Journal of Homosexuality

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The South Carolina LGBT Needs Assessment: A Descriptive Overview Jason D. Coleman, Jay A. Irwin, Ryan C. Wilson & Henry C. Miller To cite this article: Jason D. Coleman, Jay A. Irwin, Ryan C. Wilson & Henry C. Miller (2014) The South Carolina LGBT Needs Assessment: A Descriptive Overview, Journal of Homosexuality, 61:8, 1152-1171, DOI: 10.1080/00918369.2014.872515 To link to this article: https://doi.org/10.1080/00918369.2014.872515

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Journal of Homosexuality, 61:1152–1171, 2014 Copyright © Taylor & Francis Group, LLC ISSN: 0091-8369 print/1540-3602 online DOI: 10.1080/00918369.2014.872515

The South Carolina LGBT Needs Assessment: A Descriptive Overview JASON D. COLEMAN, PhD, MSPH School of Health, Physical Education, and Recreation, University of Nebraska at Omaha, Omaha, Nebraska, USA

JAY A. IRWIN, PhD Department of Sociology and Anthropology, University of Nebraska at Omaha, Omaha, Nebraska, USA

RYAN C. WILSON, MEd South Carolina Equality, Columbia, South Carolina, USA

HENRY C. MILLER Department of Epidemiology, University of South Carolina, Columbia, South Carolina, USA

Limited quantitative information exists about the demographics and needs of lesbian, gay, bisexual, and transgender (LGBT) persons in South Carolina, a predominately rural Southern state. Responses to a needs assessment survey ( n = 715) were analyzed to understand the diversity and needs of members of the LGBT community in SC. The purpose was to inform future programming and guide the development of a more comprehensive portfolio of services to be offered by a local LGBT community center. Findings suggest that a diverse LGBT community exists in SC and needs include increased programming for community members as well as efforts to provide policy-level support and increased acceptability and understanding of LGBT persons in South Carolina. KEYWORDS lesbian, gay, assessment, community needs

bisexual,

transgender,

needs

Address correspondence to Jason D. Coleman, 6001 Dodge Street, HPER 207-C, Omaha, NE 68182, USA. E-mail: [email protected] 1152

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In 2009, a community-based needs assessment survey was conducted with lesbian, gay, bisexual, and transgender (LGBT) persons who lived, worked, or participated in community events or services in South Carolina (SC). The survey was created through a partnership between leaders from a local LGBT community center, the Harriet Hancock LGBT Center (“Center”), and researchers from a local university. The Center is located in Columbia, SC, and was originally founded by the Board of the SC Gay & Lesbian Pride Movement (now known as the SC Pride Movement). The first community center opened in September 1993 and was one of the first gay and lesbian community centers in the southeastern United States. The purpose of this study was to inform future programming and guide the development of a more comprehensive portfolio of services to be offered by the Center. This article reports descriptive findings from the survey, including demographics; sexual identity and relationships; health and safety; civic engagement; services and events; and engagement with LGBT groups. The literature documents a variety of outcomes, both positive and negative, related to being a member of the LGBT community. Both urban and rural LGBT persons encounter different challenges than their non-LGBT counterparts. Such challenges may be related to geography; education, employment, and income; health and health care; safety; and discrimination. A number of LGBT community-based needs assessments have been conducted in cities, states, and regions across the United States. However, these results have been typically presented as community reports and do not appear in the academic literature. To that end, we offer this study as a starting point for understanding the demographics, needs, and engagement of LGBT persons in a predominantly rural Southern state. According to the U.S. 2000 Census, SC was the 13th highest-ranking state in the nation for persons living in rural areas, with 39.5% of the population residing in a rural area (U.S. Census Bureau, 2000). Recent estimates of the number of LGBT persons in the United States vary and may be complicated by variance in identity labels regarding sexual orientation and gender identities among people generally included under the larger LGBT umbrella. Differences between one’s sexual identity label and sexual behavior may further complicate estimates of LGBT persons (for example, a male who does not self-identify as gay yet has sex with other males). Results from the National Survey of Sexual Health and Sexual Behavior showed that between 4.8% and 8.4% of males between the ages of 18 and 59 years and between 2.0% and 9.2% of females between the ages of 16 and 49 years in the United States participated in same-sex sexual behavior (oral sex) in the previous year (Herbenick et al., 2010). Studies conducted by Gates at the Williams Institute (2011, 2012) estimated the LGB population to represent 3.5% of the United States and the transgender population to represent 0.3%. The Williams Institute estimated that over 117,000 gay, lesbian, and bisexual people were living in SC in 2005, and SC had a total of 10,563 same-sex households in the same year and same-sex households existed in every county in the state.

