1

HHS LGBT Issues Coordinating Committee

2013 Report

Introduction

In April 2010, President Barack Obama asked Secretary of Health and Human Services

Kathleen Sebelius to identify steps the Department could take to improve the health and 

well-being of lesbian, gay, bisexual, and transgender (“LGBT”) individuals, families, and 

communities. In response, Secretary Sebelius set up a Department-wide LGBT Issues 

Coordinating Committee, currently co-chaired by Assistant Secretary for Health Dr. 

Howard Koh, Administrator of the Administration for Community Living and Assistant 

Secretary for Aging Kathy Greenlee, and Deputy General Counsel Ken Choe. The 

Committee, on behalf of the Secretary, developed the Secretary’s Recommended Actions to 

the President to Improve LGBT Health and Well-Being (“2011 objectives”), which were sent 

to the President and released to the public in April 2011 

(http://www.hhs.gov/secretary/about/lgbthealth.html). In June of 2012, the Committee 

released to the public its 2012 report of accomplishments in 2011 and goals for the 

following 12 months (“2012 objectives”) 

(http://www.hhs.gov/secretary/about/lgbthealth_objectives_2012.html).

As the Department continues its efforts in support of all communities, it is again pleased to 

present in this report both some highlights of its accomplishments from this past year and 

some highlights of its goals for this coming year with respect to the LGBT community.1

2013 Objectives2

Federal Recognition of Same-Sex Spouses/Marriages 

HHS will continue to work quickly to implement the Supreme Court ruling invalidating 

Section 3 of the Defense of Marriage Act. 

Health Insurance Marketplace Outreach and Enrollment

Beginning in 2013 and continuing into the future, HHS is engaging in broad outreach to 

help uninsured Americans gain access to affordable health insurance coverage through the 

Health Insurance Marketplaces that are being established under the Affordable Care Act. It

 

1 In this report, the acronym “LGBT” may also encompass other sexual and gender minority populations, including, but not limited to, those who 

are diagnosed with intersex conditions and those who identify as Native American Two-Spirit or questioning. 2 In this report, the term “2013 objectives” means objectives for the 12 months following the issuance of this report.
2

is crucial for all communities to understand their options and how to enroll in coverage. 

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4

NIH completed a portfolio analysis and determined that 232 projects addressing LGBT 

health were active in 2010. Details of that analysis and the report, along with a statement 

from NIH Director Francis Collins charging NIH to continue the momentum into the future, 

can be found at http://www.nih.gov/about/director/01032013_lgbt_statement.htm. 

Additionally, NIH convened a scientific work group to develop strategies to expand 

research on the care of intersex children and their families.

The Health Resources and Services Administration (”HRSA”) awarded nine grants to 

organizations supporting the development, implementation, and evaluations of 

interventions to improve timely entry into and retention of quality HIV care for 

transgender women of color. HRSA also provided funding to the Center of Excellence for

Transgender Health at the University of California at San Francisco to serve as the 

evaluation and technical assistance center for these grants.

Following a recommendation from the 2011 Institute of Medicine Report on LGBT Health, 

the Office on Women’s Health (“OWH”) funded five pilot studies across the nation to 

identify and test innovative and effective ways of reducing obesity in lesbians and bisexual 

women. 

CDC has funded evaluation of the impact on LGBT communities of chronic disease 

prevention and health promotion programs currently being implemented by Community 

Transformation Grant (“CTG”) awardees. Activities include both multi-site surveillance as 

well as site-specific evaluation of CTG programs that encompass LGBT communities. Such 

evaluation efforts are ongoing, and results are expected in 2016. 

The National Intimate Partner and Sexual Violence Survey: 2010 Findings on Victimization 

by Sexual Orientation was released by CDC. CDC has worked to increase the visibility of the 

report and its findings, including by sharing information with LGBT intimate partner 

violence/sexual violence-specific service organizations, participating in national webinars 

for practitioners of such services, policymakers in the field of intimate partner 

violence/sexual violence prevention, and the LGBT community in general; as well as by 

producing fact sheets and other materials available on CDC’s website 

at http://www.cdc.gov/violenceprevention/nisvs/. 

CDC’s Tips From Former Smokers national tobacco education campaign included specific 

messaging and outreach to the LGBT community, with advertisements featuring a

representative from the LGBT community. The campaign can be viewed 

at http://www.cdc.gov/tobacco/campaign/tips/groups/lgbt.html. Additionally, CDC

worked with The Network for LGBT Health Equity on LGBT-specific paid and earned media 

efforts.
5

The Food and Drug Administration (“FDA”) is developing a plan to engage in outreach to atrisk LGBT youth, designed to educate them about the dangers of using tobacco with the 

intent of helping prevent initiation and experimentation. The plan includes conducting 

research to understand perceptions, opinions, attitudes, and beliefs around tobacco use 

within this vulnerable population. FDA is committed to reaching LGBT teenagers in a 

culturally relevant way to prevent tobacco use and plans to launch a campaign targeted at 

this audience in 2014.

