WEBVTT

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Hello and welcome to Listen Up People, a podcast

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of the USC Suzanne Dworak-Peck School of Social

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Work. I'm Dr. Eric Rice, professor and associate

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dean for research. My guests today are two prolific

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researchers who are dedicated to advancing the

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health and wellbeing of the LGBT population.

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Overall, LGBT individuals experience significantly

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higher rates of health, mental health, and behavioral

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health problems than their heterosexual peers.

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Yet research on these disparities is under -researched

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and lacking. The current political climate has

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raised questions around there being an even less

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welcoming environment for research around these

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issues. But my guests today have a vision of

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a world that promotes the physical, emotional,

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and social well -being of all people, regardless

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of their sexual orientation or gender identity.

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So let me introduce my two colleagues, Associate

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Professor Dr. John Blosnich, whose expertise

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focuses on health disparities related to sexual

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orientation and gender identity, and Assistant

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Professor Dr. Gabriel Robles, who focuses his

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research on healthcare access and wellbeing of

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sexual and gender minorities. Welcome both of

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you. Thanks. Thank you. Glad you could spend

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some time with me here today and with our listeners.

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I want to start with something a little more

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perhaps personal, rather than just jumping right

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into your research, which is something that I've

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been trying to ask folks in these podcasts, which

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is What got you interested in doing this kind

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of research? Did you have a moment in your life

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or an experience that made you think I have to

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work on, you know, with this population on these

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issues? Maybe we'll turn to to John first. Was

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there was there a white light moment for you

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in this in this world of research? You know,

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I think for me, it's clearly a personal thing,

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too. But for me, it came when I was doing my

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training in public health and how I kind of found

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my way to public health. You know, I knew I always

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want to be an advocate, but I knew I was not

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the person to be standing in front of any sort

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of decision making group to try to make a plea.

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I'm more of a behind the scenes advocate. So

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I was like. you know, to the more polished people

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who speak real well, I was like, tell me what

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you need to know, and I will find the data, find

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the studies for it, or I will do them to give

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you that information to take forward. So, you

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know, I kind of found a place to hone my advocacy

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and in research. Yeah, and that's kind of how

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that's great. That's great. Gabriel, how about

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you? Was there was there a moment that you said,

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oh, this is what I want to do with my career?

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Yeah, so it started just I had just graduated

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from undergrad. So I was in Long Beach and I

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was working at the Y. I was working with kids

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and the kids, you know, at certain times of the

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afternoon, I mean, after school hours, they go

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out and have structured kind of recess. And so

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I stayed behind and I cleaned up. the office.

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There's a bunch of toys everywhere. One of the

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white staff brings in a kid saying, oh, he's

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not feeling well. Can he, you know, sitting here?

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Well, they have recess. So I said, yes, but I'm

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going to be cleaning. If that's okay, you can

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help me. And he said, oh, I'll just watch. And

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so I was cleaning up. I had a bunch of toys.

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I put on, you know, a fake crown and like some

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beads just because I wanted to, you know, carry

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it all at once. And the kid comes up to me and

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asks, you like to play princess? Can we do that?

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And I said, oh, yeah, I like to play princess.

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It doesn't matter as long as, you know, I'm having

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fun. That's all I care about. And that's when

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I knew that there was something happening, like

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with well -being and like these kids. So I wanted

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to kind of explore that a little more. How old

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is this kid? I believe he was in either kindergarten

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or first grade. I don't exactly remember. Yeah,

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that's great. Can I play princess? Well. Speaking

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of well -being, I know both of you are really

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invested in this. I mean, John, you have been

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doing some really, I guess it's nice to start

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with a story about a kid who's making Gabriel

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smile because I think your stories tend to get

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a bit darker, a bit faster. But I know that you're

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doing some really groundbreaking work on... sexual

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orientation and gender identity that is buried

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within mortality surveillance data. So I mean,

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not to be a downer, but you're doing some really

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groundbreaking work. You want to talk to us a

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little bit about how you got into that and what

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sort of work you're doing in that space? Yeah,

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absolutely. I don't mind dimming a room. I seem

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to do that every time I walk into one. So what

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happens when we don't have well -being in a community?

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is that we know that it doesn't bode well to

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thriving or survival. And so we have a lot of

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research that focuses on the increased risk profiles

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that happen for people who are sexual and gender

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minorities. Increased rates of smoking, substance

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use, suicidal ideation, suicide attempts, a lot

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of health risks there, but we don't know a lot

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about the ultimate outcome. in public health,

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which is mortality. So one of the best ways to

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keep populations alive is to learn about what's

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killing them. It lets you focus your energies

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and your interventions on, you know, what are

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the priorities that are actually limiting people's

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lives. We don't have that for LGBT populations

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because we don't have that information about

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mortality in terms of sexual orientation and

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gender identity. You know, you could look up

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and know what are the top 10 leading causes of

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death for someone based on race, race, ethnicity,

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based on sex. I mean, hell, even where they live,

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we could generate top 10 leading causes based

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on zip code. But we don't have that for sexual

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orientation, gender identity. And for those of

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us working in the suicide prevention space, it's

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a problem. If we don't have this ultimate outcome,

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we don't know how to really quantify the burden

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of disease, which is one of the key things that

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epidemiologists do. But we also cannot do the

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second thing, which is, you know, how do we hatch

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prevention? And how do we evaluate that it's

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actually working? If you don't have a benchmark,

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you can't tell if the program you launch has

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made a dent in that because you don't know it's

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gone up or gone down. You don't have a rate of

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death. So you don't you can't evaluate your solution.

