During Pride Month, we recognize the strides that the LGBTQIA+ community has made, the adversities we have overcome and the struggles that still remain in our fight for equality. Just a few years ago in many states across the nation, it was still illegal to marry someone of the same sex, and if you worked for someone with more than 15 employees, you could be fired from your job for being gay or transgender. Now, thanks to the Supreme Court, gay and trans folks can marry and have protections in the workplace.
However, not all aspects in the fight for sexual and gender equality have been a continuous progression. The Obama-era brought sweeping change for transgender individuals, allowing them to openly serve in the armed forces and granting them protection from discrimination in obtaining health care. However, the current administration has reversed both of these rights, turning away trans folks from being able to serve in the military and now, just a few days ago, revoking the protections against discrimination in obtaining health care based on sexual orientation and gender identity.
As family, friends, colleagues and fellow citizens to our LGBTQIA+ community, this news should be upsetting. As dental students and, more importantly, health care providers, you owe it to your patients to understand how these decisions might impact their care.
According to the non-profit health care news group, the Kaiser Family Foundation, the revoking of this rule means that unless a state has its own laws, an insurance company can ask about an individual’s sexual orientation or gender identity, and use either for the purposes of underwriting or determining insurability. This means that issuers of health insurance can legally procure and use information on sexuality and gender identity to charge higher premiums, charge other fees, or even cancel or deny coverage for those who are LGBTQIA+. Yet the Obama-era rule in the Affordable Care Act about protecting patients with pre-existing conditions that affect a wider range of people still stands today.
These policies will particularly impact patients with Medicaid plans. According to UCLA’s Williams Institute, over 1.1 million LGBTQIA+ individuals ages 18–64 have Medicaid as their primary source of health insurance. Why is there such a disparity? A 2015 survey by the National Center for Transgender Equality says, “Transgender, nonbinary, and gender nonconforming people are three times as likely to have a household income under $10,000 and three times as likely to be unemployed as the typical person in the U.S.”
With statistics like these, it’s incumbent upon us as current and future health care providers to be the best advocates for our patients as possible. When you take the Hippocratic Oath to serve as a dentist and when you practice under a code of ethics as every dentist must, you pledge your support for beneficence, non-maleficence and justice, to do good, refrain from harm, and to be fair and just. Part of this oath and the ethics by which we practice means providing an environment free of judgment, whereby you care for your patients no matter their race, religion, color, creed, sexual orientation or gender identity.
I urge you to go beyond just knowing this information, though, and to live it in your everyday lives and future practices. Don’t allow injustices such as the ones we see in the news fade into the distance. Speak up, especially if you’re an ally, and fight for the rights of those who are oppressed. Help make sure your patients will be able to obtain insurance to afford your care without having to worry about being charged more or denied coverage just because of their identity.
As ASDA members, we commit to the E-8 policy, our ASDA Student Code of Ethics. We also should all be aware of the E-4 Sensitivity to Diversity policy, which states that “sexist, discriminatory or insensitive language and practices are unacceptable.” As a community and a group of young professionals, we are part of the present and future voice that will guide health care into the next century.
This Pride Month, before you hang up your rainbow flag or post something to your social media about your support for the community, take stock in the current situation of our country. Are we doing everything we can and electing the people we believe will fight on behalf of all our colleagues and patients? I then implore you to remember that feeling, to act on it in becoming a better, more educated supporter and ally of communities that continue to struggle and have their rights infringed upon, whether they’re gay, bi, trans, people of color, Latinx, Muslim, etc.
Lastly, if we want to bring about change in our country, we must participate in the democratic process, so I encourage you all to vote in your local primaries if they haven’t happened yet, and vote this November for candidates at every level of government — not just the president — based on who you believe will best uphold the same ethical principles you hold yourself to. You can even use ASDA’s newest advocacy tool, ASDA Action, to register to vote and find out more about candidates in your area.
Together, let’s make a brighter, more equal and just future for ourselves, our profession and the patients we serve.
~Joseph A. Manzella Jr., Stony Brook ’21, Chapter Immediate Past President, ASDA Speaker of the House