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15 Jun 2017

By Rob Thomas, President Australian Medical Students’ Association

As a young gay man in the 21st century, I recognise the relative ease of my existence in expressing my sexual identity, compared to the previous generations. It’s amazing to think how just a few short decades ago, open discrimination and jail terms were common for those in the LGBTIQ community in Australia just for their normal expression. Nevertheless, there are still steps to be taken when it comes to equality in this area, and marriage equality is just one of those necessary steps.

Recently, a lot of heat has been generated surrounding a prominent retired Australian tennis player’s boycott of Qantas for supporting marriage equality. Her opinion, though she is entitled to expressing it, is potentially damaging to the LGBTIQ minority, as it reinforces harmful views that these people are “abnormal”, or “morally wrong”. Even in our more progressive existence nowadays, I have known people that have been bullied, shunned and even physically threatened for being gay. It’s something that health professionals need to be aware of, and need to learn to combat.

My own experiences of LGBTIQ teaching in medical school have so far been somewhat lacking. I note that out of around 100 PBL (problem-based learning) cases in my preclinical years, only one centred around a gay relationship, and this was in the context of a cheating husband with an STI. While I don’t deny that this sort of case is an important consideration, I don’t see it as the norm in homosexual relationships. Little teaching was provided in terms of communicating with people of non-binary gender or diverse sexual orientations, and for some of my colleagues, I worry that their lack of exposure could lead to issues in communicating with patients.

In my rural term, it was amazing to see the community’s reaction (or non-reaction) to all things LGBTIQ. When I asked the town’s doctor if there were any LGBTIQ-identifying patients out of a pool of more than 1,000, I was surprised to hear there supposedly weren’t any. I can’t imagine the stigma that must still exist around being gay in some parts of the country, and for me it explains the gap in mental and physical health outcomes for sexual minorities.

Regardless of our personal opinion, as health professionals it is our duty to be accepting of our patients and provide a safe space for adequate history-taking and harm minimisation. The first step is learning the language – including the difference between sex, gender identity, and sexual attraction. Some moves to consider include incorporating non-binary gender identification on forms, and learning to be comfortable asking non-judgemental questions. Beyond that, it is our duty to speak up when significant social issues impact severely on our community’s health.

I was incredibly inspired and proud when the AMA released its position on Marriage Equality. It recognises that this institutionalised discrimination has a serious effect on the mental health and health access of LGBTIQ people. While it is not just a health issue, the health impacts are undeniable, and I hope give rise to the Government taking action.

Thanks to decisive action, gone are the days where being gay is considered illegal, immoral or a mental health condition. With further action I believe we can achieve health equality for those in the LGBTIQ community, by addressing the larger social determinants of health.

Twitter: @robmtom 

Published: 15 Jun 2017