White Coats And Closets: LGBTQ Medical Students Frequently Fear Coming Out

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A new study from Stanford university researchers indicates that LGBTQ medical students in the United States and Canada have strong fears of discrimination that lead them not to discuss their queer and trans identities. The study, which appears in the journal Academic Medicine is one of the first to examine sexual and gender diversity among medical students.

The Stanford research team, made up primarily of members of their LGBT Medical Education Research Group, sent out surveys to every medical student in the United States and Canada during the 2009-2010 academic year. While only a little under six percent of the surveys were returned, this still represented an impressive 5000+ participant pool to draw data from. Of those who responded, 917 self-identified as a “sexual or gender minority (SGM),” a term defined by the study group. Of those who identified as an SGM, nearly 30% indicated that they were not “out” to their medical school peers and instructors. While about 60% of those who were not out noted that it was because it was “nobody’s business,” almost 44% said it was due to fears of harassment or discrimination. Among those identified as a “gender minority,” the numbers are even worse: 60% were not out to their colleagues, and fears of discrimination and lack of support cited as the most common reasons.

The researchers shared some of the free-text responses from the study participants regarding their reasons for not keeping quiet about their identities. They’re all pretty disheartening. One young bisexual woman said:

“I’ve also met multiple people who believe that bisexuality does not exist. In particular, I feel that claims of bisexuality in women are regarded with suspicion—attempts at gaining attention because of the appeal of “girl-on-girl”…. When I came out about being bisexual to a very well-educated medical school colleague of mine (at the top of his class, multiple degrees, extensive knowledge about politics), he innocently commented that he never quite understood the idea of threesomes and asked whether my bisexuality meant that I would want to marry both a man and a woman. I was totally taken aback that even a highly educated peer could so honestly equate bisexuality with polygamy.”

Another of these responses unfortunately provides some reinforcement for why transgender students may be disinclined to disclose their trans status when she misgenders a patient in the course of her comment:

“I have only shared my orientation with a few friends whom I feel to be accepting. No faculty know, that I’m aware of, because I fear their prejudices will affect my grades consciously or unconsciously…. I have found no faculty who seem accepting of LGBT people based on their casual conversations, discussion about patients…. On my surgery rotation, we saw a male-to-female transgender patient who had “do-it-yourself” silicone breast implants which had become infected. He was treated like a freak by the residents and attendings behind closed doors, joking at his expense. “

Taking a deeper look at the data provides some interesting insight into the difficulties that this kind of research poses when the progressive individual identities of young people bump up against the need for researchers to use boxes. Of the 912 GSM respondents, 148 (over 16%) indicated they identified with “multiple sexual identities,” though the researchers do get some credit for including both “queer” and “questioning” as potential responses.

Unfortunately, it appears probable that their question construction for gender minorities may have frustrated their efforts to capture data about transgender students. For gender, the participants were only given the options of male, female, “female-to-male transgender,” “male-to-female transgender” and “other gender identity.” This is unfortunate and significant othering of trans people, and the use of antiquated “MTF/FTM” language may have caused transgender students to instead self-identify as male or female. Considering that 22 of the 35 gender minority participants elected “other gender identity” as their selection, it seems possible that some granularity in the data was lost. Indeed, even Stanford’s own news post on this publication referred to the gender minority students in this study as “those identifying as something other than male or female,” failing to grasp the concept of transgender identities entirely.

Regardless, this study provides important insight into the barriers faced by LGBTQ medical students early on in their careers. It’s certainly perfectly understandable that some students will choose not to disclose their gender identities or sexual orientations for a simple preference for personal privacy. However, the fact that significant numbers of queer and transgender medical students remain closeted in their professional environs because they fear discrimination or lack support from their institutions, peers, and mentors is incredibly concerning, though certainly justified in the homophobic climate of medical schools. Visibility remains one of the key methods of combatting anti-LGBTQ biases, and given how poorly queer doctors are treated, the depressing lack of LGBTQ health education in medical school, and the dismal state of medical care for the queer and transgender communities, we need as many out doctors as possible.  The Stanford research team seems to grasp this notion strongly, noting in the conclusion to their paper:

“Although SGM students often experience a different and occasionally hostile environment during training, they also bring a unique and underrepresented perspective to medicine. In particular, these individuals may be much more likely to pursue careers that encompass caring for SGM patients, who face significant health and health care access disparities. All medical students deserve a safe and respectful environment that fosters individual development and success during undergraduate medical training. As such, all institutions must take active steps to better support SGM individuals in medicine.”

Mari is a queer lady scientist and educator from Detroit, who skillfully avoids working on her genetics dissertation by writing about queer and trans life, nerd culture, feminism, and science. You can frequently find her running around at science-fiction conventions giving panels on consent culture and LGBT topics or DJing at fantastically strange parties. She is a contributing writer for TransAdvocate, maintains a personal blog at TransNerdFeminist, and can frequently be found stirring up trouble (and posting selfies) on Twitter.

