Advocating for the rights of our patients; core business
By Professor Brad Frankum, Chair of the AMA Working Group on Gender Identity and Sexual Diversity/ President of AMA (NSW)
“Get back in your box”, “it’s not your place”, “look after your own backyard” are just a few of the responses slung our way when our position statements dare to venture beyond the biomedical realm. I like to see it as a sign of defeat; your critics cannot provide a rational rebuttal to your stance, so instead, they question your right to take it. I am sure that the AMA coming out in support of marriage equality is likely to elicit similar responses, and I, for one, am ready.
I do not pretend to know how much courage it takes to place your hand in the palm of your partner’s and walk down the street, knowing full well that your simple display of affection may be met with absolute contempt or even violence. I could never understand how exhausting it must be to have to censor your every word to ensure that one of the most significant parts of your identity remains concealed from relatives and colleagues alike. I have never had to fathom what it must be like to live and grow beside someone for decades without ever having the opportunity to formalise your commitment to them, with the full blessing of the law of the land and the people you love.
What I, and hopefully all Doctors, can understand is the tragic consequences of these realities. It is evident in the suicide rate of LGBTIQ people just as clearly as it manifests in the mental illness and substance abuse patterns among LGBTIQ populations. All of the evidence points to a need for change.
Many opponents of marriage equality question the significance of the impact of marriage denial, particularly when a civil union provides many of the legal benefits of a marriage. I cannot fully explain the reasons that the right to marry is so significant for LGBTIQ people, nor do I believe that it can ever be fully understood by somebody for whom marriage was a simple birthright.
The United States achieved marriage equality incrementally; initially deemed to be the responsibility of individual States, different jurisdictions arrived at marriage equality at varying points. The inconsistency in access to marriage rights for LGBTIQ Americans essentially laid the foundations for the perfect social experiment. We now know that health outcomes and access to healthcare improved significantly for LGBTIQ individuals who lived in states that had legislated for marriage equality. All things being equal, access to a simple piece of paper made the world of difference to thousands of LGBTIQ Americans.
Thankfully, the marriage equality social experiment in the United States came to an end in 2015 when the Supreme Court ruled that the US Constitution provides same-sex couples the right to marry. I have not travelled there recently but I hear that the sky has not fallen in.
I am proud that the AMA has taken a stand to support marriage equality and when the detractors come, I am armed and ready with a slew of peer-reviewed, empirical and anecdotal evidence to justify our reasons for doing so. LGBTIQ people are telling us that this is important to them, and we need to start listening before we lose any more young lives to suicide.