By Christa Camarillo, M.Ed., CEP
Healthcare professionals spend their careers helping others feel safe. We create environments where people can heal, ask difficult questions, navigate uncertainty, and trust they will be met with dignity. We care for patients through some of the most vulnerable moments of their lives while teams work under increasing pressure and complexity. Yet an important leadership question remains: Do the people providing that care feel the same sense of safety at work?
As Pride Month invites celebration of LGBTQ communities, it also presents healthcare leaders with an opportunity to reflect on something deeper than visibility. Pride in the workplace is not simply about rainbow logos, celebratory campaigns, or public displays of support. At its core, Pride in healthcare is about belonging. It is about whether people feel psychologically safe enough to contribute fully, lead authentically, and bring their expertise to work without having to edit core parts of who they are. In California, where healthcare systems often lead national conversations around inclusion and innovation, this question feels especially relevant.
California Has Led. Belonging Still Has Work.
California has long been recognized as a national leader in LGBTQ+ workplace protections. State laws prohibit discrimination based on sexual orientation, gender identity, and gender expression, offering important safeguards for employees across industries, including healthcare (California Civil Rights Department, 2024). This progress matters. Yet policy and belonging are not the same thing. Legal protections create a foundation. Culture determines lived experience.
For many LGBTQ+ professionals, workplace navigation can still involve quiet moments of pause that others may never notice. Questions such as: Is it safe to talk about my family? Will assumptions be made about who I am? Will authenticity affect credibility, opportunity, or advancement? These experiences are often quiet. A pause before mentioning a partner. A hesitation around disclosure. A moment of deciding whether authenticity feels safe in a professional setting. For healthcare leaders, understanding these experiences matters because inclusion is not simply a moral or cultural conversation. It is a workforce conversation. A wellbeing conversation. A leadership conversation. And ultimately, a patient care conversation.
The Hidden Cost of Concealment
Healthcare leaders are deeply familiar with burnout. Staffing shortages, emotional fatigue, administrative burden, and ongoing workforce strain continue to test healthcare systems and the people sustaining them. Yet one dimension of workplace wellbeing receives far less attention: the hidden cost of concealment. Research on minority stress suggests that individuals from marginalized groups often experience an additional layer of chronic psychological burden created by stigma, anticipated bias, or the need to manage identity in ways that feel protective (Meyer, 2003). In practice, this can look like hyperawareness, self-monitoring, or quietly calculating how much of oneself feels safe to reveal. From a physiological perspective, this matters. When people feel psychologically unsafe, the nervous system notices. Stress responses can increase. Cognitive bandwidth narrows. Energy that could support leadership, connection, and collaboration becomes redirected toward monitoring safety.
In high-demand healthcare environments, where emotional labor is already significant, this additional load can deepen exhaustion. Psychological safety, a concept widely studied in organizational leadership, refers to an environment where people feel safe to speak up, contribute, ask questions, and take interpersonal risks without fear of punishment or humiliation (Edmondson & Lei, 2014). Healthcare organizations often discuss psychological safety in the context of patient outcomes, communication failures, and reporting concerns. Yet psychological safety also shapes workplace belonging.When people feel safe, they contribute differently. They communicate more openly. Trust deepens. Collaboration improves. Leadership capacity expands.Belonging is not simply about feeling good. It influences how people show up, connect, and contribute.
Why This Matters for Healthcare Leadership
Healthcare leaders today are being asked to lead through no shortage of complexity. Retention challenges, burnout, staffing shortages, and increasing pressure on workplace culture continue to affect healthcare organizations across California. At a time when many healthcare systems are asking how to sustain people in demanding environments, belonging deserves greater attention. Research consistently shows that employees who feel included and psychologically safe report stronger engagement, lower burnout, and greater organizational commitment (McKinsey & Company, 2023). For LGBTQ+ employees specifically, workplace inclusion is associated with greater job satisfaction, wellbeing, and reduced workplace stress (American Psychological Association, 2024).
This matters because healthcare is, at its core, human work. Patient care depends on trust, communication, and human connection. When healthcare professionals feel they must spend energy navigating whether they belong, organizations lose access to something valuable: the perspective, presence, and strengths people bring when they feel safe enough to fully show up.The strongest workplaces are not those where differences are merely tolerated. They are workplaces where people feel respected enough to contribute fully.
Pride in Practice: What Leadership Looks Like
For healthcare leaders, creating belonging does not require perfection. It requires intention.
More often than not, belonging is shaped in everyday moments. In how leaders listen. In what gets noticed. In whether people feel respected, supported, and safe enough to contribute fully.
Inclusive leadership can look like creating environments where people do not feel pressure to explain or minimize parts of themselves. It can mean leading with curiosity rather than assumption, paying attention to team dynamics, and recognizing when someone may not feel fully seen or supported. It also means ensuring inclusion is not simply written into policies, but practiced consistently. Not only on paper, but in how leaders show up, respond, advocate, and hold workplace culture accountable.
Importantly, inclusive leadership does not require having every answer. It asks leaders to remain open, willing to learn, and committed to creating workplaces where dignity is experienced consistently.
The Future of Healthcare Culture
Pride Month reminds us that visibility matters. But in healthcare, visibility alone is not the goal. Belonging is. California has made meaningful progress, but the work is not complete.The future of healthcare culture will not be shaped solely by policies or mission statements. It will be shaped by whether people feel safe enough to contribute fully, lead authentically, and care for others without leaving essential parts of themselves at the door. Because when people feel psychologically safe, everyone benefits. Teams become stronger. Leadership becomes more effective. And healthcare becomes more human.
References
California Civil Rights Department. (2024). Employment discrimination protections. https://calcivilrights.ca.gov
Edmondson, A. C., & Lei, Z. (2014). Psychological safety: The history, renaissance, and future of an interpersonal construct. Annual Review of Organizational Psychology and Organizational Behavior, 1(1), 23–43.
McKinsey & Company. (2023). The state of organizations 2023: Ten shifts transforming organizations.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697.
American Psychological Association. (2024). The importance of LGBTQ inclusive workplaces. https://www.apa.org
