LGBTQ+ patients face tremendous challenges in navigating our health system because of systemic barriers fueled by malignant narratives that undermine equity for the LGBTQ+ community. Research shows more than 70% of LGBTQ+ youth have reported discriminatory behavior, including from health professionals, and roughly one in five LGBTQ+ adults say they avoid medical care due to fear of discrimination.
To create a more equitable future in health care, our path forward seeks to pivot from ambivalence to urgent action in the prioritization of voices and opportunities for people, like our LGBTQ+ community, who have been historically excluded and deprived of resources. We commit to accountability toward the goal of eliminating these inequities, which are systematic and preventable as well as emotionally, mentally and physically harmful.
A new effort by the AMA Foundation (AMAF) is fully aligned with the strategic efforts of the AMA to eliminate inequities throughout health care. The AMAF is helping to create a more diverse network of health care providers who can deliver compassionate, safe and LGBTQ+-informed care as part of its newly launched National LGBTQ+ Fellowship Program.
As the inaugural recipient of a $750,000 grant award, the University of Wisconsin–Madison will strengthen its leadership and efforts to eliminate inequities and boost health outcomes of LGBTQ+ patients. This interdisciplinary fellowship in the UW School of Medicine and Public Health will draw support from a network of institutional and community leaders with expertise in LGBTQ+ health while emphasizing clinical, educational and research initiatives.
The goal is to equip medical professionals with the tools to provide LGBTQ+ individuals with quality care, empathy, and dignity by creating a pipeline of health professionals with the necessary training, skills and experience to do so.
The inaugural fellowship grant to UW–Madison seeks to address the specific drivers of health that shape LGBTQ+ patients’ experiences in our health system. The National LGBTQ+ Fellowship Program will help medical schools and other institutions from coast to coast to develop multidisciplinary standards of care and clinical best practices for LGBTQ+ health, as well as provide improved training for the hundreds of fellows who will help shape the next generation of physician leaders.
The task we face together in this undertaking is extremely challenging. Research has demonstrated that barriers posed by intersectional issues of discrimination, stigma, access to care and quality of care affect LGBTQ+ patients to a greater degree than other population groups. The problem is compounded by a shortage of physicians and other health professionals who have received specialized training to care for members of the LGBTQ+ community.
Additionally, policies and laws that limit or blatantly deny care based on sexual orientation, gender identity or related characteristics inflict even more harm and perpetuate the cycle of trauma. As they occupy multiple marginalized identities and thus exist at the intersection of several systems of oppression, LGBTQ+ individuals who are also members of other marginalized and minoritized communities—such as LGBTQ+ people of color and LGBTQ+ people with disabilities—face exponentially worse outcomes.
The launch of a single fellowship program cannot resolve these injustices. However, it is a meaningful contribution toward progress and building a more equitable health care system. This initiative serves as an extension of the AMA’s strategic plan to embed racial justice and advance health equity, was announced earlier this year.
Fulfilling the AMA Code of Medical Ethics—and the AMA’s mission of promoting the art and science of medicine and the betterment of public health—demands that we embed equity in our processes and actions, that we strive to address all determinants of health, and that we honestly reconcile with the past and present harm we have caused by deliberately failing to do these things.
As the philanthropic arm of the nation’s largest and most influential physician organization, the AMAF has awarded more than $120 million in grants and scholarships over the past 70-plus years to advance public health and improve medical education.
This fellowship is guided by the LGBTQ+ Honor Fund Founding Donors and the AMAF Fellowship Commission on LGBTQ+ Health. The latter group includes a cross-section of physicians, LGBTQ+ thought leaders, experts in education, and others led by John D. Evans, the noted philanthropist and business executive who co-founded C-SPAN in 1977. If you are interested in partnering with the AMA Foundation on this important initiative, please email Sandi Smith.
This inaugural fellowship will create pathways to better leadership, advocacy and collaboration while setting the stage for meaningful change in the months and years ahead.