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LESBIAN GAY TRANSGENDER AND INTERSEX CIVIL RIGHTS AND HEALTH ADVOCACY

All orientations and identities are normal.

Multidisciplinary evidence reveals that a sexually dimorphic spectrum of somatic and neurologic anatomy, traits and abilities, including sexual orientation and gender identity, are conferred together during the first half of pregnancy due to genetics, epigenetics and the diversity of timing and function of sex chromosomes, sex-determining protein secretion, gonadal hormone secretion, receptor levels, adrenal function, maternally ingested dietary hormones, fetal health, and many other factors. Multiple layers of evidence confirm that sexual orientation and gender identity are as biological, innate and immutable as the other traits conferred during that critical time in gestation.

 

Research reveals variable hormonal levels in the first twelve weeks of pregnancy permanently affect child’s neural circuitry for sexual orientation and gender identity to express on a spectrum between straight and gay, same or opposite gender. A little extra testosterone secreted from the adrenals during early pregnancy affects the baby girls’ brains causing nearly half to be lesbian, a tenth to be transgender. Also, a girl twin baby simply sharing the womb with a boy co-twin, in which some of his testosterone from his amniotic fluid gets into her blood, causes about one fifth of girl co-twins to be lesbian. These girls also have the bone structure and physical coordination of boys, so they are good in sports, and thus the stereotype.

 

The opposite is also true: a bit less testosterone than usual in a boy's blood during early pregnancy can make him gay or transgender. If a boy's mother has delivered many older brothers before him, which caused her to make blocking antibody to his male proteins, resulting in about one fifth of boys with many older brothers being gay. Many of these boys have phonation, gait, physiology and linguistic and visual arts skills slightly more like girls, and thus the stereotype.

 

Most homosexuals and most heterosexuals believe that they had no choice to be how they are because they were born on the far ends of the spectrum. They can firmly claim they were "born that way." But, for some straight and gay folks, it WAS and IS definitely a choice for them because they were born closer to the middle of the biological spectrum between straight and gay: they are simply bisexual. Their orientations don't change from straight to gay when they date different genders, they simply have brain wiring that attracts them to both. All orientations are hard-wired prenatally and none can change it. It is all biological and innocent, and not contagious or changeable.

 

From the American Psychological Association: homosexuality is a normal sexual orientation; homosexual relationships are normal relationships. The American Academy of Pediatrics, American Psychological Association, American Psychiatric Association, American Association of Child and Adolescent Psychiatrists, National Association of Social Workers, Child Welfare League of America, North American Council on Adoptable Children have endorsed civil marriage/adoption for same-sex couples because marriage strengthens mental, physical health and longevity of couples, and having two parents (of any gender) provides greater health, legal/financial security for children. Research confirms that children develop perfectly normally.

LGBTI Activism

Since 1988, Dr. O’Hanlan has been very involved in the translation and interpretation of and education about the experiences and lives of lesbian, gay, bisexual and trans-gendered individuals to the medical community, as well as the general public.

 

In 1989, Dr. O’Hanlan wrote and obtained faculty senate support for Domestic Partner medical insurance at Albert Einstein College of Medicine in New York where she served on the faculty for four years. She and her partner since 1986 (now her wife) then moved to Stanford University where she wrote the Benefit Parity Bill which conferred comprehensive equal employment policy in 1992 granting faculty and staff medical insurance as well as all other benefits given to married individuals. She questioned why all medical universities do not provide equal benefits to their faculties. She asked “Do we really mean health care for all?”

 

In 1993, Dr. O’Hanlan was elected president of the Gay and Lesbian Medical Association, and co-authored "A Review of the Medical Consequences of Homophobia with Suggestions for Resolution". She led the vote to include transgender people in the mission statement for the organization and has spoken at transgender health conferences. She wrote about performing laparoscopic hysterectomies for TransMen.

 

Dr. O’Hanlan met with Dr. Donna Shalala, then Director of Department of Health and Human Services, Dr. David Satcher, then Director of the CDC, and others in the National Institutes of Health which have resulted in, among other things, the inclusion of questions about orientation and behavior in federal research instruments and data surveys so that a demographic profile of the lesbian, gay, bisexual, and trans-gendered community members might be generated and furthered through research, enabling targeted projects to improve access to healthcare. Today this information is now widely published and is used to improve the health of LGBT's.

