Pride Month & Intersectionality: How PAs Can Disrupt the Mistreatment Cycle

Monica Miles, PhD

This Pride Month, we had the honor of speaking with educators, researchers, and students about their experiences, expertise in sexual and gender minority health, and advocacy efforts. We recently spoke with PAEA Chief Diversity, Equity, and Inclusion Officer, Monica Miles, PhD, about the intersection between racial and sexual identities, and how PA educators can train students to provide patient-centered care.

Pride Month & Intersectionality

In considering Pride Month, Dr. Miles said that like most social movements, sexual and gender minority health disparities should be addressed through an intersectional lens. “Patients and people have complex identities,” she reflected. “If you are a PA student in the LGBTQ+ community, you are 1.74 times more likely to experience mistreatment. Now, think of it this way: that’s just one marginalized identity. When we continue into multiplicative sexual and racial identities, those disparities pile on top of each other. We need to understand that this is happening. Black trans people are dying and we’re seeing very little national response. But it is our responsibility within our jobs and as citizens to inform ourselves and join in responding to calls to action.”

This Pride Month, Dr. Miles calls PA educators to consider the intersection between racial and sexual identities. “All of these movements have to be racialized,” she said. “One thing I love about critical race theory is that it asks, ‘Who is the most marginalized individual in the space you occupy?’ Focus your efforts on that person when developing your interventions, because if you don’t, you will miss important disparities.”

Dr. Miles believes a first step is to begin changing the patterns that have long been in effect. “Systems are connected to cultivate people’s lived experiences,” she said. “Marginalized communities have been impacted by a system that has allowed and normalized mistreatment, We must own that and understand mistreatment is normalized and rationalized to be ‘ok,’ and it is not. When we’re talking about health disparities, we must consider our role and responsibility in disrupting that mistreatment cycle.”

Looking Ahead: Providing Patient-Centered Care

PA educators have the extraordinary opportunity to create new systems and change the future of healthcare for generations of patients to come. Dr. Miles believes it must begin by training students through a cultural humility lens to provide patient-centered care. “Are we always going to be the expert in addressing health disparities?” she asked. “No. But that means we need to sit down, hush, and listen. Ask your patients, students, and colleagues who are from minoritized groups ‘How can I show up for you and support you?’ Then do those actions. The labels, the buckets that we throw people into are not big enough to fit their intricate identities.”

How do you start this work? “Find you sphere of influence,” encouraged Dr. Miles. “What is your station on this underground railroad?  What do you have control over? Every single person has influence over a space. Find yours, then instead of thinking about how you’re going to take on all systemic issues, learn what they look like where you are and within your context. We do not have to venture far to find social injustices – they are right in front of us.” 

Read more of PAEA’s Pride Month Series here: