TEXTBOOK FOR LGBTQ HEALTH

New textbook aims to close gaps in LGBTQ health in medical schools

‘The Equal Curriculum’ covers topics ranging from transgender health to global LGBTQ health, Dr. said it’s necessary

by Savannah Kind Campus News Editor

University of Wisconsin staff members helped create a new textbook designed to close gaps in knowledge about LGBTQ health.

Dr. James Lehman, a senior editor, and Dr. Elizabeth Petty helped edit the textbook. “The Equal Curriculum” covers LGBTQ friendly medical encounters, specialties like pediatrics and neurology, transgender health, HIV/AIDS, sexual health and global LGBTQ health.

Lehman spoke about why a textbook like “The Equal Curriculum” is necessary.

“Across the country, the amount of education in LGBTQ health at the graduate health science level is incredibly variable,” Lehman said. “When [medical schools] did teach about LGBTQ health it was often as its own day or singular activity, as opposed to whenever it would make sense.”

Because of this, Lehman said across the county students led grassroots eforts to add to LGBTQ health curriculum at their universities. While this led to change at individual institutions, Lehman said universities were having to come up with their own curriculum and decide what should be included — this could be a lot of pressure for schools and made teachings variable.

Lehman said the textbook content is relevant to other courses as well — many chapters have applications in sociology, social psychology and nursing.

Diversity Officer for the School of Nursing Mel Freitag spoke about reasons why gaps still exist for LGBTQ health curriculum.

“I think the gap in health care [comes from] a color blindness,” Freitag said. “The helping professional fields feel like they already treat all their patients the same. So, regardless of the patients’ background I’m going to treat the disease, not the patient.”

Freitag said health professionals may think a person’s gender or sexual identity does not impact their level of care, but because of this many health disparities continue to persist. A care giver’s lack of knowledge on LGBTQ health can make patients less trusting of their health care providers, Freitag said.

Lehman said it is a health professional’s duty to make up for broken trust between the LGBTQ community and the medical feld.

“Patients will scan the environment for signs of possible harm and for safety,” Lehman said. “And I think the medical system has been involved in discrimination and harm to these communities. We have yet to make up for problems we have caused.”

The lack of LGBTQ health knowledge impacts patients in a variety of ways, Freitag said.

LGBTQ patients often wait to visit a health care provider because of a lack of trust in health care providers. As a result, they get diagnosed later when their diseases are more progressed, Freitag said. Additionally, Freitag said when the anatomy of a person differs from what a health care provider assumes based on gender identity, it can afect how a clinical skill is done. Freitag said another reason LGBTQ persons may be hesitant to visit a healthcare professional is often the patient has to educate the health care provider on LGBTQ health topics.

The trans broken arm syndrome is a term to describe this. A trans person goes in for a broken arm but the healthcare provider wants to be educated on trans health, assuming the trans person knows about trans health, Freitag said.

Freitag said in order to start closing the gap on LGBTQ health disparities health providers need to start looking at their own privilege and become aware of the issues LGBTQ people face and what they can do to help.

Freitag said UW is on the same level as other universities for LGBTQ health curriculum, but is progressing forward with new initiatives.

“We’re at a place where we know we need to do something and there is an issue,” Freitag said. “Now people are starting to develop responses to that.”

Freitag said students are bringing their knowledge of LGBTQ topics to their classrooms across campus and helping to educate instructors and fellow students.

Freitag also organized the first LGBTQ Health Summit at UW to educate current health providers — the knowledge health providers gain at the summit can be put into practice right away. Freitag plans to make this an annual event.

“The ability for health care providers to say ‘I don’t know, but I’m going to do my homework and check on that ... is really a shift,” Freitag said. “In the end, it can really afect quality, and safety and care of a patient.”

209,000 names to be removed from state voting list, lawsuit Organizers said it will disproportionately affect voters of color, “We can’t afford to go backward,” an head of voting group said

by Janani Sundar City News Editor

A Wisconsin judge found the state’s elections commission to be in contempt Jan. 13. The judge ordered the removal of up to 209,000 names from the state’s voting lists, efective immediately, or face fnes for each day it does not, according to AP News.

Last month Ozaukee County Circuit Judge Paul Malloy sided with the Wisconsin Institute for Law and Liberty, who filed a lawsuit and ordered a list of voter registrations to be deactivated. When the elections commission did not immediately act to remove the voters, Malloy found it and three Democratic commissioners who voted against moving ahead with the purge in contempt, according to AP News.