 

She wrote the American Medical Women's Association policy endorsing same-gender civil marriage in 1994. She has spoken on LGBTI health issues at the National Institutes for Health, the President's Cancer Panel, the Office of Research on Women's Health, the American College of Obstetricians and Gynecologists and the American Medical Association.

 

She founded the Lesbian Health Fund in 1992, presiding over it until 1998, providing over $1 million through 120 grants which has fostered publication of over 84 articles by 2011. She and Dr. Donna Brogan obtained a grant from the LHF to report on “Methodologic Concerns in Defining Lesbian for Health Research” characterized the “Health of Lesbian Physicians” and to describe “Harassment of Lesbian Physicians and Medical Students.” She also wrote of the damaging effects of “Homophobic jokes and patient care.”

 

She also wrote "Lesbian Health: Perspectives for Treating Obstetrician/Gynecologists," the first chapter on lesbian health in Copeland's Gynecology Textbook in 2000, and published the first evidence of HPV transmission by lesbians. Historically, some Gynecologists would legally refuse to inseminate lesbian partners. Dr. O’Hanlan wrote case studies in lesbian health to educate Gynecologists that this discrimination was harmful.

 

She was co-principal investigator of the first NIH grant studying lesbians’ response to newly diagnosed breast cancer, and quantifying effects of a “Psychosocial Intervention for lesbians with Breast Cancer.”

 

She was invited by the Stanford Medical Students to give the keynote lecture for the Queer Medical Series independent study program every year from 2008 to 2013.

 

Dr. O’Hanlan gave the LGBT Baccalaureate speech to the LGBT graduates of Duke University in 2005 and received an award for her activism.

 

To urge health equality for lesbian patients of Gynecologists, Dr. O’Hanlan published “Health Policy for Sex Minorities” in the American College of Obstetrics and Gynecology eponymous journal. In 2008, she published the first article about female to male transsexuals undergoing hysterectomy. Download and print Surgical Instructions and Recovery Information for TransGuys and bring these with you to the office and hospital.

 

Lastly and finally, Dr. O’Hanlan compiled the many published studies of the “Biological Origins of Sexual Orientation and Gender Identity” confirming that no psychological causes for any orientation or identity have ever been identified. See the below summary.

 

This information was included as the substance of the 2013 amicus brief Dr. O’Hanlan co-authored from the GLMA to the Supreme Court of the United States endorsing recognition of the legal marriages performed by other countries by the US Government and the 2015 amicus brief from the GLMA to the Supreme Court of the United States endorsing recognition of the legal marriages in the United States. (My contribution is in yellow highlight.)

LGBTQI HONORS AND AWARDS:                               

  • Stanford School of Medicine Gender Equity Award, 1995                                                  

  • Delegate, United States Department of Health and Human Services to the Canadian Women’s Health Forum, Ottawa, Canada, 1996

  • Bay Area Career Women’s annual achievement “LAVA” Award, 1997           

  • Howard Brown Medical Center, Chicago, Friend for Life, 1998                                   

  • GAY Lesbian Medical Association Achievement Award, 1999

  • UCSF Center for Health and Aging: Advocacy Award, 2001

  • American Civil Liberties Union: Frontline Award for Activism, 2003               

  • The Mautner Project Healing Works Award, Atalnta, GA, 2004

  • Duke University Center for LGBT Life Leadership Award, 2005

  • Atlanta  Lesbian Health Initiative: Healing Angel Award, 2006

  • Society for Gynecologic Oncologists’ Trailblazing Representation Award, 2019

  • D.A. Boyes Society Honorary Inductee, British Columbia, Canada, 2019

 

PROFESSIONAL ORGANIZATIONS:   

  • Gay and  Lesbian Medical Association

Member  -  1986-2005

Member of Board of Directors - 1991-1996

President - 1993-1994

  • World Professional Association of Transgender health Professionals

                       

SERVICE TO UNIVERSITY AND HOSPITAL:

  • 1989 - Author, Albert Einstein College of Medicine, Domestic Partner Benefit Bill, passed unanimously by Faculty Senate, New York, NY, September 23, 1989.

  • 1990  - Author, Stanford University Benefit Parity Bill, passed by University Faculty Senate, Medical School Faculty Senate, Student Senate, and the Board of Trustees, December 1992, and implemented January 1993.

