Jody L. Herman

Patterns of Relationship Recognition by Same-Sex Couples in the United States

Since 1997, 19 states and the District of Columbia have extended legal recognition to the relationships of same-sex couples. The form of legal recognition has varied to include marriage, civil unions, state-registered domestic partnerships, and limited-rights statuses, such as reciprocal beneficiary relationships. These varied forms of recognition entail different packages of legal rights and responsibilities for the couples entering them. This study provides a demographic analysis of the same-sex couples who marry, enter civil unions, or register their partnership in these states, covering the full range of legal statuses.

“Counting” Transgender and Gender-Nonconforming Adults in Health Research Recommendations from the Gender Identity in US Surveillance Group

Gender minority refers to transgender and gender-nonconforming people whose sex assigned at birth is different from their current gender identity. US health surveillance systems do not routinely include questions to identify gender minority respondents, resulting in a lack of representative health data that can be used to evaluate the health of gender minorities. This omission represents a missed opportunity to understand the health and well-being of transgender and gender-nonconforming people as well as to learn more about sex and gender differences that may be relevant for the health of all people—gender minority and majority alike. In 2011, the Williams Institute at the University of California, Los Angeles, School of Law convened the Gender Identity in US Surveillance (GenIUSS) Group, bringing together a multidisciplinary and multi-institutional group of experts to increase population-based data about gender minority people through the inclusion of gender-related measures (e.g., assigned sex at birth, gender identity, transgender status) in surveys, with a particular consideration for publicly funded data-collection efforts. Drawing on the expertise and experience of the GenIUSS Group, this article provides an overview of challenges and opportunities and makes eight recommendations for “counting” gender minority adults in health research, with an emphasis on adult population-based surveys.

Demographic Characteristics and Health Status of Transgender Adults in Select US Regions: Behavioral Risk Factor Surveillance System, 2014

Objectives To describe the health status of the transgender population in the United States. Methods We used 2014 Behavioral Risk Factor Surveillance System data that comprised a probability sample from 19 US states and Guam (n = 151 456). Results Bivariate analyses showed that, in comparison with cisgender individuals, transgender individuals had a higher prevalence of poor general health (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.2, 2.4), more days per month of poor physical (b = 2.43; 95% CI = 0.61, 4.24; P < .01) and mental (b = 1.74; 95% CI = 0.28, 3.19; P = .02) health, and a higher prevalence of myocardial infarction (OR = 1.7; 95% CI = 1.1, 2.5). In addition, more transgender than cisgender people lacked health care coverage (OR = 1.8; 95% CI = 1.2, 2.7) and a health care provider (OR = 1.5; 95% CI = 1.0, 2.1), and they were less likely to have visited a dentist in the preceding year (OR = 0.7; 95% CI = 0.5, 1.0). However, transgender individuals did not differ from cisgender individuals with respect to prevalence of chronic diseases, cancers, or depressive disorders or in terms of health behaviors such as smoking, binge drinking, and always wearing a seatbelt. Conclusions Our findings highlight areas of unmet needs in the transgender population.

Incarceration Rates and Traits of Sexual Minorities in the United States: National Inmate Survey, 2011–2012

OBJECTIVES To report characteristics of sexual minority US inmates. METHODS We drew our data from the National Inmate Survey, 2011-2012, a probability sample of inmates in US prisons and jails. We determined weighted proportions and odds ratios with 95% confidence intervals to estimate differences between sexual minority and heterosexual inmates. RESULTS Sexual minorities (those who self-identify as lesbian, gay, or bisexual or report a same-sex sexual experience before arrival at the facility) were disproportionately incarcerated: 9.3% of men in prison, 6.2% of men in jail, 42.1% of women in prison, and 35.7% of women in jail were sexual minorities. The incarceration rate of self-identified lesbian, gay, or bisexual persons was 1882 per 100 000, more than 3 times that of the US adult population. Compared with straight inmates, sexual minorities were more likely to have been sexually victimized as children, to have been sexually victimized while incarcerated, to have experienced solitary confinement and other sanctions, and to report current psychological distress. CONCLUSIONS There is disproportionate incarceration, mistreatment, harsh punishment, and sexual victimization of sexual minority inmates, which calls for special public policy and health interventions.

Transgender inclusion in state non-discrimination policies: The democratic deficit and political powerlessness

Transgender people—people whose gender identity or expression is different from their assigned sex at birth—and their allies advocate for the inclusion of gender identity or transgender in state non-discrimination policies. These policies generally proscribe discrimination in employment, housing, and public accommodations. Courts and administrative agencies have determined discrimination against transgender people is a violation of existing statutes, but there remain efforts by advocates to seek policies that explicitly prohibit discrimination on the basis of transgender status, which are often the result of legislation going through the political process. A pluralist understanding of the political process theorizes that a majority coalition of minorities can offer social groups policies they support. This rests on the presumption that a majority coalition of minorities should rule. Any indication to the contrary may suggest a democratic deficit, whereby more than a majority is necessary for policy introduction. We find that there is a substantial democratic deficit regarding the inclusion of gender identity or transgender in employment non-discrimination policies. On average, state support for the policy must be 81% in order for the state to have a policy reflecting such sentiment. This leaves substantial implications for the political powerlessness of transgender people in the political process.