The District 4 Court of Appeals issued two stay orders Jan. 14, one temporarily halting the December ruling by Malloy to purge people from Wisconsin’s voter list, and the other temporarily blocking Malloy’s ruling that three members of the Elections Commission be held in contempt, according to Wisconsin Public Radio.

At least for the time being, hundreds of thousands of names will remain on Wisconsin’s voter rolls and members of the Elections Commission won’t be fned.

Public information officer at the Wisconsin Election Commission Reid Magney said no one is ofcially removed from the voter list yet.

Magney explained the elections commission sent out mailing in October to approximately 232,000 voters who may have moved. Under Wisconsin law, if someone moves, they need to re-register to vote under their new address. The election commission sent out similar mailing in 2017.

Magney said the information they get from this process is not always reliable. Because of this, the commission decided in 2019 it would decide to send out mailers to people and give them time to respond.

“If you get one of these letters, it tells you it looks like you may have moved. If you have not moved, you can go to our My Vote Wisconsin website, and you can let us know you are still living where you were originally registered,” Magney said.

Magney added if they move, they can reregister to vote online. They could also go to their regular polling place during any of the four regularly scheduled elections in 2020 and confirm their address where they are registered.

“After every general election, we look back four years and see who has not. We send them

Photo - Wisconsin Elections Commission ruled to remove names or be fned for each day it does not do so.

Courtesy of Flickr User Vox Efx

a postcard that says according to our records they have not voted in 4 years,” Magney said. “If you want to remain registered to vote just return the postcard or contact us and you will stay on the list.”

If the election commission does not hear from residents within thirty days or if the postcard comes back as undeliverable, the people are deactivated and will need to register again. Magney said this process has been in place for more than a decade.

The WILL fled a complaint against the WEC and shortly after sued the WEC, claiming the election commission was doing something wrong and stated the commission should be removing the people who were sent letters in October if they did not hear back within thirty days, Magney explained.

Malloy agreed with WILL and said the WEC should remove the people immediately. The WEC appealed the decision and last week the Wisconsin Court of Appeals stayed Malloy’s decision, Magney said. While the case is on appeal, no voters will be removed from the list. Magney explained when the mailing was sent, the WEC released a list of how many voters were in each municipality. Magney said somebody may have looked at it and thought there were more people in strongly Democratic areas like Milwaukee and Madison.

“We have no idea which voters are Republicans or Democrats or independents. In Wisconsin, you don’t register by party. We don’t have any information about what party people are in,” Magney said.

According to AP News, Democrats are fighting the lawsuit by claiming the purge would unfairly afect their voters. Republicans claim they want to ensure people who have moved are not able to vote from their old addresses.

WILL tried to take the case to the Wisconsin Supreme Court who declined its request to immediately hear the case. The case is now in a lower state appeals court and will likely not be resolved before the November presidential election, according to AP News.

Further direction includes both sides submitting briefs and arguments explaining their viewpoint and interpretation of the law. The court of appeals will consider it and make a decision. The losing party can appeal the

decision to the Wisconsin Supreme Court.

Out of the 232,000 people, 90% moved and need to reregister, Magney said, but it is unclear who those people are. Magney added most of the errors come from the Department of Motor Vehicles records. According to AP News, the commission wanted to wait until after the November 2020 presidential election before removing anyone because of such inaccuracies.

Even if a voter’s registration is deactivated, they can register again later or on Election Day at the polls if they have the necessary documents.

According to AP News, dozens of people rallied outside the courthouse before the hearing to protest the voter registration deactivation. Organizers said the purge would unfairly afect voters of color.

Rev. Greg Lewis, head of the get-out-thevote group Souls to the Polls Milwaukee, said we need to get better as the world is changing. “We can’t afford to go backward,” Lewis said. “Having a situation where you just treat folks who are already fragile in an indecent way is such a travesty of justice.”

The Republican-controlled State Assembly failed to override Democratic Gov. Tony Evers’ veto Jan. 15 on legislation concerning the required training hours needed to practice as a certified nursing assistant, according to the Wisconsin State Journal.

Federal law requires CNA trainees to have only 75 training hours, while Wisconsin policy requires 120. The bill aimed to reduce the number of hours for CNA trainees in Wisconsin, according to the Wisconsin Health Care Association.