Mari has written 36 articles for us.

53 Comments

  1. As a bisexual physical therapy student, I believe there’s another reason we don’t come out in a professional setting. We are constantly up close and personal with patients (and our classmates posing as patients in a school setting) and we are constantly battling the stereotype of “the predatory gay” who will indiscriminately hit on anyone of the gender they are attracted to. I had a professor lament to the class that she’s had “multiple lesbian patients become attracted to her during treatments” and that it was just a “problem we’ll have to deal with once we get into the field”. There’s no way I want my female classmates talking behind my back about how I was “getting too close” during a standard PT treatment even though I know I was acting completely professionally.

    • Another obstacle, in my experience, is that doctors get to use their patients as a cover. We can’t come out because it would be alienating if our patients found out (even though straight students can mention spouses or significant others). We can’t be straightforward discussing simple issues because men will be offended if we ask them if they have sex with other men. Students, at least, are told at my school that you ask everyone patient if they have sex with men, women, or both (and at least some of them take that to heart). But doctors can easily disguise their bigotry and discomfort by saying that they are acting to protect their patients.

    • ^I’m also a bisexual PT student and you took the words right out of my mouth. While I am out to my close friends in my major, I’m scared to be completely open since so much class time involves physical contact with my peers and I don’t want my female classmates to get all weird about it. It stinks because in the undergrad portion of my education I was completely out and felt “free” while now I always feel like I need to be on the down-low while talking to my friends about my relationship.

    • Yes! I’m a nursing student and I have to be in close physical contact with other students on a regular basis. I’m constantly concerned that a classmate will think I was looking at her some kind of way during a physical assessment or something. Not sure if this is just some kind of internalized junk I’m dealing with, and people really are capable of being cool about it or what.

  2. In my experience, men are at least three times more likely to be out than women, too.
    I used to be out due to my oversharing while drunk tendencies, and I remember a time I was in a club and ran into someone from my class who was with her girlfriend, and she just looked at me in shock, scared I’d out her at uni, too.
    And all I could think was,”Wow, it’s past the year two thousand, and we’re in a metropolis in the heart of Europe, and in College of all things…”
    There were others, too,with questions about books,secret girlfriends, lovers, hook ups,..
    Pulp Fiction material straight from the fifties, seriously.
    And it’s really weird come to think of it, everyone was watching “ER” at the time, and now everyone is watching Grey’s, but the media representation can’t seem to breach the conservative stigma that the “Old Boy’s Club” medicine carries.

  3. One of the links provided above notes that med school students and professors are not more or less homophobic than the general population. This leads me to wonder:what makes med school homophobia unique?

    As a law student, I couldn’t help but draw some parallels…Med school, like law school, is a very hetero-normative institution. The joke in law school is that lawyers/law students have some of the most progressive politics,yet are some of the most conventional people…The career imparts to many a sense of status and security rooted in elitist ideals. And conformity to gender roles is inherent to these ideals. Anecdotally, I’ve noticed that this tension between a group’s liberal politics and romanticization of the patriarchal American dream results in a very insidious and lethal form of homophobia. Take for example my best straight guy friend, a gay rights supporter and voter, who once remarked that he did not think one of our gay male classmates would “fit in” at an elite firm, and that he should probably “look into being general counsel for Gap, or something.” I wouldn’t be surprised if similar attitudes were present in med school..

    • As a recent law school grad, it was a frustrating environment because almost no one was out. Statistically speaking, there had to have been more queer students than the half dozen or so who were out in a student body of over a thousand, but fear of harming future employment prospects meant students weren’t wanting to risk it.

  4. Ugh, this is disheartening but not surprising. I spend a lot of time trying to attribute some of the attitudes I see daily to climate of the state I’m in. It is both discouraging, but also kind of relieving that people experience this everywhere (like, it’s not that everywhere else is rainbows and unicorns while I am stuck in this delightful state). Part of the growth will come organically from new generations of activist and accepting students, but I also think medical schools are seriously missing out on opportunities to teach sensitivity, inclusion, and tolerance when dealing with patients or peers. I hate that my classmates have the attitudes they do, but also our curriculum does nothing to help them learn to think differently.

    I also think it’s worth echoing Renee’s comment that this becomes a particularly fraught decision in fields where we have to have conversations or do procedures that would be awkward or inappropriate in other circumstances. There’s no way I want to make those experiences any more awkward (even just by perception) for myself or my patients.

    That said… I also think visibility and role models are important to making

    • There are amusing moments though. Like when lecturers repeatedly talk about “scissoring” your cadaver (using the scissors to blunt dissect) and you just sit in your corner laughing to yourself.

