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Queer Health in the Central Valley: a Focus on Mental Health and Queer BIPOC



By Bryan García (He/Him/His)


Introduction


Being raised in Merced, CA, I was never really aware of the resources and the issues regarding the topic of Queer Health and the effects the community can have on LGBTQIA+ BIPOC folks within the Central Valley. On June 29, 2021, Wasco Mayor Alex Garcia, stated in a Los Angeles Times article: “‘I knew we had LGBT residents in Wasco, but I didn’t realize how many!’” (Arellano, 2021). Which makes me ask: if the Mayor of Kern County was surprised about the amount of LGBT residents and supporters, then how is the LGBTQIA+ community being represented within the counties of the Central Valley?


This project aimed to address the lack of resources, advocacy, and promotion of mental health for queer folks that originate and/or reside in the Central Valley. This project was inspired by community based research; it considered what mental health centers, organizations, and providers would need to acquire when providing outreach to LGBTQIA+ and BIPOC identifying folks in the Central Valley. With the objective of being able to move forward in bringing awareness and being inclusive of queer folks to help contribute to the wellness that is received through mental health resources and their accessibility to queer

folks.


What is Queer Health and Mental Health?


First, the term “Queer” is best defined as being a “word that describes sexual and gender identities other than straight and cisgender” (Parenthood). Which includes lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other/more identities (LGBTQIA+). Queer Health can be described as topics that “include, but are not limited to, HIV & AIDS, mental health and well-being, drug and alcohol use, sexual and reproductive health, universal health coverage, access to affordable medicines, and training of the health workforce” (SOURCE, year) which is portrayed from LGBTQIA+ folks who “are among an

oppressed population with significant disadvantages related to health and the social determinants of health” (Casarez, Community Health Scholars).


Literature Review


Through the review of extensive literature, it has been recorded that the LGBTQIA+ community, within its own community has individuals with diverse backgrounds--- race, religion, ethnicity, nationality, and socioeconomic class. DEFINE INTERSECTIONALITY VIA KIMBERLY BRADSHAW HERE Through the overlap of identities that specifically LGBTQIA+ BIPOC folks have, this intersectionality is significant as BIPOC identifying folks will navigate, experience, and understand life differently from anglo-white queer folks would (NAMI, LGBTQI). Through the source of Mental Alliance on Mental Illness, it has been reported that LGBTQIA+ community members are at higher risk to experience mental health conditions such as depression and anxiety disorders. Among their gatherings, NAMI was able to

conclude the following in regards to how the well-being of queer folks is being affected in the mental health aspect (YEAR):

• LGB adults are more than twice as likely as heterosexual adults to experience a mental health condition.

• Transgender individuals are nearly four times as likely as cisgender individuals to experience a mental health condition.

• -LGB youth are more than twice as likely to report experiencing persistent feelings of sadness or hopelessness than their heterosexual peers.

• -Transgender youth face further disparities; they are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to cisgender lesbian, gay, bisexual, queer and questioning youth


LGBTQIA+ youth are more likely to report suicidal thoughts or attempts compared to the general youth population, experience major depression, anxiety disorders, substance abuse, and other mental health illnesses (Russell & Fish, 2016) Families, schools, faith communities, and other organizations contribute to the limitations to rights of LGBTQIA+ youth folks, due to the lack of support received within the communities. Resulting in vulnerability and social determinants to compromise queer folks’ mental health (ADAA, 2021).


Given the literature, it is evident that queer mental health demonstrate exceptional disparity to the general population. However, the statistics do not address the root to these risks. I hypothesize that there is a universal phenomenon when considering the experiences of queer BIPOC folks: white supremacy. According to the Oxford Dictionaries, the term “white supremacy” is “the belief that white people constitute a superior race and should [...] dominate society, typically to the exclusion of detriment of other racial and ethnic groups'' (Oxford). Living as BIPOC under white supremacy create a limitation for obtaining mental health resources, especially for the BIPOC LGBTQIA+ community in the Central Valley. I also hypothesize that heteronormative and eurocentric medical and psychological practices can

be another contributor to the following health disparity. The primary way of receiving professional help, whether it may be mental or physical health, is through the local clinic/medical center. In addition, lack of representation (or BIPOC and/or LGBTQIA+) within the field of health, can contribute to “patient-clinician mismatching” (Dominguez, 2017).


Community Assessment


With the help of the community and community organizations, I was able to design and promote a qualitative and quantitative based survey with the goal of understanding the impact that communities in the Central Valley have on the well-being and mental health of queer BIPOC identifying folks.


My data collection sought respondents through the social media platform of Instagram, through sharing a post I created, which included information about the survey and the significant goals of the project. Through followers and other community organizations, username handles such as @99rootz, @fresnobarriosunidos, @ocmcyouth, and @fresnostateusp, the survey was dispersed to community members within the Central Valley. Participants were entered into a raffle for a $20 Visa gift card upon completion of the Google Forms survey, and participants had the option to also receive a second entry if

interested in participating in Zoom one-on-one interview.


