Where We Stand
Section: Prescribing Guidelines
Policy: Protections for LGBTQ+ Health Professionals
Appendix T
Protections for LGBTQ+ Health Professionals
Despite the importance of LGBTQ+ representation, LGBTQ+ people are highly underrepresented in medicine and science. LGBTQ+ people are estimated to comprise 10–15% of the US population (GLAAD, 2017), with increasing representation in younger generations, but the American Medical Association estimates that only about 4% of US physicians identify as LGBTQ+ (Tanner, 2020).
LGBTQ+ health professional students are more likely to experience burnout, which is associated with their higher likelihood of mistreatment (Samuels et al., 2021). Studies have shown greater discrimination and harassment of LGBTQ+ people in medical school (Hill et al., 2020) and residency training (Pololi et al., 2020). Mansh and colleagues (2015) found that 29.5% of LGBTQ+ trainees surveyed concealed their identity in medical school, with 43.5% citing fear of bias and harassment as a reason for concealing their sexual identity (Mansh et al., 2015). Transgender and non-binary health professional students reported self-censorship of their speech or mannerisms to avoid disclosure of their identity, hearing derogatory comments, and witnessing discriminatory care (Dimant et al., 2019).
A study of LGBTQ+ physicians found that they experienced harassment and social ostracism and witnessed discriminatory treatment of LGBTQ+ patients, patients’ partners, and colleagues (Eliason et al., 2011). A recent study of health professional students and dual degree medical trainees found that a higher percentage of LGBTQ+ dual degree trainees (15.50%) identified sexual harassment as a past barrier to career advancement compared to their non-LGBTQ+ peers (8.27%) (Marr, Heffron, & Kwan, 2022). LGBTQ+ physicians commonly face discriminatory behavior from patients, with 42% of residents in a recent survey reporting witnessing discrimination within the past year (de Bourmont et al., 2020).
Status as an LGBTQ+ person in science, technology, engineering, mathematics (STEM) professional fields is an independent predictor of experiencing career limitations, harassment, professional devaluation, more frequent health difficulties, and greater likelihood of intending to leave STEM (Cech & Waidzunas, 2021). Heteronormative assumptions and environments often silence conversations about gender and sexuality in medicine and STEM workplaces, leading LGBTQ+ trainees and scientists to report feeling “invisible” (Bilimoria & Stewart, 2009; Cech & Waidzunas, 2011; Cook et al., 2020; Miller et al., 2020; Powell, Terry, & Chen, 2020).
Healthcare professionals providing gender-affirming and LGBTQ+-related care are increasingly facing threats, violence, and harassment (HRC, 2022). Additionally, many states are criminalizing the provision and receipt of gender-affirming and/or LGBTQ+-related healthcare (Park, Das, & Drolet, 2021; Kraschel et al., 2022; Turban, Kraschel, & Cohen, 2021).
Physicians, Physician Assistants, and other healthcare professionals deserve to be protected in their work environments. Protections for LGBTQ+ health professionals and health professionals providing gender-affirming and/or LGBTQ+-related healthcare is critical. In order to develop policies for the OMA, this workgroup reviewed and considered existing policies from the AMA and the GLMA: Health Professionals Advancing LGBTQ+ Equality. In addition to examining these policies, the workgroup also reviewed other policies, statements, studies, and resources from state and national medical associations and organizations advocating for LGBTQ+ health.
These recommendations will become Oregon Medical Association policy and allow the OMA to advocate, influence, and educate to advance and improve protections for LGBTQ+ health professionals and health professionals providing gender-affirming and/or LGBTQ+-related healthcare. These recommendations will further the OMA’s goals of advocating for an equitable and accessible healthcare environment and supporting the community of physicians and physician assistants.
References
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Cech EA, Waidzunas TJ. Systemic inequalities for LGBTQ professionals in STEM. Sci Adv. 2021;7(3):eabe0933. doi: 10.1126/sciadv.abe0933.
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