      • Ha! When we were doing psych, CBT = cognitive behavioral therapy, but I and my queer boy classmates were like “cock and ball torture” as effective treatment for OCD? Fascinating!

        • I met one of my best friends in nursing school through a shared giggle at CBT! So happy to learn that other people have that association too. Now I giggle every time someone mentions cognitive-behavioral therapy…

  5. As a medical student, I am surprised and disheartened by the idea that there is no more homophobia in medicine than other fields. Because this means all of the fields suck. Even when i have seen doctors try to include more lgbtq issues into the curriculum or to the residents at grand rounds, more often than not they just reinforce stereotypes and teach people that they need to be more committed in their efforts to be horrible at life.

    The students who know me know that I’m queer and I have worked on programs to education medical students about lgbtq issues. And i think its helpful to those who choose to participate. But you have to take into consideration that doctors play a large role in institutionalizing bigotry against transgender people, gay people, asexual people. Doctors generally are the ones who get to decide what we should consider normal and what is pathological. Though I am sometimes able to make some progress with younger students and residents, it’s an extremely regressive culture.

  6. I’m a 4th year, queer, FAB med student who identifies as gendequeer/agender, prefers gender-neutral pronouns. I think that people just assume that I’m fully out as a butch dyke, and a few of them seem to think that I’m an FTM. Neither is quite right. I don’t usually discuss my gender stuff unless I know someone well, but if it comes up, I will go into it. So many of the professional relationships on clinical rotations are transient, you know, you’re there for a few days, then you’re gone. I just have no idea how to bring up something so personal when I barely know someone, particularly given that genderqueer stuff is something that so many folks aren’t even aware of. I brought it up to some of our LGBTQ group’s advisors, and they thought that it would be hard to do with patients, given that it could make the encounter more about me than the patient. I don’t know. I think that it’s something that will evolve as I move on in my career, find other genderqueer health care provider colleagues, see how they handle it. I sometimes feel like I’m punking out, but making an announcement to people that I don’t know is anathema to my personality. But, that’s how community visibility starts, right? Feel free to advise, folks. I have worked on researching LGBTQ aspects of the curriculum, trying to see where we’re at and how to improve. I also try to make sure that my classmates know that they can talk to me about queer/trans stuff (because I know them better, I have brought up my personal gender identity stuff with them). I have pretty thick skin, so I’m open to having discussions with people who are well-meaning jackasses, trying to help them step up their knowledge and sensitivity. Still, it can be exhausting.
    Anyway, I second what everyone said about medicine being a relatively conservative old boys club. It’s weird how that culture pervades, even when the stuffy old boys aren’t around anymore. And so many docs are moderate, progressive, even radical!

    • Ok, here’s my advice:
      Don’t come out to patients.
      It would be about you, not them.
      You go into a patient’s room as a blank slate, trying to see what they want from you, who they want you to be.
      Some are scared of you, others want comfort, for some, you’ll be the first they admit to, that they haven’t been well for a while.It helps you a great deal in placing their symptoms and evaluating their severity! And to be honest, you will have 15 minutes for a physical plus the “interrogation”, so not getting used to any small talk past “Hello!” is very solid advice.
      If you want to do something for the community, you’re doing it right.
      How many patients will your peers see over the years? How many queer people will be amongst those, and how differently will they react to their patients because they have known you, talked to you?
      And what kind of example will they be setting for their med students and their nurses and PTs? So it’s all worth it, keep studying and good luck!

      • I’m going to have to disagree with “Don’t come out to patients”. That is why I want to be a doctor. I’ve gone through the many different medical systems globally and internationally, and I’m tired of the universal indifferent and robotic doctor that doesn’t seem to think that their values affect mine.

        Sloppydelicious would be the perfect doctor for me. They get my gender, they get my identity, and as a closeted person I would love to know that at any point I can mention my sexuality and gender to my doctor without being judged. Not just that, I want to know that my doctor is on the same page as me. I want to know that my doctor is going to advise and care for me to the best of their ability and take my queer issues seriously.

        My idea of the perfect doctor is very different from my family’s, and that of others. My mum’s perfect doctor would recommend drugs lastly, be open to the importance of spiritual healing, diet, and be considerate to her religious lifestyle. So often has my mother been judged that she is now hesitant to go to a doctor that is not from her religion. When she goes to a doctor she wants them to state their beliefs right up so she knows that that person will treat her in a way she is comfortable with.

        Doctors that are open are important to me. It’s why I strive in this career. I want to give patients something the medical system severely lacks; human connection. We are not robots, our doctors are not robots, we should not be treated like robots. Unless you want to, then that is your choice, not something thrust upon you.

      • I agree with Amidola. I am out to my colleagues at work and there are only a few people who are not aware I am lesbian.

