Advocating for Our LGBTQIA+ Patients

As June begins, we celebrate another LGBTQIA+ Pride Month.  

On June 28, 1969, at 0100 hours, NYPD Public Morals Officers raided The Stonewall Inn on Christopher Street in Greenwich Village. Officers began rounding up patrons to transport them to police headquarters. Gay bar raids were a routine part of the NYPD’s operations, but this night’s raid would have an unexpected ending. As patrons were forced out of the building, two transgender women of color took a stand. They fought back, igniting a six-day confrontation with the NYPD, rallying the city’s LGBTQIA+ population that up until that point kept themselves largely hidden. Coverage of this story was ignored or sanitized by mainstream media but the debate for LGBTQIA+ rights was sparked.  

Pride is people finding strength, courage, and a common voice to demand equality and destroy systemic legal, medical, media, and social oppressions that exist. We need to focus on this rather than the media’s focus on corporations that support the LGBTQIA+ population.  

As doctors, we need to be aware that like any other marginalized community, the LGBTQIA+ population often suffers at the hands of 20th Century medicine. LGBTQIA+ people have a history of imprisonment, involuntary commitment to mental hospitals, and extreme “treatment” to correct this perceived mental illness. It was not until 1973 that the American Psychological Association removed homosexuality as a mental disorder from the DSM. It was inappropriate then and we can take that lesson into our practice. We can be better doctors by following what is happening to the LGBTQIA+ community.  

For the past three years, there have been a record number of bills that attack LGBTQIA+ rights. These proposed laws represent censorship about identities, same-sex marriages, restricting education, and book bans. It harms public health. Currently the transgender community is the focus multiple bills which are trying to limit healthcare. Some of these laws attack the fundamental functions we as doctors provide. Violence against LGBTQIA+ people has always been a problem, being nine times more likely to be victims of violent hate crimes.  

Going forward in your practice, consider the following: Sex is assigned at birth based on biological characteristics; sexual orientation is defined by who you are physically and romantically attracted to; and gender identity is one’s inner concept of self as masculine, feminine, a blend of both, or neither. Many times, as physicians we tend to forget the aspect of the social history when we see patients. For many of us, we look at the constellation of medical conditions and consider family history. It would be unthinkable to disregard the family history. What makes social history less important? Osteopathic medicine is special because it concerns the entire patient, and the social history must be part of that tenant. We get little training relative to the scary topic of sex and identity, but is it any different than other aspects of patient care?

We must advocate for our patients. We must strive for compassion and empathy toward all individuals regardless of race, ethnicity, gender, disability, sexual orientation, and gender identity. We must look at how injustice affects our patients and continue to educate ourselves on the impacts on our patients. The struggle for justice is ongoing and not only for LGBTQIA+ population but for all populations we serve.