Be Your Authentic Self: LGBTQ+ Leadership in Public Health

June 27, 2023 | ASTHO Staff

pair-behind-wrapped-in-pride-flags-at-festival.jpgJune is Pride month and is an opportunity to support, honor, and celebrate the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. There is a strong LGBTQ+ representation within the public health workforce, and ASTHO’s Diverse Executives Leading in Public Health (DELPH) program has a specific focus on increasing the leadership profiles of LGBTQ+ leaders.

In this blog post, ASTHO explores authenticity in leadership—what does it mean, what does it take, and how do leaders show up for the LGBTQ+ community. Further, ASTHO’s DELPH scholars will share personal reflections about their identity, experiences, and representations at work and how critical allyship within public health leadership is in responding to a crisis.

What does it mean to you to be “out” at work?

I strive to show up as my authentic self every day, so it has always been important for me to be out in the workplace. After finishing my graduate degree, I worked at an LGBTQ+ youth center in upstate New York. At that time, I identified as gay, and as soon as I walked in the door, I knew it would be important for the young people I served to see what a gay adult looked like. Given the staggering rates of violence our community faces, I believed that seeing an openly gay adult would make a difference in the lives of young queer people. I would have loved to see queer adults in my life as a young person, so I could know it was possible to have the life I dreamt of. By starting my professional journey as an out queer professional, I set the tone for my work moving forward.

Share a time when you showed up as a leader for the LGBTQ+ community in public health that benefited health outcomes for the community.

In May 2022, I learned about the cluster of mpox cases among gay, bisexual, and other men who have sex with men in the United Kingdom. These cases were unusual because the individuals had not traveled to areas where mpox was endemic, and many were seeking care at sexual health clinics. Recognizing the parallels with the HIV epidemic in the 1980s, I understood the need to include representatives from the LGBTQ+ community to effectively respond to an mpox outbreak in California. Because of my role and experience within the Sexually Transmitted Diseases (STD) Control Branch at the California Department of Public Health, I was asked to serve as a core team member responsible for leading the mpox response if cases arose in California.

Throughout my involvement, I realized the significance of being the only openly gay man of color on the response team. It highlighted the absence of LGBTQ+ representation on the team and emphasized the importance of incorporating diverse voices, perspectives, and lived experiences.

Both my professional and lived experience being part of the LGBTQ+ community helped California employ effective strategies for its mpox public health response that resulted in better outcomes. We utilized social networks and trusted messengers within the LGBTQ+ community to disseminate mpox-related information. Additionally, we prioritized vaccination for high-risk individuals while pushing for equitable access for Black and brown individuals within these communities. With my involvement and efforts, we organized vaccination events at bathhouses and LGBTQ+ Pride events.

I firmly believe that including individuals from the affected communities in leadership roles is crucial for achieving the best health outcomes. As the newly appointed mpox lead for the California Department of Public Health, I am dedicated to representing and centering the views of the LGBTQ+ community in our efforts to combat mpox, HIV, and other STDs.

I have tailored my focus to ensure my department is inclusive when we talk about people, specifically in the parenting space. For instance, there has been a tendency to speak in gendered terms, such as “mothers” and “fathers,” leaving little accounting for same-sex couples, transgender, and otherwise gender-nonconforming parents.

I mentioned to my leadership the importance of both validating parents who identify as mothers while being mindful to include people who prefer to be called a “parent," "birthing person,” or a “gestating parent,” did wonders of linking people to resources, and to care during such a vulnerable time.

Inclusive language in our print and web media—how we reference gestating parents in our data and making sure to include people who chest-feed in our information about breast- and chest-feeding—is a small but impactful change I have been glad to influence at our department. Health equity has to be inclusive of all people—of all races, abilities, gender, and sexual identities.

What challenges have you faced with inclusivity in the public health workforce?

I came out as non-binary and shifted my pronouns to they/them shortly into my tenure at my current public health agency. At the time, I was working specifically in an LGBTQ+ program, and it felt easy to do so. I quickly learned that navigating settings outside of queer spaces would be a whole new ballgame.

I’m not sure a single day has gone by in the eight years since sharing my non-binary identity or new pronouns that someone hasn’t used the wrong pronouns for me in the workplace. Usually, it only bothers me a little because someone using the wrong pronouns doesn’t negate my identity or who I am. However, the lack of effort and inclusion of my identity in our public health spaces does get tiring. It’s most frustrating when a meeting facilitator decides to include pronouns in people’s introductions and others still don’t use my correct pronouns. Those instances add up and cause unnecessary harm.

Even with these instances of not using the correct pronouns or having access to all-gender restrooms, I continue to come out and be out at work as my authentic self. I think it’s important for my staff and the queer communities we serve to know there is a space for them in our agency. Over the past few years, we have added more and more non-binary and gender-fluid staff to our team. It’s so important that these folks see themselves represented in leadership roles within public health.

How does health equity and the LGBTQ+ community come together?

Framing “health equity” is important, especially as we think about ways to ensure optimal health outcomes are attainable for people from all communities. The honest truth is that it is a difficult enough hill to climb when we think of health equity in terms of just race and ethnicity. When we incorporate intersections at other identities, additional nuances come into play. What makes promoting health equity for the LGBTQ+ community important lies heavily in understanding how the government has historically treated the community.

As a proud ally of the LGBTQ+ community working in the public health space, I had the opportunity to actively participate in the annual West Hollywood Pride Parade in California. As we marched through the streets of West Hollywood, surrounded by a sea of rainbow flags and cheering crowds, I felt an overwhelming sense of solidarity and unity with the LGBTQ+ community. Being a part of the parade further reinforced my commitment to advocating for the rights and well-being of the LGBTQ+ community. It was a powerful demonstration of our collective determination to fight against discrimination and create a more inclusive society. The experience not only strengthened the bonds among my colleagues and loved ones but also deepened my understanding of the challenges faced by the LGBTQ+ community and the importance of supporting their health and equity. It serves as a constant reminder of the ongoing work needed to achieve full acceptance and health equity for all members of the LGBTQ+ community.

As a black queer member of this community and in a time of increasing hostility in all arenas toward LGBTQ+ (especially transgender) community members, I stand firmly on my belief that it’s essential for anyone who claims to be working toward achieving health equity to be bold in their support of all LGBTQ+ people.