State ignoring LGBTQ law on virus impact
SACRAMENTO — California is largely ignoring a new law requiring county health officers and providers to track the toll of the coronavirus pandemic among LGBTQ people, advocates say.
The law took effect immediately when Gov. Gavin Newsom signed legislation in September. But the state has yet to enforce the mandate consistently or report any COVID19 data among LGBTQ people.
“It’s just been a complete debacle,” said state Sen. Scott Wiener, DSan Francisco, who carried the legislation. “Once again, the LGBTQ community is being erased, even though the law mandates that we be counted.”
“Once again, the LGBTQ community is being erased, even though the law mandates that we be counted.”
State Sen. Scott Wiener
Wiener’s bill, SB932, requires health workers to ask patients who are tested for possible exposure to the coronavirus and about 90 other diseases about their sexual orientation and gender identity. Patients can decline to answer.
Data show that Latinos and Black people have died of COVID19 at disproportionately high rates. LGBTQ advocates say their community could also be more vulnerable because of underlying health problems, including higher prevalence of HIV and some cancers and respiratory problems from smoking.
State public health officials, who are charged with implementing SB932, did not respond to repeated requests for comment about why they are not regularly collecting the data.
The California Department of Public Health also appears not to have enforced its own regulations. In July, even before the state law took effect, the department issued rules requiring county health officers and providers to collect the LGBTQ patient data.
“Complete data is essential to addressing health inequities and better designing public health interventions that save lives,” Sonia Angell, thendirector of the Department of Public Health, said at the time.
Advocates began calling for California to include the LGBTQ community in its COVID19 tracking as far back as May, and Wiener said his bill was intended to cement the requirement in law.
Wiener sent a letter to the Department of Public Health on Tuesday demanding it start collecting the data immediately.
LGBTQ advocates say the data hasn’t been consistently collected in many areas, including large counties such as San Francisco, Los Angeles and Sacramento.
The state also has not added any LGBTQ data to its public COVID19 reporting website. California already collects data on race, age and
gender for COVID19 and all other communicable diseases it tracks.
LGBTQ leaders said tracking how the coronavirus is spreading in a demographic group allows health officials to better identify outbreaks and tailor messages to reach the community. Data can also influence how the state spends coronavirus relief funds.
“We fought for this for a reason,” said Samuel GarrettPate, a spokesman for Equality California, an LGBTQ advocacy group that cosponsored Wiener’s bill.
“And yet here we are in December, nine months into the crisis, and we still have no information on how it’s impacting the LGBT community,” he
said. “They’ve had more than enough time.”
There are some cases in which health providers have collected a portion of the data. For instance, Wiener said he was asked his gender identity each of the three times he’s been tested since the law took effect, but not his sexual orientation.
The San Francisco Department of Public Health has begun reporting data on patient sexual orientation and gender identity, though only from its contacttracing efforts for those who test positive. Los Angeles County has also asked orientation and gender identity questions as part of its contact tracing.
That data show that heterosexual people made up 55% of San Francisco cases, compared with 3% who were gay or lesbian and less than 1% who were bisexual. The county doesn’t have data on sexual orientation for more than a third of cases.
Cisgender men — those whose identity corresponds to their birth sex — made up 54% of positive cases, compared with 46% for cisgender women. Transgender, queer and gender nonbinary people accounted for less than 1% of positive cases.
However, LGBTQ advocates said the information from contact tracing paints a narrower picture and is less reliable because many people cannot be reached by contact tracers.
Wiener said his bill applies to data collection at the point of testing because the state cannot determine the infection rate in the LGBTQ community without knowing how many people are tested overall.
A spokesperson for San Francisco’s COVID Command Center said the city is working with its testing provider, Color, a health technology company, to expand the data requested from patients when they are tested. The department said it’s committed to responding to the pandemic with “an equity lens.”
Wiener said there are many reasons LGBTQ people could be more at risk from the coronavirus, including a higher prevalence of homelessness than the general population.
LGBTQ people could also be in more danger because many work in the service industry such as restaurants and interact directly with customers, according to a survey from the Human Rights Campaign, an advocacy group.
Wiener said he understands that “state health authorities are drinking water from a fire hose” as they fight the pandemic, but that the failure to track LGBTQ data consistently sends a negative signal.
“The culture for so long has been that being LGBTQ is a ‘ personal matter,’ that it’s a dirty little secret and you just keep it to yourself,” he said. “That’s why our community has been so stigmatized.”