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Health Equity & the Fight for LGBTQ+ Rights: It’s Personal

The LGBTQ+ community is facing an unprecedented degradation of their health equity and civil rights. Here’s why the time for silent support is over.
Megaphone and Pride colors

There’s an old saying that all health care is local. In today’s digital and post-pandemic world, where 50% of the nation’s patients used telehealth to access providers in 2021, it’s easy to believe otherwise and claim that patients are further from care. However, the sentiment is still spot on: All health care is personal. Think of local as simply a stand-in word, not meant to describe where people are seen but how they are seen.

Does that sound idealistic? If you’ve ever googled your symptoms and thrown yourself into a panic over how many serious ailments list coughing as an indication, you might have accidentally stumbled upon health care without personalization (chances are the only individualized aspect of your “keyboard physician” session was the ads served up to you). The reality is that all health care is personal because it can impact whether people live or not. You can be sure that’s personal to the patient.

At Avita, I’m proud to work with our partners at health centers across the country offering personalized and compassionate care that addresses the whole patient, including their physical, emotional, and sexual health needs. Not just some of the patients, but individuals from the most marginalized populations in our nation, people who have fought for understanding and health equity for decades. This includes a focus on and solidarity with the LGBTQ+ community, who face ever-increasing threats to their civil and medical rights.

Those threats are personal. Local.

The reality is that all health care is personal because it can impact whether people live or not. You can be sure that’s personal to the patient.

Are legislative determinants of health now a thing?

The talented professionals dedicated to serving local communities on behalf of Avita and our covered entity partners know that successfully caring for patients demands cognizance of the social determinants of health that affect their well-being. Whether these environmental factors are social, financial, or educational, they can overwhelmingly influence people’s access to life-affirming and life-saving care. Together, we address medication affordability, patient outreach and engagement, and improve access to quality medical care.

Yet increasingly, in 2023, these barriers are legislative. This year alone, the LGBTQ+ community has been targeted with more than 470 legislative bills that directly impinge upon their civil and medical rights.

I was drawn to working at Avita because the company and its partners encourage people to be their authentic selves. Yet, at times, I feel helpless as I watch initiatives being taken up nationwide that seek to push already stigmatized individuals to the margins. Attacks on sexual wellness education, sexual orientation counseling, gender-affirming care, and drag shows not only threaten to push the LGBTQ+ community into the shadows where they existed for so many years, but they also help ignite and amplify threats of physical violence against them.

It’s personal—in the worst way.

I was drawn to working at Avita because the company and its partners encourage people to be their authentic selves.

One step forward, two jumps back for LGBTQ+ care

For every achievement in health care equity and accessibility, a threat often exists to undo that success. This is nothing new; history is replete with such attempts to reverse leaps forward. To put this in context, over the last 40 years, being diagnosed with HIV has evolved from a death sentence to a health condition that can be successfully managed with access to proper holistic care. The development of the HIV prevention treatment PrEP (pre-exposure prophylaxis) can reduce the risk of getting HIV by up to 99 percent. Yet—in a thinly veiled (not to mention ignorant) attempt to target the LGBTQ+ community—the recent Braidwood v. Becerra ruling could curtail coverage of PrEP and other preventative health measures severely.

While gender-affirming therapy is proven to be life-saving care for transgender individuals of all ages, nearly half of US states have moved to restrict or ban this care, particularly for transgender youth. It’s a disturbing trend that threatens demonstrative and quantitative benefits for patients. A study by The Trevor Project shows that 50 percent of transgender and nonbinary young people seriously considered attempting suicide in the past year, a statistic the report clarifies is directly impacted by stigmatization and targeting of their health care rights, not because of their sexual orientation or gender identity.

In 2016, the U.S. Department of Health and Human Services published a final rule of Section 1557 of the Affordable Care Act that stated discrimination based on gender identity and sex stereotypes was prohibited in health care facilities, programs, and services. Now more than eight states have religious exemption laws on the books allowing medical providers to deny serving LGBTQ+ patients. Data from the Center for American Progress shows that this kind of discrimination and even “the potential for discrimination” can cause people in the LGBTQ+ community to avoid or delay seeking health care. Why are politicians and judges making medical decisions instead of experts?

Is this our personal best as a nation?

Why are politicians and judges making medical decisions instead of experts?

My role as a “silent supporter” is over

I keep asking myself the same question: What should I be doing? What should we be doing? At Avita, we can keep challenging ourselves to better meet the needs of all our patients and the covered entity partners that share in the care of those patients. In technology, we can continue to develop solutions that help coordinate care and deliver an easy and positive experience throughout the patient journey. It’s making a difference.

But what about those patients from the LGBTQ+ community facing the degradation of their medical and civil rights or threats of violence online or in their neighborhoods? What more can one do for them? Less abstractly, what more can I do? I can donate to causes. I can model tolerance. I can (and do) rock very cool Pride-themed kicks. All those things are good, but they feel insufficient compared to what we’re up against. Those actions make me feel like a silent supporter; none of them will convince a state legislature to let people in the LGBTQ+ community live in peace with a full complement of rights.

I’ve concluded that the best approach for me is loud, visible allyship. Those deeply involved in LGBTQ+ rights will lead the way, and I will support their efforts on multiple channels (this article is a step in that direction). I pledge to do my part to increase the visible numbers demonstrating broad and significant support for civil rights and to make sure that those who support LGBTQ+ rights—who believe in the right to be who you are and love who you love—are seen as the majority. I’ll be present, be local.

Because I’m taking it personally.

I’ve concluded that the best approach for me is loud, visible allyship.

Troy Polan Headshot

Troy Polan

Chief Information Officer, Avita Care Solutions

Troy sets the strategic vision and brings oversight to Avita’s technology teams. He is responsible for the long-term strategy for growth, setting clear priorities, and ensuring technology solutions continue to position Avita for success. Troy comes to Avita with over 20 years of experience in a variety of leadership roles. He recently served as the chief executive officer and chief technology officer at ExceleraRX, Inc., where he worked with the executive team and board of directors to develop innovative complex data solutions for the highest-performing network of health system-owned specialty pharmacies in the nation. Prior to ExceleraRX, Troy was vice president, technology and infrastructure at Phreesia, where he developed the infrastructure to manage a patient check-in platform serving millions of patients nationwide.

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