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Other findings from the Williams Institute showed that 73% of individuals in same-sex couples were employed, and that same-sex households in SC had an average annual income of $44,700. Further, 21% of same-sex couples reported raising children under age 18. In terms of education, 26% of individuals in same-sex relationships reported having a college degree (Romero, Rosky, Badgett, & Gates, 2008). The experiences of LGBT people living in rural areas may be different from those of city dwellers. Often, rural gays and lesbians create distinctions between their lives and those of people living in urban areas, and it is not uncommon for rural gays and lesbians to view the city as a place where a more defined gay community exists (Kazyak, 2011). Challenges experienced by non-metropolitan LGBT persons include weak and fragmented resources, living within a hostile social climate, and the lack of equal rights (Oswald & Culton, 2003). Similarly, gay men in a predominately rural state perceived an environment of social hostility, the potential for violence, the need to assimilate, and feelings of social and sexual isolation (Williams, Bowen, & Hovarth, 2005). Gay young adults in rural Texas reported both positive and negative outcomes related to their sexuality, including supportive teachers, resiliency, isolation, and abuse (Yarbrough, 2003). Disclosure of sexual orientation to a health care provider is low among LGBT people, with 37% reporting active disclosure and 38% reporting avoidance of questions about sexuality (Eliason & Schope, 2001), and lesbians may be more hesitant to disclose their sexual orientation than gay men (Klitzman & Greenberg, 2002). Lesbians have also reported delays in seeking health care because of fear of discrimination related to their sexual identity (van Dam, Koh, & Dibble, 2001). In a study conducted with men who have sex with men in New York City, 39% reported that they did not disclose their sexual orientation to their health care provider, and no bisexual men reported disclosure of their sexual orientation (Bernstein et al., 2008). Both men and women in same-sex relationships are significantly less likely to have health insurance than those in different-sex relationships (Buchmueller & Carpenter, 2010). Studies indicate that LGBT persons have disproportionate rates of smoking when compared to heterosexual persons. A review of studies from 1987–2001 estimated smoking rates for LGB people to range from 38%–59% among youth and from 11%–50% among adults (Ryan, Wortley, Easton, Pederson, & Greenwood, 2001), and that smoking prevalence is about 50% higher for men in the LGBT community and about triple for women in the LGBT community when compared to the general community (California LGBT Tobacco Education Partnership). Factors related to the high prevalence of smoking include social stress, frequency of attendance at bars and clubs, higher rates of alcohol and drug use, and targeting of LGBT consumers by the tobacco industry (Ryan et al., 2001; National Coalition for LGBT Health). High rates of alcohol use have also been documented for this population. In a study of urban men who have sex with men,

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90% of respondents reported using alcohol in the previous 6 months (Stall et al., 2001). A study of lesbian and bisexual women found that only 19.8% across all ages reported abstinence from drinking and found that over 23% between the ages of 20 and 34 years were heavy drinkers (Gruskin, Hart, Gordon, & Ackerson, 2001). Earlier studies produced conflicting results about alcoholism in LGB populations, with one estimating the rate of alcoholism around 30% (McKirnan & Peterson, 1989) and others finding no significant differences in consumption between bar-going lesbian/bisexual women and heterosexual women (Bloomfield, 1993), and no differences in alcohol consumption patterns between gay men and heterosexual men in San Francisco (Stall & Wiley, 1988). LGBT persons also report being victims of hate crimes or bias. Herek (2009) found that approximately 20% of LGBT respondents in a national probability sample had experienced a person or property crime based on their sexual orientation, about 50% had experienced verbal harassment, and more than 10% had experienced discrimination in housing or employment. Data compiled from 24 studies conducted with LGB adults between 1977 and 1991 showed that 9% of respondents reported an aggravated assault (with a weapon), 17% reported physical assault (without a weapon), 19% experienced vandalism, 44% were threatened with violence, 33% had been chased or followed, and 80% had been verbally harassed (Berrill, 1992). A study conducted in a Midwestern state found that about one in three LGBT respondents had experienced perceived or actual employment-related discrimination (Fisher, Irwin, Coleman, McCarthy, & Chavez, 2011).

METHOD The South Carolina LGBT Needs Assessment was developed through a series of meetings between leaders from the Center and researchers from the School of Public Health at a local university. Members of the community– academic partnership created survey sections and items with the goal of developing a cross-sectional survey instrument to provide data about LGBT persons in South Carolina that included demographics, health and service needs, and issue prioritization. This article reports descriptive outcomes from selected areas of interest: basic demographics; sexual identity and relationships; health and safety; civic engagement; services; political participation; event participation; and engagement with LGBT groups.

Measures Survey items to assess demographics, sexual identity and relationships, health and safety, and civic engagement were categorical with discrete

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response options. Where appropriate, an open-ended option was included to allow respondents to indicate an alternative response (e.g., gender, sexual identity, race, employment status, citizenship status, health insurance provider, and primary care provider). Services, political participation, and event participation were assessed using scales in which the respondent indicated the likeliness of his or her participation at a specific event or activity within the next 12 months, where options included “very likely,” “likely,” “not very likely,” and “not at all likely.” Respondents were given a list of LGBT groups from which to indicate their past financial support. Additional items to assess financial contributions and volunteer engagement with the Center were included and used categorical response options. All measures were created for this survey by the research team. The research team held a meeting with interested community members to review a draft of the survey instrument and assess question appropriateness, understandability, and readability prior to survey implementation.

