The Advocate

Book review:
LGBTQ-Inclusive Hospice and Palliative Care, by Kimberly Acquaviva

Wearing a red reflective vest emblazoned with the words “American Red Cross,” I served as a Red Cross volunteer at the Donald Trump’s inauguration as president. Consistent with the politically neutral stance of the American Red Cross, my personal politics were invisible. Looking out at the sea (or was it a pond?) of red “Make America Great Again” hats, though, I felt afraid. I wasn’t scared of the individual people I saw at the Inauguration. Trump’s supporters were (and are) friendly, hardworking, “regular” people who genuinely believed that America desperately needed what Trump promised to deliver. What frightened me was knowing how much damage a charismatic leader can do to the rights of those in the minority when they have the support of earnest masses yearning for better lives.

The 100th day of Donald Trump’s presidency will be Saturday, two days before the party celebrating the publication of my first book, LGBTQ-Inclusive Hospice and Palliative Care: A Practical Guide to Transforming Professional Practice. It feels strange to mention both events in the same sentence, but equally strange to be experiencing them in the same week. When I wrote the book, I was filled with a sense of hope for the future. Barack Obama was the president of the United States, and it felt like real progress was being made in the areas of health care and lesbian, gay, bisexual, transgender, gender-nonconforming, queer, and/or questioning rights. During Trump’s first 100 days, I’ve felt the sands of that progress shift backward down a sloping dune beneath my feet.

In the first 24 hours of Trump’s presidency, the acronym LGBT vanished from the State Department and White House websites. Five days later, Trump signed an executive order that barred nationals from seven countries from entering the United States. In six of those seven countries, homosexuality is punished with either prison or death. Five days after that, a leaked anti-LGBTQ executive order raised concerns that Trump planned to reverse Obama’s 2014 workplace protections for LGBTQ employees of federal contractors. On the 11th day of Trump’s presidency, the White House issued a statement denying plans to roll back workplace protections for LGBTQ people while praising Trump for being “the first ever GOP nominee to mention the LGBTQ community in his nomination acceptance speech, pledging then to protect the community from violence and oppression.” Less than two weeks into Trump’s presidency, the White House was implying that a shout-out to LGBTQ people from the podium constituted evidence of Trump being “respectful and supportive of LGBTQ rights.” Let that sink in for a second: The same man who erased the LGBTQ community from the White House website and closed America’s borders to LGBTQ people from seven Muslim-majority countries wanted a cookie for saying “LGBTQ” out loud and promising to be our friend.

After the first two weeks of Trump’s presidency, things went downhill fast. February brought the confirmation of Education Secretary Betsy DeVos and Attorney General Jeff Sessions, followed by the rescinding of guidance on equal treatment of transgender students regarding restroom and locker room access, along with name and pronoun usage In March, a question about sexual orientation was scrubbed from the National Survey of Older Americans Act Participants and Trump appointed Roger Severino to serve as the head of the Department of Health and Human Services’ Office of Civil Rights. I wasn’t alone in being alarmed by Trump’s appointment of Severino: in April, 12 U.S. senators submitted a letter to the Secretary of the Department of Health and Human Services opposing Severino’s appointment, asserting:

“Mr. Severino has a long history of making bigoted statements toward lesbian, gay, bisexual, and transgender people and attacking women’s access to health care services and reproductive rights. His appointment raises deep concerns about the employment decisions and hiring practices being established by the Trump Administration.”

As outraged as I am by Trump’s actions since his inauguration, I know there’s no objective truth regarding how well he has performed in his first 100 days as president. We each view Trump’s presidency through lenses of privilege — lenses that are only begrudgingly relinquished, if we’re willing and able to relinquish them at all. When privilege is perpetuated and protected by the president, those clinging to their privilege praise him. When privilege is threatened, the opposite occurs. Those who felt their privilege was threatened under Obama elected a president who promised to restore it.

Yes, college-educated white people, I’m pointing at you: 44 percent of college-educated white women and 54 percent of college-educated white men voted for Trump. Stop pretending you care about people of color or LGBTQ people or Muslims in your saccharine Facebook posts. Turning your profile pic into a rainbow for Pride Month doesn’t undo the fuckery you unleashed upon LGBTQ people when you voted for Trump. Being LGBTQ yourself doesn’t give you a free pass either.

If I sound angry, good: I am angry. The America I’m living in today isn’t the same America I was living in (or thought I was living in) when I wrote LGBTQ-Inclusive Hospice and Palliative Care. When I wrote this passage in the book, I genuinely believed I could convince even the most conservative, religious health care professionals that providing high-quality care to LGBTQ people is the right thing to do:

“Changing the way LGBTQ individuals with chronic or life-limiting illnesses are cared for requires a paradigm shift in the way we (collectively, as health care professionals) approach the conversation about what it means to be inclusive in our compassion. You don’t need to change your religious or moral beliefs to provide good care to LGBTQ individuals.”

This week, as the book is published and Trump’s first 100 days draw near, I’m less certain than ever that facts can persuade educated people — conservative, religious, or otherwise — to do the right thing when it comes to caring for LGBTQ people with chronic or life-limiting illnesses. I remain hopeful, though. I have to. For me, as a lesbian and mother, the alternative is unthinkable.

KIMBERLY D. ACQUAVIVA, Ph.D., MSW, CSE is a faculty member at the George Washington University School of Nursing and the author of LGBTQ-Inclusive Hospice and Palliative Care: A Practical Guide to Transforming Professional Practice.

Reviewed by Kimberly Acquaviva