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Fenway Health was founded as a federally qualified community health center in 1971 by a diverse array of community activists, including feminists, some of whom helped to write “Our Bodies, Our Selves,” as well as gay men and other residents of the neighborhood (Mayer et al., 2001). The organization came of age with the advent of the AIDS epidemic, being the first responder for the community during the early years before the etiologic agent was identified. Fenway spawned a variety of community-based programs, and in order to help understand how HIV was transmitted and how people could protect themselves, it developed one of the first community-based research programs in the United States. In those early bad old days, the center’s major health focus was on gay and bisexual men, although many of Fenway Health’s staff members were lesbians and other sexual and gender minority individuals. In recognition that there were broader sexual and gender minority needs above and beyond the AIDS epidemic, particularly as effective therapies came into play by the late 1980s and early 1990s, Fenway began to develop a series of programs focused on women’s health. One of these was an annual lesbian health research day that featured a keynote speaker. One of the first keynote speakers was Dr. Judith Bradford, who had already achieved distinction as leading some of the first national studies focusing on lesbian health (Bowen et al., 2004; Bradford, Ryan, Honnold, & Rothblum, 2001; Bradford, Ryan, & Rothblum, 1994).
Dr. Bradford’s erudition and engaging manner charmed the staff and the community in Boston. She immediately made lifelong friends and was asked to return at every conceivable opportunity and to help develop a lesbian health research agenda (Carroll, Linde, Mayer, Lara, & Bradford, 1999). By the turn of the past century, the AIDS epidemic was coming under control with the development of co-formulated combination antiretroviral therapy, and institutions like Fenway Health started thinking ahead to a broader set of community concerns. The leadership of the health center developed a strategic plan to intentionally develop additional research capacity beyond HIV/AIDS (Mayer et al., 2008). There was an increasing recognition that some of the programs that Fenway Health conducted, including behavioral and health services research, professional and community education, policy and implementation science, could benefit from a broader focus that addressed the commonalities and differences in health disparities and clinical concerns of diverse sexual and gender minority populations. This recognition led to the genesis of The Fenway Institute (www.thefenwayinstitute.org), with the intention of having diverse leadership and a broader research, education, and policy portfolio. Fenway Health leadership quickly recognized that the logical person to recruit after a national search was Dr. Bradford, given her wide-ranging vision, record of accomplishment of superb scholarship and mentorship, and her ability to develop effective multidisciplinary collaborations.
Dr. Bradford’s arrival in Boston began a period of more than 15 years of highly productive research and community engagement. She was one of the forces behind the development of a companion document to Healthy People 2010 (USDHHS, 2001), which initially was approved by the federal government (Clinton administration), but was subsequently rescinded after George W. Bush assumed office in 2001. Despite that, the document created a blueprint that identified what was known about LGBT health at the time, and identified the lacunae in sexual and gender minority health, charting a course for further research and program development. This Healthy People 2010 planning process led Dr. Bradford to develop a variety of partnerships across the country to foster new collaborations, ranging from healthcare issues of lesbians to a significant focus on transgender people (Goldblum et al., 2012; Hendricks, Goldblum, Bradford, & Bongar, 2012; Rood, Puckett, Pantalone, & Bradford, 2015) and LGBT youth (Bradford & Mustanski, 2014). Dr. Bradford’s efforts were a major impetus for the Institute of Medicine (IOM) subsequently commissioning the most comprehensive report on the state of LGBT health (IOM, 2011). The IOM report will withstand the depredations of the current administration, given that it was a thorough review of the state of knowledge regarding the many health concerns and disparities experienced by LGBT people. Dr. Bradford’s leadership as part of the IOM panel was recognized when the National Institute of Health and Health Disparities appointed her as the first openly LGBT person on their Advisory Committee. During her tenure on the Advisory Committee, she became a trusted friend and confidant of two successive directors of the institute and helped influence the shape of many federal funding announcements.