Data Collection The anonymous survey was administered in two waves. The first wave was a pen-and-paper survey given at the SC Pride Festival in September 2009. Researchers and student volunteers approached festival attendees and offered them an opportunity to participate in the survey. Prior to the festival, the research team and student volunteers met to review the research and intercept protocols. The day after the festival, the second wave was launched as an online survey using SurveyMonkey. All items, including openended items, were identical to the pen-and-paper survey. Palm cards with the online survey access information were distributed to persons who indicated an interest in the survey at the Pride festival but who did not wish to complete it on-site. Those who were given palm cards were asked to visit the site starting the next day. The online survey was advertised using social media (e.g., Facebook) and through the SC Pride Movement Listserv. Other LGBT-serving organizations and groups also distributed the survey link through their e-mail lists. Respondents were encouraged to forward the link to others who may be interested in completing the survey. The online survey was closed in December 2009. For each wave of the survey, respondents could elect to be entered into a drawing for prizes, including gift cards, iPods, and a television, following the completion of the survey. To maintain confidentiality, respondents to the online survey provided e-mail addresses using a linked survey question to register for the drawing and to ensure that responses could not be matched to an e-mail address. Respondents to both the pen-and-paper and online surveys reviewed an informed consent document and agreed to participate in the study prior to beginning the survey. The survey instrument and research protocol were approved by the Institutional Review Board at the University of South Carolina.

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Responses from respondents who identified as straight and nontransgender were eliminated from the data set for analysis. To avoid the potential for duplicate responses, subsequent responses where the ZIP code, gender, and birth date were identical were also eliminated. Descriptive analysis was conducted using IBM SPSS Statistics version 19. Frequency distributions with the number of respondents and valid percent are reported in all tables for nominal/ordinal variables.

RESULTS A total of 84 responses from respondents who identified as straight and nontransgender and 25 potential duplicate responses were removed. The final dataset contained 715 surveys, 46% (n = 329) of which were completed at the SC Pride Festival, and 54% (n = 386) of which were completed online.

Basic Demographics The mean age of survey respondents was 35.4 years, and they ranged in age from 18 to 75 years. The sample was split fairly evenly by gender, with 50.9% (n = 358) of respondents indicating they were male and 47.9% (n = 337) of respondents indicating they were female. Nine (1.2%) respondents indicated they were either transgender or intersex. Respondents were primarily White/Caucasian (85.2%, n = 593), followed by Black/African American (8.8%, n = 61) and bi- or multiracial (4.5%, n = 31). The majority of respondents were not Hispanic/Latino/Latina (96.4%, n = 676). Geographically, just over half of respondents (54.3%, n = 379) lived in the Midlands, while 21.3% (n = 149) lived in the Upstate, 15.3% (n = 107) lived in the Low Country, 3.3% (n = 23), and 5.7% (n = 40) lived out of state. The Upstate is the northwestern corner of the state, whereas the Midlands represent the center of the state and include the capital city, and the Low Country lies along the coastal region. Respondents who lived out of state were included because they likely accessed services or participated in events in SC.

Sexual Identity and Relationships Most respondents reported their sexual identity to be gay (47.4%, n = 333) or lesbian (37.2%, n = 261), while others reported being bisexual (10.7%, n = 75), queer (2.1%, n = 15), or questioning (0.7%, n = 5). Other respondents (1.4%, n = 13) indicated “other” sexual identity or that their sexual identity was a combination of responses (e.g., “two-spirit,” “gay and lesbian,” “gay and queer”). Nearly all respondents (98.2%, n = 693) reported

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being “out” to someone, and over half (54.7%, n = 386) reported being “out to everyone.” Nearly half of respondents (44.6%, n = 317) reported being either partnered or married, while 33.9% (n = 241) reported being single. Others reported dating one person (19.9%, n = 141) or multiple people (1.3%, n = 9). Two respondents (0.3%) reported being widowed. Although most respondents reported having no children under 18 years, 16.9% (n = 121) had children under 18 years. Table 1 provides a summary of demographic information. TABLE 1 Basic demographic characteristics Demographic characteristic Gender Male Female Transgender—MTF Transgender—FTM Intersex Race White/Caucasian Black/African American Asian/Pacific Islander Native American/Alaska Native Biracial/Multiracial Other Ethnicity Hispanic/Latino/Latina Not Hispanic/Latino/Latina Sexual Identity Gay Lesbian Bisexual Queer Questioning Other or Combination of Identities Region of Residence Upstate Midlands PeeDee Low Country Out of State Outness Out to someone Out to everyone Relationship Status Single Dating one person Dating multiple people Partnered Married Widowed

