Accomplices and Allies: How to Improve LGBT Health Care Education

To address LGBT health disparities and the educational programs and policies directed towards addressing these inequities, we must often rely on the endorsement of institutional allies–those persons who support LGBT people and equality. Allies are open to learning and seeking greater understanding, have a willingness to help LGBT people feel supported and included, and verbalize support for addressing barriers in their various forms. While allyship is valued and appreciated, however, what are really needed are more accomplices.

In the context of efforts to advocate for diversity, equity, and inclusion, accomplices don’t merely support policies but are willing to take action to ensure that a community is safe from physical, verbal, and emotional abuse. Being an accomplice requires more than listening and attending required human resources training. An accomplice is willing to act with and for marginalized persons even if that means suffering personal or professional consequences.

Moving towards becoming an accomplice requires deliberate action, and that may mean taking a step outside of one’s comfort zone. If your organization doesn’t offer LGBT health and advocacy programming, take the initiative to invite speakers from the community to educate and offer opportunities for engagement. If there is LGBT programming, reflect on how representative and inclusive it is for people of color. Rather than simply acknowledging the significance of racism in regards to the structural and social determinants of health affecting members of the LGBT community, an accomplice seeks to be at the forefront of elevating the voices of the most marginalized. Accomplices can seek to support the work of their respective organizations from within as well as look outward to engage stakeholders and community members.

Being an accomplice requires more than listening and attending required human resources training.

It is important to remember that accomplices build trust not by leading but by actively listening, respecting the pluralistic perspectives of others, and being accountable for their own privilege. The role of an LGBT accomplice must also include intervening and confronting homophobic and transphobic harassment and microagressions when they occur, regardless of the offender or their status within the institutional hierarchy. 

Being an accomplice isn’t just about impacting the day-to-day experiences of colleagues in our workplaces and students in our academic centers, but also our patients and the communities we serve. Any conversation regarding the health needs of LGBT persons must include an understanding of the history of oppression and discrimination directed towards members of these communities. We know through health disparities research that such harmful experiences lead to poorer overall health for LGBT patients as compared to their heterosexual and cisgender peers. Discriminatory behavior from our fellow health professionals, whether manifested in internalized or external homophobia, transphobia, gender bias, or simply a lack of awareness built on positions of privilege exacerbate barriers to respectful, person-centered, quality care. Intersectional influences of race, ethnicity, culture, disability, socioeconomic status, as well as pervasive structural and social determinants of health necessitate greater efforts toward developing and implementing LGBT curriculum and institutional policies across all health professions. 

Accomplices build trust not by leading but by actively listening.

Identifying as an ally should be welcomed as a genuine acknowledgment of support for LGBT persons, but it is also a more comfortable position of privilege. In order to break down barriers and work towards equitable treatment, allies must evolve to being accomplices.

This call to action is not limited to our cisgender and heterosexual colleagues. Within various LGBT communities there is also sexism, misogyny, transphobia, racism, ableism, classism–all threats to equality that we look to dismantle. If we are to ask cisgender and heterosexual allies to take a step towards being accomplices, then members of the LGBT community must take that step too.

Health professionals have much more work to do toward providing equitable, high-quality, person-centered health care to all patients and especially those most marginalized and underserved. When we are ready to be accomplices for one another, we can create a path for our allies.

Patrick D. Herron, D.Be.

Dr. Herron is Director of Bioethics Education and Chair of the LGBTQIA Health Curriculum at Albert Einstein College of Medicine. He is an Associate Professor in the Department of Family & Social Medicine and an Associate of the Montefiore Einstein Center for Bioethics.

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