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So we started from from scratch and from scratch

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in a very dark place, which is where do these

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mortality data originate? And that is with medical

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examiner and coroner's offices. Suicide deaths,

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specifically what I focus on my research on,

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they all go through coroner and medical examiner

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systems. And that's where we learn about the

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circumstances of how someone you know, died.

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They don't routinely gather information about

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sexual orientation and gender identity. So we

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hatched a plan to develop and test a training

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for death, specifically medical legal death investigators,

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and how to gather this information in the course

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of their investigations. So that's what we, we

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spent a couple of years doing that on a study

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that was funded from 2020 to 2022. We train death

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investigators in LA County and in the state of

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Utah. and along the way learned about how to,

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from these investigators, how do we edit this

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training, what information was left out that

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they need to know, what elements of their job

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need to be represented to increase the credibility

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of this kind of a training. So it was a really

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fascinating education. in how I became partially

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a workforce trainer when I never thought I would

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be because I always envisioned myself as a kind

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of a data jockey analyst kind of person. Yeah,

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that's that project. That's an interesting change

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of change of career paths to go from being somebody

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who runs statistical models to somebody who's

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training people to do death investigations. You

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know, I would certainly not think of those as

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one leading to the other in a linear path. Five

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years earlier, if the fortune teller had told

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me I would have been there, I would have demanded

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my money back. And it came true. It sounds like

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a really exciting thing to do, though. I mean,

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before I ask Gabriel a question, I want to just

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have one quick follow -up question with you about

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this, which is, how was this received, especially

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I'm thinking about in Utah, where I think of

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that as a much more conservative state than California

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and death investigators in Los Angeles, and just

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thinking about what was it like to work with

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people asking them to now be probing about people's

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sexual and gender identity when they had not

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been doing that before? Yeah, for sure. I think

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the main thing about this was this was not political

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work. This was about the work of getting data

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that's important to a public health end. The

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death investigators, their jobs, they have one

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of the hardest jobs on earth. I shadowed death

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investigators here in LA County. They go to scenes

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that are grisly and grim, to put it nicely. Sometimes

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these scenes are literally unstable. And their

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job is to, you know, recover and process the

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body, document evidence at the scene and talk

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to next of kin. This is not a job for the light

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hearted, but this is where these public health

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data start. And not enough of us understand.

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I think a lot of us don't have appreciation for

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it because we just didn't know. And so their

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jobs are hard and they ask people very personal

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questions. Next of kin, sometimes really personal

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things that sometimes next of kin didn't know.

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And they're delivering this to a person who just

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may have just found out that they this investigator

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is the one who's alerting them that their loved

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one has passed away. So in that regard, there's

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really no question that's off the table for them.

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They're already delivering the worst news possible.

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There's very little they can say to somebody

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that is going to be worse than the news they

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just delivered. The challenge was their conversation.

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They are not. data collectors in a traditional

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epic sense of I have a survey and I'm going to

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run through these questions. Sure, sure. They

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have to stoke a conversation. So it's, you know,

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running through this with them to identify ways

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that this can be brought into the conversation

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extremely naturally. It's just they need to know

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about the concepts and how to introduce them.

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So I think once we talked about that with them

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and ran through it with them and established

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that they are crucial to public health, I think

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that got people on a at a place where they understood

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the importance of the work and they understood

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that it was feasible and that this was not about

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anyone singular person's beliefs about what they

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thought about gay people, what they thought about

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trans people. It was rooted in we have a health

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problem and we need these data to inform that.

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You are in a very unique space to do that. They're

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tough questions, but that's the name of your

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gig is tough questions and tough news. So yeah.

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It was very cool. I imagine it was actually something

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fairly empowering for them in some regards as

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well, given the way you've described it. Gabriel,

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let me, as promised, maybe we can lighten things

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a little bit. But I know that you also deal with

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some very serious stuff, though, too. I don't

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mean to make light of, in any way, what you do.

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I know that you're very much interested in community

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cohesion. social support and how it is that people

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are accessing health care kind of born out of

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this experience of what's happening for folks

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and how do we create well -being in these communities.

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Can you talk about what you've been working on

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recently? Yeah, so one of the things that I like

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to talk about is, of course, you know, as a field,

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we are, to some extent, we're well -versed in

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kind of intersectionality. And as Kimberly Crenshaw

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describes it, like, these intersecting roads

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of oppression, or the systemic forces that kind

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of interact and like reinforce each other. But

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with that, or along those lines, I also want

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to look at kind of how people belong to multiple

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communities. They're likely drawing from various

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strengths from each of each of the communities

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they belong to. I do a lot of my work with racialized

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minorities who are in the LGBTQ community, specifically

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Latino, you know, gay, bisexual, and other queer

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men. And so we're often kind of embedded and

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I say we because I identify as part of that community.

