Professionalism and Gender Identity in Health Care

Abstract

In this work we discuss the meaning of professionalism, explore examples of tension between professionalism and recent U.S. government Executive Orders, and propose ideas for health care providers and educators to teach by modeling professionalism for future generations. Professionals in health care in the United States strive to adhere to four principles of medical ethics. Beneficence denotes a commitment to promote the wellbeing of others. Nonmaleficence refers to an effort to reduce risk to persons – to do no harm. Autonomy implies making one’s own decisions, and health care professionals strive to facilitate patients’ choices. Justice signifies fairness, and a commitment to treat individuals equally regardless of background. Each health care profession has a defined scope of practice, occupationally controlled education, program accreditation, licensure of graduates, and oversight of practitioners. Professional education includes ethics training and stipulates ongoing ethical practice. Recent Executive Orders and actions in the United States have introduced moral difficulty for health care educators and practitioners. External controls that deny gender identity, oppose gender affirming health care, and restrict programs addressing diversity, equity, inclusion, and accessibility do not align with the ethical principles of beneficence, nonmaleficence, autonomy or justice. Beyond care for the individual, directives limiting scientific funding and excluding the large population of persons who identify as transgender or gender diverse will have long term adverse effects on science, health, and health care costs in the United States. Beyond the country’s borders, United States policies are already impacting health care for vulnerable populations. The purpose of this article is to bring awareness of these professionalism issues and to support learners and health care practitioners in their efforts to uphold the four principles of medical ethics.