Dr. Bradford was a critical scholar in the area of population science. She was one of the first people to very clearly recognize that sexual and gender minority individuals constitute distinct populations and that, by definition, principles of population health would be applicable for the study of their health in society, in much the same way that scholars for years had understood that the health of racial and ethnic minority individuals was affected by individual biology and behavior, but also by social and structural factors potentiating stigma and decreasing access (Bradford & Mayer, 2007; Hendricks et al., 2012). Dr. Bradford’s vision encompassed the recognition that certain specific practices might directly affect sexual gender and minority health, be it anal intercourse increasing the risk of HIV for men who have sex with men and transgender women or internalized homophobia leading to depression and substance use and body dysmorphia for all sexual and gender minority individuals (Haas et al., 2011; Mereish, O’Cleirigh, & Bradford, 2014). By recognizing that some of the physical determinants of health disparities could be exacerbated by societal intolerance, Dr. Bradford was able to develop unique and creative analyses of the interactions of the diverse levels of the eco-social model affecting LGBT health (Van Wagenen, Driskell, & Bradford, 2013). Her interest in population science was recognized by the National Institute of Child Health and Human Development (NICHHD), which awarded her the first Population Studies Center focused on sexual and gender minority health.
While acting on a national level, Dr. Bradford persistently continued her important scholarship locally. She help lead analyses that demonstrated the important role that peer health navigators could play in improving clinical outcomes of socially marginalized HIV-infected people (Bradford, Coleman, & Cunningham, 2007; Cunningham et al., 2007). She helped to develop studies of LGBT aging, including studies of the health benefits of congregate meal programs for LGBT elders (Porter, Keary, VanWagenen, & Bradford, 2016). The findings from this study have the potential to influence the development of culturally tailored programs to increase the socialization of LGBT elders, who may be at more risk for social isolation, depression, and attendant adverse health outcomes without proactive policies. Dr. Bradford continued to be interested in both ends of the age spectrum, helping to lead a major study of LGBT youth of color that involved community-based participatory research. Her interest in the next generation extended to training as well as research. She was the recipient of the first grant from the NICHHD to run a Summer Institute to train emerging LGBT research scholars. The Summer Institute program fostered camaraderie among young scholars and created new intra- and intergenerational collaborations. It was particularly poignant to see several of the Summer Institute scholars who have now launched distinguished research careers of their own at the memorial service for Dr. Bradford. Dr. Bradford was always a kind and engaged mentor, and a major part of her legacy lives on as the next generation of LGBT scholars build on the skills and wisdom she imparted.
Dr. Bradford’s passing occurred almost a year ago, and her loss still feels extremely profound to many who knew her, worked with her, and enjoyed her graciousness and good counsel. She was always affable and engaged when interacting with any group of individuals. She had a tremendous commitment to social justice and a profound respect and humility regarding all human beings. She liked to say that some of this came from being born into a Quaker tradition but also manifested some of the traditions of Southern gentility. She cared deeply for social justice and was a valiant warrior against intolerance. Although her charm and ease in genteel conversation might be misperceived as someone who was easygoing, Dr. Bradford clearly had goals in mind when she began conversations and collaborations. Her aim was always to make the world a better place and to ensure that the healthcare needs of the most vulnerable individuals in the LGBT community be recognized, understood, and approached in the most sensitive, effective, and responsive manner. Her colleagues continue to miss her, but her successes still manifest on a daily basis, given the increasing recognition by the academic community and public health officials that LGBT people are discrete populations with unique healthcare needs, which require a sophisticated understanding of the interplay of social, structural, individual behavioral, and biological factors.
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Mayer, K. Gracious and Tenacious: The Enduring Legacy of Judith Bradford (1943–2017). Arch Sex Behav 48, 327–329 (2019). https://doi.org/10.1007/s10508-018-1345-x
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DOI: https://doi.org/10.1007/s10508-018-1345-x