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"...even unicorns have a herd somewhere."

“I came out when I was 18. I had to come out several times to several different family members. I always thought that coming out was going to be like this Disney movie experience where I just tell my parents one time. But that’s not how it worked out. I’ve had to come out to my mom three times and my dad twice. After them I came out to each family member individually because my mother insisted on a ‘don't ask, don't tell policy.’ Having to come out like that so many times when I wasn’t even fully realized in my identity was definitely traumatic at the time.

I always wanted to be a doctor, I just don't know why but it was my calling. Even though both of my parents are nurses, they never really pushed me to become a doctor. It was something that I just made up in my mind at the age of seven. And I never deviated from that dream. It was only after I grew up when I realized how important it was for me to become a physician as a gay man of color. Representation matters. I have dedicated my entire life to the pursuit of becoming a doctor. And when it came time, I applied to medical schools all over the country. When I found out that I got into Howard University, an HBCU, I was elated. I had never gone to an HBCU. I was born in Michigan and raised in Florida. I went to Florida State University for undergrad. And I knew that this experience would be critical to my career as a physician.

I was anxious once I got in though. I was anxious because I knew that I would fit in because of my skin color, but I didn't know if I was going to fit in because of my sexuality. There's such a diaspora of people that include individuals of color, it's hardly a monolithic representation. So there's a lot of different people in a lot of different cultures and I was nervous about how I was going to navigate that while still being true to myself. I didn't know how my professors would view me…would I have to come out to them? Would I have to come out to my preceptors on my clinical rotations? Would it have to come out to my attendings, to my Dean? How would I navigate that? How would my peers view me? But I actually didn’t have to worry about that because everyone here is super supportive, overwhelmingly actually. My experience here at Howard as a gay man has been incredibly positive. All of my peers know, and I don't feel like I have to hide that part of me anymore.

I remember one time, before medical school, I had to go to urgent care because I didn't have a great PCP. And there was something that I needed to handle. So I get there and they asked you the questions, do you have sex with men or women or both? I put men and, you know, there's that, and it was fine. The nurse was neutral and it felt like those interactions should feel…like not a big deal. Then the doctor came in, he was a black guy! I was so surprised. I was so happy. It was nice to identify with my provider in that way. But then I noticed he was a little uncomfortable, a little hesitant. In the middle of the interview, he starts twiddling his fingers and he goes, ‘I hate to ask you this, but, um, are you gay?’ I was like, ‘uh yes.’

At this point, I am mortified. So I felt embarrassed because he asked me like it was something to be ashamed of. Like he hated going there. But I know why he said it like that and it is because, in black culture, it can be offensive to assume someone is gay. It is hard to explain if it is not your lived experience but, culturally, I could see where he was coming from. Regardless though, it made me feel like there was something wrong with me. And it was especially hurtful because I had high expectations for the encounter because he looked like me. So I automatically thought, ‘Oh, he'll understand.’ But I learned that the two are mutually exclusive. I’ve learned that it can be particularly challenging to navigate healthcare situations for individuals of color who are also sexual minorities.

My identity as a black man and as a gay man can be very conflicting. I feel that my blackness prevents me from disclosing my queerness. My two different representations are kind of at war with each other, honestly. It is hard sometimes to feel like I really belong in any one place. There's a higher expectation of masculinity within the black community. There just really is, there are strong traditional feelings about how men shouldn't act, how men shouldn't dress, and just how men shouldn't be. And I remember some of the challenges that I have with my mother in terms of coming out, she wasn't concerned about me being gay. She was concerned about me looking gay. I remember one time I was picking her up from her job. She texted me beforehand and said, ‘when you come into my job, can you act like a man?’ And that really stung. For me, though, I feel like what you see is what you get. I feel like I do act like a man, regardless of my sexuality. I feel I am masculine ‘enough’. So for me, I was confused because I was like, what do you mean? Act like a man. What do I look like? I have never attempted or tried to present myself as anything other than a man. I am just me.

This has been a challenge for me, but it is through this that my role and representation in medicine have become so important to me. There are a whole lot of people out there who are double minorities who need someone who understands their cultural and sexual background. I am excited to be their doctor and spend my life working to create a space for them. At first, I wanted to be an anesthesiologist, but lately I’ve started to realize that, I am happiest when I’m close with my patients. The relationship bond between physician and patient is what drew me to medicine in the first place, and I feel that the best parts of me came out when I was able to help them in that way. It’s where I feel most impactful.


My advice to the readers at Dx:Q is this…follow your heart and will not be alone. You are not alone. You are not the only one. When I was younger, I was convinced that I was the only black gay kid who wanted to be a doctor on earth. I thought I was the unicorn of all unicorns. But that was because I hadn’t learned yet that even unicorns have a herd somewhere."

-Joshua Metcalf, 3rd Year Medical Student, Washington D.C. (he/him/his)


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