SAMHSA and HRSA identified and reviewed curricula that help behavioral health and 

primary care practitioners assess, treat, and refer LGBT clients in a culturally competent 

manner. Curricula were identified by HHS, technical assistance providers, and stakeholder 

organizations. SAMHSA and HRSA reviewed the curricula to ensure that they were 

federally-supported and available for Continuing Medical Education/Continuing Education 

Unit (CME/CEU) credit. This list of existing federally-supported LGBT culturally competent 

training curricula that are available for CME/CEU credit was disseminated to stakeholder 

organizations and is posted online at http://samhsa.gov/lgbt/curricula.aspx

and http://www.hrsa.gov/lgbt/. SAMHSA and HRSA will continue to disseminate this 

information over the course of the next year. 

ASPE disseminated resources about LGBT homeless youth 

at http://findyouthinfo.gov/youth-topics/lgbtq-youth/homelessness, including a profile of 

a collaboration in Oregon that focuses on training staff to provide unbiased services for 

LGBT youth in in-home and out-of-home care settings and a podcast from Administration 

for Children, Families, and Youth Commissioner Bryan Samuels on the need to include 

LGBT youth in teen pregnancy prevention efforts. With respect to ASPE’s continuing work 

with ACF on its Research Development Project on the Human Services Needs of LGBT 

Populations, ASPE funded a sub-study under which site visits were conducted at four 

runaway and homeless youth programs to examine how these programs collect data and 

target services for homeless LGBT youth. 

ACF required grant recipients in its runaway and homeless youth programs to assure that 

they have policies prohibiting harassment based on sexual orientation or gender identity, 

and that their staff is trained to prevent and respond to harassment and bullying.

ACF issued revised operating instructions for the placement of unaccompanied immigrant 

youth in ACF’s custody, and added consideration of the safety and well-being of LGBT youth 

as a factor when making placement decisions. ACF’s technical assistance providers will 

continue to host trainings for staff working at ACF-funded shelter care facilities that focus 

on creating a safe and inclusive environment for LGBT unaccompanied immigrant youth. 
6

The Centers for Medicare & Medicaid Services (“CMS”) and the Administration for 

Community Living (“ACL”) are completing a training video to educate key stakeholders 

about LGBT older Americans, the impacts of the social stigma on them, and their rights in 

nursing homes and other settings. The video will be released in the summer of 2013. 

CMS also released guidance clarifying visitation rights of LGBT individuals in Medicare- and 

Medicaid-participating nursing homes. 

Section 1557 of the Affordable Care Act provides for federal nondiscrimination protection 

in the health care system, including on the basis of “sex.” The Office for Civil Rights (“OCR”) 

clarified that this prohibition includes discrimination based on gender identity and sex 

stereotyping. 

The Office of Minority Health, in collaboration with federal and non-federal partners, 

published LGBT-inclusive enhanced National Standards for Culturally and Linguistically 

Appropriate Services in Health and Health Care (National CLAS Standards). The National 

CLAS Standards are intended to advance health equity, improve quality and eliminate 

health disparities, and establish a blueprint for health and human services organizations to 

provide culturally and linguistically appropriate services. The enhanced standards 

promote a more inclusive definition of culture encompassing not only race, ethnicity, and 

language, but also elements such as sexual orientation and gender identity. The National 

CLAS Standards raise awareness of the importance of the role of sexual orientation and 

gender identity in all areas of health – mental, physical, social, and spiritual – and provide a 

host of resources that will empower health and human service professionals and 

organizations to address the needs of and better serve the LGBT community.

The Office of the Assistant Secretary for Health (“OASH”) expanded the Healthy People 

2020 LGBT Topic Area to include two national objectives. The objectives aim to increase 

the number of population-based data systems used to monitor Healthy People 2020 

objectives that include in their core a standardized set of questions that identify 1) lesbian, 

gay, bisexual, and 2) transgender populations. The establishment of the first-ever national 

LGBT objectives with targets to be achieved by the end of the decade underscores HHS's 

commitment to securing data that are critical to understanding the health issues and needs 

of the LGBT population and working to address those needs. 

ACL funded a new grantee to further develop and extend the National Resource Center 

(“NRC”) for LGBT Aging work to reach its three distinct audiences: aging network entities, 

LGBT stakeholder agencies, and LGBT individuals. The grantee will focus on the use of 

efficient and effective strategies to more fully embed NRC activities into the LGBT and 
7

Aging Services Networks; employ technology to reach greater numbers of trainees and 

consumers; enhance the volunteer potential of the LGBT community as a sustainable 

resource for training and other NRC activities; and expand technical assistance activities as 

they relate to LGBT aging, including in the key areas of housing, mental health, family 

caregiving, and aging with disabilities. 

The Office of Global Affairs (“OGA”) continues to work with the World Health Organization 

(“WHO”) to improve the health and well-being of LGBT persons. OGA successfully 

petitioned an item on this topic be added to the May 2013 Executive Board meeting agenda, 

and in preparation WHO wrote the first ever summary report on barriers to care for LGBT 

populations. This marked the first time that the global health body had ever discussed the 

role that it should play in addressing the health of LGBT populations. A vigorous debate 

took place at the meeting, and, although countries were unable to agree on steps forward at 

this time, the discussion alone, in the face of opposition, has been seen as a historic step 

forward. As a result, the WHO Director General Margaret Chan is now personally leading 

regional consultations on this topic, and it will likely be added to the January 2014 meeting

agenda.