N

%

358 337 5 3 1

50.9 47.9 0.7 0.4 0.1

593 61 5 3 31 3

85.2 8.8 0.7 0.4 4.5 0.4

25 676

3.6 96.4

333 261 75 15 5 13

47.4 37.2 10.7 2.1 0.7 1.4

149 379 23 107 40

21.3 54.3 3.3 15.3 5.7

693 386

98.2 54.7

241 141 9 258 59 2

33.9 19.9 1.3 36.3 8.3 0.3

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Education, Employment, and Income Most respondents (56.8%, n = 402) reported holding a college degree (associates, bachelor’s, or advanced degree), while others (31.5%, n = 223) reported completing some college (42.1%, n = 298) or high school or a general education degree (GED; 10.6%, n = 75). Eight (1.1%) respondents reported completing less than high school or the equivalency. Most participants were not currently a student (71.8%, n = 501). The majority of respondents (83.0%, n = 582) reported being employed either full-time or part-time. Fewer reported being retired (3.3%, n = 23), disabled (1.3%, n = 9), or in another employment status (2.1%, n = 15; e.g., self-employed, military). The greatest number of respondents reported having an annual household income between $30,000 and $39,999 (14.6%, n = 101), followed by respondents with an annual household income of $14,000 or less (13.0%, n = 90), between $20,000 and $29,999 (12.6%, n = 87), and $100,000 or greater (12.6%, n = 87). Table 2 provides a summary of education, employment, and income results.

Health and Safety Most respondents (73.7%, n = 482) reported having a primary health care provider (e.g., doctor, nurse practitioner), while others reported using an urgent care facility (10.1%, n = 66) or emergency room (4.6%, n = 30) for primary health care. Most respondents (75.1%, n = 531) reported that they had health insurance. Of those who reported having health insurance, most (66.5%, n = 353) indicated that the source of their health insurance was their job. Other reported that the source of their health insurance was their parents (13.4%, n = 71), self-insurance (7.7%, n = 41), or Medicare/Medicaid (4.9%, n = 26). Just over half of respondents (52.6%, n = 364) reported that they disclose their sexual orientation/gender identity to their health care provider “always” or “most of the time,” while others (47.4%, n = 328) reported that they disclose their sexual orientation to their health care provider “some of the time” or “never.” Nearly half of respondents (45.4%, n = 315) reported that they consumed between one and five alcoholic beverages in a typical week, while 28.1% (n = 195) reported consuming no alcoholic beverages in a typical week. Two thirds of respondents (66.0%, n = 458) reported that they smoked no cigarettes in a typical week, while 34% (n = 236) reported that they smoke half a pack or more cigarettes in a typical week. Most respondents (59.6%, n = 413) reported that they had not been a victim of hate crime or bias. Nearly all respondents (91.1%, n = 633) reported that they felt “very safe” or “safe” in their community. Most respondents (71.5%, n = 498) also reported that they trusted law enforcement to protect their best interests “always” or “most of the time.” Table 3 provides an overview of health and safety findings.

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TABLE 2 Education, employment, and income Demographic characteristic Education Completed Grades 9–11 High School Diploma/GED Some College Associates Degree Bachelors Degree Advanced College/University Degree Student Status—Current Enrollment Status Not a student High school or GED program Two-year or community college College or university (undergraduate) College or university (graduate or professional school) Employment status Full-time Part-time Not currently employed Retired Disabled Self-employed Military Full-time and part-time Annual Household Income Less than $14,000 $14,000–$14,999 $20,000–$29,999 $30,000–$39,999 $40,000–$49,999 $50,000–$59,999 $60,000–$69,999 $70,000–$79,999 $80,000–$89,999 $90,000–$99,999 $100,000 or greater

N

%

8 75 223 68 169 165

1.1 10.6 31.5 9.6 23.9 23.3

501 4 46 87 60

71.8 0.6 6.6 12.5 8.6

462 120 72 23 9 11 1 3

65.9 17.1 10.3 3.3 1.3 1.5 0.1 0.4

90 53 87 101 60 57 48 40 40 28 87

13.0 7.7 12.6 14.6 8.7 8.2 6.9 5.8 5.8 4.1 12.6

TABLE 3 Health and safety Variable Current Health Insurance Yes No Not sure Health Insurance Provider (for those covered only) My job Partner’s job Parents Self-insured Medicare/Medicaid Student health insurance

N

%

531 172 4

75.1 24.3 0.6

353 11 71 41 26 12

66.5 2.1 13.4 7.7 4.9 2.3 (Continued)

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SC LGBT Needs Assessment TABLE 3 (Continued) Variable Cobra Military Primary Health Care Source Primary health care provider (doctor/nurse/nurse practitioner) Urgent care Hospital emergency room Health department Community clinic College or university health center Veterans or military hospital Work clinic Combination of sources Disclosure of Sexual Orientation/Gender Identity Never Some of the time Most of the time Always Alcoholic Beverage Consumption in a Typical Week None 1–5 drinks 6–10 drinks 11–15 drinks 16–20 drinks More than 20 drinks Cigarette Smoking in a Typical Week None Half a pack 1 pack 2 packs 3–5 packs 6–10 packs More than 10 packs Victim of hate crime or bias in lifetime Yes No Feel safe in local community or neighborhood Not at all safe Not very safe Safe Very safe Trust local law enforcement to protect your best interests Never Rarely Most of the time Always

