The Other Side of Medical Homophobia

I have had enough experience in hearing about how LGBT patients are mishandled, dismissed and minimized in medical situations that I expect a certain amount of entrenched homophobia and transphobia (especially transphobia) from medical staff.  It had never occurred to me to consider that the same unpredictable field of hostility would also affect those in training and employment as well.  Yet another example of my privilege showing, I suppose; I’m glad that others are there to help me educate myself, like when Queereka linked to a New York Times article discussing homophobia and doctors.

I feel blind and honestly a bit stupid not to have considered the impact on medical students and graduates facing this kind of bullshit.

Most poignant, however, is what happens to Dr. Schuster toward the end of medical school. A powerful figure in the specialty he hopes to pursue quickly becomes a father figure, doling out advice to the young man and volunteering to write glowing recommendation letters for residency training programs. One day, Dr. Schuster decides to reveal to his mentor that he is gay. “I felt I had to,” he recalls. Residencies wanted leaders, and his most important experiences as a leader to date had been with a gay group. Moreover, he writes, “I didn’t want him to hear from someone else and think I didn’t trust him.”

His mentor’s reaction is silence. And a few months later, with only weeks to go before the deadline for submitting residency applications, he tells Dr. Schuster he will no longer write a letter of support.

“I felt blindsided; and there were no policies, no grievance boards and no mechanisms in place to protect us,” Dr. Schuster said when I spoke to him last week. There is no anger in his voice when he talks about his experiences. “It wasn’t just me, nor was it just the places where I was learning and working. There were a lot of doctors who had the same experiences as I did all over the country.”

The NY Times piece links to American Pediatrics’ reprinted remarks of Dr. Mark Schuster to the Children’s Hospital Boston GLBT & Friends Celebration in June 2010.  What he has to say is important.

Around the same time, a Harvard physician I later met was just coming out. He was spotted at a social event with someone his hospital’s Chairman of the Board suspected was gay. The Chairman reported to the hospital that he thought the physician was gay too and said that people like that should not be allowed to work there.

Seriously, this kind of shit is terrifying; how entrenched are these attitudes among senior administrators deciding the careers and livelihoods of doctors?

There was a junior faculty member at Beth Israel Hospital who was out and actually willing to talk with gay students. When I made my pilgrimage to meet her, even she advised me to remain closeted until after I got my first semester grades. She explained that the school would want to kick me out if they learned I was gay, and they could use poor grades as an excuse.

That’s not to say that there was silence about gay people. We did learn about them in an elective course on “special” populations. One week we learned about prostitution; another, about drug addicts. In between, we learned about homosexuals. A real live one showed up to tell us what it was like.

Sorry, I just can’t get over the idea that in between talking about drug addicts and sex workers, a “real live one” showed up to talk about what his life is like.  Are you fucking kidding me?  Of course, this is in the same program where students were advised to stay in the closet to avoid being punished academically.  And his experiences with administrative discrimination were not limited to just this one institution.

During medical school, I was on the admissions committee. Two people interviewed each applicant and then presented to the rest of the committee. There was an applicant who was outstanding in every category; I gave him a 10 out of 10. The other committee member who interviewed him, a doctor at Children’s, gave him the worst score we’d seen. His record at one of the top schools in the country meant that he would have had to have confessed to murder, or worse, preferring Yale to Harvard, to get such a low score. We waited to hear the explanation. He said that he just didn’t feel “comfortable” with the applicant. The committee was baffled. I wasn’t, because I had met the applicant. He was a man who was effeminate. I didn’t know if he was gay, but I did know that he was someone who was likely to have been called names or to have been roughed up because people thought he was.

It’s not surprising what this sort of medical educational system would do terrible damage to the attitudes of peers and classmates.

I came out to classmates I felt close to. They were mostly supportive. One time I was talking with a classmate about a guy who had asked me out on a date. She confessed that she had thought that being gay  meant simply that men had sex with men; it had never occurred to her that they might actually go to a movie or fall in love. Her honesty gave me a window into what many peers believed, as I would learn repeatedly over the years when people let down their guard.

This makes me want to cry.  So much for the idea that pathologizing homosexuality was on its way out when it was removed from the DSM in 1973.  And we’re still dealing with the sort of misinformation and bigotry that says gay men can’t and won’t commit to another partner, that they’re just sex obsessed and diseased.

I feel like a fool for thinking this sort of thing was mostly a problem for patients.  I can think of multiple instances where and OB/GYN found a (in my case) mistake on my office paperwork where I accidentally checked “same-sex” rather than “opposite-sex” on the portion asking about my sexual activity.  The doctor each time asked if it was a mistake, because although it’s on her form, no one is actually gay or bi, right?

That’s the kind of bullshit I expect when talking about medicine’s homophobia (and elephantine transphobia) problems.  I’ll know to be more careful in the future, because why look, straight privilege, it looks like that’s where you were hiding all along.

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