 

RESEARCH GRANTS:                              

  • 1994 - American Medical Association, Women Physicians Health Study, Erica Frank, M. D. M.P.H., and K. O'Hanlan, M.D., a cross sectional survey of 2,500 female members of the American Medical Association and the Gay and Lesbian Medical Association.

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CLICK TO DOWNLOAD ARTICLE

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Lé and Kate at their wedding ceremony in 1986.

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Kate with one of her men having hysterectomy.
(photo with his permission)

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Kate  & Léonie, since 1986

PEER-REVIEWED LGBT JOURNAL PUBLICATIONS:

  1. O'Hanlan KA, ed Lesbian Health and Homophobia:  Perspectives for the treating Obstetrician/Gynecologist. Los Angeles: Mosby Yearbook Publishers; 1995. Barberieri, ed. Current Problems in Obstetrics and Gynecology.

  2. O'Hanlan KA. Do we really mean preventive medicine for all? American journal of preventive medicine. 1996;12(5):411-414.

  3. O'Hanlan KA, Crum CP. Human papillomavirus-associated cervical intraepithelial neoplasia following Lesbian sex. Obstetrics and gynecology. 1996;88(4 Pt 2):702-703.

  4. O'Hanlan KA, Robertson PA, Cabaj R, Schatz B, Nemrow P. A review of the medical consequences of homophobia with suggestions for resolution. Journal of the Gay and  Lesbian Medical Association. 1997;1(1):25-39.

  5. Brogan DJ, Frank E, Elon L, Sivanesan SP, O'Hanlan KA. Harassment of  Lesbians as medical students and physicians. JAMA : the journal of the American Medical Association. 1999;282(13):1290, 1292.

  6. O'Hanlan K.A. Domestic partnership benefits at medical universities. JAMA : the journal of the American Medical Association. 1999;282(13):1289, 1292.

  7. Brogan D, Frank E, Elon L, O'Hanlan KA. Methodologic concerns in defining Lesbian for health research. Epidemiology. 2001;12(1):109-113.

  8. Fobair P, O'Hanlan K, Koopman C, O'Hanlan KA, et al. Comparison of Lesbian and heterosexual women's response to newly diagnosed breast cancer. Psycho-oncology. 2001;10(1):40-51.

  9. Fobair P, Koopman C, DiMiceli S, O'Hanlan KA et al. Psychosocial intervention for Lesbians with primary breast cancer. Psycho-oncology. 2002;11(5):427-438.

  10. Brogan DJ, O'Hanlan KA, Elon L, Frank E. Health and professional characteristics of Lesbian and heterosexual women physicians. Journal of the American Medical Women's Association. 2003;58(1):10-19.

  11. O'Hanlan KA, Dibble SL, Hagan HJ, Davids R. Advocacy for women's health should include Lesbian health. Journal of women's health. 2004;13(2):227-234.

  12. O'Hanlan KA. Health policy considerations for our sexual minority patients. Obstetrics and gynecology. 2006;107(3):709-714. Questions and my reply.

  13. O'Hanlan KA, Dibble SL, Young-Spint M. Total laparoscopic hysterectomy for female-to-male Transsexuals. Obstetrics and gynecology. 2007;110(5):1096-1101.

  14. O'Hanlan KA. Homophobic jokes and patient care. The virtual mentor: VM. 2010;12(8):618-621.

  15. O'Hanlan KA, Gordon JC, Sullivan MW. Biological origins of sexual orientation and  gender identity: Impact on health. Gynecol Oncol. 2018;149(1):33-42.

 

LGBTQI INTERNATIONAL, NATIONAL, or PEER-REVIEWED PRESENTATIONS:

  1. Medical concerns of  Lesbian, bisexual, Transgendered and intersexual patients, American College of Obstetricians and Gynecologists, Annual Clinical meeting, Philadelphia, PA, May 17,1999.

  2. Fobair, P, O'Hanlan K.A, et al, Comparison of  Lesbians and heterosexual women's response to newly diagnosed breast cancer, American Association of Psycho-Oncology, June, 2000.

  3. Culturally competent obstetric and gynecologic care of lesbians, Seattle Obstetrical Society, September 30, 2006.

  4. Risk assessment and cancer prevention among lesbian patients, British Columbia Cancer agency, division of medical oncology, Vancouver Center, BC, September 5, 2006.