        I can’t see the point of a health professional “requiring” their “patient” accept the back story of the health professional, of which sexuality/gender is only a small part. The patient is seeking help with a health problem, they have not seeking to be “educated” about sexuality or gender, or indeed any of the personal agenda or politics of the health professional they are assigned to. It is not about you, and your need for acceptance/understanding/recognition, it is about the patient. The patient has sought your help, in your professional clinical capacity. They do not care about your personal life, as their health problem is currently overriding most other human needs at this point in time. In fact their health need has lead them to seek professional clinical help as it is beyond their ability to manage their problem for now.

        I have worked as a nurse for a number of years and simply treating all human beings with respect and time is the best thing that you can do for them, this will get their attention and respect.

    • I’m a third year transmasculine/genderqueer med student and I was really happy see proof that I’m not the only non-binary med student around. I only realized the trans part of my identity while in med school, and it’s been very difficult to navigate how much to come out, and how much I will already be outed by my months of low-dose testosterone treatment. I have definitely felt singled out my peers, professors, residents, and attendings – and the majority of the time I just hold my tongue. Occasionally I come across someone more open, and then like you I’m happy to answer whatever questions they have. Since most of my projects and extracurriculars have to do with transhealth issues, I think I’m not actually very stealth 🙂

  7. While I’m not a med student, I am a PhD student within a medical school. Within that environment, I’m pretty out about my queerness, and totally stealth about being trans. Once I figured out that no one was clocking me, it was just easier/less awkward to keep quiet. I will spend 5 years working on the same floor as many of these people, and the last thing I need is awkwardness when I use the bathroom. Plus, there’s just ZERO LGBTQ support at my institution. There’s no direct hostility, but I definitely feel like an outsider.

    Previous to that, I worked in hospitals for years, and the sexism, transphobia, and homophobia was RAMPANT in the culture, especially among doctors.,

  8. Ok guys, this thread is getting entirely too negative.
    It states above, that medicine is no more or less homophobic than other fields.
    As I said, I’ve been mostly out, and while I had my run ins and share of idiots, I did give people the opportunity to surprise me, and surprise me,they did.
    You can’t expect people from a priviledged and conservative background to always use the right language and do the right things.
    How do they even know they know a queer person?
    The positive aspects outweigh the negative ones by far.
    I do get that a large part seems to have to do with the physical aspect being awkward.
    But even if the contact is physical, it’s not sexual.
    Even if states of undress and touching people is private, it’s not intimate.
    What you’re afraid of is making people uncomfortable when touching them.
    That people might choose to not be touched by you.
    Or, the horror, that you might be turned on, and people would know!
    You wish to be the neutral party whose touch is indifferent, who is always indifferent.
    And you are.
    Or at least you will be.
    As soon as you put on scrubs or a coat, it doesn’t matter if you’ve had your coffee,yet, slept for two hours, that your dog died or that you’re happily in Love.
    It doesn’t matter if you’re gay or your birth name was different from the one you’re sporting now, your name doesn’t even matter.
    You’ll just be busy reminding people, that you’re not the Nurse.
    It’s incredibly liberating, actually.
    “The Old Boys Club” is a lot more sexist than it is homophobic, btw., my charming superiors even went through a phase where they hired a disproportionate amount of gay men, because they wouldn’t suddenly get pregnant and drop out of shift rotations from one day to another (a strangely recurrent condition in young women, who knew?) or take parental leave like a lot of the young dads did.
    So,what I’m trying to say is,”My sexuality is not the most interesting part about me.”
    There are so many things so much more important, like ECGs, for example.(Like really, you will never lack respect or friends if you can read those really well).
    Make sure to be known for your competence and kindness, then your sexuality won’t matter at all.
    The trick is, though, that it mustn’t matter to you first.
    And who knows,the Nurses might even try to set you up with their gay sisters 🙂

    • Are you serious? This word-scramble mess is the absolute WORST. Is this supposed to be performance art? Am I reading bad advice in a magazine?
      There are no “tricks” to ignoring a central part of your identity in your life’s work, full stop. I can’t believe I even have to say that. Of COURSE your competancy and kindness are vital, but SO IS YOUR IDENTITY and how it intersects with your profession! Take your terrible opinion elsewhere.

      BTW, everybody knows you’re not here for the right reasons when you start saying things like “the Nurses might even try to set you up with their gay sisters.” Go away.

      • Oh, cyber mobbing.
        Just wonderful.
        What I was trying to say yesterday, while being sick as a dog and my ipad dying on me two times is this:
        Things might seem really,really bleak, but they might not necessarily be so.
        I was terrified,each and every time I came out (I still am), and it wasn’t pretty at times.(I got into hot water with the openly homophobic chief examiner in my final exams,for example).
        But usually,when I came out, after a while, my sexuality became such a non issue, I wondered why I even fretted.
        What I was not prepared for,were the sometimes overwhelmingly positive responses. When the nurses jokingly tried to hook me up with their siblings after coming out or told me to get a girlfriend already who’d scold me for working overtime, or when co-workers accompanied me to the gay club for a couple of drinks after hours, my gay and my medical world finally settled into a whole that was previously very separate.
        That separation was a heavy weight on my soul for a long time.