N

%

7 5

1.3 0.9

482 66 30 11 18 11 5 2 29

73.7 10.1 4.6 1.7 2.8 1.7 0.8 0.3 4.6

163 165 106 258

23.6 23.8 15.3 37.3

195 315 113 31 20 20

28.1 45.4 16.3 4.5 2.9 2.9

458 45 23 30 82 51 5

66.0 6.5 3.3 4.3 11.8 7.3 0.7

280 413

40.4 59.6

5 57 422 211

0.7 8.2 60.7 30.4

32 166 399 99

4.6 23.9 57.3 14.2

Civic Engagement Nearly all respondents (99.3%, n = 705) reported being citizens of the United States, and most (92.4%, n = 657) were registered to vote. Further, most

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TABLE 4 Civic engagement Variable U.S. Citizenship Status U.S. citizen Legal resident Registered Voter Yes No Not sure Vote in 2008 Presidential Election Yes No

n

%

705 5

99.3 0.7

657 49 5

92.4 6.9 0.7

607 104

85.4 14.6

respondents (85.4%, n = 607) voted in the 2008 presidential election. Table 4 provides information on variables related to civic engagement. Among respondents, the most likely political participation in the next 12 months was voting or registering to vote (57.2%, n = 480), followed by writing a letter to an elected official (44.0%, n = 369), attending a protest (35.5%, n = 298), attending a town hall or community meeting (33.5%, n = 281), meeting with an elected official (26.0%; n = 218), or attending a candidate debate forum (24.7%; n = 207). Table 5 provides a summary of likelihood of participation in political events in the next 12 months.

Services and Events Respondents were most likely to report the need for services related to legal documents (36.9%, n = 287) in the next 12 months. Other services needs included a LGBT business directory (36.6%, n = 307) a faith-based group (34.5%; n = 290), and lesbian (26.8%, n = 225) or gay male (25.3%; n = 212) groups. Table 6 provides a summary of reported service needs. Respondents were asked the types of events in which they were most likely to participate, both for no charge and if a small fee was required for participation. The events that respondents were most likely to attend at no charge included the Pride festival (81.0%, n = 680), Pride parade (76.5%; n = 642), a TABLE 5 Likelihood of political participation in next 12 months Event Voting/Voter registration Writing a letter to elected official Protest Town hall or community meeting Meeting with elected official Candidate debate forum

n

%

480 369 298 281 218 207

57.2 44.0 35.5 33.5 26.0 24.7

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SC LGBT Needs Assessment TABLE 6 Services likely to be needed in next 12 months∗ Service Legal Documents LGBT Business Directory Faith-based Group Lesbian Group Gay Male Group Estate Planning Employment Assistance Sustainability/Recycling Information Educational Workshops Health Group Personal Relationships Group LGBT Library at HHC Legal Representation Youth Alliance HIV/AIDS Group GLBT Archive at USC ∗ Percentages

n

%

287 307 290 225 212 190 186 178 173 156 149 144 132 127 126 114

36.9 36.6 34.6 26.8 25.3 22.6 22.2 21.2 20.6 18.6 17.8 17.2 15.7 15.1 15.0 13.6

reported are valid percent and include only the n for the item.

musical event (76.3%; n = 643), a theater event (74.7%; n = 627), and an art gallery event (67.9%; n = 570). The events that respondents were most likely to attend for a small fee were similar and included the Pride festival (66.9%, n = 561), a musical event (63.6%, n = 534), a theater event (62.6%, n = 525), Pride parade (54.6%, n = 458), and a film screening (55.4%, n = 465). Respondents were more likely to attend all events if there was no charge. Table 7 summarizes likelihood of participation in specific events, both for a free or paid. TABLE 7 Likelihood of participation in events, free or paid∗ Free Events Pride Festival Book Club Film Screening Musical Event Art Gallery Theater Event Picnic Pride Parade–Participate Pride Parade–Attend Political Rally Political March Bar Night Dating Event Sporting Event–Participate Sporting Event–Attend Lecture Radio Program ∗ Percentages

n

%

Pay Events

n

%

680 370 543 643 570 627 540 488 642 471 428 491 280 354 480 421 382

81.0 44.1 64.7 76.6 67.9 74.7 64.4 58.2 76.5 56.1 51.0 58.5 33.4 42.4 57.2 50.2 45.5

Pride Festival Book Club Film Screening Musical Event Art Gallery Theater Event Picnic Pride Parade–Participate Pride Parade–Attend Political Rally Political March Bar night Dating Event Sporting Event–Participate Sporting Event–Attend Lecture Radio Program

561 244 465 534 436 525 389 365 458 270 254 365 205 267 375 285 206

66.9 29.1 55.4 63.6 52.0 62.6 46.4 43.5 54.6 32.2 30.3 43.5 24.4 31.8 44.7 34.0 24.6

reported are valid percent and include only the n for the item.

