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Indian Health Service discusses LGBT issues at 'historic' meeting






Acting Indian Health Service Director Robert McSwain addresses the July 27, 2015, meeting in Rockville, Maryland. Photo by Andrew Bahl for Indianz.Com

Top leader commits to serving overlooked community
By Andrew Bahl
Indianz.Com Staff Writer

ROCKVILLE, Maryland -- Roughly 40 people crowded the suburban D.C. headquarters of the Indian Health Service on Monday to discuss how the agency can better serve lesbian, gay, bisexual, transgender and Two Spirit clients.

The daylong meeting differed from a normal listening session, a first for the agency. Participants -- who represented Indian Country, the IHS and other federal agencies -- were encouraged to engage with one another. They also posed questions to senior IHS staff.

“When I first heard the words ‘listening session’ I had images of setting a mic up and having people walk up one at a time,” said Gale Marshall, the coordinator for Let’s Move! in Indian Country who served as moderator for the event. “I think the administration did a good job in trying something new.”

Acting IHS Director Robert McSwain and Chief Medical Officer Susan Karol were among the top officials who participated in the meeting. McSwain, a member of the North Fork Rancheria of Mono Indians, stressed the significance of the event.

“This is critical, this is such a historic meeting and this is the first of many,” McSwain told attendees.

McSwain, who was named acting director in February, has worked for the IHS for nearly 40 years. He said the agency wants to adequately serve the often overlooked Two Spirit community.

“The IHS is committed to equal health care access and the goal of this meeting is to further understand the health care needs of LGBT tribal members,” McSwain said.


Members of the Navajo Nation are working to repeal the Dine Marriage Act of 2005, which outlaws same-sex marriage. Photo from Repeal the Dine Marriage Act / Facebook

Topics included the recent U.S. Supreme Court decision that requires all states to recognize same-sex marriage. Participants wondered how the ruling, which does not apply to tribal governments, will affect the IHS.

Geoffrey Roth, a senior advisor to McSwain, said the agency is ready to provide services for same-sex couples. But the decision -- which came after another case in which the Supreme Court required the federal government to recognize all marriages -- does not apply to tribes.

And while the marriage equality laws are spreading in Indian Country, Roth said some tribes don't want the IHS to serve same-sex couples. The Navajo Nation and the Cherokee Nation, the two largest tribes in terms of membership, outlaw same-sex marriages.

“We’re in compliance to allow same-sex couples to get service,” Roth said. “We may need to get the word out … and think about how we provide those services. But we have done the policy work.”


The Cherokee Nation will be building a new W.W. Hastings Hospital in Tahlequah, Oklahoma, as part of a Joint Venture Construction Program with the Indian Health Service. The tribe does not recognize same-sex marriage but the IHS is ready to provide services to same-sex couples, a senior advisor said. Photo from Anadisgoi / Cherokee Nation

Other participants discussed ways in which IHS facilities can be more welcoming, efficient and inclusive. Potential changes include adding gender neutral bathrooms, eliminating the use of gendered pronouns and providing more LGBT training for employees.

Josh Lowe came all the way from Seattle, Washington, for the listening session. He's an outreach worker for the 45th Street Home Youth Clinic and said addressing entrenched behaviors is often an uphill battle.

“It seems so hard to get people to change their minds on little things,” Lowe said.

IHS staff said they were pleased with the turnout and they expect to hold future meetings on Two Spirit issues. The agency sought public comment in advance of Monday’s meeting.

In a 2014 report, the Department of Health and Human Services said the IHS was planning to establish an advisory committee to address LGBT / Two Spirit issues. Similar committees exist for other subject areas at the agency.

The report also said the Administration for Native Americans was developing "mandatory" training for its senior management on LGBT / Two Spirit issues. The agency vowed to reach out to groups that serve the community as well.

Elsewhere in the federal government, the Department of Housing and Urban Development is working on a rule to bar discrimination against LGBT individuals who are seeking housing in Indian Country. There isn't a concrete timeline for the proposal.

Federal Register Notices:
Meeting on American Indian/Alaska Native Lesbian, Gay, Bisexual, and Transgender Health Issues (July 22, 2015)
Notice of Request for Information (June 5, 2015)

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