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We're often embedded in, you know, at least the

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Latino community. And so that community comes

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with lots of sources of strengths and, you know,

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things that can help us be resilient in our daily

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lives. And some of us are also kind of connected

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to the LGBTQ kind of broadly speaking. And those

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in that community kind of has this, you know,

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history of advocacy, this history of kind of,

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you know, you know, being out there and in the

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front lines trying to, you know, fight for what's

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right. And so you know, at people who belong

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to both communities, I think that we can kind

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of draw upon, you know, various strengths and

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kind of build one kind of cohesive, you know,

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life or one cohesive community where we can kind

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of all, you know, work together collectively.

00:13:44.320 --> 00:13:46.240
Sure. I mean, are there other challenges though

00:13:46.240 --> 00:13:48.639
there as well? I mean, I would imagine that there's

00:13:48.639 --> 00:13:51.250
some ways in which the I don't know, the idealized,

00:13:51.389 --> 00:13:56.610
the archetypical Latino man and the stereotypes

00:13:56.610 --> 00:13:59.090
in the gay community. I mean, those things don't

00:13:59.090 --> 00:14:03.509
necessarily go as easily as the mutual strengths

00:14:03.509 --> 00:14:06.470
you were just talking about, right? Right. Exactly.

00:14:07.049 --> 00:14:10.070
So for example, I've done some work on machismo.

00:14:11.470 --> 00:14:14.750
So, you know, people just report that, oh, if

00:14:14.750 --> 00:14:17.549
I'm going to be a part of the Latino community,

00:14:17.769 --> 00:14:20.610
I might not be as accepted as I would be if I

00:14:20.610 --> 00:14:22.950
were kind of interacting with people in the LGBTQ

00:14:22.950 --> 00:14:27.470
space. And so that kind of leads us to like,

00:14:28.110 --> 00:14:31.870
where is the work and where do we need to do

00:14:31.870 --> 00:14:35.250
the work? Is it that we need to really make spaces

00:14:35.250 --> 00:14:38.460
that are, you know, historically Latino? more

00:14:38.460 --> 00:14:42.360
inclusive of LGBTQ individuals? Or is it the

00:14:42.360 --> 00:14:46.100
inverse in which we're making LGBTQ spaces more

00:14:46.100 --> 00:14:49.620
inclusive of racialized minorities? My answer

00:14:49.620 --> 00:14:51.399
is always like, we need to be doing the work.

00:14:51.549 --> 00:14:54.090
you know, in tandem together at the same time,

00:14:54.370 --> 00:14:56.730
because we can't kind of prioritize one experience

00:14:56.730 --> 00:14:59.889
over the other. Because it may be that today,

00:15:00.149 --> 00:15:02.149
you know, on this specific day, I'm interacting

00:15:02.149 --> 00:15:04.110
with the Latino community, but it may be later

00:15:04.110 --> 00:15:06.629
on tonight, I'm interacting with the LGBTQ community.

00:15:06.649 --> 00:15:10.110
So there really isn't this, you know, separate

00:15:10.110 --> 00:15:13.149
or the separation that we kind of find in research

00:15:13.149 --> 00:15:15.850
or in these data sets. It's very complex and

00:15:15.850 --> 00:15:19.230
it's kind of together. Yeah, yeah. I mean, it's

00:15:19.230 --> 00:15:21.490
interesting you say the separation in these data

00:15:21.490 --> 00:15:23.750
sets, right? I think, I mean, maybe even in the

00:15:23.750 --> 00:15:25.570
data, there's not necessarily the separation.

00:15:25.570 --> 00:15:27.809
We just like to have these very separate concepts

00:15:27.809 --> 00:15:32.250
in research dialogues. And at least in my experience,

00:15:32.250 --> 00:15:34.610
I don't think that that necessarily, as you suggest,

00:15:34.809 --> 00:15:37.590
jives with people's reality, right? I mean, people's

00:15:37.590 --> 00:15:41.529
reality is much more nuanced, complex. It's fluid.

00:15:41.809 --> 00:15:44.250
It moves, you know, changes from moment to moment

00:15:44.250 --> 00:15:47.950
during the day sometimes. And I think that doesn't

00:15:47.950 --> 00:15:50.370
necessarily lend itself to statistical models

00:15:50.370 --> 00:15:53.950
in the easiest of ways, but it certainly is the

00:15:53.950 --> 00:15:58.850
reality of our lives. So John had mentioned his

00:15:58.850 --> 00:16:01.049
focus being on suicide and suicide prevention.

00:16:01.769 --> 00:16:05.350
What are some of the issues for this population

00:16:05.350 --> 00:16:10.649
of Latino, you know, LGBTQ men that you're interested

00:16:10.649 --> 00:16:15.190
in working on? So I primarily, you know, as we're

00:16:15.190 --> 00:16:17.110
talking about research, you know, researchers

00:16:17.110 --> 00:16:18.789
often ask, well, what's the outcome of interest?

