Institute, the State has provided millions of dollars for HIV/AIDS education, counseling and prevention in the lesbian and gay community. The State has also provided significant amounts of funding through the Office of Children and Family Services (formerly the Division for Youth), Office of Alcohol and Substance Abuse Services, Division of Criminal Justice Services, and Crime Victims Board, among others, for lesbian and gay youth services as well as anti-violence and substance abuse programs.

It was not until 1997, however, that the State publicly recognized the non-HIV/AIDS related service needs of lesbian and gay men and their families. That year, the Governor and the Legislature included in the budget an historic first, a separate and clearly identified $1 million initiative, appropriated to the Department of Health, to fund community-based organizations across the state. The funding was earmarked to provide a range of non-HIV/AIDS specific services to promote wellness and access to health and human services for New York's LGBT community.

Late adoption of the budget and delay in issuing a Request for Proposals by the Department of Health meant that none of the money for the initiative was spent. Recognizing the importance of this funding, the Legislature passed a budget in 1998 which included an additional $1 million in funding plus a reappropriation of the unspent $1 million from SFY 1997-1998. After directing DOH to issue the RFP, the Governor vetoed the entire $2 million. Letters and phone calls from lesbian, gay and straight New Yorkers, along with the dedicated work of several legislators, ultimately led to the Governor agreeing to make $1 million available in discretionary funding under the lesbian and gay health and human services initiative.

Seventy-two organizations from all parts of the State submitted proposals in 1998 for funding under the initiative which, according to state guidelines, is designated for non-HIV specific programs that will "promote wellness and access to health and human services for lesbian and gay individuals and their families."

In December of 1998, eleven groups across the state were awarded grants totaling $1 million for this historic program to begin addressing the health and human service needs of lesbians, gay men and their families. The funding has already served as a catalyst for building partnerships between lesbian and gay health organizations and local churches, hospitals, and community centers. And it has helped to start an important statewide discussion of the health care concerns of lesbians and gay men.

While these funds will do tremendous good, simply put, community-based organizations serving LGBT New Yorkers need much more support. Investments in lesbian and gay health and well-being pay back the State, its communities, and its citizens many times over. The return on the State's investment is too good not to increase the funding for such organizations. And the need is too great to ignore.

This year, the Network approaches the legislature with a request that this historic funding not only be made available on an on-going basis, but also be significantly increased by an additional $5 million. This money is desperately needed, will be effectively spent, and is a wise investment in the future of New York State.

Who Are Lesbian and Gay New Yorkers

ew York City is a global hub, and home to a large and culturally diverse lesbian and gay community. But the story of lesbian and gay New Yorkers goes far beyond New York City. In the state's smaller cities and towns, and in rural areas across New York, lesbians and gay men are telephone installers, grocery clerks, insurance salespeople, working mothers - in other words, we represent the full social, cultural, and economic spectrum of New York State.

Studies show that, nationally, lesbians and gay men are similar to the heterosexual population in terms of age, gender, race, ethnicity, and formal political affiliation.⁶

One study found that 50 percent of lesbians and gay men identify as parents.⁶ The National Lesbian and Gay Task Force reports that 67 percent of lesbians have children.

It is difficult to measure the size and needs of the LGBT population because not everyone who chooses a same sex partner identifies as "gay", "lesbian", "bisexual", or "transgendered" (these terms are defined in Appendix B). Few large-scale studies of the LGBT population have been conducted. At least part of the reason for this lack of information is that government and foundations have been unwilling to acknowledge the needs of LGBT communities. A commonly accepted estimate of the number of LGBT people in the overall population is 10 percent. Even the most conservative estimates indicate that New York State is home to about 1 million LGBT citizens.

It is also important to keep in mind that people may claim a range of sexual identity, including bisexual and transgendered. Some, especially youth, may identify as gay or bisexual but have never had a relationship with another person. Other lesbians, gay men, bisexuals or transgendered people have religious, ethnic, or cultural identifications that may obscure their LGBT identity in the minds of funders and policy makers.

Even some well-intentioned policy makers may not consider that an immigrant to the U.S. could be lesbian, gay, bisexual, or transgendered. That person's health and social service needs may be characterized according to their racial or ethnic identity, with no acknowledgement that they may be best served by an organization, such as many of those profiled in this report, which serve immigrants or individuals from different cultures who are also LGBT.

The preponderance of national data reveals that both gay men and lesbians earn less than their heterosexual counterparts.^7/8

A common myth is that lesbians and gay men have more money than their heterosexual counterparts. On the contrary, while 65% of heterosexual men in a recent national survey earned less than $25,000 per year, 81% of gay men earned less than $25,000.⁹ And, according to several studies, "the preponderance of the national data reveals that both gay men and lesbians earn less than their heterosexual counterparts."^7/8 While some data indicate that gay men and lesbians are more likely to have attended college or graduate school, their higher degree of education did not correlate with the same increases in income experienced by heterosexuals. The myth of wealthy lesbians and gay men appears to be based on biased marketing studies, and sometimes on purposeful misrepresentation by political extremists who seek to equate homosexuality with privilege.

Frequently overlooked groups of LGBT people, and those who may be particularly poorly served by mainstream health and social service providers, include youth, the elderly, people of color, and immigrants.

Youth

LGBT youth, struggling to develop a positive self-identity in a hostile or dangerous environment, may be more susceptible to depression, drug or alcohol abuse, or dropping out of school. Frequently, teachers and counselors, whose role is to positively guide youth, can be as hostile and condemning toward gay and lesbian youth as other students and peers. Some parents, teachers, and counselors truly want to be helpful, but don't know how to best provide such help.

