Abortion Rights made LGBTQ Health Possible

Everything I know about being Queer, I learned from Abortion.

I was a teenager in Ohio during the late 80s obsessed with Abortion. It was all I talked about. I was on the Pill, I went to my first March on Washington, I spent my entire High School Graduation speech talking about “Choice”. I got to college in the early 90s in Westchester County right after their local abortion clinics had been bombed by Operation Rescue. I spent my weekends in the cold rain escorting patients in and out of the Clinic protecting them from the violence of the protesters. I Marched on Washington again. My politics and my identity always started with Abortion.

Abortion was how I could imagine my Queerness.

Living and breathing Abortion possibilities meant everything else was possible, too. In questioning the restrictions and shaming of Abortion, you had to get at what the world imagines for women. And if you get at what the world imagines for women, you have to question your sexuality, too. Questioning the category of woman and everything that was tied to it – heterosexual sex, birth, and marriage – is liberating. The promise of abortion releases women from stereotypes about what it means to be a woman. Abortion being controlled by others is the exact same premise as women being controlled by others. Access to abortion on demand and without apology released me from the constraints of womanhood, including heterosexuality. Fighting for Abortion made me Queer.

It was a natural step to AIDS activism where the well-organized ACT UP movement had so clearly and passionately connected the dots to access and drugs and information about medicine and healthcare. It was clear we had to fight back against any form of shame or stigma for needing lifesaving drugs and information. I knew this because of Abortion. I knew that our bodies were our own to love and save and protect and heal and those who knew more about them must help us – with no judgement about how we got here in the first place. We had to always separate our personal journey around “mistakes” and “risk” and “should have known better” from a medical professional’s ability to provide a fix.

Then there was the Lesbian Feminist Cancer Movement. The women who had worked so hard protecting Abortion and then fighting for AIDS drugs were getting older and getting diagnosed with Cancer. Here they personally met up against the systems they knew all too well from fighting on behalf of everyone else. Doctors that judged them for being gay, or fat, or smoking, or all three at once. Cancers that should have been caught earlier with screenings or prevention. But we had just spent the previous 20 years witnessing medicine’s sexism and homophobia and cold and unjust attitude toward Abortion and HIV. You think I’m gonna voluntarily get a mammogram now?

So we didn’t. We couldn’t. We couldn’t trust any of them. And we started our own clinics and our support groups and our educational campaigns. We healed each other. We buried each other. And we looked around and said enough is enough. We joined with our brothers who started their own AIDS clinics and we became a larger movement that we now call LGBTQ Health. We knit it all together.

The healthcare system was sick – not us. The political system was broken – not us.

We built new worlds together. We played and imagined. We celebrated and partied. We raised our own money. We had our own bars. We kept articulating what it meant to open our body up to possibilities of health and life and demand a system that did, too. That understood us.

In the early 2000s, my then partner came out as transgender. My program director at the Lesbian Community Cancer Project came out as transgender. My queer community was once again changing and growing with the power and promise of personal liberation. Imagining their bodies into existence. New names, pronouns, hormones, surgeries. All another step in our goal of making medicine work FOR us and not AGAINST us. A movement of autonomy and joy and bodies of our choosing. Choice was always our mantra.

Everything we knew from Abortion, HIV, and Cancer became our movement for Transgender Health. No longer would we have to suffer in bodies or lives prescribed by the world upon our birth.

We could live as we wanted. We could bring our inner most thoughts to the surface to be seen and appreciated by all. If we were to truly shed the dogma of heteronormativity – we must also shed gender, too.

Today’s LGBTQ Health Movement is all of us. The fight for Abortion and HIV medicine. Cancer support. Hormones and surgery. It is our right to control our own bodies. It is our fight to make medicine work for us. It is our bond to work across and with our differences to usher in something better for all. We have built a new world and new conversations that I could have never imagined in the 80s, 90s, 2000s. We know more than ever.

The Abortion fight is our fight. Not because we are women or not; or have a uterus or not; or have sex that could lead to pregnancy or not. This is our fight because they are all our fights. We must bring everything we have learned from Transgender Health and HIV and Cancer and access and shame and stigma to benefit Abortion. Because there is no LGBTQ Health anywhere without Abortion Rights everywhere.

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American Medical Association LGBTQ & Allies Caucus June 2021 Meeting highlights

Jessica Halem, MBA, award-winning educator, advocate, communicator and consultant on LGBTQ+ issues delivered a keynote address aimed at recentering foundational concepts in LGBTQ health. Ms. Halem explored historic milestones, current demographics, public policy achievements and challenges, and ongoing challenges and opportunities for improving physician awareness and understanding of LGBTQ+ health and well-being and the importance of centering patients in charting the course for the future.

