Why Health Care Is the Next LGBT Battleground

Doctor's office
Everyone deserves to be treated with respect and sensitivity.

Photo by Stuart Jenner

If you want to know how much work the LGBT movement still has to do, come answer phones at the offices of Garden State Equality.

Patrick, our beloved director of operations, answers the phones most of the time, and maybe half of the questions he has for me—I’m the executive director at GSE—are about the complicated binds that members of our community find themselves in. These frequently involve doctors who have no idea how to work competently or sensitively with transgender people, or housing administrators who have no idea how to make their LGBT residents feel safe when another resident or staff member is being a bigoted jerk. The list goes on.

I’m one of those people who thinks of health in broad terms: Health isn’t just about doctors. It’s about mental health. It’s about having a roof over your head. It’s about being able to get an education. It’s about feeling safe. Philosophers Amartya Sen and Martha Nussbaum talk about true equality being a world where people have the resources they need to live to their fullest potential. True equality is making sure those health service providers—doctors, psychotherapists, social workers, even shelter providers—actually know how to work with members of every community.

I hereby throw down the gauntlet: A major front in the battle for LGBT equality is making sure health service providers are competent and sensitive enough to meet our community’s needs.

Of course, some LGBT organizations have been doing this for years. ONE Colorado, for example, is a leader in pulling together providers and activists to improve the extent to which that state’s medical system meets LGBT community needs. Human Rights Campaign has been pushing hospitals and corporate health insurance policies to meet certain nondiscrimination and cultural competency criteria for years. Transgender Law Center and Basic Rights Oregon have done extensive work on health equality.

What I’m saying is that the entire LGBT movement should focus as many resources on this as we did, say, marriage equality. This work shouldn’t be the province of far-thinking organizations and health care wonks. This should be the kind of thing we sink a ton of money into to determine how to explain it to non-activists, how to get our entire community behind it, how to generate the kind of passion and investment that past struggles have generated.

This week, my organization is kicking off a program called Map & Expand LGBT Health Services in New Jersey, where we’re 1) mapping (by geography and specialization) the providers who specifically meet LGBT community needs (for example, doctors who provide hormone therapy for transgender people) and/or are particularly sensitive to community members; and 2) working with those providers to expand the map.

This is a multi-year project. It won’t end, because until we’re sure doctors and other service providers are as knowledgeable and sensitive to LGBT community needs as providers are generally knowledgeable and sensitive to heterosexual and cisgender needs, we’re not done. And I have no idea how long that will take.

Then again, social justice movements are never done. We should never demobilize. The notion that marriage equality was an endpoint was always pernicious. I get apoplectic whenever I hear an activist saying that their job is to work themselves out of a job. At the risk of sounding like Richard Nixon, our enemies are everywhere. If you extend the definition of enemies to encompass people who are ignorant about our community and systemic inequality—like a health care and social service system that inadequately responds to our needs—we’re in one of those forever wars.

Maybe that’s something we shouldn’t say too frequently, but we have to acknowledge the stakes, which, to quote De La Soul, “is high.” That’s bleak, but Patrick and I still get desperate calls from homeless community members who have been shuttling from shelter to shelter because they can’t find a safe place. Patrick and I keep hearing from community members who can’t find health insurance that meets their needs. I just talked to a mastermind of LGBT health reform who told me that Jersey is a desert for doctors who are competent to work with LGBT people. Stakes is high. Let’s focus.