According to a study by the Center of Population Options, one in four gay or bisexual males is forced out of the parental home prematurely due to their sexual orientation. Data from the U.S. Centers for Disease Control and Prevention (CDC) indicate that 35% of homeless youth in New York City identify as gay or lesbian. Youth who are estranged from their parent or guardian may have increased difficulty accessing health care and social support services. Gay and lesbian youth are two to three times more likely to attempt suicide than their heterosexual peers, and many experts believe that suicide is the leading cause of death among gay and lesbian youth.⁴

Elderly

Lesbian, gay, bisexual, and transgendered elderly can be equally isolated and at-risk. Older people are the greatest users of medical care services, but services for the elderly, including nursing home and residential care, almost never consider the possibility of a LGBT identity. The need to provide appropriate and sensitive care for LGBT elderly is acute in places such as New York City, which attracts many LGBT people who moved to New York City and are now growing old far from their home towns and from family and community support. It is also critical in small towns and rural areas across New York State which are also unlikely to provide services for older LGBT people.

People of Color

Communities of color are often particularly vulnerable to economic pressures and discrimination. Several forms of discrimination that predominately affect communities of color also appear to affect gay and lesbian people. These include workplace and housing discrimination, as well as lack of access to primary and preventive health care. For people of color who are also lesbian, gay, bisexual, or transgendered, the weight of discrimination is often multiplied.

Immigrants

Language and cultural barriers leave many new immigrants economically vulnerable and serve to isolate LGBT immigrants from appropriate services. Immigrants may have particular reason to fear the disclosure of their sexuality, and may hide their sexual orientation for fear of encountering legal problems or issues with immigration authorities. In addition, immigrants from cultures that condemn homosexuality may experience particular difficulties in accessing health or social services that are appropriate both culturally and in terms of their sexual orientation.

The Economic Issues that Affect All New Yorkers

esbian and gay New Yorkers are affected by many of the same socio-economic issues that touch other New Yorkers. These include the growing income gap between rich and poor, cutbacks in social safety net services such as welfare and Medicaid, increases in the number of uninsured and underinsured, and the growth of managed care. In many cases, these social and economic changes, and the disruptions they cause, may more adversely affect LGBT communities because of their particular vulnerability to social and economic discrimination.

Government Income Support

State and federal cuts in the programs that constitute the economic safety net, including Home Relief, SSI, AFDC, and food stamps, may have a particularly devastating effect on lesbian and gay New Yorkers. Because there is no statewide employment or housing protection against discrimination based on our sexual orientation, LGBT New Yorkers are more vulnerable to housing or job loss, and thus have to rely on the fraying economic safety net.

Lesbian, gay, bisexual, or transgendered teens may have more difficulty completing their education because of harassment at school. LGBT teens are also more likely to be kicked out of their homes, thus severing family ties before they are educated or skilled enough to support themselves. Doing poorly or dropping out of school, or being separated from the parental home at an early age, leads to greater economic vulnerability and increased reliance on a disappearing system of social support.

Income Disparity

New York State leads the nation in many things, including income disparity. In no state in the U.S. is the income gap as wide as in New York, with its vastly wealthy Wall Street elite, and its considerably larger communities of working poor struggling to get by. The New York Times reported that while the top 20% of New York State families earn over $132,000, the bottom 20% earn $6,787, a 20% decline in their incomes over the past ten years.

Reasons cited for the decline in economic status for New York's working poor include a large drop in manufacturing jobs, competition for low-paying jobs from other states and nations, and the end of free education at the state's public colleges. LGBT New Yorkers are highly vulnerable to the disruptions caused by this widening social and economic gulf. According to the New York Community Trust, "Few mainstream services address the social, familial and health issues that isolate and marginalize low-income lesbians and gays."

The Insurance Gap

As with the income gap, the "insurance gap" has left more and more New Yorkers with inadequate health insurance, or with no health insurance at all. According to the United Hospital Fund, New York State leads the national average with 17% of its citizens, or 3.1 million New Yorkers, living without health insurance. Between 1991 and 1996, the proportion of non-elderly New Yorkers living without insurance grew at a faster rate than that of the rest of the U.S., while the percentage of New Yorkers holding private coverage declined at a rate faster than that of the rest of the nation. In this period, nearly three-quarters of uninsured adults were employed in any one year.

The United Hospital Fund study found that single adults and those without children living below 200% of the poverty level are most likely to lack insurance. Single parent families are the next most likely to be uninsured. Residents of New York City are also more likely to be uninsured. New York City has 41% of the state's population and 60% of the uninsured. Nearly 28% of New York City residents were uninsured during 1996 compared to 13% of other New York State residents. Demographic indicators show that LGBT adults closely match those most likely to lack health insurance coverage; thus, we can reasonably infer that New York's insurance crisis disproportionately affects the state's LGBT community.

Managed Care

For those with insurance coverage, managed care has become a fact of life in New York State. Yet it is becoming increasingly clear that managed care plans may be more likely to deny claims, refuse treatment, and turn away patients than private insurance. What's more, the rigorous managed care review process intentionally or unintentionally discourages customers from seeking care. This is particularly true for those New Yorkers, such as low income New Yorkers, immigrants, and LGBT individuals, who are most likely to avoid extensive inquiries because of fears of discrimination.

Exorbitant price increases for managed care plans, especially for New Yorkers who buy their own insurance, are driving larger numbers of the state's citizens into the uninsured column. Statistics show that gay and lesbian New Yorkers are more likely to be self-employed. Thus, skyrocketing insurance premiums affect LGBT New Yorkers in greater numbers.