00:16:19.090 --> 00:16:21.750
And my outcome of interest is kind of accessing

00:16:21.750 --> 00:16:25.049
health care services. OK, there's a history in

00:16:25.049 --> 00:16:28.490
the LGBTQ space that, you know, when we look

00:16:28.490 --> 00:16:31.259
at health care access, we look at sexual health

00:16:31.259 --> 00:16:34.240
care access. And I do think that's very important.

00:16:34.539 --> 00:16:36.779
That's extremely important. It's, you know, it's

00:16:36.779 --> 00:16:39.720
a salient need and we need that. I also think

00:16:39.720 --> 00:16:41.899
that we can think broader than that. We can start

00:16:41.899 --> 00:16:44.700
to think about how we can start to access preventative

00:16:44.700 --> 00:16:47.700
services, primary care services, and how can

00:16:47.700 --> 00:16:51.980
we kind of integrate this idea of being inclusive

00:16:51.980 --> 00:16:56.179
to both Latino and LGBTQ people in one space.

00:16:56.419 --> 00:17:00.379
And I think the clinic could be a space where

00:17:00.379 --> 00:17:03.220
we can do that or we can begin that work and

00:17:03.220 --> 00:17:07.519
ultimately, you know, make communities, I guess,

00:17:07.740 --> 00:17:11.960
healthier again, I know, right? I think that

00:17:12.089 --> 00:17:16.049
focus, I've certainly done some research on within

00:17:16.049 --> 00:17:18.410
the work that I've done with homeless young adults

00:17:18.410 --> 00:17:22.049
around some of the issues that face LGBT communities

00:17:22.049 --> 00:17:24.170
within that space. And you're right. I mean,

00:17:24.190 --> 00:17:26.549
oftentimes some of the research and even advocacy

00:17:26.549 --> 00:17:29.349
work was around sexual health. And that's only

00:17:29.349 --> 00:17:31.369
part of people's lives. And honestly, when I

00:17:31.369 --> 00:17:33.930
do work in those communities, those young people

00:17:33.930 --> 00:17:37.539
are much more concerned about their You know,

00:17:37.579 --> 00:17:39.640
there's their safety for the night or they're

00:17:39.640 --> 00:17:40.920
concerned about where they can get some of the

00:17:40.920 --> 00:17:42.720
e there Maybe if they've got a health concern,

00:17:42.720 --> 00:17:44.539
it's more about, you know, their mental health

00:17:44.539 --> 00:17:47.400
maybe or even the fact that they've got an infection

00:17:47.400 --> 00:17:49.180
They're there, you know, and by infection. I

00:17:49.180 --> 00:17:50.799
don't mean like a sexually transmitted infection

00:17:50.799 --> 00:17:53.259
I mean, you know, they they like cut themselves

00:17:53.259 --> 00:17:55.759
and now they've got a big, you know infected

00:17:55.759 --> 00:17:58.079
boil on their on their leg and they're not really

00:17:58.079 --> 00:18:01.160
in sexual health is is an important thing which

00:18:01.160 --> 00:18:03.980
I think maybe easily tracks on to those communities,

00:18:04.039 --> 00:18:06.500
but people are so much more than that. That's

00:18:06.500 --> 00:18:07.880
one of the things I love about your research,

00:18:07.980 --> 00:18:10.900
and John's too, is that it's a much more holistic

00:18:10.900 --> 00:18:14.559
vision of people. It's not just trying to pigeonhole

00:18:14.559 --> 00:18:17.119
sexual and gender minority folks around their

00:18:17.119 --> 00:18:21.180
sex lives. I mean, I think that that's so limiting

00:18:21.180 --> 00:18:25.460
in some respects. And thinking about why do people

00:18:25.460 --> 00:18:27.880
live healthy, thriving lives, or why do people

00:18:27.880 --> 00:18:29.619
end their lives when they're not having health

00:18:29.619 --> 00:18:33.619
and thriving is really fascinating. I want to

00:18:33.619 --> 00:18:38.579
touch on the way in which some of the recent

00:18:38.579 --> 00:18:42.000
federal decisions around research initiatives

00:18:42.000 --> 00:18:44.670
have impacted research and I know that John,

00:18:45.069 --> 00:18:49.529
you had a grant that was focused on parents who

00:18:49.529 --> 00:18:52.410
had a child who was a sexual minority that had

00:18:52.410 --> 00:18:54.529
come out and about how they were coping with

00:18:54.529 --> 00:18:57.430
that experience that was defunded and then perhaps

00:18:57.430 --> 00:19:00.069
reinstated. And I'm kind of wondering if you

00:19:00.069 --> 00:19:01.730
can share with folks a little bit about what

00:19:01.730 --> 00:19:03.650
that research was about, why you thought it was

00:19:03.650 --> 00:19:05.490
important, and also maybe some of your thoughts

00:19:05.490 --> 00:19:08.910
about the future of that kind of work. Yeah,

00:19:08.910 --> 00:19:14.630
absolutely. So the grant was focused on like

00:19:14.630 --> 00:19:16.829
you said, parents who had a child come out to

00:19:16.829 --> 00:19:20.450
them about sexual orientation. This project did

00:19:20.450 --> 00:19:23.750
not involve gender identity. It was terminated

00:19:23.750 --> 00:19:26.910
by the NIH citing that it was focused on gender

00:19:26.910 --> 00:19:29.529
identity, which was patently false. That was

00:19:29.529 --> 00:19:34.769
not part of the grant at all. But the impetus

00:19:34.769 --> 00:19:37.890
for the grant was really taking an upstream approach