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Engagement with LGBT Groups Respondents were asked about their financial contributions to local and national LGBT organizations. Over one quarter of respondents (n = 199, 27.8%) reported no financial contributions in the past year. For local organizations, just over half of respondents (n = 344, 51.3%) made a financial contribution to the South Carolina Pride Movement in their lifetime, and 30.4% (n = 204) made a financial contribution in the past year. Other local organizations to which respondents reported making financial contributions in the past year included SC Equality (n = 129, 18.0%), Sean’s Last Wish (n = 77, 10.8%), SC Gay and Lesbian Business Guild (n = 60, 8.4%), the Harriet Hancock Center Foundation (n = 57, 8.0%), and Alliance for Full Acceptance (n = 56, 7.8%). SC Equality was founded in 2002 and has a mission to “secure civil and human rights for gay, lesbian, bisexual and transgender South Carolinians” (www.scequality.org). Sean’s Last Wish was established in 2007 following the murder of an openly gay young adult, Sean Kennedy, in Greenville, SC. Kennedy’s mother created the foundation “to raise awareness to the fact that in the State of South Carolina, law enforcement officials, solicitors and judges do not have the tools with which to investigate crimes of violence and intimidation that are motivated by bias against actual or perceived race, religion, national origin, ancestry, age, disability, gender, sexual orientation or gender identity of the victim” (www.seanslastwish.org). The SC Gay and Lesbian Business Guild was founded in 1993 “to encourage networking, business development and support within the gay and lesbian community,” and it has a vision “to encourage networking, business development and support within the gay and lesbian community” (www.scglbg.org). The Harriet Hancock Center Foundation was originally formed in 1987 as the Gay and Lesbian Advocacy Research Group and was renamed in 2008. The Foundation oversees the daily operations of the Harriet Hancock LGBT Center and operates various community-based projects (www.lgbtcentersc. org). The Alliance for Full Acceptance is based in Charleston, SC, and serves as “a social justice organization achieving equality and acceptance for gay, lesbian, bisexual and transgender people” (www.affa-sc.org). Respondents also reported making financial contributions to national organizations in the past year. Almost one third (n = 234, 32.7%) made a financial contribution to the Human Rights Campaign, while 9.9% (n = 71) contributed to the Gay and Lesbian Alliance Against Defamation (GLAAD), 5.6% (n = 40) contributed to the National Gay and Lesbian Task Force (NGLTF) or Lambda Legal, and 4.6% (n = 33) contributed to Stonewall Democrats. Most respondents (n = 444, 65.9%) participated in one or more SC Pride Movement events in the previous year. The majority (n = 465, 69.8%) had never visited the Harriet Hancock LGBT Center, and even fewer (n = 114, 17.0%) reported volunteering for the Harriet Hancock LGBT Center or SC

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SC LGBT Needs Assessment TABLE 8 Engagement with LGBT groups∗ Variable Financial Contribution SC Pride Ever SC Pride Year HRC Year NGLTF Year Lambda Legal Year GLAAD Year SC Equality SC Business Guild PFLAG Year Alliance for Full Acceptance Year SC Black Pride Year Stonewall Democrats Year Log Cabin Republicans Year The Center Project—Myrtle Beach Year Upstate Pride Year Augusta Pride Year Sean’s Last Wish Year Rainbow Radio Year Harriet Hancock Center Foundation Year Lesbian and Gay Community Center–Charlotte Year None in Past Year Volunteer Engagement Ever volunteered at HHC or SC Pride Never Visited HHC Participated in 1+ SC Pride Events in Past Year ∗ Percentages

n

%

344 204 234 40 40 71 129 60 54 56 24 33 13 12 37 24 77 21 57 17 199

51.3 30.4 32.7 5.6 5.6 9.9 18.0 8.4 7.6 7.8 3.4 4.6 1.8 1.7 5.2 3.4 10.8 2.9 8.0 2.4 27.8

114 465 444

17.0 69.8 65.9

reported are valid percent and include only the n for the item.

Pride Movement in their lifetime. Table 8 shows the frequency of engagement with LGBT groups.

DISCUSSION Findings from this study provide a snapshot into the demographics, lives, and needs of LGBT persons in South Carolina. The survey included a sizeable cross-section of individuals and was balanced between men and women. White persons were overrepresented in our sample (85.2% compared to 68.4% of the general SC population), as were persons of mixed race (4.5% compared to 1.5% of the general SC population), while Black and Hispanic persons were underrepresented (8.8% and 3.6% when compared to 28.1% and 5.3% of the general SC population, respectively; U.S. Census Bureau, 2011). The number of transgender and intersex respondents in this survey was extremely low. Most of the respondents conformed to traditional non-heterosexual identity labels (gay, lesbian, bisexual), although a small proportion identified

