Public health practitioners focus on the health and the threats to health of populations, which can be delineated in various ways using a wide variety of taxonomies. Geography was one of the first classifications used in public health as it conveniently mapped to geographically bound governmental structures that were responsible for the public’s well-being.1 However, taxonomies for classifying individuals have moved beyond geography to include many characteristics of individuals and groups of individuals. Ideally, these taxonomies identify people and clusters of people based upon characteristics that allow us to understand and improve the public’s health.
This chapter discusses several interrelated taxonomies that have proven valuable for addressing public health. These include taxonomies based on: (1) sexual orientations, (2) gender identities and expression, and (3) sex characteristics (going forward noted as “SOGIESC”).2,3
SOGIESC minorities in the United States have been, and in many countries around the world still are frequently arrested, imprisoned and executed for same-sex sexual behavior; arrested for wearing clothing not representative of their biological sex; required to use bathrooms that do not correspond to their gender identity; arrested for dancing together; arrested for publishing and mailing literature not critical of homosexuality; forcibly hospitalized and placed in mental institutions; banned from being represented in literature, plays, and movies; fired from their jobs (e.g., restaurant workers, bankers, school teachers); as students, thrown out of schools and colleges (both public and private); denied parental rights to biological children and adoption rights; denied service in restaurants and bars; banned from serving in the military; denied housing (e.g., rental, homeless shelters); refused the ability to marry, and if intersex, abandoned or killed as infants.4–10
Arguments based upon scientific, including public health, research have played a role, often a critical role, in debates about each of these issues. Most fundamentally, the arguments have often concerned whether SOGIESC minorities are inherently ill or defective and deserving of basic rights, or whether they simply represent natural variations of sexuality, gender, and sex characteristics. The stigma and discrimination they often experience fundamentally impacts the health of SOGIESC minorities in ways that have not been adequately assessed or addressed.11–13
This chapter provides an overview of SOGIESC terms, how they are defined, and common taxonomies/measures used to sort individuals into SOGIESC categories. This is followed by a review of a few of the pressing public health concerns for SOGIESC minorities, and an introduction to several examples of successful efforts to protect and improve the health of these populations. We then discuss how the study of SOGIESC health requires integrating the concerns of SOGIESC minorities throughout all public health practice, which requires the participation of every discipline currently engaged in public health.
SOGIESC TERMS AND DEFINITIONS
Fundamental to the practice of public health is the monitoring of health and threats to health using epidemiology. Epidemiology requires that ...