        I hope I’m making more sense today,I’m not a native English speaker and my head still feels like someone is driving nails through it.
        Your comment to me was very hurtful, Chelsea. I didn’t even know if I should respond and clarify or just hide away.
        I chose the former to find closure and won’t come back to this thread.

        But I do wish all of you good luck on your journeys!
        Have some Faith:-)

      • Chelsea,

        You are disclosing more about your own insecurities in blindly denying Amidola’s strategy in gaining experience as a doctor and lesbian.

        Amidola was only putting forth a suggestion that focusing on one’s competency as a professional (what the health professional can offer a patient who is seeking clinical expertise)can provide as a clinically safe and culturally competent health service provider rather than focusing on developing the nuances of one’s sexuality and gender (which is not included in the professional competencies of any health professional’s role) to a patient. The distinctions are clear and contribute to the entire health professional’s identity, however patients are normally seeking evidence based clinical expertise in a health speciality, and preferably free of any personal agenda driven by the health professional, themselves. Chill out a little.

        • I am so sorry. I had misinterpreted what you’d originally said in the worst way. I had taken “the Nurses might even try to set you up with their gay sisters” as something of an insult to the integrity of those in the profession… almost like you were making fun of this clearly important discussion in healthcare. I had taken it to mean that you were saying, “I know women/minority women are pushed to the outskirts of the profession by the aforementioned Old Boys Club, and that they make it almost unbearable to exist here, but why don’t you/women/minority women just take what you can get and stop asking for more?! The nurses might even set up with their gay sisters!”

          Does this make sense? I thought you were being intentionally condescending with that comment. That’s why I said “I can tell you aren’t here for the right reasons.” However, I never stopped to think that by writing in the manner that you did, it may have been due to a language disparity/difference. I so regret not considering that in the first place. I thought that the spacing and word choices were all about making fun of people who are sensitive to the fact that healthcare is often rife with professionals who are not culturally competent at all. Because that is SO important, and it is not something to gloss over in favor of simply saying, “my sexuality has nothing to do with my profession at all.” Like your lived experiences coming face-to-face with oppressive people do not color your profession or the way you deal with patients in any way? THAT’S what I was saying. I am so sorry that I hurt you with what I said, but the anger I felt in that first response was because I thought I saw condescension coming from you.

          Annalou: I have no idea why you blamed my insecurities for what I wrote. Aside from that, I don’t know why your response makes it seem like you think the healthcare industry exists in a vacuum? Of course patients don’t want the professional they’re seeing to share “their agenda” with them in lieu of actually treating them, but I think I can say (at least for myself) that it IS comforting to know exactly how aware my doctor is of who I am. And I want to know a little bit about where THEY are coming from so that my interaction with them isn’t uncomfortable at best or cold and devoid of empathy at worst. The fact that my doctor could potentially offer a queer perspective to connect with my own seems refreshing, and totally calming in an otherwise anxious setting. Please tell me that these are not high hopes. Because if you think that saying healthcare professionals should be more personable, inclusive, and culturally competent with their patients and colleagues is a far stretch, then I probably already proved my point.

    • Now that’s a brilliant post.
      Until the world is exposed to the normalcy of human diversity, it’s probably expecting a little too much for everyone in the ‘normal’ (read: actually-different-but-don’t-tell-anyone) range to put their heads over the parapet and ask each other to stop making out like everyone ‘else’ is a bit weird & therefore an okay target of derision.

    • People are saying negative things because they’ve had negative experiences. People are commiserating on shared experiences in this field. If there is any place to voice frustration about a topic that is obviously up for discussion, this is the place to do that.

  9. This explains so much. I have prayed to the heavens for a queer doctor so many times, hoping they would finally be competent and understanding.
    With the slew of doctors I’ve seen, it’s statistically probable that I’ve met a queer doctor, but not only have I not known at the time, they were also no better than the rest in terms of awareness of queer issues.

