Global Health Institute

On Tuesday, March 11, health equity policy scholar Katie Keith, J.D., MPH, joined Georgetown University students for a discussion on health equity and law as a part of the Conversations in Global Health: Global to Local course.  

The dialogue touched on Keith’s calling to public service through her current legal engagements domestically and her international work early on in her career with the Peace Corps. Drawn back stateside during the Obama administration, Keith spoke about her extended dive into the Affordable Care Act (ACA) as a means of advancing health equity, particularly among gender minorities and the LGBTQ+ community. As a lawyer, the massive amount of litigation generated in response to the ACA and its implementation provided Keith with many opportunities for advocacy, as well as opportunities to expand her knowledge of how litigation works.  

Keith remarked that her legal training was her way of “joining the fight,” and her strong writing and political skills continue to be key tools in advancing policy goals and reforming the law. Additionally, she pointed to her undergraduate background in the basic sciences as likewise fundamental to this advocacy, helping her to make connections and understand complex systems.

The conversation then turned to key health equity issues in current legal discourse. Students asked Keith about present challenges across the country like transgender health care and legal avenues to prevent bans on therapies. This inspired broader reflection on how to balance protecting individual rights under significant economic and political pressure.

In light of these constraints, Keith offered that she relies on a baseline of fundamental protections as her north star in her legal advocacy. However, she recognized that these political circumstances can be a boon to advocacy efforts. Because gender health policy issues tend to generate a significant amount of stakeholder engagement, Keith is able to bring these perspectives and momentum into the legal discourse via amicus briefs, public comment, and benefit outreach. She also added that the continual feedback loop of the public and the law enriches the discourse and strengthens the cases advocates make.

Finally, Keith closed out the conversation by encouraging students to lean into new and different experiences which may present themselves as they set out on their careers, reminding them that sometimes the most rewarding or informative opportunities may be the ones they least expect.

Bailey Coghlan (H’25) is an undergraduate student at Georgetown University majoring health care management and policy. She is a student in the Conversations in Health: Global to Local class.

On March 11, 2025, the Conversations in Global Health: Global to Local class welcomed Katie Keith (L’12) to discuss her life and career. From her time as the director of the Health Policy and Law Initiative at the Georgetown University O’Neill Institute for National and Global Health Law to her role as the deputy director of the Gender Policy Council in the Biden administration, Keith has been at the forefront of policymaking in gender-affirming care. We opened our discussion by reflecting on the path Keith took to where she is today.

One of the key topics of our discussion was gender-affirming care. Keith emphasized its importance within health care rights, noting that this care should be treated as a basic human right. We touched on the current political climate and how it is becoming increasingly difficult to fight for basic human rights for marginalized communities. Between the court cases happening, state-level restrictions, and federal challenges, it has been harder for people to access the care they need and deserve, which has created a tense legal environment. Keith’s perspective on this is both personal and professional, as she sees the protection of gender-affirming care as a matter of equity and human rights, and she underscored that legal battles are likely to shape health care access for years to come.

Following this, we discussed the relationship between the Affordable Care Act (ACA) and gender-affirming care. While the ACA has provided critical protections for individuals seeking gender-affirming treatments, Keith acknowledged the challenges in ensuring these protections remain intact. All ACA provisions are vulnerable to political shifts. Keith’s insights highlighted how in a highly polarized political climate, it can be difficult, and at times, near impossible, to make forward progress for historically excluded communities. This speaks to the broader struggle in United States health care to implement and maintain laws that protect citizens with changing political parties.

Reflecting on Keith’s journey, I am reminded that creating change in health care policy is not about a formal education but rather an understanding of law, policy, and human rights and using that understanding to push for a more equitable system. Keith’s perspective is a valuable reminder that policy work is just as vital as courtroom advocacy in shaping the future of public health.

Jenna Mertes (C’26) is an undergraduate student at Georgetown University majoring mathematics. She is a student in the Conversations in Health: Global to Local class.