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LGBTQ+ journalist BJ Ferguson discusses the article, “Why physician voices matter in the fight against anti-LGBTQ+ laws.” The conversation serves as a call to action for medical professionals, arguing that their duty to protect patient health now extends beyond the clinic and into the legislative arena. BJ outlines how anti-LGBTQ+ laws, particularly those targeting gender-affirming care, directly threaten patient well-being and undermine a physician’s core commitment to do no harm. The discussion provides five clear, actionable steps for doctors to engage politically, from testifying at hearings and meeting with officials to using media and organizing their peers. Citing recent examples where physician testimony helped halt harmful legislation, this episode makes the powerful case that advocacy does not compromise medical ethics—it fulfills them.

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Transcript

Kevin Pho: Hi. Welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome BJ Ferguson, journalist. Your KevinMD article is “Why physician voices matter in the fight against anti-LGBTQ+ laws.” BJ, welcome to the show.

BJ Ferguson: Thanks for having me.

Kevin Pho: All right, so let’s briefly share your story and what led you to share this article on KevinMD.

BJ Ferguson: Sure. So, as you mentioned, I’m a journalist. I’ve been reporting on health, science, identity, and justice for about the last decade. And I recently founded Wellbeing’s News, which is an independent media project for providers who want to offer better LGBTQ+ care. I really wanted to create something that doesn’t just preach inclusivity but gives professionals the research, reporting, and cultural context they need to practice it.

As for the op-ed, I’ll say it definitely came from a bit of an emotional place. I tried to keep it grounded, but what is happening, especially with transgender health care access in the U.S. and the UK right now, is honestly pretty scary. I’ve heard a lot of straight or cisgender clinicians express concern privately but who feel unsure how to act while the queer and trans people in my communities are out in the streets and on the front lines. I don’t think enough people in the health care industry are seeing legislative harm as a clinical issue, so I wanted to reframe LGBTQ+ rights not as a culture war but as a patient safety crisis, something that providers can do something about.

So the article was a bit of a call to move from the exam room out to the public square, not as a partisan political statement but as an ethical obligation.

Kevin Pho: So tell us what we are not seeing. Tell us about the article itself for those who didn’t get a chance to read it.

BJ Ferguson: Sure. So in the article, I bring up, of course, that we are in a real moment that I think demands action from clinicians, and I talk about a few of the ways that I think clinicians can take that action outside of their clinical practice. So things like testifying in front of legislative bodies. They frequently hold public hearings on proposed bills, and I feel we’re in a moment where maybe the lived experiences of trans patients isn’t taken as seriously as it should be.

Doctors and other health care workers, clinicians, have real authority in those spaces. And I feel they have the power to really humanize our experiences when we aren’t necessarily taken seriously on our own merit.

Other things that I’ve suggested people could do: call and meet with the elected officials directly. You don’t have to be an expert to do that. You can just get on the phone or show up in an office and make the same argument you might make in front of a larger legislative body. Using media, writing your own op-eds, doing interviews, that sort of thing, and organizing amongst your peers. There is a lot of good work already happening, and you don’t have to reinvent the wheel, but I think more clinicians just getting together and talking together about what they can do to fight for the rights of LGBTQ+ people to access health care and to be visible in health care science as well is just really vital right now.

Kevin Pho: You mentioned something earlier that LGBTQ+ issues, you want to reframe that as a patient safety issue, so tell us more about what you mean.

BJ Ferguson: Well, I think there are two big issues right now that queer people are facing in terms of that intersection between legislation and health care. The first is just access. We know that gender-affirming care saves people’s lives. And when that care is made illegal, people die. That’s just the reality we’re dealing with.

And fighting for not just the direct impact of not having access to care, but I think there’s also an impact. If you are a provider who claims that you want to be inclusive of trans people, that you care about our access to health care, but you shrug your shoulders while that care is being made illegal, your patients will notice that, and they might not come back. In my opinion, that is a provider’s responsibility. That’s part of doing no harm. Is mitigating the risk of patients just avoiding health care altogether because of what’s going on.

I think the other big issue is the science research. When we don’t have access to good data about queer and trans health, it makes it so much harder for clinicians to provide adequate care. And right now, queer and trans health is so understudied, so misunderstood, and in this political climate, a lot of the times intentionally so, and that is going to have impacts on queer and trans people in our daily lives.