    • YES, I’d love a lesbian doctor. Don’t get me wrong, I love my current PCP—she’s incredibly down to earth and better than other doctors I’ve had—but she can be a little awkward about some things. And, I’d love to, for once, not have the awkward silence when the doctor’s like “How do you KNOW you’re not pregnant?” and I tell them it’s because I don’t dig the d…their reactions are always a little awkward, I think because I kind of look like a good little straight Christian girl.
      Seriously, my campus doctor in undergrad made me take a pregnancy test every time I came to see her, whether it was because I broke my foot, or had the flu or a cold, or whatever…

  10. it really is a shame to see how hostile the environment can be in med school.

    but aah my current dr is a very butch very out married lady and i love going to see her so much. i don’t think she discussed her wife with me, but it’s listed on her website, i’m pretty sure? when i did my first general appt with her she did the necessary questions about being sexually active and it made me so much more comfortable to be able to tell the truth instead of being like “Ahhh i’m not really sexually active.” i went to see her to get an anxiety med perscription, and she immediately opened up about having a family history of depression, which made me so much more able to have a frank discussion with her and not gloss over anything. i think it improves the experience as a patient when you can truly connect with medical health professionals

    i also had a chiropractor who was married to a woman, and i’d seen her for about two years, along with a friend of mine who both thought she was kinda cold (not quite cold, but definitely rigidly professional), and at one point i think she could tell i was also a gaymo so she asked me for the cool places in a city she was going to a conference in (i had mentioned living there before) because her partner was tagging along and she didn’t want her to be bored the whole time. from then on we had so much more open/comfortable conversations during my appointments and always chatted about orange is the new black. i was sad to find a new chiro when i moved again

  11. I am in the veterinary medical community, and there’s definitely an interesting contrast. I think my class is reasonably representative of the profession, at 70% women and maybe 15% gay men. The college has a thriving LGBTA group – the “Homophiliacs” 🙂
    The group is almost completely social, maybe because – my impression – it is so RARE, in this generation and in the northeast, for for any of our members to be made to feel uncomfortable about our sexuality.

    Why?

    No one even has a good idea of why the profession is now so predominantly female, much less of why we’re so darn gay. Maybe women and gay men are guided here by a penchant for nurturing.

    The biggest difference I can think of between the veterinary and human medical professions is that we do not have the prestige that they have. We often struggle to maintain ourselves financially, and struggle to show that our profession and education are equally rigorous and demanding of respect. Few of us would be here if our primary drive were not a love of animals. So, I also wonder if those who are used to being outsiders, and used to striving for excellence on their own on the outskirts of society, are more comfortable here.

    • Edit: the LGBTA group is “almost completely social” – I mean that we could organize lectures and panels on dealing with discrimination, but don’t feel an urgent need to.

    • Unfortunately, I must report the northwest is not so progressive. When word got out that I was transitioning, my partner, who’s just finishing up her DVM, discovered that some of her colleagues had started having rather long, protracted conversations featuring gross speculation about my anatomy and our sex life. She ended up reporting it to the Office of Equal Opportunity, and while they took it seriously, so far nothing’s happened with the case because none of the people who witnessed were willing to speak up. The Vet School also initially supported her, but hasn’t done much, either; however, some of the things they stated suggested that this wasn’t an isolated incident, so at least they seem aware that this is a problem.

    • To be blunt, I would rather put my life in the hands of my (dog’s) vet than some of the staff at our hospital. I don’t go to hospitals much (luckily), but one occasion the on-call gyno specialist said that I was more likely to be having an adverse drug reaction (interesting, since I don’t take drugs) than a twisted ovary. My money was on the twisted ovary having had one just 6 months earlier which needed surgery to fix. Unfortunately it took 4 more hours before a surgeon arrived and decided to do an ultrasound to see what the problem was. Lo and behold, yes it was a twisted ovary which they had to remove immediately because it was by that time necrotic.
      Now, if that had been my vet …
      Clearly there are some good and not so good medical practitioners, and obviously vets would suffer the same range. Yet still … if I had to choose my vet, or a random on-call medical practitioner hmmm.

  12. Mm. This article was 110% relevant to my life and struggles as an out dental student. I came into school intent on creating a safe space for LGBT people like myself, so I contacted someone who felt safe at the school and created an LGBT organization. We are one of only a handful of LGBT student organizations at dental schools across the US. It was difficult dealing with the prospect of tarnishing the perception of me as a professional/student by my peers and mentors. I was afraid that my identity would be the only thing people would connect me with and that it would limit my future opportunities if I were to ever meet a homophobic mentor/advisor/professor. But then I realized that most of my fears were based in internalized homophobia rather than in reality. For the most part (99% of my experiences), people are fine with my identity.

    The kicker was coming out once again in the middle as a trans person. That was really tough. I can sense tensions within my peers about how to broach the topic, their discomfort with my gender, via microaggressions and consistent misgendering.

    I do agree with one of the commenters above that medical/professional schools funnel in the most hetero- and cisnormative people. Sometimes I wonder why I ended up where I am, and then I remember that I strive for the same things as my peers, and while it makes me uncomfortable to be around some of them, I still have to pursue my career aspirations.

