October 20, 2021
July 1, 2020
By Jonathan Baker, PA-C, and Christina Wojnarwsky, PA-C
While this June wasn’t filled with the rainbow covered floats in a parade we’ve come to know as Pride, we can’t remember a time when Pride has been so sincerely and genuinely celebrated. Pride was born not in celebration, but in protest from years of discrimination and indignity. Fifty-one years ago, Pride began when a Black transgender woman named Marsha P. Johnson and her compatriots had had enough suffering and repeated harassment, as well as arrests of their community on questionable charges. LGBTQ+ people took to the streets in protest of the criminalization of their identity, starting the modern LGBTQ+ civil rights movement. The LGBTQ+ and Black Lives Matter movements are inextricably linked.
Intersectionality a theme
Intersectionality has become the theme this Pride month. Intersecting or overlapping minority identities lead to magnified oppression, essentially making a bad situation worse. To illustrate, a Black gay man might be excluded from much of the gay community because of his race and excluded from the Black community for his sexual identity. He must also make a choice whether he is a “Black gay male” or a “gay Black male.” These intersecting oppressions correlate with poor health outcomes including increased incidence of mental health conditions, substance abuse, HIV/STI, and cancers which are preventable with screenings. In fact, one in two Black gay men will be diagnosed with HIV in their lifetime compared to one out of 11 White gay men, and one in four Latinx gay men.
As healthcare providers, PAs have an opportunity to address these unacceptable health disparities, but for LGBTQ+ PAs, this can prove to be challenging. A fellow PA, colleague and friend of ours lost his job in the past because he was gay. This unjust outcome not only impacted him, but also his patients, most of whom were living with HIV; they lost a caring and culturally sensitive healthcare provider.
Supreme Court ruling provides protections
In a victory for LGBTQ+ PAs and patients, the Supreme Court ruled this month that Title VII of the 1964 Civil Rights Act, which bars discrimination based on sex, also applies to discrimination based on sexual orientation as well as gender identity. The ruling affirms that existing federal law protects employees from being fired simply for being LGBTQ+. This decision provides federal protections to sexual and gender minority LGBTQ+ individuals against discrimination in federal employment and for large companies.
This ruling not only helps protect LBGTQ+ healthcare providers but also the patients they serve as employment is linked to our healthcare system in the U.S. For example, most individuals manage HIV with daily medication, which suppresses their viral load, reduces risk of opportunistic infection, and eliminates risk of sexual HIV transmission to partners. While the treatment for HIV may seem as simple as taking a daily medication, it is rooted more deeply than that and is significantly influenced by social determinants of health. Access to healthcare in the U.S. is dependent on socioeconomic status; if you are fired from your job, you lose your health insurance, and with it your access to medication and treatment. Without the means for stable housing, your focus shifts to survival, and taking that medication on a daily schedule is no longer your priority.
Just prior to the LGBTQ+ community celebrating the Supreme Court ruling, the Administration passed a rule discontinuing the prohibition of discrimination in the provision of healthcare on the basis of sexual orientation and gender identity Affordable Care Act, Sec 1557. While this rule, which AAPA opposed, will result in reduction to healthcare access for the LGBTQ+ community, we are hopeful that this Supreme Court ruling may invalidate this rollback of protections.
Strong and resilient community
Ruling after ruling confirms that all members of the LGBTQ+ community are valid and worthy of the same human rights afforded to others. We have repeatedly proven that our community is strong and resilient. As a community, we must continue to work together with the Black community as our fight for equality is one. Just as the LBGT PA Caucus and the African Heritage PA Caucus have collaborated for decades, we continue to support the statement that no one is free until we are all liberated.
Black Lives Matter. Black Trans Lives Matter. Black Bisexual Lives Matter. Black Lesbian Lives Matter. Black Gay Lives Matter. All Black Lives Matter.
Jonathan Baker, PA-C, currently serves as AAPA’s Liaison to the GLMA, is the Past President of the LGBT PA Caucus, and the incoming President-Elect of the NYSSPA. Christina Wojnarwsky, PA-C, is the Director of Policy and incoming President-Elect of the LBGT PA Caucus.