News on Women's and/or LGBTQ Health

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Report: Women have rare egg-producing stem cells
By Lauran Neergaard


WASHINGTON—For 60 years, doctors have believed women were born with all the eggs they'll ever have. Now Harvard scientists are challenging that dogma, saying they've discovered the ovaries of young women harbor very rare stem cells capable of producing new eggs.

If Sunday's report is confirmed, harnessing those stem cells might one day lead to better treatments for women left infertile because of disease -- or simply because they're getting older.

"Our current views of ovarian aging are incomplete. There's much more to the story than simply the trickling away of a fixed pool of eggs," said lead researcher Jonathan Tilly of Harvard's Massachusetts General Hospital, who has long hunted these cells in a series of controversial studies.

Tilly's previous work drew fierce skepticism, and independent experts urged caution about the latest findings.

A key next step is to see whether other laboratories can verify the work. If so, then it would take years of additional research to learn how to use the cells, said Teresa Woodruff, fertility preservation chief at Northwestern University's Feinberg School of Medicine.

Still, even a leading critic said such research may help dispel some of the enduring mystery surrounding how human eggs are born and mature.

"This is going to spark renewed interest, and more than anything else it's giving us some new directions to work in," said David Albertini, director of the University of Kansas' Center for Reproductive Sciences. While he has plenty of questions about the latest work, "I'm less skeptical," he said.

Scientists have long taught that all female mammals are born with a finite supply of egg cells, called ooctyes, that runs out in middle age. Tilly, Mass General's reproductive biology director, first challenged that notion in 2004, reporting that the ovaries of adult mice harbor some egg-producing stem cells. Recently, Tilly noted, a lab in China and another in the U.S. also have reported finding those rare cells in mice.

But do they exist in women? Enter the new work, reported Sunday in the journal Nature Medicine.

First Tilly had to find healthy human ovaries to study. He collaborated with scientists at Japan's Saitama Medical University, who were freezing ovaries donated for research by healthy 20-somethings who underwent a sex-change operation.

Tilly also had to address a criticism: How to tell if he was finding true stem cells or just very immature eggs. His team latched onto a protein believed to sit on the surface of only those purported stem cells and fished them out. To track what happened next, the researchers inserted a gene that makes some jellyfish glow green into those cells. If the cells made eggs, those would glow, too.

"Bang, it worked -- cells popped right out" of the human tissue, Tilly said.

Researchers watched through a microscope as new eggs grew in a lab dish. Then came the pivotal experiment: They injected the stem cells into pieces of human ovary. They transplanted the human tissue under the skin of mice, to provide it a nourishing blood supply. Within two weeks, they reported telltale green-tinged egg cells forming.

That's still a long way from showing they'll mature into usable, quality eggs, Albertini said.

And more work is needed to tell exactly what these cells are, cautioned reproductive biologist Kyle Orwig of the University of Pittsburgh Medical Center, who has watched Tilly's work with great interest.

But if they're really competent stem cells, Orwig asked, then why would women undergo menopause? Indeed, something so rare wouldn't contribute much to a woman's natural reproductive capacity, added Northwestern's Woodruff.

Tilly argues that using stem cells to grow eggs in lab dishes might one day help preserve cancer patients' fertility. Today, Woodruff's lab and others freeze pieces of girls' ovaries before they undergo fertility-destroying chemotherapy or radiation. They're studying how to coax the immature eggs inside to mature so they could be used for in vitro fertilization years later when the girls are grown. If that eventually works, Tilly says stem cells might offer a better egg supply.

Further down the road, he wonders if it also might be possible to recharge an aging woman's ovaries.

The new research was funded largely by the National Institutes of Health. Tilly co-founded a company, OvaScience Inc., to try to develop the findings into fertility treatments.

© Copyright 2012 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

[Nat]

HEALTH CARE: LGBT health-coverage needs recognized

Scott Fearing, director of the Gay Alliance of the Genesee Valley, says that the Obama administration has consistently included LGBT health issues in the national health care discussion.

Even if you're a healthy lesbian, gay, bisexual, or transgender person, finding affordable health insurance can be frustrating. The Obama administration has tried to make it easier, however, for the LGBT community to find coverage through the Affordable Care Act.

The US Health and Human Services Department recently updated its main web site to include insurance information aimed at the LGBT community, such as plans for same-sex domestic partners. The National Gay and Lesbian Task Force hailed the development, saying on its web site that "finding domestic partner health insurance coverage just got easier."

Though the update recognizes the often special health insurance needs of LGBT people, the web site requires some patience to navigate. And the costs of the available insurance plans might still be unaffordable for many LGBT consumers.
To find the plans, go to www.healthcare.gov and click the blue "Find Insurance Options" tab at the top left corner, and then input the necessary information: ZIP code, age, and medical needs. Scroll nearly to the bottom and click "same-sex" or "domestic partner" to help narrow the search.

The LGBT community, according to several studies, is an underinsured population. Many are employed in low-paying or part-time positions that don't offer health care coverage, says Scott Fearing, director of the Gay Alliance of the Genesee Valley. And the inability for LGBT couples to marry in most states also prevents many people from having access to insurance, he says, since not all companies offer domestic partner benefits.