Kevin Pho: Can you tell us a story or share an experience that you have heard about how that lack of access is affecting the queer and trans community?

BJ Ferguson: Yeah. From my own personal life, I grew up during a time where being trans was not something I heard a lot about. Especially being a non-binary trans person was just not something that I understood as an option, and I wish that the care providers I had in my life when I was younger had the knowledge and language to ask me better questions to help me explore the physical discomfort that I now understand was gender dysphoria.

I wish someone had offered me the option to access transition care in my teens or my late twenties. Instead, it took me until my late thirties to finally piece it all together, and it not only does that make certain aspects of transition care more difficult, but I had to endure a lot of years of real pain and suffering that I just didn’t understand. And that had real impacts on my life and my ability to just live and thrive in the world.

And that hole in care, I think, is a big part of what drives my work now because I’m not just writing about policy or research. I’m writing the information that I needed from my care team and for people who I hope now know to be looking for it.

Kevin Pho: In your article, you argue that an affirming exam room is no longer enough. Can you share an example of successful clinician advocacy? Tell us a story of what that would look like.

BJ Ferguson: Sure. So I actually shared a few examples in the article as well where pediatricians, in particular, because care for youth has been so targeted, have organized themselves to get into legislative bodies and to testify about their patients in particular and what it looks like for people when they cannot access care. I’m thinking about the Utah study that was commissioned. So in Utah two years ago, they banned gender-affirming care for young people and at the time said, OK, this is something we’re putting in place for now while we study it to see what is really happening to make sure that this care is actually helping people.

And the report was first sent to legislators, I think back in August, and is just being reported on now. It’s a thousand pages and overwhelmingly supports gender-affirming care for trans youth. It improves social experiences and lowered suicide risk, improved instances of depression and anxiety, and now legislators are waffling a bit on whether they’re actually going to roll back the law that they passed. Even though they said at the time, as I mentioned, that if the study came out in support of this, that they would do so.

And I think that if I were a researcher or a clinician who worked on that study, I would be offended that I did all of this work, spent two years compiling all of this information, and it’s just being ignored.

And I really think that the collective power of health professionals would make a big difference in getting those voices heard. There are most professional medical organizations, in particular, that have come out in favor of gender-affirming care, and whether or not those letters of support make a difference, I think, depends on what is behind them, what action is behind them. Are those doctors and other clinicians going to show up at legislation and speak on behalf of their beliefs?

Kevin Pho: So as a journalist, what do you find is the most common piece of misinformation regarding topics like gender-affirming care, and how can I, as a clinician, counteract that misinformation in the exam room?

BJ Ferguson: That’s a good question. I think that the most common misconception, especially regarding gender-affirming care for young people, is that it is a huge life-changing decision and that young people don’t have the capacity to make those decisions.

And I would argue that allowing someone to go through a puberty that is going to harm them is also a huge, life-changing decision, which is why puberty blockers are such a common prescription for trans youth: because it gives young people the time to spend some time in therapy to explore their gender a little bit.

In a medical context, people make huge life-changing decisions all the time. And I would note that while I won’t argue that there is no one who has ever regretted a medical decision related to gender-affirming care, regret is a normal thing that happens in medical decision-making. But regret rates for trans people, especially people who transition young, are significantly lower than just about any other medical procedure—magnitudes lower than knee replacement surgery or back surgery, for example.

I think we just need to take these conversations in context, in the medical context that we’re talking about, and not silo off trans care as if it’s somehow incredibly different or special compared to other types of medical care.

Kevin Pho: We are on with BJ Ferguson. They’re a journalist. Their KevinMD article is “Why physician voices matter in the fight against anti-LGBTQ+ laws.” BJ, can you share some take-home messages that you want to leave with the KevinMD audience?

BJ Ferguson: Sure. What I really want to say is that allyship with queer and trans people is not a trend, it’s not a feeling, and it’s not an identity; it’s a skill. And like any other skill, it can be learned, practiced, improved upon, and shared.

So to the medical professionals in the audience, I just want to say, you have real power to improve queer and trans people’s lives, and I want to see you use it.

Kevin Pho: BJ, thank you so much for sharing your story, time, and insight. Thanks again for coming on the show.

BJ Ferguson: Thank you for having me.