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"Say it, Stand up for it, Speak up for it..."


"I'm a first year medical student now, I took a pretty long route to it – so I'm 28. I came out in HS twice. I first came out in 10th grade in a video to my entire school. There was a girl doing a diversity project and she was panicking because she had no diversity in the sexuality section. She was like, 'Oh no! I need to find someone who can talk about being not straight.' I had never really considered doing something like that, but I decided to do it. At the time, I identified as bisexual. I also didn't really have a lot of access to words or discourse or other queer people, so that was the first word that felt accessible to me. So I came out in this little video, and I remember it too vividly, in the video, I go: 'Yeah, so as a bisexual person...' realizing that anyone watching this doesn't know I'm bi, so *surprise*! And that was my first

*coming out*.


The downside, though, was that no one really believed it or took it seriously. Everyone thought bisexuality was a phase. Which, of course experimentation is a real and valid thing, but to completely erase an entire facet of someone's sexuality...? So I spent about two years identifying strongly as bisexual and dating women, but still feeling like no one was listening to me.


The term bisexual didn't mean as much to me as an identity as it did as a descriptor. In high school, I didn't use the word queer and so being 'not-straight' was just a thing I used to describe myself. It didn't feel crucial as part of my identity.


There were a lot of folks in my life who were very excited that I was bisexual and not gay because that meant that there was an 'option' for me to date men. They would say, 'Well, you'll probably end up with a guy though, right? So then it's fine, as long as you end UP with a man and this is just like a thing.' Somewhere in the 10-12th grade time period, I came to realize that I'm not particularly interested in most men. Bisexual felt like a very odd word to describe me as I started to meet people who didn't have genders, had more than one gender or were non-binary, and I was like, 'I don't know if this word and the way that people are experiencing it when I say it is quite encompassing me entirely.' For them it was 'Okay, you like men and women.' At the time, that was the only definition of bisexual that I knew. As an adult now, I know that that's not the only definition of bisexual. I really like the definition [of bisexuality] that is "you are attracted to people of your gender and of not your gender.” I think that's a lovely way to frame it, but it is not how I thought of it at the time. So somewhere in those two years, I came to identify with the word "queer" a lot more, which created a rift with people because there were many adults in my life who felt that that was a slur and that it shouldn't be used. These were not queer adults, these were straight adults who thought that was a bad word.


What I couldn't articulate then, that I'm glad I can articulate now, is that if you think queer is a slur as a straight person when I say it, that means there's something in your thought process that's negative about the word and about the person using it... It's not that I'm negative, it's that you hear that word and you have negative associations using it. I was really anxious about it as a kid. Now, as an adult, if a straight person tells me they don't like my identifying word, that's their problem. I've had a lot of good conversations with older members of the queer community who say, 'I don't know how I feel about that word, I don't know if I feel comfortable with it.' I think that's totally valid for people within the community to have nuanced conversations about the words that we use. But, it felt good to me at 18 and that's how it feels right now. So that's what I identify as right now, I feel like [the word queer] encompasses a lot more than just sexuality. It includes gender presentation and gender performance and a general 'leaving-of-stereotype' is the important part for me.


Queer is about breaking down boundaries and parameters that have been prescribed to me and deciding which ones I want and which ones I don't. There's a lot of things that I like about the traditional ways of performing gender. I love a lot of traditionally feminine things, but I also don't love a lot of traditionally feminine things. For me, queerness isn't about rejecting all of them, or taking all of them, it's allowing me to give myself a consensual relationship with gender, let me give myself a consensual relationship with sexuality – letting me pick and choose the ways in which I want to express myself or identify. So it’s been a long journey to queerness.

 

It's really interesting to go into medical school now after having had the last 10 years of my collegiate community and my post-graduate community being very queer. Now, I am coming into a space where I'm distinctly a minority for that particular reason. I'm used to being a minority – I'm a south asian woman, specifically a Bangladeshi woman, which is not the most widely represented of the Asian identities in the world. I'm always a person of color in a lot of white spaces – so, minority experience isn't new to me. But, I have the privilege of cultivating some really queer spaces and having a lot of comfort in those spaces where assumptions aren't made about me. I was surrounded by people who asked about and cared about the question: 'What are your pronouns?' I'm not in spaces like that anymore – and that is definitely a culture shock. I didn't even leave the city that I've been in for the last 10 years for med school, I stayed here. But, there's a whole other world of being a queer minority that I hadn't experienced since high school. The last time I was this alone in my queerness, I was 17 and still half-way in the closet. It's definitely a weird throw-back feeling. I'm coming out everyday now in a way that I got used to not having to do.