    Anyway…it took a lot of pep talks and self-doubting and “f–k it, I’m just going to be myself” to be completely and fully out in professional school. But God, it was one of the toughest things I’ve had to do.

    • *high-five* yesss dental! awesome work on the LGBT organisation, i wish i had that in dental school. my year cohort was only 60-ish people and i know very few other LGBTQ dentists even now, and none at all during uni. now at work i’m only semi-out to staff and colleagues, like if it comes up in conversation. so i admire your self-confidence!

      • *high-fives* Dental peep, hollaaaa. lol.

        My class is 80 people. Few of them are out as LGB, and we have a few out gay professors, but I can imagine that it would be difficult to be an out queer person at work 🙁 considering it’s a smaller number of people and much tighter-knit. It’s so hard always considering whether it’s okay to come out or not.

        • actually that reminds me we did have one out gay professor! so it wasn’t as arid a desert as I remembered.

          I think the small business thing in some ways can be a supportive and close environment, if the team gels. it’s just my preference not to share my private life with people I don’t know well. with patients though the topic very rarely comes up, but when it has I’ve never had a bad experience (I live in Sydney Australia though). I also love seeing patients who are lgbtq!

  13. I think its appropriate that the LGBT Medical Education Research Group seems to be attempting to change the schools culture from the top down.

    I don’t think it reasonable to expect current students to risk their professional future to come out in an un-accepting environment.

  14. Just wanted to say that I agree with so much said above. I saw some of the most blatant homophobia and transphobia in medical school (mostly from residents/attendings but from some sheltered med students too) and at first I was hesitant to come out. The worst example was with a surgeon who refused to address a transwoman by her preferred name and gender pronoun. He went on a rant in the middle of a cholecystectomy (on a different patient) about how she disgusted him so much and how he “wasn’t going to support that lifestyle”. I didn’t dare say a thing because the surgical specialties are already so malignant (I mean med students can hardly even speak in the OR) but thankfully a chief resident did halfheartedly speak up for our patient.

    Eventually though the pressure to perform combined with the stress of keeping a secret became too much and I ended up in counseling. I decided to come out to my class and things were instantly better. Never could get myself to come out to more than a handful of attendings though, and always in the setting of me correcting them when they assumed I had a boyfriend.

    Now I’m currently in an Ob/Gyn residency. I almost didn’t go into Ob/Gyn for fear of the “predatory gay” myth but I absolutely love my work and it is such an incredible privilege to get to take care of these extraordinary women. I decided to adopt a DGAF attitude towards coming out during residency interviews. I figured I don’t want to go to a program that wouldn’t support me. After I matched I also decided to be fully out to my program. Maybe I just got super lucky but all of my attendings and co-residents have been super wonderful and supportive. It’s been lovely. I’m still trying to figure out though how open I want to be with patients. On occasion they’ll ask me if I have a boyfriend and I think it’s very important to be honest with them. (I also worked in med school with a gay male who would lie to his patients and pretend to have a wife instead of a husband. I don’t want to be that person.)

    Sorry I also have night float brain so I hope this makes sense and wasn’t me rambling. It’s just so nice to hear everyone’s stories and share a bit of mine.

    • Some of the surgeons I’ve come across are despicable: friends and I have all observed surgeons being quite sexist/misogynist, etc, but the prevailing culture where I live is incredibly hostile to whistleblowers (to the point that I’m apprehensive about leaving this comment here.) A friend of mine – med student – reported a surgeon for performing a DRE on a patient without consent, and then not ceasing the examination when she screamed in pain. While the authorities were grateful for his courage in coming forward, a few of our fellow students said that they’d think twice about hiring known whistleblowers, if they were in a position to do so, because they wanted to avoid “trouble.”

      (Not to single out surgeons specifically, but it is the most “old boys’ club” of all the specialties and they’re quite stubborn people generally so therefore resistant to change.)

      On another note, I’m very encouraged to read that you’re an obs/gynae resident! I’m seriously thinking of specialising as an ob/gyn – it’s my first love, and shadowing an ob/gyn was what convinced me to pursue a medical career – but lurking at the back of my mind is fear that I’ll be stigmatised as a “predatory lesbian” which I know WILL happen even though I live in a fairly large, otherwise gay-friendly city. Did you explicitly “come out” or did you just give people information as and when they asked?

      On (yet!) another note, do any of y’all watch “Call the Midwife”? It’s a show set in the 1950-60s about a group of midwives in a deprived part of London, and one of the characters this season is queer; I think they’re portraying her – given the period in which its set! – quite well, IMHO.

  15. Anything that cannot be scientifically and logically explained is difficult for a doctor to comprehend and accept. Hence, homosexuality is not easily embraced in the medical community.

    I have been questioned many times about my sexuality. The surgeons love to put you in a hot seat during OR’s while assisting because you have no ESCAPE from any of their questions. I never admitted that I was a lesbian. At first, I said I was bisexual (while talking to 2 male surgeons). After that, they didn’t bother to teach me as much as my other girly girl classmates.