  5. Oncologic Implications Of Stigma In The LGBT Population, presented To The Canadian Association Of Psychosocial Oncology, Halifax, Canada, May 9, 2008.

  6. Toward Higher Standards: Issues Regarding Sexual Orientation In AcaDemic Health Care Environment, University Of Pennsylvania School of Medicine, April 17, 2009.

  7. Biological origins of sexual orientations and gender identities, American Medical Association (AMA) annual meeting, San Diego, CA, November 5, 2010.

  8. Evidence of Biological origins of sexual orientations and gender identities: impact of denial of rights on health, Conference Supporting the Mental Health and Wellness of Transgender Individuals at Stanford University, August 26, 2011.

  9. Biological Origins of Sexual Orientation and Gender Identity, Stanford University Undergraduate SomGen 150Q class,  October 29, 2018.

 

LGBTQI POLICY WORK:

  • 1989 - Benefit Parity Bill passed by Faculty Senate of Albert Einstein college of Medicine

  • 1991 - Author, Benefit Parity Bill passed by Stanford University Faculty Senate, Board of Trustee

  • 1993 - "Lesbians in health research [presentation to the Office of Research onWomen's Health, National Institutes of Health] Scientific Meeting: Recruitment and Retention of Women in Clinical Studies: 1993 July 10; Washington (DC)." US Department of Health and Human Services: NIH Publication 95-3756.

  • 1994 - Shatz, B., and O'Hanlan K.A. "American Association of Physicians for Human Rights. (1994)." Anti-gay discrimination in medicine: Results of a national survey.

  • 1994 - Author, American Medical Women's Association, Policy Statement on Health for Gay And Lesbian Individuals, JAMWA, 49(3), 86, May/June, 1994. 

  • 1994 - Co-author of the Stanford University Investigational Review Board Policy on Inclusion of  Women in Clinical Trials, implemented 1994.

  • 1995 - O'Hanlan, K.A., Chair, Committee on Cancer, "Recruitment and Retention of Lesbians in Health Research," Recruitment and Retention of Women in Clinical Studies, p101-1-4, Office of the Director of the National Institutes of Health, United States Department of Health and Human Services, Public Health Service, National Institutes of Health, NIH Publication # 95-3756, Bethesda, Maryland, January, 1995.

  • 2000 - Institute of Medicine: Scientific Workshop On Lesbian Health 2000 Planning Committee

  • Member Department Of Health And Human Services, Washington do you see.

  • 2001 - Transgender issues, Duke University Student Health Grand Rounds, September 27, 2001.

  • 2004 - San Francisco Civil Rights Commission: Intersexuality and management of ambiguous genitalia: A Human Rights Issue, San Francisco, CA.

  • 2003 - Opportunities For Health Policy Leadership In LGBT Health, American Medical Association Women’s Physicians Congress Leadership Summit, Washington DC, March 1, 2003.

  • 2003 - LGBT Health: It matters, National Institutes of Health, Washington DC June 23, 2003.

  • 2007 - American College of Obstetricians and Gynecologists, District IX Policy on AB14 and 43 regarding Marriage Non-Discrimination Act, California Judiciary Committee, April, 2007.

  • 2009 - The Intersection Of Medical Science, Health, And Civil Rights, The Matthew Shepard lectureship of Whitman College, Walla Walla WA, April 1, 2009.

  • 2009 - Origins Of Diversity Of Sexual Orientation And Gender Identity: How Civil Rights Impact Health, University Of Pennsylvania Health Symposium, Philadelphia PA, April 17, 2009.

  • 2010 - Origins Of Diversity Of Sexual Orientation And Gender Identity And How Discrimination Impacts Health, American Medical Association Annual Clinical Meeting, San Diego  CA, November 5, 2010.

  • 2011 - Testimony to the California Department of Insurance regarding implementation of AB 1586: insurance gender nondiscrimination, November 29, 2011

  • 2013 - Amicus brief from the GLMA to the Supreme Court of the United States endorsing recognition of the legal marriages performed by other countries by the US Government.

  • 2015 - Amicus brief from the GLMA to the Supreme Court of the United States endorsing recognition of the legal marriages in the United States.

  • 2018 - Origins of Diversity of Sexual Orientation and Gender identity, Seattle Gender Odyssey Conference, August 12, 2018

​

LGBTQI BOOKS, CHAPTERS AND THESES:

O'Hanlan K.A. "Lesbians in health research [presentation to the Office of Research on Women's Health, National Institutes of Health] Scientific Meeting: Recruitment and Retention of Women in Clinical Studies: 1993 July 10; Washington (DC)." US Department of Health and Human Services: NIH Publication 95-3756.

