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AMA Begins to Tackle LGBT Issues
by Marie-Jo Proulx
2005-07-06

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At its Annual Meeting of June 18-22, the Chicago-based American Medical Association ( AMA ) debated a small number of LGBT-related resolutions. While some were rejected and others were weakened by amendments, the few that were adopted signal a modest but significant move toward an acknowledgement of the LGBT community's healthcare needs.

Out of the more than 150 resolutions considered, a handful were of interest to LGBT doctors, medical students, and patients. Each resolution was first discussed and re-drafted by one of eight reference committees before being sent for a vote to the entire House of Delegates on the meeting's last days. In these committees, doctors speaking either on their own behalf, or as a representative of a state delegation or medical specialty, were allowed to comment on all aspects ( spirit, title, language, intended benefit, potential harm, etc. ) of the resolutions.

It is following this stage of the process that additional amendments are crafted and entire resolutions can be either withdrawn or fused with others. Such was the case of Resolution 409, which called for the AMA to 'educate the public and our legislators of the negative medical aspects of the Defense of Marriage Act.' It was introduced by the Wisconsin Delegation and cited issues like hospital visitation rights and insurance coverage. The American Academy of Pediatrics, whose representative was especially concerned with the legal disadvantages facing children of same-sex couples, strongly supported a resolution that would advocate for equal protections. But delegates from Ohio and Florida voiced their opposition to any explicit reference to DOMA, saying it would place the AMA at odds with a policy of the Bush administration. A delegate from Tennessee invoked last November's 11 ballot initiatives against gay marriage before declaring that defending LGBT rights was not the business of the AMA.

As a result of this input, 409 was replaced by Resolution 445, entitled 'Health Disparities Among Gay, Lesbian, Bisexual and Transgender Families.' As later adopted by the House of Delegates, 445 recommends that the AMA 'work to reduce the health disparities suffered because of unequal treatment of minor children and same-sex parents in same-sex households … .' A second component that called on the AMA to 'speak up for the health care equality of same-sex partnered families when laws or constitutional amendments are being considered that would prohibit civil unions or domestic partnerships … .' was unanimously rejected.

Also regarding disparity, earlier this year, then AMA President Dr. John Nelson sparked a controversy when he declared that a New York state medical college was within its right to ban an LGBT student group. The Gay, Lesbian Medical Association ( GLMA ) reacted by asking to meet with Dr. Nelson in order to explain the detrimental effects of his remarks on LGBT medical students, doctors, and patients. Following the GLMA-AMA encounter in March, a joint statement was released in which the AMA announced it would 'seek to broaden the scope' of its already existing Commission to End Health Care Disparities to include LGBT concerns.

The Commission had been set up in conjunction with the National Medical Association ( NMA ) , the country's largest organization of African American doctors, and the National Hispanic Medical Association ( NHMA ) . Some observers, both within and outside the AMA, were skeptical at the time that the association would convince the NMA and NHMA to focus on LGBT as well as ethnic and racial disparities. After some probing, it was revealed at the end of the Annual Meeting that the request to integrate an LGBT perspective was indeed turned down.

On the specific topic of medical education, the AMA's Resident and Fellow Section introduced Resolution 323, which directly speaks to the practice of banning LGBT or other student groups. It is unequivocal in its support of the right of students and residents to form associations and 'meet on-site to further their education … without regard to their gender identity, sexual orientation, … .' By adopting Resolution 323, the AMA has acted decisively to counter the appearance that it may have tolerated discrimination against LGBT medical students.

Resolution 314, 'Improving Sexual History Curriculum in the Medical School' was presented by the New York Delegation. It aims to make the next generation of doctors more comfortable when discussing sexuality with patients. First, it encourages all medical schools to train students 'to take thorough and nonjudgmental sexual history in a manner that is sensitive to the personal attitudes and behaviors of patients … .' Second, it recommends that the AMA 'support the creation of a national public service announcement' that would foster better doctor-patient communication on matters of sexual health. While LGBT people would not be the only group to benefit from physicians' increased awareness and understanding of their particular sexual health circumstances, it is believed that, at least in certain rural areas, an open-minded and well-informed doctor can reduce the stigma experienced by LGBT individuals seeking medical attention. The status of Resolution 314 was temporarily in doubt as it was not clear whether it had been withdrawn. In the end it was adopted.

The Medical Student Section submitted Resolution 511, which asked the AMA to promote the use of FDA-approved Rapid HIV Tests ( like OraQuick ) . After a provision was added stipulating that testing as well as pre- and post-test results counseling be done in accordance with Center for Disease Control and Prevention ( CDC ) guidelines, Resolution 511 was adopted.

Finally, the AMA's new Advisory Committee on GLBT Issues elected its seven members at the start of the Annual Meeting. A family physician and PFLAG dad from Madison, Dr. Paul Wertsch, and a member of GLMA from Atlanta, Dr. Jason Schneider, were respectively voted Chair and Vice-Chair. Asked what will be the committee's first tasks, Schneider mentioned putting LGBT health resources for doctors and patients on the AMA Web site; starting a list-serve on LGBT issues within the association; organizing information forums at the AMA's Interim Meeting ( Dallas, in November ) ; and reaching out to straight allies in the wider medical community.

The committee is also composed of three other male physicians, a woman physician, and a M2F transgender physician. Unfortunately, especially in light of CDC findings on the disproportionate number of HIV-AIDS cases among African Americans, there are no members of visible minorities on the committee. It has a two-year mandate.


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