On the Importance of Supporting LGBTQ+ Rights, Particularly Trans Rights
Thoughts on recent legislation and threats to the dignity and health of LGBTQ+ populations.
In 2018, Massachusetts voters were given an opportunity to repeal a state law which banned discrimination against transgender people in places of public accommodation. At the time, I wrote:
“The future of this law matters not just for the dignity of transgender populations, but for their health. Indeed, both dignity and health are linked; the latter cannot exist without the former. Marginalized groups, such as the LGBTQ community, face distinct health challenges as a result of the discrimination they too often face.”
In the face of a plainly discriminatory attempt to strip transgender individuals of basic civil equality, it struck me as necessary and right to speak as a community on behalf of health and dignity, and to endorse keeping in place a law that supports both. Fortunately, the attempt to repeal the MA law failed. After the failure of this effort, and after the broader gains in LGBTQ+ rights over the last few years—notably the embrace of marriage equality at the federal level and the Bostock v. Clayton County Supreme Court decision protecting gay and transgender employees from discrimination—it was possible to hope, perhaps naively, that it would be less necessary to have to argue against further attempts to marginalize this population. Sadly, this has not been the case.
We now see across the country a number of proposed and enacted laws which challenge the human rights of the LGBTQ+ community, and particularly transgender people. These include laws addressing when children can be given puberty blockers and surgeries, if at all, whether transgender athletes can compete in the categories which match their gender identity rather than their biological sex, and what can be taught to young children around issues of sex and gender identity in schools, as in Florida’s Parental Rights in Education Bill. At face value the issues addressed by this legislation appear to be complex, nuanced, with room for good faith debate. However, when one digs deeper, the impact of the legislation appears quite dark, creating a climate of fear for well-meaning teachers that they may be policed by their students, colleagues, and parents for making statements that are against the law, as well as contributing to even worse outcomes for the mental health of LGBTQ+ youth. There is no room in any debate to deny basic rights, or to attempt to roll back hard-won gains made in the effort to ensure everyone can access human rights and civil equality.
This calls on us to again affirm a central truth of public health: there can be no health without respect for the dignity and basic rights of populations. All efforts to deny members of the LGBTQ+ community their civil equality threaten to undermine health and should be opposed on that basis. I have often written about how bigotry and marginalization directed towards these groups threaten health, and how safeguarding LGBTQ+ rights is core to supporting the broader health of populations. This was the case in writing in favor of marriage equality, in addressing the link between supporting the dignity of transgender individuals and their health, and in arguing that LGBTQ+ health is inseparable from LGBTQ+ rights. I have written so often about these issues because they are, to my thinking, core to the work of public health, to our central mission of supporting the health of populations, particularly the vulnerable and marginalized, by creating the socioeconomic conditions for all to live healthy lives. We can accomplish this mission by making what was once acceptable unacceptable. For example, while we once lived in a society where discriminatory attitudes towards LGBTQ+ populations were broadly accepted, we have made tremendous strides towards making such attitudes unacceptable, and have eliminated, at the legal level, most, if not all, barriers to full civil equality for these groups. If we are to have a healthy country and a healthy world it is necessary that we do not reverse course on this overdue progress.
We can support this progress in two key ways. The first is by engaging in the debate over any legal measures that would undermine LGBTQ+ rights, using the public health tools of advocacy and activism to persuade voters and lawmakers to take the side of dignity and justice. The second is by continuing to be a community that welcomes all, guided by our core values of diversity and inclusion. At SPH, fundamental to our mission of building a healthier world is being the change we wish to see by living our values each day, as a welcoming, respectful community, where all can be seen, heard, and supported. In doing so, we are guided by science motivated by purpose and principle that aims to build a better future on a foundation of what was best about the past, while discarding the worst of prior eras, including the bigotry which long undermined the health of LGBTQ+ populations. Core to this liberal vision is the understanding that our laws and cultural norms should reflect the fundamental dignity of each human being. This means continuing to fiercely support the LGBTQ+ population, as we work towards a world where it is no longer necessary to do so.
Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Acknowledgement: I am grateful to Eric DelGizzo and Dean Julia Lanham for their contributions to this Dean’s Note.
A note that my previous writing on this issue, in case useful as a resource, is here:
And a note that two chapters in my book Healthier are about issues covered here.
Previous Dean’s Notes are archived at: https://www.bu.edu/sph/tag/deans-note/