189 Afterword: A Call to Action Ronica Mukerjee, Randi Singer, Linda Wesp, and Pia Pauline Lenon As we write this conclusion, it is July of 2020 and our world as we knew it is both exactly the same and entirely diferent from when we began writing this book several years ago. Te systems we work within continue to be shaped by intersecting systems of oppression. Voices rising against these systems are louder, but dismantling of the systems still needs to happen on every level. Our biggest disappointment, now more than ever, would be that clinicians will read this text, close the book, and continue their usual method of care without ini- tiating new actions to increase social justice for their patients. We are worried that you, our colleagues, will ask for more learning opportunities, more reading groups, and more continuing education, but that you won’t do the necessary personal work to transform yourselves. Tat work, in conjunction with outward positive action, is exactly what is required, and although it should have started a long time ago, starting immediately will do. With privilege that comes from being in healthcare leadership roles comes the ability to forget and/or to simplify solutions. It is easier for us as faculty, staf, and students to say, “We understand the problems,” but then shrug our shoulders and say that the system is too difcult to change. We implore you to remain uncomfortable. Employ your knowledge of the fve tenets of cultural safety: partnerships, per- sonal activities of daily living (ADLs), prevention of harm, patient centering, and purposeful self-refection (see Chapter 1). Utilizing this framework, providers will shif the power balance to patients through learning, through engaging in the strug- gle for body and community autonomy, through challenging police aggression and other biased violence, and through putting our brains and intellects and selves on the line too as much as is needed to create real, conscientious, and relevant change. If this book has made a lasting impression on you, you will fnd yourself asking more complex questions than you will have simple answers. How do we turn an op- pressive system into an opportunity for change? How do we restructure culturally and medically negligent healthcare systems into ones that refect appropriate care for the most excluded people in healthcare? Patients who identify as part of the LGBTQIA+ population, particularly BIPOC (black, indigenous, people of color) people, expe- rience a multitude of barriers to obtaining healthcare, and many of these barriers stem from providers’ lack of knowledge regarding the type of care patients require and how to approach patients. But these barriers are also inherently a part of our larger healthcare system—a system that has been designed within a framework of Copyright Springer Publishing Company. All Rights Reserved. From: Clinician’s Guide to Lgbtqia+ Care DOI: 10.1891/9780826169211.ap01