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in other ways (queer, questioning, two-spirit). These identities may indicate that LGBT persons who completed our survey view themselves through traditional lenses of identity or that they are comfortable in these traditional identity categories. Alternatively, respondents selected these labels out of convenience, although there was an open-ended response option. Over half of our respondents reported being out to everyone, and most respondents said they were out to at least one person. Being “out” has been associated with lower levels of internalized homophobia (Herek, Cogan, Gillis, & Glunt, 1997), and this finding may indicate that through strong community connections in SC, particularly through affiliation with LGBT-serving organizations, respondents experience less internalized homophobia than LGBT persons in more fragmented or less supportive environments. This finding may also be an artifact of convenience sampling, where “out” persons were more likely to attend Pride events or be part of LGBT-friendly organizations, and thus participate in our study. Nearly half of the survey respondents reported being either partnered or married, while just over one third reported being single. Although we did not ask about the legal status of partnerships or marriages, it is important to note that such a large number of our respondents are in long-term relationships. In 2006, the citizens of South Carolina voted to enact a constitutional amendment to ban same-sex marriages. Our findings demonstrate that a significant number of LGBT persons in SC would benefit from the rights and protections that are afforded to persons in state-recognized marriages. In this survey, nearly 17% of respondents had children under the age of 18, which is slightly lower than the estimate of 21% by the Williams Institute (Romero et al., 2008). These children would likely benefit from the legal recognition of their parents’ partnerships (Pawelski, Perrin, et al., 2006). Compared to the general population of SC, respondents were highly educated. Over 98% completed high school or the equivalent, and nearly half held a bachelor’s degree or higher. Over one fourth were currently enrolled in a higher education degree program. The U.S. Census Bureau (2011) reported that among the general population over age 25 in SC, 85% graduated from high school, and 27.9% held a bachelor’s degree or higher. Eighty-three percent of respondents reported being employed, either fulltime or part-time, and just over 10% reported being unemployed, compared to an unemployment rate of approximately 12% in the general population in late 2009 (U.S. Department of Labor, 2012). Just over one fourth of respondents reported an annual household income of between $20,000 and $39,999 per year. Overall, levels of income followed a fairly normal distribution, with the exception of those earning under $14,000 per year and those earning over $100,000 per year, with approximately 13% of respondents falling into one of those income categories. Over three fourths of respondents reported having a primary health care provider, and just over three fourths have health insurance. However, similar

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to previous findings (Buchmueller & Carpenter, 2010), LGBT respondents in our survey had lower rates of health insurance than did members of the general population. The U.S. Census Bureau estimated that 84.1% of Americans had health insurance in 2005 (DeNavas-Walt, Proctor, & Lee, 2006). The majority of respondents accessed health care coverage through their jobs. Recognition of same-sex partnerships may increase the number of insured LGBT persons by making insurance coverage accessible and affordable to those in partnerships. Nearly one half of respondent never disclosed their sexual orientation to their health care provider, which is higher than rates of non-disclosure reported in other studies (Eliason & Schope, 2001; Bernstein et al., 2008). It is likely that stigma or perceived stigma contributes to the failure to disclose sexual orientation to a health care provider. Increasing acceptance and perceived acceptance of non-heterosexual orientation should be a priority for health care providers to ensure optimal health care for LGBT persons. In this sample, over 28% of respondents reported abstinence from alcohol use, and 66% reported that they do not smoke cigarettes in a typical week. These findings support other research that has found disproportionate rates of alcohol and tobacco use among LGBT persons. Social stress and frequency of attendance at bars or nightclubs may contribute increased alcohol and tobacco use (Austin & Irwin, 2010; Ryan et al., 2001; National Coalition for LGBT Health). Living in a rural area or an area with fewer resources may increase social stress for LGBT persons, and fewer options for social engagement may make LGBT persons more likely to frequent bars and nightclubs. Higher rates of smoking may also be related to the influence of the tobacco industry in SC. Most respondents reported feeling safe or very safe in their communities, and the majority trust law enforcement to protect their best interests most or all of the time. It is of concern, however, that over 40% of respondents reported being a victim of a hate crime or bias. Hate crimes or biases related to sexual orientation have been widely reported in the literature, and based on our findings LBGT persons in SC are no exception. The survey did not ask the nature of the offense; yet it is clear that regardless of the nature of the offense, a sizeable proportion of our respondents reported having experienced a hate crime or bias. It is hoped that the passage of the Matthew Shepard Act in 2009 decreases the number of hate crimes and results in a safer environment for LGBT persons across the United States (The Matthew Shepard and James Byrd, Jr., Hate Crimes Prevention Act of 2009). Nearly all respondents were U.S. citizens, and a sizeable proportion reported that they were registered to vote. Further, over 85% voted in the 2008 presidential election. These percentages were high compared to the general population; approximately 76% of registered voters in SC voted in the 2008 presidential election (SC Election Commission). Respondents reported being politically engaged, which indicates that the LGBT community in SC

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may hold power politically. Respondents were most likely to vote, register to vote, or contact an elected official when compared to other political engagement activities. Organization around political issues may further strengthen the LGBT community and thus lead to supportive policy changes and the election of candidates sensitive to LGBT needs and issues. The greatest service needs included assistance with legal documents and a LGBT business directory, as well as faith, gay, or lesbian specific groups. The SC Pride Festival and parade were the events most likely to be attended by respondents. Other event interests included musical and theater events, as well as film screenings and art gallery events. Respondents were most likely to attend events if free of charge. LGBT organizations should work to secure sponsorships or grants to support community events to ensure maximum attendance and eliminate cost-related barriers to attendance. Nearly three fourths of respondents reported making a financial contribution to an LGBT organization in their lifetime, and nearly one in three reported a contribution in the previous year. Most participated in a SC Pride Movement event in the previous year. However, only 30% reported visiting the center in their lifetime. The results indicated that respondents are engaged financially in the community. The Harriet Hancock Center and other similar LGBT community centers may benefit from diversification of the types of events in order to engage a broader audience, thus increasing participation and financial support. A limitation of this study was that it relied on a convenience sample of LGBT persons who attended the SC Pride Festival or who were recruited via electronic communication from an LGBT organization. Thus, respondents were likely already engaged in the LGBT community and may differ from those who are not. However, the findings from this study may strengthen LGBT organizations in SC and thus lead to improved outcomes for community members. Future research should consider other methods of survey administration for this population in order to increase response rates from minorities or people who are not “out.” The data collected for this study focuses on the LGBT population in SC. This may be a limitation because of the geographic specificity. However, this study may help inform future studies in other geographic locations.

