LGBT PEOPLE IN MEDICINE:
THE IMPORTANCE AND
NECESSITY OF INCLUSION
E. Cabrina Campbell, M.D.
Associate Professor of Psychiatry
Perelman School of Medicine
University of Pennsylvania
NAMME CONFERENCE 02/18/12
EMBODIMENT OF DIVERSITY
African American
Woman
Lesbian
Inter-racial Relationship
Bi-Racial Daughter
Founding Member of LGBTPM Faculty/Staff at Penn Med
LGBTPM Symposiums
• 2008
• 2009
• 2010
Sallyann Bowman, M.D. University of
Pennsylvania, School of Medicine
“Career Narrative”
Katherine A. O’Hanlan, M.D. Gynecologic
Oncologic Associates (Formerly at Stanford)
“LGBT Health: The Medical is Political
Robin Williams, M.D. (then Penn Med
Student)
“My Right Self”
Importance: Human Rights in America
• Personal Autonomy
• Marriage
• Non-discrimination
Housing
Education
Employment
Military service
Necessary Inclusion:
LGBT RIGHTS ARE HUMAN RIGHTS
INTEGRATION INTO THE MILITARY
• Blacks
1948
• Women
1948
• Today, the President signed into law a bill which lifts the current ban
on homosexuals serving openly in the U.S. Military. During a signing
ceremony at the Interior Department in Washington, D.C., President
Obama said he is proud to sign the bill, which he says will strengthen
national security. President Obama has been dedicated to lifting the
ban on homosexuals serving openly in the military, since the
beginning of his presidential campaign. Dec 22, 2010
DOMA Impact on LGBT Families
• Couple receives SSI in the amount of single person only.
• Cannot file a joint tax return
• Cannot have partner immigrate for citizenship
• Cannot receive SSI support when partner dies
• Children cannot receive SSI if earner dies or becomes
disabled
• Cannot bring body home from most states
• Estate taxed at 55% before domestic partner inherits it
Marriage Benefits Health
• Marriage confers stability on the home, gives children
security in their identity.
• Marriage is correlated with reduced rates of cardiac
disease and cancer
• Marriage is correlated with with greater longevity.
Gardner J, J Health Econ. Nov 2004;23(6)
Janicki DL,. Psychosom Med. Nov-Dec 2005;67(6)
King M. J Epidemiol Community Health. Mar 2006;60(3)
What do we want for our family?
• Safety from violence
• Quality education
• Job security
• Serve our country (military)
• Marry loved one
• Financial security for family (health insurance, social
security, pension)
• Age through a healthy, contented life
• Equal treatment under the law
Importance: Experienced Discrimination
Kaiser Foundation Survey revealed that LGBT
• 74% Have experienced verbal abuse.
• 74% Have experienced discrimination in job, housing,
healthcare, military.
• 32% Have experienced physical violence.
• 39% Are worried about being assaulted or beaten.
Kaiser Family Foundation Report, Nov. 2001 KFF.org
Discrimination leads to Reduced Quality
of Life and Psychiatric morbidity.
• N=2,917 adults:
• 42% of LGBT reported anti-homosexual discrimination
with twice the rate of anxiety(panic), depression,
substance abuse.
• 58% reporting no discrimination did not have these
psychiatric problems (normal profile)
Mays & Cochran, Am J Public Health. 2001 2001
Discrimination
• Experiences of oppression lead to social alienation, low
self esteem, and increased risk of STD’s, drug abuse
• N=912 Gay men
17% had suicidal ideation
44% reported anxiety
80% had depressed mood
• In every analysis, the only predictor of mental illness was
experience of social discrimination
Diaz RM, et al Am J Public Health. 2001
Impact of Stigma on Development
• Stigmatized youth report no models for successful aging,
relationships, and parenting
• Restricted perceptions of career options
• Limited in self-care, help-seeking & health promotion
behaviors
Ryan & Futterman, 1998
Risk factors for Suicide Among Gay
Lesbian youth < 20 years old
• Discovering early in adolescence.
• Rejection by family members.
• Rejection by faith organization.
• Experiencing violence due to orientation.
• Having multiple socially marginalized statuses, e.g. race,
ethnicity, and sexual orientation, depression
Bagley & Tremblay, Crisis 2000;21(3):111-7.
Reparative therapy is contraindicated
Reparative therapy aimed at changing an individual's
sexual orientation, has been found to be:
• Ineffective no therapy works
• Unethical to treat a normal sexual variant
• Harmful
stigmatizes the individual
• Need
acceptance by society
American Academy of Pediatrics: Pediatrics, 1993
American Psychological Association, 1995
American Medical Association, 1995
Diversity in the 2010
Penn Med Entering Class
Underrepresented in Medicine
25%
Economically Disadvantaged
19%
Asian
18%
Post-Bac
14%
Non-Science Majors
38%
Non-Traditional
68%
0%
20%
40%
60%
80%
Current State LGBT Education
85% Response from medical school deans
• Median total time 5 hours often preclinical yrs
• Wide variation of 0-32 hours
• Only 24.2% rated their coverage “good” or “very good” on a 5category Likert scale
Obedin-Maliver et al. LGBT Content in Undergrad Med. Edu. JAMA,
September 7, 2011—Vol 306, No. 9.
Be Part of the Solution
Include sexual orientation in non-discrimination policy:
Diversity is a defining feature of an eminent medical school. The Perelman School of
Medicine at the University of Pennsylvania embraces diversity and inclusion as core
values. We are committed to the recruitment, retention, promotion and advancement of
faculty reflecting a multitude of ethnicities, races, genders, gender identities, sexual
orientations, historical traditions, ages, religions, disabilities, veteran status, and
socioeconomic backgrounds. We are dedicated to enriching both depth and breadth of
backgrounds, experiences, perspectives, and ideas represented in our institution to
strengthen the quality of the education, produce innovative research and deliver the
healthcare to increasingly diverse local and global communities. By fostering a vibrant
and dynamic environment of inclusion, the Perelman School of Medicine will continue to
welcome opportunities to address challenges and excel in academic medicine.
Equal Human Rights is Essential for
Excellent Healthcare
• Find your strength in love