00:19:37.890 --> 00:19:42.450
to suicide prevention for sexual minority youth,

00:19:42.650 --> 00:19:44.950
who we know have very high rates of suicidal

00:19:44.950 --> 00:19:47.730
ideation and attempts. But because when I talked

00:19:47.730 --> 00:19:49.549
about our other project, we don't have any idea

00:19:49.549 --> 00:19:51.809
if suicide deaths are greater in this group.

00:19:51.910 --> 00:19:53.609
But we know enough to know that ideation and

00:19:53.609 --> 00:19:57.049
attempt are massive problems for youth who identify

00:19:57.049 --> 00:20:00.109
as sexual minority. But we wanted to take a family

00:20:00.109 --> 00:20:03.819
systems approach because research consistently

00:20:03.819 --> 00:20:06.680
demonstrates that family rejection is a major

00:20:06.680 --> 00:20:09.640
predictor of mental distress among sexual and

00:20:09.640 --> 00:20:11.880
gender or sexual minority youth. You know, naturally

00:20:11.880 --> 00:20:14.079
we're like, it's really, we want to know more

00:20:14.079 --> 00:20:17.599
about parents. You know, so when a kid comes

00:20:17.599 --> 00:20:21.279
out, you know, parents are a cornerstone of a

00:20:21.279 --> 00:20:23.819
family unit and parents need to figure out how

00:20:23.819 --> 00:20:26.279
they sort of guide and manage their families.

00:20:26.740 --> 00:20:28.920
And when a kid comes out, that's a family system

00:20:28.920 --> 00:20:32.799
change for sure. but we don't know what parents

00:20:32.799 --> 00:20:35.460
need or how they navigate that family system

00:20:35.460 --> 00:20:37.980
change. The lore is kind of, you know, well,

00:20:37.980 --> 00:20:40.019
if a parent doesn't automatically sign up to

00:20:40.019 --> 00:20:42.160
be the marshal of the pride parade, they're awful,

00:20:42.440 --> 00:20:44.640
right? Parents just love their kids unconditionally.

00:20:45.160 --> 00:20:48.920
And many parents do. But parents are afraid for

00:20:48.920 --> 00:20:51.779
their children for, ironically, the very reasons

00:20:51.779 --> 00:20:54.480
why our grant was terminated. A kid who comes

00:20:54.480 --> 00:20:57.440
out for a parent who's not a sexual minority,

00:20:57.859 --> 00:20:59.579
they Their understanding is their kid's going

00:20:59.579 --> 00:21:03.799
to have a very different time in life, which

00:21:03.799 --> 00:21:05.720
frankly is going to be a tougher time in life

00:21:05.720 --> 00:21:07.920
than if their kid was straight. And a lot of

00:21:07.920 --> 00:21:09.619
parents react poorly because they're just afraid

00:21:09.619 --> 00:21:12.599
for their child. But ultimately, the literature

00:21:12.599 --> 00:21:14.759
does not know where parents go for help, what

00:21:14.759 --> 00:21:16.619
they consult. Do they just Google what to do?

00:21:16.720 --> 00:21:19.940
Do they go visit clergy, religious leaders, medical

00:21:19.940 --> 00:21:22.539
professionals? Do they not talk about it at all?

00:21:22.779 --> 00:21:24.740
And what do they need to get through this? Because

00:21:24.740 --> 00:21:27.259
most families will get through this. But that's

00:21:27.259 --> 00:21:29.339
what we wanted to focus on was surveying and

00:21:29.339 --> 00:21:31.759
interviewing parents. And this is not an easy

00:21:31.759 --> 00:21:35.019
group to find. Right? Folks who are going to,

00:21:35.059 --> 00:21:38.579
you know, who are parents of the person who identifies

