Coming Out of the Closet with Diabetes

Challenging Discrimination: Eileen Bahlsen & Daryl Williams

Mar 25, 2025

Each person with diabetes somehow faces the realities of living with a chronic condition, whether they want to or not—but it’s a choice whether or not to tell everyone you have diabetes.

Something also has to happen inside to make a person actually proceed with treatment or not. What makes diabetes even more complex—beyond the highs & lows, blood sugar monitoring, carb counting and the rest—is discrimination.

On the outside, a person with diabetes may look perfectly “normal,” and it’s a struggle to navigate whether coming out of the closet with diabetes in certain situations will bring support or stigma. If people are so blatantly discriminatory when it comes to things like pilot licensing, scuba diving, giving blood and driving, it’s no small wonder that people with diabetes don’t volunteer the information to everyone they meet.

We might say that discrimination on the basis of religion or race is wrong—that prejudice or bias does not recognize the other as an individual—but what about discrimination on the basis of a known medical condition such as diabetes?

For example, a varsity coach may decide not to play a team member with diabetes because he or she may have an insulin reaction. While this fear may be justified to some extent to protect the school’s liability in the event of an accident, it is often a fear based on misunderstanding diabetes.

Constantly having to justify diabetes and explain it to others is frustrating and exhausting. Rumours are often unfounded and are based on misinformation and ignorance, but they’ve usually already done their damage in the minds of people who are stigmatizing. People with diabetes are just that—people—not an illness. They are marathon runners. They are teachers. They are doctors. They are successful in many different walks of life.

To face diabetes is a massive challenge—the reality is that people with diabetes are discriminated against in all walks of life. Three of the most obvious areas are employment, vehicle licensing (and licensing in general) and school.

Sugar man

Employment and diabetes

Employers often cite fear and apprehension that a person with diabetes presents a safety risk to the employer or the public. Such fear is often based on misinformation or a lack of up-to-date knowledge about diabetes. Many people with diabetes know when they are having a low blood sugar because there are often warning signs such as rapid heartbeat, sweating, shakiness, anxiety and hunger. All it usually means is a quick break to eat some sugar.

In other words, people with diabetes should be considered on an individual basis and should not be excluded from employment purely on the basis of their diabetes. All people with diabetes are not the same.

People with diabetes have rights on the job. Both the American Diabetes Association and Diabetes Canada have position statements on this.

According to the ADA:

As a person with a disability, you are protected from discrimination because of your diabetes.
This means that an employer:
Cannot fail to hire or promote you because of your diabetes
Cannot terminate you because of your diabetes (unless you pose a “direct threat”)
Must provide you with reasonable accommodations that help you perform the essential functions of your job
Must not discriminate with regard to employer-provided health insurance.1

But employers do discriminate. Putting the onus on the individual to “know their rights” isn’t actual protection against employers who discriminate against people with diabetes based on stereotypes or outdated information.

This is despite the fact that when people with diabetes are hired, their “employment experiences ... appear to be similar to the experiences of the nondiabetic population...” according to the research, and most make excellent employees. As far as taking time off, research was done to compare siblings with and without diabetes, and found that “absenteeism among [insulin dependent diabetes] cases currently working did not differ from that of the nondiabetic siblings.”2

What about safety-sensitive jobs? Can I get a job, for example, in the armed forces? Short answer? Probably not. There are some jobs where medical information is confidential, and some where disclosure is mandatory.

According to Diabetes Canada:

Your medical information is confidential unless you work in a safety-sensitive position. Examples include:
firefighters
police officers
commercial pilots and cabin crew
train engineers
train conductors
heavy machinery operators
professional/commercial drivers
These jobs require a determination of medical fitness as a part of the employment selection process and then regularly thereafter. Mental and physical fitness is mandatory.3

So there are some limitations to the promises that a person with diabetes is just like anyone else. There are some jobs that are rightly more challenging for people with diabetes to have—but the problem is blanket discrimination, which still happens. Let’s take a look at pilot licensing. Should people with diabetes be allowed to fly planes? I’ll have to save driver’s licensing for a future post.

Flying with Diabetes

Eileen Bahlsen was the first person in the world with type 1 diabetes to be licensed to fly an aircraft solo in Canada. That’s solo—without any safety pilot. Before April 1992, anyone who wanted a pilot’s license had to obtain a medical certificate, which was not granted to people with T1D.

That’s blanket discrimination.

On June 10, 1991, Eileen was told she was “medically unfit to hold any form of flight-crew license.” On November 4, she launched a federal court case against this blanket restriction, claiming that it violated her rights under section 15 of the Canadian Charter of Rights and Freedoms.

The Charter reads:

15. (1) Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.4

Eileen realized that she was not being considered on an individual basis and that if she were, she’d be seen as fit to hold the license. Justice Frederick Gibson agreed. On June 30, 1995, the federal court judge declared the regulation was against the Canadian Charter of Rights and Freedoms, and therefore was of no force or effect.

The American Diabetes Association (ADA) became embroiled in a similar struggle with pilot Daryl Williams who had qualified for a commercial as well as a private pilot’s license, until he developed diabetes and his license was revoked. The Federal Aviation Administration (FAA) denied anyone with insulin-treated diabetes a certificate that would allow a person to pilot a plane. The ban did not stop Daryl from piloting a plane with another pilot on board.

In 1991, the ADA filed a petition with the FAA that asked them to drop its blanket restriction. It also asked that each pilot be considered on an individual basis.

Through letter-writing campaigns, a protocol written by endocrinologists and many organizations including the JDRF (now Breakthrough T1D), the Aircraft Owners and Pilots Association, and the American Association of Diabetes Educators, history was in the making.

It took medical professionals to join in the struggle before the petition was considered seriously. In December 1996, after a full five years of convincing, the FAA finally dropped its policy, taking the protocol seriously. Those with type 1 diabetes could be evaluated on an individual basis at last.

Williams describes the experience like this:

One of the most devastating effects of my diagnosis of Type 1 diabetes when I was 40 was that I could no longer fly because of the FAA's blanket prohibition on granting medical certificates in view of the perceived risk of hypoglycemia. It seemed an anachronistic rule. I had to fly with young flight instructors, who were the official pilots on board, though they had less flight experience.

Air Surgeon General Dr. Jon Jordan said, “This [granting pilot licenses to diabetics] will never happen on my watch.” Six years later, he called to say he'd changed the law and would personally sign my application, allowing me to fly again. I now have 3,000 flight hours on multi-engine planes under my belt, where an automatic insulin pump is clipped.5

People with diabetes have the ability to oppose unjust blanket restrictions and blatant discrimination. Eileen Bahlsen and Daryl Williams are great examples of people with T1D who did it and so can you. It just takes a lot of time, dedication and perseverance.

I’m still writing the book. I’m editing it. It’s shaping up well.

If you become a paid subscriber, you’ll be first to receive a copy of the new book.

If you become a founding member, you’ll receive a signed copy of the book when it’s published. Think positive, I keep telling myself. Focus.

Coming Out of the Closet with Diabetes

Challenging Discrimination: Eileen Bahlsen & Daryl Williams

Employment and diabetes

Flying with Diabetes

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