In the ongoing fight for LGBTQIA+ rights, distinguishing between “ally” and “accomplice” is vital. While both play essential roles, a deliberate shift from allyship to accompliceship can be crucial in advancing LGBTQIA+ patient care. As we reflect upon the strides made in LGBTQIA+ rights, we realize that a deliberate shift from ally to accomplice is a move that demands confronting systemic biases and possibly risking reputation. It is a move that champions effective inclusiveness and equity, and prioritizes advancement in LGBTQIA+ patient care.

Understanding Allyship

An ally is a supporter and advocate for the specific needs of the LGBTQIA+ community, and are individuals who:

• acknowledge the unique health challenges the LGBTQIA+ community faces, ensuring a welcoming and non-judgmental space.
• consistently expand their knowledge on LGBTQIA+ health topics.
• visibly signal their commitment through inclusive symbols, language, and behaviors.
• implement tools, such as diverse intake forms and gender-neutral restrooms.

The Call for Accompliceship

An accomplice uses their privilege and power to challenge and rectify systemic barriers. They take action to:

• listen to the community, especially when it challenges their current thinking.
• push for systemic change, such as modifying clinic policies and overarching healthcare guidelines. 
• confront and overhaul outdated practices, sometimes risking professional backlash.
• meaningfully partner with LGBTQIA+ organizations, ensuring their actions are informed and impactful.
• address and rectify non-inclusive conduct among their peers without hesitation.

You may wonder about the word “accomplice” and how it became part ofLGBTQIA+ terminology. In recent history, LGBTQIA+ individuals were unjustly labeled as criminals, deviants, or mentally unstable. Showing support for an LGBTQIA+ person could be perceived as a criminal act. Though legal protections have improved, the trauma inflicted on this community is a history not easily forgotten. As societal biases endure, healthcare disparities persist, and LGBTQIA+ rights remain contested, the urgency for accompliceship is magnified.

Challenging the System

Historically, the LGBTQIA+ community didn’t just grapple with societal discrimination. They were often subjected to overt medical discrimination. In 1952, the American Psychiatric Association classified homosexuality as a “sociopathic personality disturbance,” a label that persisted until 1973. This, coupled with harmful “treatments,” showcased a medical system in dire need of education and empathy.

In spite of these challenges, sparks of hope and change emerged. In the 1920s, Magnus Hirschfeld established the Institute for Sexual Science in Berlin, where he provided much-needed medical and counseling services to the LGBTQIA+ community. Such early initiatives paved the way for later transformative events like the Stonewall Uprising in 1969, which catalyzed the modern LGBTQIA+ rights movement.

Perhaps one of the most telling examples of the acute need for accompliceship in healthcare was the onset of the HIV/AIDS crisis during the 1980s. First reported in 1981, the disease was initially mislabeled as “GRID” (Gay-Related Immune Deficiency). This name narrowed the perception of those affected and further marginalized an already vulnerable community within a discriminatory healthcare system. Alarmingly, by the end of 1990, AIDS had claimed the lives of over 100,000 individuals in the United States.

With countless lives at stake, healthcare professionals were thrust into a situation where they had to actively push against the grain of both societal prejudice and medical bureaucracy. Some providers and researchers, like Dr. Linda Laubenstein, recognized the critical need for adequate care and began the journey of challenging the system from within. These early pioneers didn’t just provide medical care; they also provided a voice for the voiceless, challenging policies that excluded or marginalized HIV/AIDS patients and advocating for better understanding and categorization of the disease, often at significant personal and professional risks.

Against the backdrop of a historically hostile environment and legislative inaction, these trailblazers stood firmly on the front lines. Their dedication transcended conventional caregiving, emphasizing that allyship alone was not enough. Instead, true progress required bold accompliceship, a readiness to confront the system, and, if needed, to take personal and professional risks in pursuit of equitable care for all. In doing so, they paved the way for future generations of medical accomplices.

To move forward, it’s paramount to recognize that the dental and healthcare landscape wasn’t historically designed with the LGBTQIA+ community’s unique needs in mind. It is our responsibility to change that narrative.  

Our Responsibility

The 21st century saw improvements in legal and medical practices as countries acknowledged same-sex marriages and medical associations introduced LGBTQIA+ health-focused training programs. Yet, challenges still persist today. We must continue to be proactive in creating an environment of trust and inclusivity and recognize that many LGBTQIA+ individuals are wary of seeking care due to potential discrimination.

Our challenge to you is to move from ally to accomplice. Do not tolerate or accept established protocols that marginalize or exclude LGBTQIA+ patients. Actively participate in designing environments where everyone feels seen, heard, and respected, regardless of their identity. Stand with and also defend the right to equitable healthcare for marginalized groups, even when you may face personal or professional repercussions.

We have an opportunity and a responsibility to do more —  we must advocate and transition from allies to accomplices to shape a more inclusive and equitable future.

This blog post is sponsored by the DENTAL ASSISTING NATIONAL BOARD (DANB) and their DENTAL ADVANCEMENT THROUGH LEARNING AND EDUCATION (DALE) FOUNDATION. Thank you for your support!