Don’t Say Gay— A Nurse’s POV

As nurses, we are taught not to follow the Golden Rule. We know that its lesson—do unto others as you would have them do unto you—incorrectly assumes YOU as the central figure.

Your wishes, your cultural background, your outlook on life. Instead, in nursing, we strive to do unto others as they would have done unto themselves. While some may dismiss this shift as mere semantics, it underscores a HUGE aspect of nursing—culturally competent care. 

Culturally competent care means the delivery of quality care that is respectful to our patients’ diverse backgrounds and beliefs. It underscores our understanding that certain patient cohorts are at higher risk for healthcare disparities based on their background.

It allows us to meet our patients where they are, with compassion; it values diversity and keeps our biases in check. It begins and ends with awareness and validation of the lived experiences of others. In essence—it is believing our patients when they come to us for care, and supporting them from that place.

Once only a few paragraphs-worth of mention in nursing textbooks, cultural competence in healthcare delivery has become a much more talked about subject in the past 2 years. This shift in awareness has largely arisen because of how much more these types of healthcare disparities are called out; that, along with recognition and reconciliation efforts towards combatting institutionalized racism and implicit bias have thrust previously ‘swept-under-the-rug’ topics into mainstream healthcare discussions. And rightfully so. 

The more we, as nurses, can advocate for our patients, the better. And the ones who need our voices the most are vulnerable populations. Populations like LGBTQIA+ folks. Access to inclusive healthcare is so important for a number of reasons, not the least of which includes access to quality mental health care. 

There’s work to be proud of here. Standardized nursing care for queer patients has advanced leaps and bounds in recent years—there is now an NP fellowship training specifically for LGBTQIA+ care, for example—and centers dedicated solely to the care of queer populations have sprung up as well. 

Nurses are responsible for expanding their own understanding when it comes to the needs of LGBTQIA+ patients. We must actively work to create—and maintain—an environment that is safe and welcoming and familiarize ourselves with the specific healthcare risks that members of this diverse population face, in order to screen our patients effectively. 

In other words, typical nursing for atypical patients, with love, as per usual. 

Centering care on a patient should not come as a new concept to you. And it is precisely the reason that nurses should be infuriated with the recent wave of anti-LGBTQIA+ laws being drafted—and passed!—around the country. One such bill—Florida’s ‘Don’t Say Gay’ bill—has been a particular grotesque headline-grabber. 

The Parental Rights in Education Bill is framed as putting the decision-making about when to introduce concepts of sexual orientation and gender identity back into parent’s hands. Targeting classrooms between kindergarten and 3rd grade, (but with language that polices these discussions in later grades, too), supporters say young children needn’t be exposed to such topics in an educational setting. Opposers point out that legislation like this is highly discriminative at best, and would increase the isolation and suicidality of vulnerable youth at worst. 

Almost immediately, several mental health associations came out condemning the bill. In a joint statement, seven of these organizations expressed their outrage.

“Schools should be welcoming, safe and inclusive places for youth, families and staff members who identify as LGBTQ+. We want students to know that they are seen and valued just the way they are. We will all strive to continue to provide and advocate for affirming, supportive and safe spaces for students.”

In many schools across Florida (and elsewhere, nationally), students staged walk out protests in response to the bill being passed through each legislative  branch. Discussions have lit up social media channels, with many rightly highlighting the negative effects sure to come from  erasing the existence of whole demographics of students.  

While it’s true that children go to school primarily to learn, they are not just being educated from a teacher’s prescribed curriculum. Students, even young ones, are learning social skills, emotional regulation, and emotional intelligence. They are learning about cultures different from their own.

Teachers of this age group often marvel at the natural inquisitiveness and empathy they display. Rather than limiting discussions about diverse family structures—many of whom drop their children off at the doorstep of these public institutions—they should be celebrated!

As a society, it seemed as if we were moving past tolerance towards acceptance. This, after decades of work by LQBTQIA+ advocates and allies. This, after significant shifts and progress in the ways in which healthcare access is offered to all.

The Don’t Say Gay Bill is more than two steps back. It’s a scythe clearcutting our most vulnerable from existence—our children. 

As nurses we’re not here for this. 

I don’t know about you, but one of my favorite and most cherished parts of my job as a bedside nurse was when patients would share their own personal stories. Sometimes those stories were about their health, but most often, not. They centered on the highs of life: family, friends, challenges overcome, celebrations; but also the lows—grief, loss, times of desperation and intense suffering.

These moments always felt sacred to me. It was where I was able to connect most deeply with my patients. This deepened rapport always, always widened the channel for care.

We were both better for having these conversations. It’s where the sacred work of nursing happens, in my opinion.   

Imagine if we were made to keep quiet.