After Past Vetoes, Bias Training Bill for Medical Licenses Could Become Law

A bill requiring unconscious bias training for medical license renewals was rejected multiple times by former Gov. Glenn Youngkin. Now the measure, via Senate Bill 22 by Sen Mamie Locke, D-Hampton, and House Bill 1147 by Cliff Hayes, D-Chesapeake, is on its way to Gov. Abigail Spanberger and is likely to become law.

The proposal has always been carried by Locke and other Democratic Black lawmakers, and Sen. Chris Head, R-Botetourt, a white male Republican, lent his bipartisan support. As a key part of the Virginia MOMnibus package, the bill has often been framed as a solution to causes of disparities in Black maternal health.

“Women whose skin is darker than my wife’s skin have significantly worse outcomes,” Head said in 2024 while advocating for the bill on the Senate floor. “Something needs to be examined and done about that.”

Studies show Black parents-to-be experience disproportionately negative health outcomes, often due to provider bias. Black women are also more likely to die from pregnancy-related complications. This disparity has also been confirmed by Virginia’s Maternal Mortality Review Team.

Danville-based community health worker Kitt Mayo said she’s seen clients face biases in her three decades of work, but she has personal experience with medical bias, too.

While pregnant with her first child, she recalled telling her doctor that lying on her side felt like “lying on rocks.” She said he dismissed her concern and attributed it to her weight. Two weeks later, she had emergency gallbladder surgery.

With much of South Side Virginia having less hospital or clinic access than other parts of the state, accessing care can be a hurdle for anyone living in the area. For Black patients like herself, Mayo said, it feels even harder.

“A big thing around here is finding a physician in this area that’s actually going to listen,” she said. “It’s like a needle in a haystack.”

The bill addresses both “explicit bias” — meaning attitudes and beliefs held at a conscious level — and “implicit bias,” meaning judgments or behaviors that a provider may not be aware they exhibit.

To counter that, the training mandated in the measure aims to help providers confront how assumptions about their patients, particularly with regard to race, can lead to “delayed diagnosis, inadequate treatment, and disparate health outcomes.”

Compassion in health care

While combating racial bias is a top goal of the bill, Virginians who experience other forms of bias have kept tabs on its advancement.

J Gallienne, a nonbinary community care organizer with the nonprofit He She Ze & We, called the unconscious bias bill “beautiful” because it can help patients feel seen and respected. Gallienne has assisted patients as a social worker and organizer.

Gallienne said their husband, a nurse practitioner, shared that little discussion existed about transgender and nonbinary identities in their schooling. Gallienne also hears a lot from clients about going to the doctor for one thing and then the physician focusing more on their status as a transgender or nonbinary person than on the symptoms at hand.

“I think a lot of stuff people don’t realize they didn’t know or that they carry with them as biases,” Gallienne said.

Fear of discrimination can be a contributing factor for transgender or nonbinary people to put off seeking care, studies have shown.

He, She, Ze & We executive director Shannon McKay recalled her own reservations as a parent when taking her transgender daughter to the emergency room for a hand injury.

McKay wondered if providers were going to treat her daughter differently because her name and gender identity differed from the paperwork indicating her assigned sex at birth.

“It just creates so much stress,” she said.

Providers gaining more knowledge about gender identities and medical compassion at large can help, she and Gallienne explained. Mayo, the Danville community health worker, agreed.

“Health care professionals need to lead with compassion and empathy in order to best listen to their patients,” she said.

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