[Nat]

http://lgbthealth.webolutionary.com/...LGBT%20POC.pdf

All of the Above: LGBT People of Color


Lesbian, gay, bisexual, and transgender (LGBT) people of color are left vulnerable to cumulative negative health outcomes by a combination of persistent racism and the stigma attached to their sexual orientation and/or gender identity. The available studies are unambiguous about the disparities affecting the health of LGBT people of color: research indicates that Black and Latino LGBT people are more likely to be in poor health than both their heterosexual and non-transgender counterparts within communities of color and their White counterparts within the LGBT community.i Asian and Pacific Islander American LGBT and Native American LGBT/Two-Spirit communities undoubtedly bear similarly disproportionate burdens, though there is a serious lack of research in this area. Factors contributing to these disparities include limited access to health care and insurance, lower average socioeconomic status, fear of experiencing bias from providers, a lack of provider competence in the particular health concerns of the LGBT community and different racial and ethnic groups, and the stress of managing multiple types of societal discrimination.
Black gay man faces disparities common to the African-American community as well as those suffered by the LGBT community, and a transgender Spanish-speaking woman, regardless of her sexual orientation, must navigate multiple instances of discrimination based on language, ethnicity, and gender.
For example, a Black gay man faces disparities common to the African-American community as well as those suffered by the LGBT community, and a transgender Spanish-speaking woman, regardless of her sexual orientation, must navigate multiple instances of discrimination based on language, ethnicity, and gender.

The full extent of the health disparities affecting LGBT people of color remains unknown. Federal, state, and local health surveys collect data on a range of demographic information, including age, sex, race, and socioeconomic status. These data sets determine funding and program priorities for efforts to address health disparities. Because the importance of LGBT data collection continues to go unrecognized, health surveys collecting data that can identify racial and ethnic disparities do not ask respondents about their sexual orientation and/or gender identity, while research exploring LGBT health disparities must often rely on anecdotal data and convenience samples. What little data can thus be collected cannot be fully representative of the experiences of LGBT people of color. The omission of sexual orientation and gender identity measures from surveys leaves LGBT people, particularly people of color, with a serious lack of tools to assess and improve their health.

Health Disparities Affecting LGBT People of Color

A lack of access to high-quality health care delivered by competent providers is a major factor in the poorer health status of many LGBT people of color, and the primary obstacle to care is a lack of access to insurance coverage. The ratio of uninsured gay and lesbian adults to heterosexuals in America is estimated at 2 to 1.iv For LGBT people of color, discriminatory hiring and firing practices based on race, sexual orientation, and/or gender identity regularly prevent them from enjoying the protection of steady employment and employer-provided health insurance. In a recent study of 1,000 men, for example, 64 percent of Latino gay and bisexual men had some college education or more, but more than a quarter of them were the stress of managing multiple types of societal discrimination.
Black gay man faces disparities common to the African-American community as well as those suffered by the LGBT community, and a transgender Spanish-speaking woman, regardless of her sexual orientation, must navigate multiple instances of discrimination based on language, ethnicity, and gender.

The Importance of Data Collection

The full extent of the health disparities affecting LGBT people of color remains unknown. Federal, state, and local health surveys collect data on a range of demographic information, including age, sex, race, and socioeconomic status. These data sets determine funding and program priorities for efforts to address health disparities. Because the importance of LGBT data collection continues to go unrecognized, health surveys collecting data that can identify racial and ethnic disparities do not ask respondents about their sexual orientation and/or gender identity, while research exploring LGBT health disparities must often rely on anecdotal data and convenience samples. What little data can thus be collected cannot be fully representative of the experiences of LGBT people of color. The omission of sexual orientation and gender identity measures from surveys leaves LGBT people, particularly people of color, with a serious lack of tools to assess and improve their health.

Health Disparities Affecting LGBT People of Color

A lack of access to high-quality health care delivered by competent providers is a major factor in the poorer health status of many LGBT people of color, and the primary obstacle to care is a lack of access to insurance coverage. The ratio of uninsured gay and lesbian adults to heterosexuals in America is estimated at 2 to 1. For LGBT people of color, discriminatory hiring and firing practices based on race, sexual orientation, and/or gender identity regularly prevent them from enjoying the protection of steady employment and employer-provided health insurance. In a recent study of 1,000 men, for example, 64 percent of Latino gay and bisexual men had some college education or more, but more than a quarter of them wereunemployed.v For transgender people, who enjoy few legal protections from workplace discrimination and whose healthcare needs are often explicitly denied coverage by insurance companies, accessing and retaining health insurance coverage can be almost impossible. A recent survey found that almost 50 percent of predominantly Black transgender people in the Washington, D.C. area were without health insurance.vi Moreover, the lack of government recognition of same-sex relationships and alternate family configurations denies same-sex partners and other family members access to benefits that are extended to heterosexual married couples and their families.
Even when LGBT people of color are able secure insurance coverage, barriers to health care remain. Fear of bias and mistreatment from health care providers plays a significant role in preventing LGBT people from seeking care in a timely manner.vii Reluctance to seek care compounds the seriousness of conditions such as heart disease and diabetes and worsens the prognosis for diseases such as cancer. In one study, lesbians were found to have had their first Pap test at an older age, to have had fewer Pap tests in the previous five years, and to report a longer interval between their two most recent Pap tests than heterosexual women.viii Elevated rates of smoking and obesity in the LGBT community also take a high toll: LGBT people smoke at rates of up to 200 percent of the general population and are thus disproportionally at risk for several kinds of cancer.ix Native American communities in particular are heavily impacted by tobacco use.x Black and Latina lesbian and bisexual women were much more likely to be overweight than their heterosexual peers in an L.A.-based study, and several studies indicate that women who are overweight or obese are less likely to be screened for breast and cervical cancer in primary care settings.xi HIV/AIDS also continues to take a devastating toll among LGBT people of color, particularly Black gay and bisexual men and transgender women.

Such statistics only hint at the scope of the problem. Until questions about sexual orientation and transgender status are routinely included on all health and demographic surveys, these health disparities will continue to exacerbate the divide between LGBT people of color and others in America. Ensuring that LGBT people of color are consistently counted both as LGBT people and people of color is crucial to documenting and addressing the disparities that affect the health of LGBT people of color and recognizing their well-being as an integral part of a healthy America.