As an out, gay, white doctor, and father of a lovely, biracial child, it is an honor to be asked to write a blog for Allina Health about the LGBTQ+ community for Pride Month.
This year and this month in particular, the most prudent topics to write about seem to be advocacy, change and resilience. This month also highlights how we as a community demonstrate “intersectionality”. This word means that each of us has several identities that overlap other communities. And, our community is made up of and intersects with other communities.
Reflections on racism and health care
Over the past month, I have seen in new ways how Black Americans are subject to significant barriers. Among these are systemic barriers rooted in policy, and individual barriers rooted in our personal behaviors and actions, which we may or may not recognize.
Racism is now described as a public health crisis by both Minneapolis City Council member Andrea Jenkins, a Black transgender woman, and the American Academy of Family Physicians. Racism is not new, but in the aftermath of the death of George Floyd we are at a point to better understand it and engage in new, meaningful work to change the culture for and the health of Black people in our communities.
Racist is an adjective not a moral judgment
To help me better understand racism, I have started listening to the audiobook “How to Be An Anti-Racist,” by Ibrahim Kendi. It has helped me recognize and question my own racist ideas that have been ingrained in me. It has helped me understand that “racist” is an adjective, not a moral judgment.
It is difficult for me to understand how my unconscious racist ideas influence perceptions about a patient’s barriers to care, their reason for a clinic visit, or even reasons they might avoid care altogether. Being able to identify my own racist ideas is a very powerful tool for me to understand and consciously overcome some of my unconscious presumptions that are based on racist ideas.
For example, I have begun to wonder, "Was I taught in medical school why Black patients are disproportionately affected by diabetes and hypertension?” Is it because they are Black or is it because many Black patients are experiencing social determinants of health differently than other groups? Only research will help us learn the answer to that question.
An example of disproportionate health care can be seen in the number of Black patients in treatment for opioid addiction who are treated with the life-disrupting methadone maintenance while white patients with the same diagnosis are more likely to be treated with the self-managed prescription Suboxone. As I learn what the war on drugs has done to criminalize Black lives, I wonder how this fact has improved or worsened health and life outcomes in the Black community related to controlled substance prescriptions.
Why talk about racism during Pride Month?
You may be wondering why I am writing about racism during Pride Month? If you have studied the history of advocacy in the LGBTQ+ community, you have likely learned that a transgender woman of color, Sylvia Rivera, was a particularly important person who started the change we benefit so much from today that was catalyzed by the Christopher Street uprising in 1969 (often referred to as “Stonewall,” the name of a bar where the uprising began). Since that awakening, we have been resilient and persisted as an LGBTQ+ community. We have survived a plague (HIV/AIDS), and built awareness and community by coming out. Today, we continue individual acts of bravery by living our authentic lives in the face of frightening danger that continues to this day. This is especially true for transgender Black women who routinely are dying from physical violence directed specifically at them.
Family reflections on resilience
On a recent afternoon my family took an unplanned detour to visit the intersection of 38th and Chicago. It was an incredibly powerful family and parenting experience. My 4 ½ year old daughter had asked to go and see where George Floyd was killed by a policemen, because in her words, “That policeman didn’t agree with Martin Luther King Jr.” And, she wondered why he didn’t agree. As a parent, that’s a good question and one that’s hard to answer.
As we walked, I tried to read out loud the names of the people killed by police. "Breonna Taylor, Philando Castile, George Floyd...” The names went on for an entire block. Some from Minnesota, some not. Some stories I knew, others I did not. I ended up speaking a dozen names or so, randomly chosen by my ability to speak through tears.
“Did they all get hurt by the police daddy, like George Floyd?,” my daughter asked?
“They were all hurt by police, some in the way that George Floyd was, and some in other ways,” I said.
She saw me fighting my tears and said: “That’s enough daddy, you don’t need to read any more right now.”
We continued on our way, each lost in our own thoughts.
I encourage you during this Pride month, to demonstrate resilience in the face of adversity and enjoy fueling your human spirit with celebration. Participate in a Pride celebration in a way that moves you.
For me, I find myself moved to commit to strengthening our LGBTQ+ community and broader community by ending racist policies and actions in myself, my community, my work, and my country. I hope you may be similarly moved to do this with compassion and an understanding that we are not alone, we are not perfect, and that we can, despite the immense size of the task, succeed.
Happy and healthy Pride to you all!