00:21:38.579 --> 00:21:41.079
as a section of the minority person, right? So

00:21:41.079 --> 00:21:43.220
this research really digging into how do we find

00:21:43.220 --> 00:21:45.299
them? And when we find them, you know, we have

00:21:45.299 --> 00:21:47.559
a lot of questions we need to ask both in a survey

00:21:47.559 --> 00:21:50.539
and then getting more detailed information from

00:21:50.539 --> 00:21:52.619
them from folks who would agree to do an interview

00:21:52.619 --> 00:21:55.700
with us. So that grant was terminated. It was

00:21:55.700 --> 00:21:58.640
reinstated in July. We've been working on it,

00:21:58.960 --> 00:22:01.319
resuming work on it as best we can with that

00:22:01.319 --> 00:22:05.619
kind of a disruption to it. Sure. But yeah, so

00:22:05.619 --> 00:22:07.920
that's where that project currently stands. I

00:22:07.920 --> 00:22:09.819
want to get really nerdy with you for just a

00:22:09.819 --> 00:22:12.019
second here. Forgive me for this, but I can't

00:22:12.019 --> 00:22:14.859
help myself. You know, you said, how do we find

00:22:14.859 --> 00:22:17.480
these parents? It makes me think that I guess

00:22:17.480 --> 00:22:21.559
my assumption would be that the two places you

00:22:21.559 --> 00:22:24.680
might find parents are in some space where they're

00:22:24.680 --> 00:22:29.319
being a very loud positive advocate for their

00:22:29.319 --> 00:22:31.819
child that's come out, or perhaps they're being

00:22:31.819 --> 00:22:36.480
a very loud decryer of their child's coming out.

00:22:36.619 --> 00:22:40.180
And I wonder you know, what you're how you're

00:22:40.180 --> 00:22:41.819
trying to deal with, not just trying to find

00:22:41.819 --> 00:22:44.200
the extreme cases. Right. Because I mean, I think

00:22:44.200 --> 00:22:46.480
that those are the the visible folks, the people

00:22:46.480 --> 00:22:48.259
that are very upset about it or the people that

00:22:48.259 --> 00:22:51.539
are very welcoming or proud of it. And I would

00:22:51.539 --> 00:22:53.640
imagine there's a lot there's a lot in between.

00:22:53.799 --> 00:22:57.440
Right. Maybe there is. And we really want the

00:22:57.440 --> 00:22:59.720
between. Right. You don't want the outliers necessarily.

00:22:59.900 --> 00:23:02.680
I mean, they'll be there. But our main component

00:23:02.680 --> 00:23:07.220
is, you know, and this is sort of survey recruitment

00:23:07.220 --> 00:23:11.460
nightmare slash experiment 101 was being able

00:23:11.460 --> 00:23:15.019
to target large enough samples where we could

00:23:15.019 --> 00:23:18.980
find the baseline inclusion criteria is, are

00:23:18.980 --> 00:23:22.380
you a parent? The stepwise thing of, are you

00:23:22.380 --> 00:23:26.720
a parent? And then, you know, do you have a child

00:23:26.720 --> 00:23:29.000
who identifies or is coming? So it's sort of,

00:23:29.099 --> 00:23:31.240
we're starting at that umbrella level, trying

00:23:31.240 --> 00:23:34.359
to find them. So we're using very large level

00:23:35.100 --> 00:23:39.319
recruitment avenues. So research match is a resource

00:23:39.319 --> 00:23:42.279
developed by NIH of individuals who have opted

00:23:42.279 --> 00:23:45.819
in to basically volunteering for research projects.

00:23:46.559 --> 00:23:48.640
The inclusion criteria is not that you want to

00:23:48.640 --> 00:23:51.720
do this because of any number of things in your

00:23:51.720 --> 00:23:53.920
characteristics that make you who you are. It's

00:23:53.920 --> 00:23:55.440
just you have an interest in being in research

00:23:55.440 --> 00:23:58.559
and then you get this kind of newsletter that

00:23:58.559 --> 00:24:00.539
shows you all these different opportunities and

00:24:00.539 --> 00:24:04.500
you can opt into it. Gabriel, I'm wondering if

00:24:04.500 --> 00:24:07.299
you wanted to talk a little bit about some of

00:24:07.299 --> 00:24:10.240
the sampling or some of the research strategies

00:24:10.240 --> 00:24:11.700
that you've been employing recently, because

00:24:11.700 --> 00:24:12.920
I think it's really interesting to hear from

00:24:12.920 --> 00:24:15.420
John about the death investigators and about

00:24:15.420 --> 00:24:18.180
trying to reach these samples. But I mean, where

00:24:18.180 --> 00:24:22.039
have you been targeting the actual time that

00:24:22.039 --> 00:24:24.019
you spend in the day working with these folks

00:24:24.019 --> 00:24:27.460
recently? So one of the things that I want to,

00:24:27.460 --> 00:24:30.000
I guess, be clear and give credit to is that

00:24:30.140 --> 00:24:36.579
I work with a group of kind of men, like gay,

00:24:36.759 --> 00:24:39.539
bisexual, and other queer men, kind of throughout

00:24:39.539 --> 00:24:43.680
the United States. When I first started here

00:24:43.680 --> 00:24:48.339
at USC, I was trying to create some type of community

00:24:48.339 --> 00:24:51.099
group or advisory group. And so I kind of recruited

00:24:51.099 --> 00:24:54.740
on social media. Is anybody willing to work with

00:24:54.740 --> 00:24:57.640
me? We can work on projects together. And so

00:24:57.640 --> 00:24:59.920
several men did. They signed up, they emailed

00:24:59.920 --> 00:25:01.519
me and they were like, oh, yeah, I'm interested

00:25:01.519 --> 00:25:03.400
in like, you know, giving I'll give you some

00:25:03.400 --> 00:25:05.539
of my thoughts and like where we can go as kind

00:25:05.539 --> 00:25:11.539
of as a field. And so one thing that I I personally

