“Like every little gay boy, my journey to coming out started at about 4 or 5-years-old. I remember running around the house in my mom’s shoes, playing with dolls, and being confused about how I fit in with everybody else. Growing up in the ‘90s, there were still fixed gender roles and little allowance to explore our relationships with those gender roles. That confusion started in elementary school, maybe even before, and it sparked an initial discomfort, which a lot of us who are in the closet feel. And it shaped the way I interacted with the world throughout my primary education days.
In high school, I started realizing that these feelings probably weren’t going to go away. I began experiencing attraction to other guys. It got to the point at which I was forced to come out of the closet. I won’t go into details about that, but in short, someone found out about this and someone found out about that. So, I ended up having to come out myself, in fear that someone else would out me. That traumatic experience kind of shaped the way I wanted to present myself to the world. I decided that if something like that could happen, I needed to take control of how I would come out.
Having that experience as a child and in high school really pointed me to a career working with children, especially those who have similar experiences to mine. That might not be just kids who identify as LGBTQ+, but also those with other minority identities that may result in discomfort or produce other traumatic experiences throughout their lifetime.
That propelled me into college where I decided to get a degree in psychology and explore the world of discrimination, behavior, and how our behavior impacts our interactions with the world. Once I realized that the traumatic experiences we have as children impact our health in the future, I decided to go into medicine and then, eventually, pediatrics.
Thinking about medicine and health, kids are malleable. It is easy to catch kids in the prevention stage rather than jumping to the defense as adults at which time we end up trying to put out fires. As kids, we can catch them and work with them to change or prevent unhealthy behaviors. As a queer physician, I can be that representative to kids that might not feel comfortable with themselves yet and to the parents/caregivers as someone that has a similar identity and is still successful while being my true self.
I started medical school in 2016 and Donald Trump was elected that year. That was a very tumultuous time in thinking about whether our rights as queer people would be stripped away. I came out at the end of high school and at the time medical school started I was about 25. So, I had spent quite a number of years exploring my sexuality and how I felt comfortable presenting myself. Prior to applying to medical school, I had anxiety and went to therapy to face my own demons. I concluded that being queer was actually a strength of mine and could make me a unique applicant. When I applied, my personal statement was about my journey as a queer person and how that strengthened my candidacy for medical school. I know not everyone is comfortable doing that because you don’t know how people will react. I was of the mind that if you do not like who I am, then I don’t want to be there. I felt like if I can put this out there and people are willing to accept it and take me as I am, then that is the place I want to be. That is how I got to the medical school I ended up attending.
When I got to medical school, I realized that there was not a lot of official support for the queer community, particularly in curriculum, but also in extracurricular groups. So, I helped create a queer support group for medical students. That is the legacy I left at my medical school, and it is something I am very proud of.
Part of my journey has been realizing that, whether I like it or not, I am a representative for those who come after me, including pre-medical students, medical students, and those that go into pediatrics. I think the nature of being an openly gay man in medicine is that people will look to me as an example. I have no control over that, so over the past few years I have made it a mission to be a representative and example to those who might need to see that in medicine.
Recently as part of my residency group, I have created a similar group for trainees and faculty at my institution, simply creating a space that was not there before. These institutions that I have been a part of aren’t necessarily outwardly homophobic or discriminatory, but no one ever took the effort to make those spaces for LGBTQ+ individuals. It did take quite a bit of effort to identify mentors and create those spaces, but I think in the long run it is worth it to have that representation for those that come after me.
From the patient-provider relationship perspective, as a pediatrician our relationships are both with the kids and the caregivers. I have felt a very warm welcome. Many of the children, whether they have directly expressed it to me or not, see that I represent something to them, whether it be that they are queer too or hold some other minority identity. I haven’t had too many people express it to me directly, but I can feel that I am filling that role for many of my kids. Like I said before, I also provide that representation to family members that might not have seen anyone that is LGBTQ+ in a role like I am currently in as a professional and physician. Seeing that representation might dispel some of those fears that many parents have of their children not being accepted or being hindered from achieving success in life.
I actually had a teenager who identified as female. I don’t think the child was struggling with her identity. She saw my rainbow pin and asked, ‘Hey Dr. PJ are you part of the community?’ I responded, ‘What community?’ I didn’t realize she had seen my pin. She said, ‘The LGBTQ community!’ I said, ‘Oh yeah! Definitely.’ Her mom who was just sitting and listening, her demeanor changed. The kid responded, ‘My mom’s part of the community too!’ Then her mom opened up and said, ‘Yeah, me and my wife identify with the queer community.’ She thanked me for representing the community and being a positive role model for her child. I think it is really cool that I am not only impacting the kids, but also their caregivers.
On the other side, being a queer provider I also feel like I have been able to be a resource to other providers, including residents and faculty providers that have reached out to me. Faculty have reached out asking, ‘Is this the right way to say this to someone that is struggling with their identity? How would you approach this? How would you want your provider to approach this situation?’ I have had several people of varying levels of training ask me for advice. In this I have been able to use an integral part of my identity, my queerness, to help others be better providers themselves.
A couple of years ago during medical school, I went to a family medicine doctor for a physical examination for school. There was a specific form that we had to fill out. I was very thankful that the form included pronouns, gender preference, and those kinds of things. When I gave it to the nurse to fill out, the first thing she said was, ‘Why are they asking you if you prefer to be male or female?’ She was very upset about the inclusion of pronouns and gender identity. I don’t identify as transgender. I am cisgender. I am white. I am a man. I fill all those majority roles, but being a part of the community, hearing that outward discrimination against another part of the community made me fold into myself. And I did not want to share anything else with her. I didn’t trust her to be open to what I am dealing with. What if I had health conditions that are related to being a queer person? And how are you going to deal with those things?
That experience also shaped my career in how I wanted to approach medicine. If I could go back, I would confront her, but in that moment, I felt fear. I don’t think that moment was an appropriate time for me to feel comfortable confronting her. I wish I could go back and say, ‘This is an important part of my identity, Whether or not you like it, as provider, you are going to see queer people, whether you know it or not. There are queer people everywhere. They are coming into this office. They may not tell you, but your actions have an influence with how honest they are with you and how much they tell you.’
At that time, I was at a point at which I was no longer questioning my identity, so it did not really impact me. Yet, it showed me that there is still work to be done to realize how microaggressions impact our relationships with patients.
I’ll be honest, the program I am at now, I selected because of their diversity efforts and how welcoming they are to queer communities. Generally speaking, pediatricians are women and queer men. I don’t mean to put pediatricians in a box. I haven’t faced very much resistance to being queer and trying to incorporate queer medicine. I think that is because I am in pediatrics, and I am in a program where I know they have already been working on some of these things.
Being unapologetically queer, I feel like people have been more receptive than I thought they would be to my ideas. I always use the hashtag #RepresentationMatters. Being that representative of the queer community and being confident in that, allows people to see me as an expert and someone who can help educate others. I think the openness that I have experienced has been largely warm as they feel that I fill that role as an expert. I am also here to tell you that many people look to you as representatives as well. People look to you as avenues for education and information, as well as dispelling misinformation. Regardless of your level of training, your experience makes you an expert.
If I were to speak to my younger self, particularly the Michael who was experiencing discomfort before coming out, I would say, 'You have more strength than you realize. Right now, you may be focusing on areas that feel like weaknesses. But eventually you will realize those ‘weaknesses’ are actually the things that make you the best person you could possibly be. If you embrace those areas, you will be a shining representation for others that are experiencing the same pain you are right now.” -Dr. Michael PJ, Pediatrician, Houston, TX (he/him/his)