Should medical professionals wear symbols of support for diverse populations?

Recently, I raised the idea of medical providers wearing an LGBTQ+ pin on their white coats as a show of support for a marginalized and discriminated group. Since I was sharing this idea online, I was prepared to receive some negative comments about my suggestion. What I wasn’t prepared for was that some of the opposing comments would make me reflect on the idea that it is OK and helpful to wear a supportive pin.

I realized that this issue is more complex and nuanced than I initially thought and is in fact a gray area. I started to research and read about both sides of the argument. In this article, I will present both perspectives, allowing you to decide on the course of action that works best for you.

It is important to note that while this article focuses on the LGBTQ+ pin as an example, the broader issue is the concept of showing support for any minority group.

Opposing arguments

Impartial care

As doctors, we all accept to take on the white coat. That coat symbolizes se abre en una nueva pestaña/ventana our professionalism, the trust our patients put in us, and our willingness to take equal care of every patient. By attaching to the white coat any type of symbol that supports or opposes a specific religion, race or minority, we are taking away the neutrality medical providers are generally seen to have towards their patients. Medical providers should always treat everyone equally while remaining impartial, and there is no need for an outward display to show that.

Politics and medicine

Speaking of the example of the LGBTQ+ pin, such a pin can be perceived as a political statement. As the writer of this article, who identifies as part of the LGBTQ+ community se abre en una nueva pestaña/ventana, I had a problem understanding this point. How can sexual orientation — or a community and our display of support for it — be seen as a political statement? A discussion with a couple of medical providers helped me understand this point better.

I believe we all agree that politics and medicine should never mix. The hospital should always remain impartial; it should always be a safe place for anyone who seeks medical attention. If we agree on this point, we can continue to the next point.

The LGBTQ+ community is not inherently political; however, some people believe that the LGBTQ+ topic plays a part in the political stage. There are politicians and political parties who have built their main campaigns around LGBTQ+ issues. In addition, a 2020 Williams Institute report se abre en una nueva pestaña/ventana states that out of the LGBT adults who are registered to vote, 50% are Democrats while only 15% are Republicans. That means that an LGBTQ+ pin may be associated, in some people’s minds, with left-wing political groups.

The main reason some medical providers oppose a display of support for any minority has to do with the possible chain of reaction such a pin might cause. This small act of support can pave the way for healthcare providers to show their support for other issues or movements, such as Black Lives Matter   (BLM), and it can veer off to extremely controversial topics like displaying support for political parties or even their position on abortions. No matter what pin medical providers choose to display on their coat, some patients might feel negatively affected by it, which may lead to a less than ideal visit.

According to the 2020 Williams Institute report, more than half of LGBTQ+ Republicans   do not feel a connection with the community. While this is a small minority of the LGBTQ+ population (7.5%), this suggests that a display of support may not create the intended effect of making all LGBTQ+ individuals feel more comfortable and open to sharing.

Supporting arguments

Medical providers as role models

Medical providers are often respected and even admired by the general community. This respect and admiration allows us to influence people inside and outside of the hospital. While we are not politicians and should never use our influence in any political way, should we not use our place in the community to promote information and values that can help our society become more accepting and understanding?

Have we not been using our influence and reach to debunk the myth regarding HIV being a gay-only disease? Have we not been using the same influence now to educate the public about the importance of wearing a mask and getting vaccinated against COVID-19? By wearing a supportive LGBTQ+ pin, we can show our support to a discriminated minority group and help lead a positive change in our society.

Bringing back our patients

Unfortunately, people from the LGBTQ+ community and other minority groups still suffer from stigma and discrimination by medical providers. This is especially true for transgender patients se abre en una nueva pestaña/ventana. People from the LGBTQ+ community may   avoid coming to the hospital se abre en una nueva pestaña/ventana because of previous mistreatment. Even those who do come might sit across their medical provider and wonder how much they can share yet avoid outing themselves. This can lead to patients not sharing relevant medical information because of embarrassment and fear of a medical provider’s reaction. For instance, an MSM patient (a male who has sex with other males) may not mention a sore he has around the anal region. That patient might be embarrassed and afraid to mention the sore and its implications (having anal sex, a “homosexual” activity), but by withholding that piece of information, he might be misdiagnosed and not treated for syphilis.

We medical providers share the inner knowledge that we will take care of every patient to the best of our abilities, regardless of who they are. But the patient doesn’t necessarily know this. An outward display of support is a simple, easy and effective way to show our patients that they are in a safe and accepting environment. Even if a patient sees one medical provider wearing an LGBTQ+ pin, it can change their perception regarding the whole place.

Finding the right provider

Any display of a belief or opinion will always cause some reaction in someone else. A medical provider displaying a BLM pin or an LGBTQ+ pin can make some patients more at ease while putting others on edge. As an example, imagine you are a person of color or a transgender person; both are in minority groups that are commonly mistreated se abre en una nueva pestaña/ventana. Not knowing how you will be received by the medical staff can be very stressful and lead to an unpleasant visit even if nothing bad happens. For these minorities, finding the right medical provider can range from hard to impossible since there is no way of knowing beforehand.

An outward display of support may make a big difference; it may help people open up and share their problem, which will in turn help us give them the best care possible. On the other hand, a patient who feels so uncomfortable by the display of an LGBTQ+ pin that they wish to change their medical provider will probably have an easier time finding someone without any outward displays of support.

Here are a few suggestions for this specific dilemma:

1. My dream is that in the future, hospitals and medical clinics will reflect the same diverse interior I see in many clothing stores. This means featuring diverse patient images on the walls, just like some clothing stores show models from different ethnicities on their walls. While I work towards making this into a reality, in the meanwhile I will show my support by wearing an LGBTQ+ pin to help create a more comfortable environment for my patients.

2. Wearing a pin isn’t the end! It should signify that you have taken the time to educate yourself on the best practices when treating patients from different groups. Encourage your colleagues and friends to join you in leading the change in your community by educating themselves as well. To get started, consider reading this article about the specific medical needs of the LGBTQ+ community se abre en una nueva pestaña/ventana, which I co-wrote with Dr Roy Zucker, the first to specialize in LGBTQ+ health at the Icahn School of Medicine at Mount Sinai.

3. Learn more about the experiences of different groups. You can start by reading the following Osmosis articles:

   • Say My Name: A Medical Student’s Experience with Microaggressions se abre en una nueva pestaña/ventana

   • An LGBTQ+ Student’s Perspective on Medical School se abre en una nueva pestaña/ventana

   • Words Matter: The Power of Inclusive Language in Medicine se abre en una nueva pestaña/ventana

4. Respectfully educate medical providers who have acted in a discriminatory way.