The assembly passed the bill in May by a 66-31 vote. Members such as Rep. Steve Doyle, D-Onalaska; Rep. Beth Meyers, D-Bayfield; and Rep. Don Vruwink, D-Milton exhibited bipartisan support for the bill by joining GOP lawmakers.

But, Evers vetoed the bill in November. Evers said in a statement he is concerned about reducing training for those who care for Wisconsin’s most vulnerable citizens, according to the Wisconsin State Legislature. Addressing the shortage of CNAs, he sent the Governor’s Task Force on Caregiving to seek strategies to attract and keep nurses.

The Republican legislature sees the current 120 hours as excessive and preventing many competent CNAs from providing care many Wisconsin residents desperately need. They also cite the state’s increasing nursing shortage and call for members across the aisle to display support for what they see as a nonpartisan issue, according to a joint statement from Sen. Robert Cowles, R-Green Bay, and Rep. Warren Petryk, R-Eleva.

Groups such as the AARP view this federal requirement as necessary and possibly preventative of an extreme risk, such as under-certified CNAs providing faulty care, according to wispolitics.com. In order for the veto override to be successful, three additional Democrats would have had to join their GOP colleagues in backing the veto override. Regarding the Jan. 15 vote, the three aforementioned representatives who previously voted in favor of the 120-hour requirement chose to vote against the override, according to The Cap Times.

Rep. Cindi Duchow, R-Delafield, said partisans may receive consequences for voting against their party.

“My understanding is the minority leader had threatened them with taking away their staff and some other things if they voted with us, so they always vote along party lines,” Duchow said.

Assembly Republicans attempted and failed in November to override three of Evers’ budget vetoes, and these veto overrides have not been tried for nine years. These four attempts were only permitted because a chamber decision allowing unlimited veto override votes was passed last fall. Before this, a veto override could only occur once, according to The Cap Times.

So far, the Assembly has largely voted along party lines, as seen in the attempted CNA override. Republicans control 63 of 99 seats in the Assembly, so achieving the two-thirds majority vote for a veto override remains challenging.

Steven Davis, a political science professor at Edgewood College, spoke on the current position of the Republican party in Wisconsin, and how this may afect bills.

The GOP in Wisconsin is strengthened by gerrymandering, Davis said. He explained that in 2018, 54% of all votes cast in the State Assembly races were for Democrats. But, because of how the districts were drawn, they only won 36% of the seats.

“Though a new redistricting plan must be drawn up by the legislature after the 2020 census, a less extreme and less biased compromise map is more likely this time because Gov. Evers must sign of on it,” Davis said.

This new plan will be based on the 2020 census and put into efect by 2022, Davis said.

So far, many of the bills Evers signed are relatively nonpartisan. Duchow said if Evers continues this trend, bipartisan task forces for important issues like adoption and clean water could push lots of legislation through with no issue. But, the Republicans may subsequently have trouble pushing bills concerning more controversial issues, like welfare and voter ID requirements, Duchow added.

“We want to have stricter requirements for people getting welfare, and Gov. Evers is not going to go along with that,” Duchow said. “We want to tighten up the elections—right now. In Milwaukee, you can vote up to six weeks prior to an election, and I personally think that’s wrong.”

Six bills unanimously passed the Assembly Jan. 15 regarding two years of collective bargaining agreements for the several hundred unionized trades workers spread across the University of Wisconsin System campuses, according to the Wisconsin State Journal.

These workers, who are carpenters, painters, bricklayers and plumbers, were still waiting for costof-living raises despite the UW Board of Regents approving these agreements nine months ago.

The workers are entitled to the retroactive 2018- 2019 agreement of a 2.13% increase and the 2019- 2020 2.44% raise.

Duchow spoke on Governor Evers’ goal for the year and the Assembly’s next steps.

“Right now, he’s trying to get some things done so that the Democrats have something to run on in the fall,” Duchow said. “So we have put a lot of bipartisan legislation forward.” Assembly fails to override Gov. Evers’ veto on CNA legislation by Lindsey Knuth Reporter Bipartisan effort to reduce CNA training hours to match federal rules, legislature sees current 120 hours as excessive NEWS @badgerherald

Dane County to strengthen mental healthcare access for inmates Forty six percent of inmates within the county’s jail system were diagnosed with some form of mental health ailment

by Ben Baker Reporter

Dane County received a series of grants to further improve mental healthcare access within the criminal justice system and broader population. A report from the Dane County Behavioral Health Needs Assessment found approximately 46% of inmates within the county’s jail system were diagnosed with some form of mental health ailment. Given nearly half of Dane County’s inmates may require varying degrees of mental health assistance, the county moved to address the issue.