00:25:11.539 --> 00:25:15.240
implemented first was this social media kind

00:25:15.240 --> 00:25:18.059
of recruitment. Let's recruit, you know, Latino

00:25:18.059 --> 00:25:23.559
gay men on social media. And things became a

00:25:23.559 --> 00:25:27.830
little complex once the election happened. and

00:25:27.830 --> 00:25:30.789
nobody was kind of signing up. And then it was

00:25:30.789 --> 00:25:34.410
like, I don't want to give up or let you know

00:25:34.410 --> 00:25:38.529
what some of my demographic information is. And

00:25:38.529 --> 00:25:42.130
so I went back to the community advisory group

00:25:42.130 --> 00:25:47.309
that we formed and they were like, yeah, we are

00:25:47.309 --> 00:25:49.730
literally, this is happening in our communities.

00:25:49.789 --> 00:25:52.509
This is happening at our clinics, at our CBOs.

00:25:52.670 --> 00:25:56.799
Nobody wants to come. come in for any service.

00:25:56.900 --> 00:25:59.640
Nobody wants to come in and fill out any intake

00:25:59.640 --> 00:26:03.640
form. Wow. And so one of the things that they

00:26:03.640 --> 00:26:05.700
recommended and you know, I'm really grateful

00:26:05.700 --> 00:26:08.299
that they did is that I work with community organizations

00:26:08.299 --> 00:26:11.759
directly because each community organization

00:26:11.759 --> 00:26:16.220
is kind of finding out is tailoring the recruitment

00:26:16.220 --> 00:26:19.119
methods that is good and appropriate for their

00:26:19.119 --> 00:26:22.049
own community. And so that's kind of how I've

00:26:22.049 --> 00:26:25.309
been working with these participants of the studies

00:26:25.309 --> 00:26:27.670
is let me connect with organizations throughout

00:26:27.670 --> 00:26:30.950
the United States. One of the things that we

00:26:30.950 --> 00:26:33.690
saw was, you know, depending on which community

00:26:33.690 --> 00:26:37.390
you're in, you know, some Latino gay men are

00:26:37.390 --> 00:26:40.589
receiving all the services. But if you're you

00:26:40.589 --> 00:26:43.230
happen to be in a community that is not, you

00:26:43.230 --> 00:26:46.009
know, where health is and kind of at the forefront

00:26:46.009 --> 00:26:48.269
of their community, they may not be receiving

00:26:48.269 --> 00:26:50.680
services at all. I mean, it just depends on what

00:26:50.680 --> 00:26:53.980
the priorities are. Are these community organizations

00:26:53.980 --> 00:26:56.279
mostly health organizations, or are they mostly

00:26:56.279 --> 00:27:02.500
organizations for gay, bisexual, queer men? So

00:27:02.500 --> 00:27:07.119
they're for gay, bisexual, and queer men. They're

00:27:07.119 --> 00:27:10.440
specifically ones that are working with the Latino

00:27:10.440 --> 00:27:15.559
communities. Oh, OK. And so often, these organizations,

00:27:15.660 --> 00:27:19.079
they fill the gaps. that the broader health care

00:27:19.079 --> 00:27:21.400
system is not meeting. And so what it means is

00:27:21.400 --> 00:27:23.339
that they integrate services. It's mental health

00:27:23.339 --> 00:27:26.099
services. It's, you know, primary care services.

00:27:26.279 --> 00:27:28.519
As we mentioned, it's sexual health services.

00:27:29.319 --> 00:27:32.700
Often, they're just providing a space for kind

00:27:32.700 --> 00:27:34.940
of social well -being. No, that's great. And

00:27:34.940 --> 00:27:37.920
I think the way that you just mentioned this

00:27:37.920 --> 00:27:40.500
community advisory board helping you think through

00:27:40.500 --> 00:27:44.259
the future of research, this is... I think how

00:27:44.259 --> 00:27:47.160
I wanna lead us out of this conversation, which

00:27:47.160 --> 00:27:51.099
is to ask both of you what you are envisioning

00:27:51.099 --> 00:27:55.500
over the next few years as being important avenues

00:27:55.500 --> 00:27:58.500
for research to work with the health and wellbeing

00:27:58.500 --> 00:28:01.059
of the communities that you each are a part of.

00:28:01.460 --> 00:28:05.019
So maybe I'll turn to you, John, first and then

00:28:05.019 --> 00:28:06.940
end with you, Gabriel, about what you think is

00:28:06.940 --> 00:28:09.900
an important direction for the research to move

00:28:09.900 --> 00:28:12.539
in in the next few years. Yeah, I think for me,

00:28:12.619 --> 00:28:16.359
I'm still in the space of vital statistics, especially

00:28:16.359 --> 00:28:20.480
around mortality data, to really understand the,

00:28:20.579 --> 00:28:24.519
from my perspective, the toll of inequity on

00:28:24.519 --> 00:28:27.759
populations. And these mortality data are key.

