The US health care system* fails people of color on several metrics, including maternal and infant mortality, rates of chronic illness in youth and adulthood, and overall life expectancy.
Some of this is driven by poverty and lack of health insurance, which disproportionately affect Black Americans. Some is a result of decisions made by medical professionals, who are less likely to take seriously the symptoms of Black patients, especially Black women.
And some is attributable to the corrosive stress of dealing, day in and day out, with racism, in its individual and systemic manifestations.
Into the breach? “Do No Harm,” a lobbying group and think tank that’s been in the news lately for opposing gender-affirming care.
But only for trans people.
They have no beef with teenagers who get labioplasty, breast augmentation or reduction, tummy tucks and thigh lifts, chin and cheek implants, and botox: a quarter of a million procedures in 2023 (pdf: page 17). That’s in a year.
But trans teenagers, 13,994 of whom had gender-affirming care of any kind in the five years from January 2019 through December 2023 are the victims of “extreme gender ideology.”
As if the pressure to conform to gender norms isn’t ideology, or gendered.
“Do No Harm” was founded by a retired nephrologist, by the way. A kidney doctor. With an axe to grind, and no specialized training in psychology, social work, endocrinology, pediatrics, or any other profession devoted to the study of gender, or ideology, or young people.
Doctor Kidney’s mission: to drive “discrimination and division” out of health care — by opposing any initiatives to address gender and racial disparities in health care outcomes, clinical trials, medical school admissions, and hospital policies. Developing and supporting anti-trans legislation got added to the mix a year later.
Put another way: they want it to be illegal to think about including a diverse sample of the population in clinical studies. If women are excluded because “menstruation might mess up the results” or “they might be pregnant” — fine. If Black women are ignored in recruiting channels — fine.
Do No Harm claims its members “physicians, nurses, medical students, patients, and policymakers.” But the 21 members of the (all-white) team only include five with medical training, only one of whom is certified in psychiatry.
The director of outreach is an RN with a background in cardiac health, the gender ideology specialist is an oncology nurse, and the director of eliminating DEI is distinguished for getting fired when she refused to participate in bias training; her nursing experience includes home health care, hospice nursing, and emergency department work.
Just to be clear: diversity and inclusion efforts opened doors for women, Jews, African-Americans, Hispanics, and other members of the not-white-male majority to enter medical school.
They work to provide access to medical students from impoverished backgrounds: male or female, white or Black, and to make sure LGBTQ populations are comfortable accessing health care.
They push for including elderly people in clinical trials, so your grandpa won’t die from a medication that was only ever studied in young adults.
And they seek to analyze disparities in care that lead to dramatically distinct outcomes among different populations. Demographics, like those cited above, make clear the rationale for this. It’s not rocket science.
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Should you be tempted to check out the “Do No Harm” website, please note that it is full of misstatements and outright fabrications, including the claim that Europe limits gender-affirming care; their report doesn’t even mention Germany, which has explicit guidelines about caring for trans youth.
Also of interest: repeated warnings on the site that its contents “should not be interpreted as medical or professional advice.”
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*Health care in the US isn’t really a system; it’s a collection of often-competing, poorly integrated entities that individuals in need of care attempt to navigate at their peril. It’s three vulture capitalists in a trench coat fighting to extract every last penny from the business of selling drugs, diagnostic procedures, and doctors’ time.
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