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When the riots happened at and around the Stonewall Inn in Greenwich Village, New York, in 1969, the rioters included many gender diverse members of the nascent gay (now LGBTQ [lesbian, gay, bisexual, transgender, and questioning]) community. Little did anyone know then, including those drag queens and butch lesbians, that they would get their own letter-"T" for transgender-within the evolving gay rights movement. Evolving queer theory has identified separate concepts of sexual orientation and gender identity, the former focused on the gender of the individual one is attracted to versus the latter focused on having an internalized and outwardly expressed gender identity different from the sex one was assigned at birth.
In 2001, AJPH published a theme issue on Lesbian, Gay, Bisexual, and Transgender Health, making it among the first, and possibly the first, mainstream scientific health journal with such a focus. Within that issue, Lombardi's commentary "Enhancing Transgender Health Care" (reprinted in part in this issue on p 230) identified a new health care concern-training health care providers to provide competent and appropriate care to transgender people-which today remains unaddressed to a large degree. In this issue, dickey's editorial (p 222) revisits this topic with a clarion call for competent clinical care and how such care can impact not only physical health, but emotional and mental health and well-being as well.
One factor limiting the ability to address transgender health, as well as other sexual minority health issues, was the lack of population-based data. While convenience surveys and anecdotal data indicated that the LGBTQ community experienced health disparities, the findings from such studies were limited in their scientific validity. In a classic chicken-and-egg dilemma, advocates for LGBTQ health argued that if population-based surveys, primarily administered by government agencies, did not add questions about sexual orientation or gender identity, valid data could not be produced. Government officials responded with concerns about the lack of validated measures to assess either sexual orientation or gender identity.
Two crucial efforts to address the lack of validated measures provided the necessary support to various expert panels deliberating on how to ask valid questions on these surveys about sexual orientation1 and gender...