Pride or Prejudice: A Call to Action

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iStock/Aron M

June may mark the start of summer, but it’s also Pride month. This month has been designated to honor LGBTQ+ people, highlight their rights and acknowledge their struggles. June was chosen to commemorate the 1969 Stonewall Uprising in Manhattan, which occurred on June 28. It was led by transgender women of color, including Marsha P. Johnson and Sylvia Rivera.

This Pride month, as a queer immigrant of color with a womb, I am alarmed by the flood of bills introduced in several state legislatures aimed at opposing immigrant rights, nullifying reproductive rights and reduce the rights of LGBTQ+ people. As a psychiatrist, I am particularly concerned about how these anti-rights bills will affect the mental health of the millions of people they affect.

By April, 175 anti-LGBTQ+ bills had been tabled. This stands in stark contrast to the 45 bills filed throughout 2018 and represents an already staggering 400% increase in anti-LGBTQ+ bills in just four years. And other bills could be tabled later this year. About half of these bills target transgender people, with some going so far as to target the clinicians who serve them. For example, two Texas bills, SB 1646 and SB 1311, target physicians involved in providing lifesaving and transition-related health care: they seek to revoke a physician’s license to practice medicine. under the pretext of qualifying these medical interventions as “child abuse”.

Another state, Alabama, recently passed SB 184, making it a felony, punishable by up to 10 years in prison, for doctors to provide gender-affirming medical care to minors. Similar bills have passed in Louisiana (HB 675), Arizona (SB 1138), and Idaho (HB 675). What happens next for a marginalized population that loses access to care directly correlated with a reduction in suicidal tendency? In this month of June, we may be proud, but we are also exhausted.

Our professional organization, APA, has openly opposed any type of legislation that compromises patient safety, including access to gender-affirming care for all individuals, regardless of age. For example, in response to the two Texas bills, the APA tweeted its 2020 position statement on the treatment of transgender and gender-diverse youth and released a similar position in conjunction with five other medical organizations. The APA has also joined an amicus brief in a lawsuit to block a directive issued by Texas Governor Greg Abbott regarding SB 1646 and SB 1311 that directs state agencies to categorize care asserting the gender as child abuse; he also joined an amicus brief against an Arkansas law banning gender-affirming therapy.

The APA strongly opposes state legislative efforts to criminalize or penalize physicians who provide necessary care to their patients. Patients and their doctors together, not decision makers, should be the ones deciding what care is best. As physicians, we must advocate to protect not only the rights of our patients, but also our own right to provide evidence-based and affirmative patient care.

More than half of the states (29 to be precise) do not provide full protection against discrimination for LGBTQ+ people. We must look to federal law for redress. Please reach out to your US Senators to urge them to pass the HR 5 Equality Act. This bill has already passed the House of Representatives with the support of the APA and will amend the Civil Rights Act of 1964 to protect people from discrimination based on sexual orientation or gender identity. . Ask your senators to support the Equality Act!

Want to go beyond? Support organizations like the Transgender Law Center (TLC), which is the largest transgender-led national organization grounded in legal expertise and committed to racial justice. TLC uses community-driven strategies to keep transgender and gender non-conforming people alive, thriving, and fighting for their liberation.

We could reflect on key moments of injustice in history, hypothesizing what would have been done if we had been alive then, but we are alive now, and this moment is a call to action, not only for our patients, but also for our profession. and for our colleagues across the gender and sexuality spectrum. ■

Photo: Fiona Fonseca, MBBCh., BAO, MS

Fiona Fonseca, MBBCh., BAO, MS, is chief resident at St. Mary Mercy Hospital in Livonia, Michigan. They pursue careers in academic medicine and advocacy for underserved populations, with special interests in cultural psychiatry, psychotherapy, medical ethics, and physician wellness. They would like to thank Katherine Kennedy, MD, for her mentorship and support in the development of this piece. Kennedy is chair of the APA’s Council on Advocacy and Government Relations.

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