Equality can feel like oppression to those who have only ever known privilege, as the saying goes. Ten years ago in this small, once arch-conservative country we made the great leap forward in diversity terms by voting for same sex marriage. 

Now, in 2025, president Trump’s executive orders to abolish Diversity, Equality and Inclusion (DEI) from public and corporate policy in the United States has already led to many large companies and organisations abandoning DEI from their corporate strategy, including healthcare providers,¹ inspiring anti-diversity movements internationally. 

The ultimate material effect on public health of the executive order in removing DEI policy from healthcare and education is yet to be fully realised. But the pain and fear of a return to discrimination, oppression and exclusion of minorities is already being felt. In what has been termed a ‘war on diversity’, political actors throughout the world have sought to gain by attacking minorities and removing concessions previously extended to people who have experienced oppression.

In the UK, the Supreme Court recently ruled that the legal definition of a woman is based on the biological state of a person’s sex at birth,² ostensibly to allow legal protections which might address the problem of mixed gender wards and bathrooms in hospitals and workplaces. The decision, rather than sending a message of affirmation to patients of the NHS or to workers generally, instead has been celebrated by some as a political message of exclusion to trans and inter-sex people.³  While the intention of the Supreme Court may not have been to attack trans people, and it may well be difficult to ensure that legal language necessary in employment or health accessibility law is inclusive of all, a law designed to ensure clarity of access and accountability of employers or health providers should not inspire fear or oppression in anyone. And, unfortunately, the legal ambition to protect a class of citizen, such as has been suggested in the UK Supreme Court’s decision to protect the privacy of women in healthcare facilities, has inevitably come to be celebrated as an ‘anti-trans’ victory.  

As GPs we have direct experience of the way oppression affects mental and physical health. We experience first-hand the health inequalities experienced by people with autism, people with ADHD, people who are transgender, people who are non-binary, people who are lesbian and gay and bisexual; people who have often been forced to try to find a way to be themselves in a world that often seems not made for them, and in which they will often have to fight to fit in. 

As GPs, we understand what is meant by intersectionality, because we know from first hand-experience the health risks that diversity brings, from depression, to obesity, to educational failure, to premature death.³

A key value of all members of the Irish College of GPs is to continue to value diversity as part of our communities and to treat everyone with respect.⁴ As GPs, our fundamental privilege is to be the first point of contact, the principal advocate, for all people from all walks of life who are being oppressed.⁴ Now more than ever GPs will keep in mind what it is to hold that privilege.