Opinion | Doctors, Take Note: Pride Is More Than a Parade

This past weekend, I stood with my husband looking up into the sky. People packed the pier on the Wharf in Washington, D.C., as a rainbow of fireworks sparkled in the warm, June sky. Music played. People laughed and danced. “Pride” was in full swing, and I was proud.

But this year, Pride is different.

“Pride” represents much more than a parade and rainbows; it embodies the collective mantra of the LGBTQ+ community, encouraging unabashed dignity despite external judgments. Pride also serves as a reminder for healthcare workers to listen, learn, embrace, and understand the lived experiences of the LGBTQ+ people we treat and work with daily — a community that is scarred by significant healthcare disparities.

Today, Pride is more important than ever. For those outside the LGBTQ+ community, we need more than corporate logo changes, rainbow t-shirts, and LinkedIn posts. Allyship goes deeper. It means getting off the sidelines to address injustice and hate speech. It means changing the way we, as physicians and healthcare workers, practice.

There is plenty to do.

Since my childhood in eastern North Carolina, the nation has undergone significant positive transformations in support of the LGBTQ+ community. According to Gallup, support for same-sex marriage has risen from around 27% in the mid-1990s to 71% today. Substantial disparities in acceptance persist, however, and some politicians are actively aiming to create divisions among Americans over LGBTQ+ rights — despite the steadfast beliefs held by most citizens.

Discrimination also abounds in proposed legislation across statehouses nationwide and in Congress. The recent surge of anti-LGBTQ bills (more than 491) is nothing short of disheartening, and with the Supreme Court overturning Roe v. Wade, a looming threat to Lawrence v. Texas and Obergefell v. Hodges — the rulings that permitted same-sex intimate relationships and marriages — remains.

The legal situation is terrible, but the rhetoric used to promote certain policies is just as harmful.

As toxic rhetoric grows, violence toward the LGBTQ+ community soars. LGBTQ people are four times more likely to experience interpersonal violence than non-LGBTQ people.

Clinicians have a special role to play in combatting this hate. I know this from my own lived experience.

It wasn’t until I began medical school in the early 2000s that I embraced my identity as a gay man. Joining this diverse community has enriched my personal and professional lives while helping me stay informed so I can better serve my patients.

Prior to medical school, my understanding of homosexuality was limited to negative media portrayals and church sermons, as well as painful comments from friends and family. I stayed silent, burying my feelings and focusing on excellence in academics, work, religion, and music.

When I eventually came out in medical school at 23, it was very difficult to find allies and support — especially in North Carolina. Eventually, however, I found a supportive, chosen family. As I progressed through my career, I had attendings, nurses, friends, and family members who were affirming and supportive and served as mentors and colleagues. I hope I have carried forward the spirit of inclusivity.

But despite my personal and our national progress, assumptions and biases persist.

An example: A few years ago, I did a promo for my company. Getting into camera-ready position, I noticed the props team had placed a picture on the desk with my face superimposed on an image of what they deemed a “proper” family: a wife, husband, two kids, and a fluffy white dog. That family was definitely not my family.

Internally, I panicked, believing anyone who saw the video would assume this was an accurate representation. I also worried how I would be perceived if I pushed back. Would I be viewed as a stereotype? Sexualized? Thought of less as a leader?

I decided to speak up, pointing to the actual complexion of my family: I was gay, married to an amazing man, and had a Great Dane.

What if I was a patient and a healthcare provider made similar assumptions? “So, Adam, tell me about your wife.” If I was honest, would it affect my treatment? Perhaps. In some U.S. states today, citing “moral consciousness,” a physician or insurance provider can withhold treatment.

Clinicians must speak up. We cannot allow any patient, not one, to be treated as a second class citizen because of who they love. What’s more, by making assumptions about sexual orientation or gender, we cannot force LGBTQ+ people to endure a “coming out” moment every time they speak about their family or relationships.

I often hear assertions that we should teach “only medicine” in medical school, and avoid discussions about diversity and LGBTQ+ health. Some say, “Just treat everyone the same.”

We cannot. Each person is unique with a different set of lived experiences that contribute to their health. Let’s take one example: as a provider, would you treat a military veteran — someone you know has been through combat trauma — the same way you would a high school student from a placid suburb?

People are not robots or widgets in a factory. Connection matters to their health.

The ability to connect establishes respect and trust, fostering an open dialogue about our patients’ health and well-being. That’s why study after study demonstrates that connecting with patients improves outcomes. We must learn to listen and connect as humans with hopes, desires, and lived experiences.

We not only listen to patients’ heartbeats and the rhythm of their breath, but also their spoken words and most pressing concerns. Appreciating and understanding diverse backgrounds, health histories, and communities equips us to provide comprehensive care. Doing the same for LGBTQ+ patients specifically, reflects active listening as a crucial skill for healthcare workers including physicians, medical scribes, and surgeons.

As caregivers, it is imperative to foster a culture of empathy: promoting an environment where patients feel comfortable disclosing details of their personal lives and medical history without fear of judgment or discrimination. Regrettably, many healthcare facilities are perceived as unwelcoming or even hostile to queer individuals who may experience judgment, misgendering, or deadnaming while pursuing essential medical care.

This must change.

During Pride Month, all healthcare professionals must commit to better learning the experiences and needs of the LGBTQ+ community and to being sensitive to unique patient backgrounds — and maintaining these skills long-term. We must prioritize inclusivity and understanding, embracing the full spectrum of the human experience, and thus ensuring every individual — regardless of identity — receives care and compassion. It is our duty to listen, learn, believe, and support our patients so we can create a culture where everyone feels welcomed, respected, and valued.

Not just for Pride’s sake. Lives depend on it.

N. Adam Brown, MD, MBA, is a practicing emergency medicine physician, founder of ABIG Health, and a professor of practice at the University of North Carolina’s Kenan-Flagler Business School. Previously he served as president of emergency medicine and chief impact officer for one of the nation’s largest national medical groups.