Caucus participants engaged in discussion to assess the impact of the pandemic on LGBTQ+ health, raise awareness of related AMA work and the vital importance of stakeholder alliances. Central to this work is including and elevating the diverse voices and experiences of LGBTQ+ patients, medical students, physicians, and community care and service professionals.

Read more HERE.

Optimism: A Building Block for Organizational Change

I believe that optimism can be taught. Or more specifically, remembered and conjured when needed. Finding ways to deal with these difficult moments requires us to engage our own personal mix of optimism, resilience, and self-efficacy. And the very act of using these personal attributes in small ways everyday can actually build up our reserves and make those necessary muscles stronger. The beauty of resiliency isn’t found in the ability to keep taking the hits, but in the bouncing back part. Every time we bounce back, we get stronger and wiser. The bounce can get faster, and the hits can sink in less deeply.

"Optimism: A Building Block for Organizational Change," Medical Care, December 2018

Who Gets to be the Authority on LGBTQ Medical Terms?

[Reposted from the blog Paging Dr. Rainbow]

"Hello! I have a question for the experts: Do any medical organizations have established guidelines against the usage of the term "homosexual"? I know GLAAD, The Associated Press, the NYT and many media sources and universities advise against usage of the term, but do we still use it in a medical setting? I had a lecturer today say that MSM, MSW, WSW, WSWM, etc. are incorrect and to use the terms, "heterosexual, homosexual, and bisexual" when giving a case presentation. I challenged the idea and was told they are "medical terms" and we always use the "medical terms." So, help a student out!"

-PA in training seeking better answers

Dear PA in training seeking better answers:

First off, let me say how pleased I am to hear that you have cases with LGBTQ patients in your education. It wasn’t that long ago that cases like this weren’t available, discussed, or appreciated as an important part of patient care. We have come a long way.

Language that describes the LGBTQ community has changed and will continue to change. But language is just a tool to use to describe what we observe, learn, or hear from our patients. So, everyone will have to be a bit flexible as we continue to listen better and illicit more information from patients. In fact, at the turn of the last century in the US, the “medical term” was “invert” which represented the conflation of gender and sexual orientation and then the word “homosexual” became more widely used. Both were terms used more with derision and judgement than care from the medical community. So, there’s that history.

Today, we know “nonbinary” is a widely used word to describe a gender identity or expression that some would have called “androgynous” just a few years ago. And of course, transsexual was a word we used to use as well, but now use the word transgender. I am sure there are cases and textbooks that haven’t been updated accordingly.

So, finding an authority on “medical terms” seems to be the issue with your lecturer. I can say with authority -- we do not use the word “homosexual” to describe patients anymore. It actually isn’t a word that people use to describe themselves or does a good job of describing behavior that needs to be discussed.

What is key here is appreciating two distinct differences in discussing sexual orientation – first, language that describes the SEXUAL BEHAVIOR of our patients and secondly, language that patients use to describe themselves. What we still like about MSM is that it describes sexual behavior and doesn’t assume identity. We know plenty of men have sex with other men and are married to women. We also know plenty of women describe themselves as lesbians but have had or will have sex with men.

In terms of who else is an authority on medical terms for the LGBTQ community – the NIH now uses the phrase “sexual and gender minorities” and the hospitals you will work with have electronic health records that probably already have SOGI (sexual orientation and gender identity) data collection in place and use words like “gay” and “cisgender”.

Medical terms are only authoritative if they are helpful in understanding, valuing, and supporting the patients you are being trained to care for in the future.

If this analysis doesn’t work, attached here are guidelines from Harvard Medical School here.

-Jessica Halem, MBA, LGBT Program Director, Harvard Medical School

Thank you Jessica for your awesome contribution to our blog! What an amazing conversation starter you have been!

Career Progression in Academic Medicine: Perspectives from Junior Faculty Women of Color

Women of color continue to be particularly underrepresented in academic medicine, and yet there is a dearth of research about this group’s specific needs. This qualitative study provides insights on how WOC junior faculty experience career progression. We hope that this study will help minority women and institutions identify ways to overcome these barriers, so that ultimately, women and men of all backgrounds are able to progress in their academic careers while also achieving their personal goals and meaningfully contributing to their institutional missions.

Author Caterina F. Hill is Research Associate for the Department of Global Health and Social Medicine at Harvard Medical School. Author Emorcia V. Hill is Director of Research and Evaluation in the Office for Diversity Inclusion and Community Partnership at Harvard Medical School. Author Michael Wake is Program Manager in the Office for Diversity Inclusion and Community Partnership at Harvard Medical School. Author Stacy Blake-Beard is Professor and CGO Faculty Affiliate at the Simmons School of Management. Author Jessica Halem is an MBA student and Research Assistant at the Simmons School of Management. Author Joan Y. Reede is Associate Professor and Dean for Diversity and Community Partnership at Harvard Medical School.