 

Rosenbaum, M. and O'Hanlan, K.A., "Sexuality," Chapter 12. The American Medical Women's Association Women's Healthbook, The Philip Leif Group, Inc., New York, NY 1995.

 

O'Hanlan, K.A., Chair, Committee on Cancer, "Recruitment and Retention of  Lesbians in Health Research," Recruitment and Retention of Women in Clinical Studies, Office of the Director of the National Institutes of Health, United States Department of Health and Human Services, Public Health Service, National Institutes of Health, NIH Publication # 95-3756, Bethesda, Maryland, p 101-104, January, 1995.

 

Perry, M. J., O'Hanlan, K.A., " Lesbian Health: Psychosocial and Relationship Issues," in Behavioral Medicine for Women:  A Comprehensive Handbook, ed.: E. Blechman, Guilford Publications, New York, in press, 1995.

 

O'Hanlan, K.A.,  Lesbian Health: Therapeutic perspectives, Lila Wallis’ Comprehensive Textbook of Women’s Health, submitted September, 1996.

 

O'Hanlan, K.A., Homophobia and the Health Psychology of Lesbians. In: Kato P.M., Mann T. (eds) Handbook of Diversity Issues in Health Psychology. The Plenum Series in Culture and Health. Springer, Boston, MA.  1996.

 

Perry, M. J., O'Hanlan, K.A.,  " Lesbian Health: Barriers to Accessing Quality Care," p843-848, in Behavioral Medicine for Women:  A Comprehensive Handbook, ed.: E. Blechman, Guilford Publications, New York, 1997.

 

O'Hanlan, K.A.,  Lesbian Health: Therapeutic perspectives, Lila Wallis’ Comprehensive Textbook of Women’s Health, submitted September, 1996.

 

O'Hanlan, K.A., Homophobia and the Health Psychology of Lesbians. In: Kato P.M., Mann T. (eds) Handbook of Diversity Issues in Health Psychology. The Plenum Series in Culture and Health. Springer, Boston, MA.  1996

 

O'Hanlan, K.A. "Homophobia and the health care system: Solutions for the future." The lesbian health book: Caring for ourselves: 23-38, 1997.

 

O'Hanlan, K.A. Lesbian and Gay health:  Therapeutic perspectives. Medical Encounter; 14(2):3-7, 1998.

 

O'Hanlan, K.A., Burrs, Demetra, Health Issues of Sexual Minorities, Copeland’s Textbook of Gynecology, Second edition, WB Saunders Company, Philadelphia, PA, 2000.

 

O'Hanlan, K.A., and Isler, CM, Healthcare of  Lesbians and bisexual women, Chapter 20, in: Meyer IH, Northridge ME, eds. The Health of Sexual Minorities: Public Health Perspectives on  Lesbian, GAY, Bisexual and TRANSgender Populations (hardcover). New York: Springer-Verlag; 2006.

 

O'Hanlan, K.A. Gynecologic cancer risks among  Lesbians,  Lesbian Health 101: A Clinician’s Guide, Eds: Dibble and Robertson, UCSF Nursing Press, 2010.

 

Bostwick,  W.B.,  O’Hanlan,  K.A.,  &  Silverschanz,  P.  Issues  in  lesbian,  bisexual  and  transgender healthcare.  In  L.  Hansen,  M.B.  O'Connell,   J.  Smith  &  K.  Calis  (Eds.)  Health across  the  lifespan:  A pharmacotherapeutic  approach.  Bethesda,  MD:  American  Society  of  Health-System  Pharmacists  Publishing, 2010.

 

O'Hanlan, K.A. Clinical Case. Homophobic Jokes and Patient Care. Virtual Mentor. 2010; 12:618-621. August 2, 2010.

 

O'Hanlan, K.A., Top 10 Things Lesbians Should Discuss with their Healthcare Provider, Gay and Lesbian Medical Association - Retrieved on November, 2011.

 

Harrington M., O’Hanlan K.A. (2018) Sexual Minority Health. In: Knaus J., Jachtorowycz M., Adajar A., Tam T. (eds) Ambulatory Gynecology. Springer, New York, NY, 2018.

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