Within one week of the survey being published, a total of 29 survey responses and 7 interview participants showed interest and were part of a scheduled one-on-one interview via Zoom were collected. Although, two survey participants were removed due to not meeting the criteria of originating and/or currently residing in the Central Valley— a total of 27 survey participants met the survey’s criteria. Participants represented counties within the Central Valley, such as Fresno, Kern, Merced, San Joaquin, and Tulare counties--- with the majority of participants representing Merced County and belonging to the 18-24 years old age group.


The purpose of my survey was to gather data how identit(ies) impact the mental health of LGBTQIA+ and Black, Indigenous, and Persons of Color (BIPOC) identifying folks in the Central Valley. The data collected was analyzed in order to identify unmet community needs and move forward in creating a response plan.


The intention of conducting interviews was to go into qualitative depth of the responses the participants were able to provide in their survey responses. The interview helped in gaining a greater understanding and perspective of individuals within the community and their thoughts on the unmet needs in regards to the topic of Queer Mental Health in the Central Valley. It is important to indicate that questions were kept optional, confidential, and anonymous, so that participants could contribute to the survey as much as they felt comfortable sharing.



Table 1. Overview of Queer Health Survey Participants


Survey & Interview Results: Limitations in Expressing and/or Exploring Identity:


Family/Community


According to the open-ended questions and further interviews, participants were able to express their parents and older generations' contribution to the stigma of being LGBTQIA+ and the significance of mental health. This is due to the conservative beliefs and traditional morals that these individuals hold. Not only this, but the treatment that the LGBTQIA+ community receive by being made “less than” the heteronormative society they are a part of. LGBTQIA+ youth compromise their mental health due to family conflict or child maltreatment (Russell & Fish, 206). The dangerous environment causes for queer

folks to be cautious at all times to avoid discrimination from the rest of the community.


Queer Spaces/Centers


The lack of sustainability with nearby Central Valley centers, some even resulting in closing down. Nonetheless, the lack of knowledge, effort, promotion, and awareness of the actual resources and services for the community is resulting in not creating that safe space within each county. Like Graph 3 presents, majority of queer folks do not consider their counties to be a safe space.



In Graph 1, right above, correlates to how the lack of knowledge of the resources that are within the counties and their way to expand their outreach to provide that support to queer folks. As we move on to Graph 2, we are able to visualize the significant roles these community organizations provide for Central Valley folks. As we can see in the following graph, due to the lack of resource knowledge the majority of participants indicated that it was “unlikely” for one to reach out to community organizations while going through moments of emotional stress, anxiety, forms of depression, and other mental health illnesses.


Mental Health Providers



Lack of health insurance is generally a barrier to access of care, especially in the Central Valley. But, even ith insurance, the quality of care may not meet Queer folks where they are. MediCAL is an example of health insurance that does not provide the adequate resources for queer folks seeking mental health treatment. This may be the difficulty in finding queer-affirming mental health specialists. Professionals and specialists within the field must be required to take training regarding working the intersecting identities of Queer and BIPOC folks within the Central Valley--- understand the different shared experiences that BIPOC may share compared to privileged white folks--- all with the goal of being inclusive.


Next Steps


It is important to note that a lack of resources does not always indicate nonexistent resources, but it does show that there is a lack of promotion of these resources which affect the mental health and well-being of LGBTQIA+ BIPOC communities. A way to move forward is to take into consideration the intersectional identities of queer folks, especially those who identify as BIPOC.


Due to the absence of inclusivity of BIPOC folks among LGBTQIA+ centers within the Central Valley, it is important to present the collected data and have take into consideration how the organization would expand their outreach and resources for better accessibility. It is especially important to ask: How do we target young LGBTQIA+ BIPOC folks in the Central Valley to promote a positive mental health lifestyle?


Given the results, I recommend creating sustainable resources and spaces for LGBTQIA+ BIPOC identifying folks to rely on for support, questions, promoting mental health environments, staying informed, and empowerment. In addition, due to the COVID-19 pandemic, I would highly recommend creating a virtual spaces, such as podcasts, social media accounts and virtual community events to allow for broad inclusion. In regards to a clinical partnership, I would recommend presenting the collected data to medical/health facilities to take an inclusive approach to advocate for LGBTQIA+ BIPOC folks through staff representation and training as well.


References


ADAAA. (2021). LGBTQ+ communities: Anxiety and Depression Association of America, ADAA. LGBTQ+ Communities | Anxiety and Depression Association of America, ADAA. https://adaa.org/find-help/by-demographics/lgbtq.


Arellano, G. (2021, June 29). Column: 'oh, you're out?' gay politician can't get pride flag raised in his small California town. Los Angeles Times. https://www.latimes.com/california/story/2021-06-29/alex-garcia-wasco-pride-flag-centralvalley.


Casarez, A. (2020). Community Health Scholars. Central Valley Scholars. https://


Dominguez, M. L. (2017, June 8). LGBTQIA people of Color: Utilizing the cultural psychology model as a guide for the mental health assessment and treatment of patients with Diverse identities. Taylor & Francis.



Oxford. (n.d.). QUEER English definition and meaning. Lexico Dictionaries | English. https://www.lexico.com/en/definition/queer.


Parenthood, P. (n.d.). What does queer mean? Planned Parenthood.


Russell, S. T., & Fish, J. N. (2016). Mental health IN lesbian, gay, bisexual, and TRANSGENDER (LGBT) Youth. Annual review of clinical psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4887282/.

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