We're watching and we're worried: A future doctor urges med schools to keep teaching inclusiveness
When the government puts legal barriers in place to strip away or prevent health care access, it's not just politics — it's real people's lives at stake.
During the summer of 2024, countless transgender and gender expansive patients expressed to me fears about what might happen to their access to gender affirming medical care if a conservative administration were to win the White House. This worst-case scenario became reality in the first weeks of 2025, when President Donald Trump signed an executive order redefining legal gender identity as a strict binary of male and female — effectively erasing recognition of nonbinary and transgender individuals and interrupting federal funding to institutions providing gender-affirming health care.
As a transgender health program intern, I have seen providers try to reassure patients of their well-being and safety while they themselves fear how their job will be affected if the laws would drastically alter the way we practice medicine.
As a gay man about to enter the medical profession, I am afraid. The recent wave of anti-trans initiatives pushed by this administration is part of a much broader effort to dismantle diversity, equity, inclusion, and belonging (DEIB) programs across the country under the guise of 'restoring meritocracy' and 'leveling the playing field.' But in health care, the playing field has never been level. Minority populations continue to face disproportionate health risks and barriers to care.
DEIB is the foundation of medical education. It teaches future physicians how to address these disparities and combat the structural inequities that put vulnerable patients at risk. Studies show medical students have felt unprepared to manage transgender and gender expansive patients upon graduation. One study even claimed that only 27% of students were confident in their knowledge of the health needs of transgender patients. Beyond that, they could not correctly answer questions about race-related medical history despite affirming that understanding historical context is important in medicine. This lack of education was always a problem, and efforts were underway to solve it. Eliminating DEIB would not only erode this progress but set us back behind where we were even before we started.
In 2020, the American Association of Medical Colleges (AAMC) rolled out the Structural Competency Curriculum which aims to train providers 'to recognize and respond to the impact of upstream, structural factors on patient health and health care.' Since then, medical schools around the country have adopted the values of this curriculum and incorporated it throughout the course of their students' training. Health equity is a core pillar of medical students' professional development and should be embedded into the culture of patient-centric care.
When DEIB is dismantled, programs like these disappear, and awareness of health disparities among marginalized patient populations fades from the culture of those whose job is to provide the proper care and treatment.
If physicians are not trained on specific health risks that directly impact transgender patients, how can we provide adequate care? If we are not taught about racial health disparities, how will we work to combat them? If we stop prioritizing inclusion, how can we ensure equal health care for all?
Everyone deserves to be treated with respect and dignity. Legislation cannot change a person's identity, but it will change their access to health care. Medical schools need to teach this, and we as students want to learn.
Future doctors like me are watching everything that is happening, and we are worried. When students apply to medical school, the number one question they are asked is, 'Why medicine?' While the answer to this question can take many different forms, the bottom line is pretty simple: We want to help people. Medical schools can make a monumental difference in how future doctors navigate this political environment and provide care to patients. We urge medical schools to keep teaching us how to do that for all patients.
New Hampshire Bulletin is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. New Hampshire Bulletin maintains editorial independence. Contact Editor Dana Wormald for questions: info@newhampshirebulletin.com.
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