    In my other assist for OBGYNE, 2 female surgeons asked me if I ever had a boyfriend. And, what made it worse was that that I had a major crush on the girl surgeon who first asked. I just awkwardly and nervously blurted “NO!” I had that great feeling that she was gay too. She gave me many dirty hot looks during OR’s but it was most likely my hallucination during my 30 hour duty shift. But that’s another story.

    I still denied my sexuality because I like how I was being treated and I feared that i was going to be treated differently.

    It’s hard to be out in this profession that requires you to live your personal life separately from work. Yes, your colleagues and bosses will always tell you that it is no one’s business to know because when you are at work, we just all think about the patients. It’s the number rule. Patient will always come first.

    But subconsciously these doctors will always know you are gay/lesbian. You will notice how they will treat you differently. You will notice how they don’t refer to you as much. You will notice why they don’t teach you.

    What I have learned in the hard way is that medicine is political. If you want to be on top, you have to live according to the unspoken traditional rules. If you lose the game, it’s hard to climb back up because everyone is connected with each other. If you want to be one of the best in the field, you have to deal with worst homophobic doctors before you get to be part of the club. It is political. It is expensive.

    I am not sure if they are just threatened by homosexuality or they see us as incapable.

    Today, I prayed to God and asked:

    “why am i gay?”

    “why am i doctor?”

  16. Bi cis woman medical student here. The only reason people know about me is because I help with a club aiming to dismantle the idea that SGM are rare and we will rarely encounter them in the patient setting. Had classmates say things to me like “Oh but, you’re just an ally right? You have a boyfriend, there’s no way you’re gay.”

    I’ve seen my share of discrimination from residents re: SGM patients. The disdain I’ve heard from physicians even about trans patients and how they’re “confused” is just not okay.

  17. I’m a gay, cisgender, fourth year pharmacy student. The survey results, and the experiences mentioned here, feel really familiar. The culture in pharmacy school and in the related health schools on campus is more conservative and conformist than I expected. There’s no campus-wide LGBT oragnization, though the school of social work does have an organization that puts on some events, and I went to a great panel discussion on transgender health care last year that they sponsored. The campus administration is clearly making an effort, with LGBT identities included in events and training days, but then again the pharmacy school curriculum mentioned LGBT people once, and incorrectly, when the lecturer of a management course said that gay people were protected by federal law against employment discrimination (I wish, dude).

    I’ve been out since my first year and haven’t had any directly negative experiences, though I’ve heard classmates say mildly homophobic or transphobic things. There have been two other out gay students while I was in school, both guys, which is demographically odd in that about 70% of my classmates are female. There are other people who I would guess are some combination of discreet and closeted. I hate being the lone, or one of the only, people out in a school of several hundred students–I feel like I’m representing all queer women, and probably not well enough.

    During my fourth year clinical rotations my private life hasn’t come up much at all, but when I’ve had more personal conversations with preceptors or other people at clinical sites, I’ve been open about having a girlfriend, and have felt only small, temporary bursts of anxiety about whether it could negatively affect my career. I’ve even had one preceptor who was gay and mentioned his husband right away. I rarely have interactions with patients that would be conducive to being out (our interactions have been more specifically about their medications, and didn’t include much small talk), but I wore a rainbow button while doing a rotation in an HIV clinic and had one patient ask me if I was gay (I said yes).

    Best of luck to everyone who’s written in–hope we all wind up with a job/practice/residency/school where we can be out if we want to be and where we can be visible to patients who want to know we’re there.

  18. I’m currently in an accelerated nurse practitioner program, and while the atmosphere of my program is more LGBTQ-friendly than med school (it sounds like), it’s a little disheartening to learn how unfriendly health care as a whole is. However, I’m interested in LGBTQ health and take every opportunity to queer up my presentations and case studies as much as possible, to try to open my classmates’ minds and remind them that straight cis people are not the default. I do think that nursing school and med school are fundamentally different, and that as nurse practitioners become more common, things might get a bit better… Less of an old boys’ club in the nursing profession!

  19. Are we going to acknowledge that the quote selected from a student who identifies as a gender minority was using male pronouns to refer to a patient that identified as a trans woman…while critiquing the disrespect that she (the patient) was given by health profressionals?

    • That is definietly worth noting, and it is acknowledged in the article. The author (a trans woman) wrote “Another of these responses unfortunately provides some reinforcement for why transgender students may be disinclined to disclose their trans status when she misgenders a patient in the course of her comment”.

      • Thank you for pointing that out! I called attention to that (and used that particularly excerpt) specifically because it’s such a clear demonstration of the transphobia/transmisogyny occuring in the medical community.

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