LGBTQ + Health
The Future for LGBTQ+ Physicians is Bright
I
n the over 50 years since the Stonewall riots, the United States has made dramatic progress in the way LGBTQ+ people are viewed and embraced. More strikingly, in just the past five years, LGBTQ+ Americans have had these changes reinforced into legal protections. Both in the landmark 2015 marriage equality Supreme Court ruling and most recently the title VII ruling that ensured federal protection in the workplace, change has been brisk. While the country as a whole has made tremendous progress in LGBTQ+ rights and acceptance, the culture in medicine has seemed to lag. Medicine, in general, has been a straight, white, male profession. It wasn’t until 1973, the American Psychiatric Association (APA) removed the diagnosis of “homosexuality” from the second edition of its Diagnostic and Statistical Manual (DSM). These theories regarded adult homosexuality as a disease, a condition deviating from “normal,” heterosexual development. With language like that in the medical literature, it is no wonder why it took so long for the culture in medicine to change. While we have made considerable progress, I’ve seen firsthand — as a patient, student and young physician — areas where we have room to grow. I distinctly remember being a premed student and going to get a routine physical. The physician was going through sexual history and used tones and phrases to insinuate I was straight. By Barrett Holen, MD
20
September/October 2020
I didn’t correct him. It was a minor and brief encounter, but I remember that feeling of “not being normal” and the awkwardness that accompanied it. I reflected on that experience and realized if I felt that way during that simple history taking, I can’t even imagine what other folks have experienced in health care. I vowed at that time that I would do my best to ensure my future patients didn’t have similar feelings that I did, regardless of sexual orientation, race, or any other culturally sensitive topic. As I started medical school in 2012, I initially didn’t disclose my sexual orientation to my classmates or faculty. I didn’t want this part of me to potentially affect my career. I initially feared discrimination from my peers, faculty, evaluators, and even patients. I then reflected again. If I wasn’t honest and open about myself, what example am I setting for my patients? So, I slowly started to open up to my classmates. When someone would
ask if I had a girlfriend, I would correct them and say “boyfriend.” They usually apologized. I never was offended; I just didn’t want to propagate something that wasn’t true. Being able to speak casually about your personal life or loved ones may seem trivial to some, but feeling comfortable to do so is so incredibly important and it reaffirms that you matter. I was in medical school during the time when LGBTQ+ curricula started to gain traction. I could sense there was meaningful change happening. However, these changes weren’t embraced by everyone in the medical community. I remember hearing an elderly attending comment that he thought that it was a “waste of time” and “unnecessary.” Regardless, it was positive change both for the culture within medicine and the care we provide our patients. Still, I struggled with if it was possible to be “out” in medicine. I sometimes believed in the false dichotomy of having to choose between being a physician and being openly gay. As I progressed through medical school and started to think about possible specialties, I wondered to myself if certain specialties wouldn’t be possible as a gay person. There were certain specialties that further reinforced the straight, white, male stereotype. If I wanted to be a surgeon or have a career in academics (areas traditionally straight males dominated) would I have to hide who I was? Being gay was just one part (a wonderful part) of who I was, and I didn’t want it to limit my future career opportunities. In some ways I felt a way that perhaps many women or people of color feel — that a
MetroDoctors
The Journal of the Twin Cities Medical Society