00:28:27.980 --> 00:28:30.019
I think we see this happening. Well, I mean,

00:28:30.099 --> 00:28:32.460
the case in point, what's happening with maternal

00:28:32.460 --> 00:28:36.099
mortality in the country now, in a post -Dobbs

00:28:36.099 --> 00:28:41.559
decision, America, where states that have banned

00:28:41.559 --> 00:28:45.519
abortion care are seeing increases in rates of

00:28:45.519 --> 00:28:48.720
maternal mortality. And that's only known to

00:28:48.720 --> 00:28:52.160
us because we count, we collect this information

00:28:52.160 --> 00:28:54.059
and we count this information at the time of

00:28:54.059 --> 00:28:57.420
death. And that is absolutely crucial to knowing

00:28:57.420 --> 00:29:00.359
again where interventions should be placed, but

00:29:00.359 --> 00:29:03.539
also holding people and policymakers accountable

00:29:03.539 --> 00:29:07.279
for decisions that they made. So I am all about

00:29:07.279 --> 00:29:11.029
finding ways to enhance our mortality. information

00:29:11.029 --> 00:29:13.750
because I just think that's the that is a bedrock

00:29:13.750 --> 00:29:17.269
of our our public health and it's if we don't

00:29:17.269 --> 00:29:20.329
have it inclusive of our communities we're not

00:29:20.329 --> 00:29:23.190
understanding the full toll of what's going on.

00:29:23.490 --> 00:29:27.490
So well put. Gabriel? Along the lines with inclusive

00:29:27.490 --> 00:29:31.779
inclusivity I think that the future of research

00:29:31.779 --> 00:29:35.579
in this area is how can we make every healthcare

00:29:35.579 --> 00:29:39.200
setting kind of inclusive to people so that the

00:29:39.200 --> 00:29:42.819
burden isn't on the community member, on the

00:29:42.819 --> 00:29:45.519
queer man to figure out, okay, if I need primary

00:29:45.519 --> 00:29:47.940
care services, let me see if I can find someone

00:29:47.940 --> 00:29:50.319
who can provide services that is specifically

00:29:50.319 --> 00:29:54.440
tailored to me. But if I want to go to a place,

00:29:54.619 --> 00:29:56.259
doesn't matter where it is, I should be able

00:29:56.259 --> 00:29:59.650
to do so. and make sure that the staff and the

00:29:59.650 --> 00:30:02.089
health care providers are providing services

00:30:02.089 --> 00:30:05.190
that are not only scientifically sound, but that

00:30:05.190 --> 00:30:07.690
are socially and culturally appropriate. So I

00:30:07.690 --> 00:30:09.710
think that that's kind of where we're headed,

00:30:10.230 --> 00:30:12.309
something that's a little more integrated. That's

00:30:12.309 --> 00:30:16.180
great. That's great. certainly hope that both

00:30:16.180 --> 00:30:20.119
of your agendas are things which we pursue in

00:30:20.119 --> 00:30:23.180
the near future. I think they're both absolutely

00:30:23.180 --> 00:30:25.920
needed. I just want to thank you, John and Gabriel,

00:30:25.920 --> 00:30:28.380
both for such a great discussion. So I hope that

00:30:28.380 --> 00:30:30.900
you will be willing to come back and share more

00:30:30.900 --> 00:30:32.500
with me in the future. I also want to commend

00:30:32.500 --> 00:30:36.599
the two of you on being in the center of research

00:30:36.599 --> 00:30:39.799
that is requiring people to be brave. And I really

00:30:39.799 --> 00:30:42.440
appreciate your bravery of doing work that you

00:30:42.440 --> 00:30:45.460
believe is important to and scientifically relevant,

00:30:45.799 --> 00:30:48.940
and I wholeheartedly support you and believe

00:30:48.940 --> 00:30:52.200
in its importance and scientific relevance. So

00:30:52.200 --> 00:30:54.460
in the meantime, if listeners are interested,

00:30:55.079 --> 00:30:58.619
they can check out more on our school's website

00:30:58.619 --> 00:31:00.819
where we have a lot of information about ongoing

00:31:00.819 --> 00:31:05.480
research. So you can go to dworakpeck .usc .edu

00:31:05.480 --> 00:31:07.940
to learn more about all the work that's going

00:31:07.940 --> 00:31:12.069
on. at our school around these topics. And if

00:31:12.069 --> 00:31:14.170
you have questions for our guests or for me about

00:31:14.170 --> 00:31:16.109
the show and you want to support the transformative

00:31:16.109 --> 00:31:19.269
research of our program, you can email us at

00:31:19.269 --> 00:31:24.069
listenuppeople at usc .edu. So that's L -I -S

00:31:24.069 --> 00:31:28.109
-T -E -N -U -P -P -E -O -P -L -E at usc .edu.

00:31:28.650 --> 00:31:31.849
And just one more time, John and Gabriel, thank

00:31:31.849 --> 00:31:34.329
you so much for spending your time with me and

00:31:34.329 --> 00:31:36.109
I hope our listeners enjoyed it as much as I

00:31:36.109 --> 00:31:39.539
did. you
