Pride Month 2023

Pride Month 2023

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Equality means more than passing laws. The struggle is really won in the hearts and minds of the community, where it really counts.
- Barbara Gittings (1932-2007), American activist for LGBTQIA+ equality 

Here at the Center for Nutrition and Health Impact (formerly the Gretchen Swanson Center for Nutrition), we remain dedicated to learning how social identities and statuses are relevant to understanding and addressing public health issues such as low food security. Members of the LGBTQIA+ community experience higher rates of low food security than the general population. According to the U.S. Census Bureau’s 2021 Household Pulse Survey, 13 percent of LGBTQIA+ adults in the U.S. reported living in households where there was sometimes or often not enough to eat in the past seven days, compared to seven percent of non-LGBTQIA+ adults. When it comes to federal food assistance programs, the Center for American Progress found that LGBTQIA+ respondents reported utilizing Supplemental Nutrition Assistance Program (SNAP) benefits at more than twice the rate of non-LGBTQIA+ respondents. 

The intertwined nature of low food security’s root causes, such as economic instability, employment status and lack of consistent, safe access to nutritious food, makes finding solutions incredibly challenging. According to the Health Equity Promotion Model (HEPM)—a conceptual, life course framework created for health equity research of the LGBTQIA+ population—social positions (i.e., race, ethnicity, national origin, age, gender identity, sexual identity, (dis)ability status, geographic location, socioeconomic status) and multi-level contextual factors intersect with health-promoting and health-adverse pathways to impact health outcomes for LGBTQIA+ people. These multi-level factors can systematically and institutionally disadvantage LGBTQIA+ people, impacting their ability to gain employment, earn equal income and access resources that improve food security, such as safe transportation, adequate housing for storing and cooking food, nutrition education and green spaces. 

The HEPM differentiates between structural- and individual-level factors: 

Structural-level factors

Social stigma

Anti-LGBTQIA+ legislation

Social exclusion

Institutional heterosexism

Example 1: LGBTQIA+ people may not seek medical care because of factors such as economic instability, exclusionary health insurance policies and lack of any health insurance coverage, which can lead to poor health outcomes. The 2022 Center for American Progress survey assessing cost barriers to accessing medical care found that 36 percent of LGBTQIA+ adults reported “postponing or not trying to get needed medical care” because they could not afford the costs, compared to only 17 percent of non-LGBTQIA+ adults. 

Example 2: According to the American Civil Liberties Union (ACLU), at least 491 anti-LGBTQIA+ bills have been introduced across the U.S. as of May 25, 2023, 142 of which relate to LGBTQIA+ health care. In May 2023, the Senate Bill 1580, “Protections of Medical Conscience”, and its companion bill HB 1403 were signed into law. These bills allow healthcare practitioners and insurance companies in Florida to deny patients care based on their religious, moral or ethical beliefs. 

Individual-level factors

Microaggressions

Violence

Discrimination

Family-of-origin rejection

Example 1: According to a recent study (Wilson, Badgett & Gomez, 2020) exploring the low food security experiences of LGBTQIA+ people, 14 percent of follow-up questionnaire respondents reported avoiding going to food pantries because of bias against LGBTQIA+ people. During in-depth interviews, some reported fearing rejection or judgment when visiting church-based or religiously affiliated charitable food services in particular. 

Example 2: In 2021 and 2022, a group of researchers utilized data from the Women’s Daily Experiences Study (WoDES) to investigate the relationship between microaggressions and health outcomes among cisgender, bisexual women. The 2021 study found a significant relationship between intersectional microaggressions (“i.e. those related to co-occurring racial and sexual minority identities”) and poorer self-perceived mental health, as well as higher levels of depression and anxiety. In the 2022 study, participants reported an average of eight microaggressions in the past 28 days and at least one microaggression for more than 42 percent of days.  

Although all members of the LGBTQIA+ community face many of the same challenges, it’s important to recognize that each subgroup is uniquely impacted by structural inequities based on their intersecting identities. For example, a 2019 study on economic instability within different sexual orientation and gender identity (SOGI) groups found that bisexual women and transgender people experience the highest rates of economic instability, with nearly 30 percent reporting income levels at or below the federal poverty threshold. This study also highlighted that, for nearly all SOGI groups, people of color had significantly higher rates of economic instability than LGBTQIA+ people who identified as White.  

Farm workers who identify as LGBTQIA+ also face significant challenges such as discriminatory policies and practices on the federal, state and local level. For example, LGBTQIA+ people are currently not recognized as eligible for “socially disadvantaged farmers and ranchers” benefits, which include farm loans, farm credit programs, crop insurance and conservation programs. And the loans that do exist are not set up to support LGBTQIA+ farmers. Consider this federal Farm Ownership loan’s very first eligibility requirement: “Be a family farmer.” For LGBTQIA+ people looking to work in agriculture, some may not want to get married, taking land acquisition through marriage off the table. Additionally, many LGBTQIA+ people may have family relationships that are strained or nonexistent, eliminating the possibility of inheriting a farm. 

As LGBTQIA+ activist Barbara Gittings said above, “Equality means more than passing laws. The struggle is really won in the hearts and minds of the community, where it really counts.” Without federal or institutional support, LGBTQIA+ farmers and activists have taken food justice into their own hands and uprooted the unjust systems that perpetuate low food security and create barriers to participating in agriculture. Many have reimagined the concept of “traditional farms” using practices that are rooted in sustainability and regenerative agriculture, defined by the Rockefeller Foundation as “a process with roots in Indigenous traditional ecological knowledge and food systems [that] takes a holistic approach to production that starts with the soil and includes the health of people, animals and the environment.” Most importantly, LGBTQIA+ people in agriculture are creating safe spaces for their communities which ensure equitable, consistent access to nutritious food and understand the unique needs of their community members. 

This Pride Month and all year around, we encourage you to learn about the unique food justice, health equity and farm ownership challenges LGBTQIA+ community members, farmers, activists and food security organizations face. If you are interested in supporting LGBTQIA+ farms directly, we invite you to explore Civil Eats’ list of queer- and trans-led farms and land projects. We will continue honoring the resilience of LGBTQIA+ activists who are paving the path for future generations to advance health equity, build inclusive food systems and support healthy food access throughout the month of June and beyond.