IMPLICATIONS The results of this needs assessment have contributed to the strategic plan for the Center and have been used to guide planning and service delivery. For example, the Center has initiated monthly workshops and educational forums on topics identified through the survey, and it has also created an LGBT Violence Task Force. Findings have also been used to justify programs operated through the Center (e.g., Youth Empowered Against HIV)

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and to apply for grants from national foundations to support increased programming. A community report was completed in 2012 and distributed to community members based on the findings from this study. Descriptive studies are critical for understanding the needs of community members, and they facilitate mutually beneficial outcomes for both community organizations and the persons that they serve. We hope that the findings from this study will continue to benefit LGBT persons in South Carolina and contribute to the broader understanding of the lived experiences of LGBT persons.

ACKNOWLEDGMENTS The authors would like to acknowledge Dr. Lisa L. Lindley and Santi Thompson for their contributions to the research and study design. We would also like to thank the community members and organizations that assisted in this study through providing insight and input on the survey instrument and for assistance with participant recruitment.

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Fisher, C., Irwin, J., Coleman, J., McCarthy, M., & Chavez, J. (2011). The Midlands LGBT needs assessment report. Available at http://www.unmc.edu/publichealth/ docs/Midlands_LGBT_Community_Report.pdf Gates, G. (2011). How many people are lesbian, gay, bisexual, and transgender? Los Angeles, CA: Williams Institute, UCLA School of Law. Gates, G. (2012). LGBT identity: A demographer’s perspective. Loy. L.A.L. Review 45(3), 693. Retrieved from http://digitalcommons.lmu.edu/llr/vol45/iss3/2 Gruskin, E., Hart, S., Gordon, N., & Ackerson, L. (2001). Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization. American Journal of Public Health, 91(6), 976–979. Herbenick, D., Reece, M., Schick, V., Sanders, S., Dodge, B., & Fortenberry, J. (2010). Sexual behavior in the United States: Results from a national probability sample of men and women ages 14–94. Journal of Sexual Medicine, 7(Suppl. 5), 255–265. Herek, G. (2009). Hate crimes and stigma-related experiences among sexual minority adults in the United States: Prevalence estimates from a national probability sample. Journal of Interpersonal Violence, 24(1), 54–74. Herek, G., Cogan, J., Gillis, J., & Glunt, E. (1997). Correlates of internalized homophobia in a community sample of lesbians and gay men. Journal of the Gay and Lesbian Medical Association, 2, 17–25. Kazyak, E. (2011). Disrupting cultural selves: Construction gay and lesbian identities in rural areas. Qualitative Sociology, 34, 561–581. Klitzman, R., & Greenberg, J. (2002). Patterns of communication between gay and lesbian patients and their health care providers. Journal of Homosexuality, 42(4), 65–75. McKirnan, D., & Peterson, P. (1989). Alcohol and drug use among homosexual men and women: Epidemiology and population characteristics. Addictive Behaviors, 14, 545–553. National Coalition for LGBT Health. LGBT people and smoking. Available at http:// www.lgbttobacco.org/files/LGBT%20People%20and%20Smoking_Coalition%20 for%20LGBT%20health.pdf Oswald, R., & Culton, L. (2003). Under the rainbow: Rural gay life and its relevance for family providers. Family Relations, 52(1), 72–82. Pawelski, J. G., Perrin, E. C., Foy, J. M., Allen, C. E., Crawford, J. E., Del Monte, M., . . . Vickers, D. (2006). The effects of marriage, civil union, and domestic partnership laws on the health and well-being of children. Pediatrics, 118(1), 349–364. Romero, A., Rosky, C., Badgett, M., & Gates, G. (2008). Census Snapshop: South Carolina. Available online at http://williamsinstitute.law.ucla.edu/wp-content/ uploads/SouthCarolinaCensusSnapshot.pdf Ryan, H., Wortley, P., Easton, A., Pederson, L., & Greenwood, G. (2001). Smoking among lesbians, gays, and bisexuals: A review of the literature. American Journal of Preventative Medicine, 21(2), 142–149. South Carolina Election Commission. Statewide results: 2008 general election. Retrieved from http://www.enr-scvotes.org/SC/8562/15723/en/summary.html Stall, R., Paul, J., Greenwood, G., Pollack, L., Bein, E., Crosby, M., . . . Catania, J. (2001). Alcohol use, drug use, and alcohol-related problems among men

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The South Carolina LGBT needs assessment: a descriptive overview.

Limited quantitative information exists about the demographics and needs of lesbian, gay, bisexual, and transgender (LGBT) persons in South Carolina, ...
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