The Dane County Criminal Justice Council applied for a grant to assist countywide efforts in developing stronger, less racialized mental healthcare for its prison population. The National Association of Counties and the John D. and Catherine T. MacArthur Foundation provided Dane County additional funding for their mission, prompting celebration among county officials like Colleen Clark Bernhardt, the CJC Equity and Criminal Justice Council Coordinator.

“This allows Dane County to work with peer counties and national experts and signifes the long term commitment Dane County has to racial equity and criminal justice improvement,” Bernhardt said. The new funding arrives on the heels of

8 • badgerherald.com • January 28, 2020 a period marked by an increase in prisoner suicides nationally. A Bureau of Justice Statistics report found for every 100,000 prisoners, 50 would commit suicide, between 2000 and 2014. Additionally, 40% of inmate suicides during the same time period occurred within seven days of an inmate’s admission.

National inmate death rates also point to racial discrepancies related to healthcare access. According to a BJS report, in 2014 non-white prisoners accounted for over half of all inmate deaths and African American inmates made up nearly 32% of inmate deaths.

As part of this new grant, Dane County will begin working with the Peer Learning Network, a collaborative efort of counties and criminal justice experts, to reduce the number of incarcerated people suffering from mental illness, Bernhardt said. The CJC’s Behavioral and Mental Health Subcommittee, created in May 2019, is tasked specifcally with issues like this, Bernhardt said.

The information from the PLN will contribute to the subcommittee, Bernhardt said.

“It advances learning on diferent ways to divert folks who are struggling with a behavioral health crisis from formal criminal justice involvement,” Bernhardt said.

Elizabeth Doyle, Dane County’s District 1 supervisor, said in conjunction with the CJC’s work related to the MacArthur Foundation, the Behavioral and Mental Health Subcommittee also received $1.5 million to work alongside the C.J. Tubbs Fund for Hope, Healing and Recovery in the hopes of closing socioeconomic and racial gaps in access to mental healthcare.

Doyle added this project plan to take an innovative approach to their task, and will implement technology and peer support networks. Doyle said of the total funding, $500,000 will be allocated to establishing a new mental health call center to help those wrestling with mental health issues maneuver through the process.

“One of the things that emerged when talking with the Tubbs family and other folks that have struggled to navigate the system of substance abuse and mental health resources is just how difcult it is to navigate,” Doyle said.

The call center is meant to help people navigate the system and point them towards specific services, Doyle said.

In addition to combating racial divisions in mental health care access, Doyle said there are hopes to simplify treatment for those experiencing addiction or mental illness while also improving accessibility.

As mental healthcare moves to the forefront of the county’s public health discussion, there are many who see these recent grants as a vital step in normalizing mental wellness, such as Anna Moft, the Executive Director of Dane County’s National Alliance on Mental Illness chapter.

“What’s taking place right now at the county level is very exciting for us because we’re really seeing a strong move toward the decriminalization of mental illness,” Moft said.

The PLN will hopefully defer and defect those living with a mental illness away from the criminal justice system, Moft said.

Dane County’s work toward equity in mental healthcare is viewed by many, including Bernhardt, as a concrete example of the county’s dedication to combating racial inequality.

Doyle believes while the CJC and the subcommittee’s actions are taking the right step in the direction of equity, the county is still far from where she believes it should be with regards to social justice.

“We defnitely have very stark racial disparities in Dane County be it mental health or infant mortality,” Doyle said. “We’re definitely behind where we should be.”

Dane County will begin implementing its new mental health measures at the end of the month. The PLN will run from Jan. 2020 until June 2021.

Lake Mendota’s late freeze, warming climate induced trends The average freeze date is a lot later than 150 years ago, consequences important to community, UW professor said

by Erin Gretzinger City News Editor

Lake Mendota ofcially froze over in January, joining the ranks of other lakes in the Northern Hemisphere as a part of new later freeze date trends as the result of a warming climate.

Mendota was declared frozen by the Wisconsin State Climatology Office Jan. 12, marking the 10th time in the past 20 years the lake completely froze over in January, according to the University of Wisconsin’s Center for Limnology. Though, data on Lake Mendota’s freeze patterns dating back to the 1850s show the lake only froze 25 times in January over 150 years or approximately 16% of the time.

