An Arc Towards Greater Inclusion and Sense of Belonging

As this year’s Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) Pride Month comes to a close, I can’t help but reflect on my experience as a federal employee who is part of the LGBTQI+ community and the public health scientific and practice accomplishments that CDC LGBTQI+ employees have attained. Prior to accepting a position at CDC over twenty years ago, I would not have thought that a governmental agency, even the premier US public health organization, would address issues impacting LGBTQI+ populations in its scientific and programmatic efforts as prominently as it has in recent years. Of course, there are legitimate reasons to have been concerned about its ability to do so.

Discrimination against government employees who are LGBTQI+ is well documented.^[i] Throughout the 18^th and 19^th centuries, people who are homosexual were systematically targeted and discriminated against in the military, reaching its peak during the McCarthy era (late 1940s to 1950s).^[ii],[iii] The practice of purging employees who were LGBTQI+ within the federal government between the 1940s and 1960s was popularly known as the lavender scare, referring to a term often used by government officials (“Lavender Lads”).^[iv] The complex system of homophobic, heteronormative, and sex-phobic policies, practices, and beliefs that make up structural homophobia^[v] in the US are still well entrenched in society and government in the 21^st century.

My concerns about working at CDC, as a gay cisgender Puerto Rican male, were significant, even after joining CDC’s LGBTQI+ employee organization and later becoming its first black and Hispanic president. These concerns remained because my participation was both a strategy and challenge – to myself as much as the agency – to persist in doing much needed good work. The opportunity to do the work was as lifesaving as the impact the work itself has had on the lives of LGBTQI+ people at large. Thankfully, I was not alone in wanting to do this necessary work, as I have had the pleasure of working with many others over the years. And there is much work to be proud of.

CDC scholars and scientists are producing a growing body of work relevant to lesbian, gay, bisexual, and transgender populations, from science and practice publications on intimate partner violence approaches, stigma elimination, and mental health (such as Supporting LGBTQ Youth and Mental Health for Gay and Bisexual Men) and intersectional considerations^[vi] of infectious disease, social behaviors, sexual orientation, and gender identity to the creation of CDC workgroups focused on sexual and gender minority populations. In collaboration with multiple external partners, we advance an initiative committed to ending the HIV epidemic; support anti-bullying and anti-stigma activities; co-created an LGBT topic area for Healthy People 2030; experienced the recent creation of a chief health equity officer unit in the mpox response focused on gay, bisexual, and transgender populations; enjoyed several David J. Sencer CDC Museum exhibits inclusive of LGBT populations; and built a robust LGBT health CDC webpage.

In our collective interest as public health practitioners to advance health equity and reduce health disparities, sustaining and enriching the body of work being contributed by LGBTQI+ employees is critically important. This underscores that the health of LGBTQI+ populations merits rigorous and sustained public health attention and intentional collaboration toward the production and use of this information for the benefit of the nation’s health. No more in the shadows, this work now occurs with broad support from the agency. CDC is evolving in its stance against homophobia, biphobia, transphobia, and cisgender bias and is developing organizational activities in support of LGBTQI+ employees.

Ally, humility, and cultural competence trainings are available that explicitly define and refer to homophobia, providing resources and approaches for creating and supporting safe workspaces. Employees’ use of pronouns in their email signature blocks and public presentations is quickly becoming a common practice. But, in my experience continued and expanded support of LGBTQI+ employees will create and sustain a work environment that fosters greater acceptance and belonging of all CDC employees.

I often think of CDC’s mission in tandem with the phrase Dr. Martin Luther King, Jr. is famously quoted for– “the arc of the moral universe is long, but it bends towards justice.” I associate a public health mission with one of justice that takes place through collective effort and common purpose.  Initially working in the shadows, the many examples I listed are part of the foundation of work that LGBTQI+ employees and their allies have committed to in efforts to make a meaningful contribution to the CDC’s mission to improve and protect the health of the public, both domestically and globally, irrespective of sexual orientation or gender identity and expression.

CDC’s Office of Health Equity celebrates our 35^th anniversary of “baking” health equity into our public health work. “Baking” health equity into our work means that health equity principles are foundational ingredients in our work, rather than separate ingredients we layer in, sprinkled on top, or served on the side. More of this commitment to the acknowledgment and inclusion of LGBTQI+ health issues is needed in CDC’s workspace if we are to truly build an agency together that is affirming of everyone’s experiences and identities and allows everyone to contribute while being their whole selves.

I look forward to that day when everyone at work can feel so proud.

Bien proud y presente!! (Translation: Very proud and present)

Citations

[i] Riccucci, N. M. & Gossett, C. W. (1996). Employment Discrimination in State and Local Government: The Lesbian and Gay Male Experience. The American Review of Public Administration, 26(2), 175–200. https://doi.org/10.1177/027507409602600203

[ii] Lewis, G. B. (2001). Barriers to Security Clearances for Gay Men and Lesbians: Fear of Blackmail or Fear of Homosexuals? Journal of Public Administration Research and Theory, 11(4), 539–558. https://doi.org/10.1093/oxfordjournals.jpart.a003514

[iii] Sinclair, G. D. (2009). Homosexuality and the military: A review of the literature. Journal of Homosexuality, 56(6), 701–718. https://doi.org/10.1080/00918360903054137

[iv] Johnson, D. K. (2023). The Lavender Scare: The Cold War persecution of gays and lesbians in the federal government. University of Chicago Press.

[v] Pincus, F. L. (2019). From individual to structural discrimination. In F. L.  Pincus & H. J. Ehrlich (Eds.), Race and Ethnic Conflict (pp. 120-124). Routledge.

[vi] Collins, P. H. & Bilge, S. (2020). Intersectionality. 2nd ed. Polity Press.