Celebrating Pride Month

During June, we celebrate another LGBTQIA+ Pride Month. While today many feel a sense of security in gay bars, it is important to reflect about our culture and lack of civil rights that the LGBTQIA+ shared little more than a half century ago. Homosexuality was a criminal act enforced with the same tenacity used to combat pedophilia, drug sales, and prostitution. It was not until 1973 that the American Psychological Association removed homosexuality as a mental disorder from the Diagnostic and Statistical Manual of Mental Disorders (DSM). Imagine being at your favorite bar and being arrested. This was a common occurrence in the 1960s, for nothing more than being a suspected homosexual.  

Yet on June 28, 1969, at 1:00 am, something different happened. What started out as a routine bar raid by NYPD Public Morals Officers at the Stonewall Inn on Christopher Street in Greenwich Village took a decidedly different turn. As patrons were forced out of the building and arrested, two transgender women of color took a stand against the NYPD. They fought back and they inspired others to join their defiance and ignited a six-day long resistance by Greenwich Village’s LGBTQIA+ community against the NYPD. This act of defiance ignited the conversation and debate for LGBTQIA+ rights in the United States. Pride is people finding strength, courage, and a common voice to demand equality and affect social change.  

As doctors, we need to be aware that like any other marginalized community, the LGBTQIA+ population often suffers at the hands of 21st Century medicine. LGBTQIA+ people have a history of imprisonment, involuntary commitment to mental hospitals, and extreme “treatment” to correct this perceived mental illness. Even now gay “conversion” camps exist in attempts to “treat” and convert individuals.  

For the past three years, some states have tried to pass laws attacking LGBTQIA+ rights. This is censorship about sexual orientation, gender identity, the use of pronouns, same-sex marriages, restricting education, and book bans. It harms public health (see https://williamsinstitute.law.ucla.edu/press/lgbt-hate-crimes-press-release/). Currently the transgender community is the focus of 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. Some of these laws even make it illegal for doctors to provide gender-affirming care, restricting our oath to care for individuals.

Go forward in your practice considering the following: sex is assigned at birth based on biological characteristics; sexual orientation is defined by who you are physically and/or 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 this aspect of the social/sexual histories when we see patients. For many of us, we look at the multiple medical conditions and limited time to address all the issues. We do focus on family history since this gives us insight into what conditions a patient may be predisposed to. What makes social/sexual history less important? Osteopathic medicine is special because it concerns the entire patient, and the social/sexual history must be part of that tenant. The problem is we get little training during medical school and our residency 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 of it on our patients, and effect change in the institutions that try to limit these rights. The struggle for justice is ongoing, not only for the LGBTQIA+ population, but for all the populations we serve.