John Magnuson, UW professor and director emeritus of the Center of Limnology, said January freeze dates for Mendota are a relatively new phenomenon connected to warmer temperatures.

“The average freeze date is a lot later than 150 years ago,” Magnuson said. “It’s a lot warmer now than 150 years ago, so the water doesn’t cool down enough to freeze over.”

Mendota’s ice-on date this year was approximately three weeks later than average. Magnuson said in the 1850s, about fve months of ice would cover Mendota on average. Due to later ice-on dates in more recent years, Mendota now has about four months of ice cover per year.

Magnuson said while inter-year variability factors such as the exact temperatures, wind and cloudiness contribute heavily to a lake’s final freeze date, the later ice-on trends can be traced back to a warming climate.

“The reason it’s freezing later is those really bitter cold nights are not occurring as early in the winter,” Magnuson said. “But the main crux of this, the reason we are in this situation, is because our climate is warming.”

One key change with the warming temperatures of lake water is the temperature stratification of a lake. Magnuson explained lakes have four seasons defned by the layered temperatures of water. Cold and warm water are stratified for the winter and summer seasons, with the warm on top in the summer and the cold on top in the winter. Magnuson said the periods of mixing temperatures between cold and warm occur during the spring and fall.

Magnuson said if a lake doesn’t have any ice, it loses the winter season because the ice is what protects the lake from mixing. The lake is essentially cut down to two seasons, resulting in diferent impacts on a lake’s ecosystem. Without a distinct cold water season, the reproductive

Photo - Mendota’s ice-on date this year was approximately three weeks later than average.

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cycles of cool and cold water fsh such as yellow perch, trout and cisco are interfered with. Magnuson said this factor may be especially prominent in the decline of walleye seen across Wisconsin, Michigan and Minnesota.

“Since the period of open water is longer … it favors the warm water fsh and the cool water fsh do more poorly,” Magnuson said.

In the next 30 years, Magnuson said it is expected that Mendota will have its frst winter without freezing over completely and the average annual air temperatures will average at about 46ºF, meaning it will not be cold enough to freeze.

In the next 60 to 90 years after Mendota has its first year without complete ice cover, Magnuson said Mendota will still have ice cover for most years, but the proportion of winters without ice cover is expected to slowly increase. As more winters pass, Magnuson said it becomes more of a mystery of how safe the ice will truly be.

“As you go farther down that period, it’s more difficult to predict whether the ice is safe, and it is not likely that the ice is as thick,” Magnuson said. “We end up having to be more aware of how we interact with the lake if we want to be safe, even on the ice years.

Emily Whitaker, a UW grad student with the Freshwater and Marine Sciences Department, is attempting to tackle some of the mystery with the impacts of ice periods on lakes’ ecosystems. Whitaker is currently conducting research to explore the ecological impacts of less lake ice.

Whitaker said traditionally not a lot of work is completed in the winter time on the lake due to safety issues. Though, with new, safer technology available, a new frontier is open to new questions.

“With new ways to access the ice that are much safer, we can now start asking these questions about how ecology is changing as ice is changing,” Whitaker said.

One focus of Whitaker’s research is about how light entering through the ice impacts the ecosystem below, relating to the thickness and type of ice now accessible to measure. Whitaker said the exposure of light and energy based on ice-on and ice-off trends can shape different communities in an ecosystem.

Whitaker’s specific focus is how the phytoplankton community may be changing due to light exposure from the ice. With a shortening winter time and consequently a longer spring and summer, Whitaker is interested in how ecological community structures are working under the ice as well as how they may evolve going forward.

“This is kind of to understand the basis of what the new normal is now, but also that the new normal is always changing,” Whitaker said.

Based on research Magnuson and colleagues published in the Nature Research Journal, there are currently 14,800 lakes experiencing intermittent winter ice cover in the Northern Hemisphere, meaning they do not freeze over at all. Magnuson said that number will double to 35,300 if the climate warms 2°C, the goal of the Paris Climate Accord. If the mark is missed with little or no climate change mitigation and the climate warms a predicted 8°C, 230,400 will have no ice cover.

Magnuson said looking into how a warmer climate affects lakes is like “opening a Pandora’s box.” Though, Magnuson believes people can better understand and see the effects of a warming climate with changes with ice currently occurring.

“Ice on and off dates are very easy for people to relate to. They are based on direct observation,” Magnuson said. “I think one of the most important things that people don’t realize is that the duration of ice, when it freezes and when it breaks, has a lot of consequences important to people.”