 

My hope is that people will stop assuming [pronouns] so immediately, and stop inserting their own preconceptions into the conversations. My partner uses they/them pronouns and if someone asks, 'Are you dating anyone?' I'll say 'Yes! Their name is...' and people will respond back to me, 'He sounds cool.' It floors me every time – I just gave them the information and they'll still ask, 'Yeah, he sounds great! Is he a cool guy?' I'm like, 'He's not a guy at all, there's no 'he' there's no 'guy'.... their name is 'this' and they are my partner.' Some people get it and some people don't, and I've had a lot of conversations where I've basically had to diagram sentences to explain how they/them pronouns work. I'm a teacher. I have no problem sitting down and educating others, but sometimes when I'm walking home I feel this weight leave me where I know I can now be in my queer home, with my queer partner, with my hopefully queer cats... I don't know how they identify, but I like to believe that they're just a little gay. It's a lot! It's a lot to have to do that every time and I still haven't been in a room where someone else instigated pronoun sharing, before me. It's been me the first time every time. I use she/her pronouns, I use the pronouns people assume I use when they look at me. But the reason I do it is that I know that there are people out there who don’t use the pronouns everyone assumes, and if they have to be the first one to come out about it, it's very awkward. I pass as a very cis person, whether or not that's actually how I identify is anybody's guess... me included, I'm not sure!


I say to my partner, 'I think woman is a political identity for me. It's a political and social experience.' I don't know what that word means. I know what it means in terms of how I walk through the world and how the world walks through me, but other than that... I don't know. I get to be a cis-ally, just based on how people perceive me. And that works, that carries weight to have someone who appears cis be the first person to say, 'Hey, let's do pronouns! My pronouns are she/her and here's what that means.' That takes the burden off of other people.


We've found each other in my class, there's a queer group chat and most of us are in it. But, there's not that many of us, it's a class of 200 so in any given room, it's highly likely I'm the only queer one. Even within our queer community, there are varying levels of understanding of gender identity, familiarity with language, and the types of questions that we should and shouldn't ask. There's definitely a lot of educating to be done. I'm older than most of my classmates, which is a double-edged sword – I definitely find myself in an educator role a lot, but I also think people are listening because I'm older. That's helpful, I think there's an inherent power dynamic between a 28-year old and a 22-year old in an educational setting. It's nice when that can work to everybody's advantage, where I'll just explain something without being mean and they can learn it without feeling shamed. And then everyone can go away and hopefully introduce themselves with their pronouns in the future. That is the dream, and I don't know how much of that is happening but I'm trying!


I've tried to hold so much compassion for people's oversights because I'm sure that I did the same thing once upon a time. But, I don't remember the last time that I assumed someone's pronouns because it's been such a conscious effort in my life not to do it, that it's hard to remember what that must've been like. Although, I was a dumb kid in high school, I've definitely assumed someone's pronouns. I'm sure I've misgendered someone who never told me because they didn't feel safe. I know that's a reality of living in a really cis-normative and heteronormative world. But in the last ten years, I've spent a lot of time deprogramming my brain so that I don't look at people and say, 'That's a man. That's a woman.' I don't have that impulse anymore, which I'm really happy about! But that also makes it hurt a little extra when I say, 'My partner's name is ___ and they use they/them pronouns,' and someone goes 'He sounds cool.' I have to really reign in that response of Why? Why would you do that? That's not a productive response. I can have it in my head, I can have it with my therapist, I can have it at home. But, in a potentially teachable moment and a potential moment of confrontation, I'm really trying to pick the teachable moment. But, I think that's a really unspoken, or unacknowledged, burden of being a queer person in a space is that you do that so much. Sometimes, I want there to be room for my anger when someone misgenders my partner again. I hate it, but yelling at my classmates will not get me anywhere, so I don't. But, there's only so many times you can bite your tongue before you start to taste blood.


The thing that's been almost harder is the gendered language that I hear from my professors and not having much recourse to say anything in those spaces. I can say something to a classmate because we are on relatively equal footing. But our professors refer to obstetrics and gynecology as Women's Health every time... *Women's Health, mothers, Pregnant moms*. I've sent a couple emails, I've spoken to a couple of professors in private to say 'Hey, what if we called it ob-gyn or obstetrics and gynecology or reproductive healthcare? Would those be options?' They are much more descriptive and even more scientifically accurate. Women's health can be anything... women have health! By that description, cardiology is women's health and GI is also women's health – because women have hearts and stomachs. Women's health as a descriptor means nothing, essentially. It's painful to hear that and know the really harmful legacy of that conflation for queer people – specifically for trans and non-binary people who can't get gynecological care, have worse outcomes in cervical, ovarian, and uterine cancers. As a result, they go decades without endometriosis diagnoses.


So many things are overlooked and actually have clinical outcomes in queer and trans patients because we paint all of our OBGYN offices pink and say women-only. I had a friend a few years back who had security called on him in a gynecologist's office. He was just trying to get a pap smear because he has a cervix and needed one. He called ahead and explained the whole situation (which he shouldn't have had to do). He's a very binary-presenting trans man and they called the police on him! It was terrifying for him and I went to meet him because he told me, 'I think they're gonna call the cops on me, what do I do?' We had this long, awful, drawn-out conversation. This was around 3 years ago, he left and said, 'I'm never going to a gynecologist again, I don't care what happens to me, I don't care about my health – I'm never going again.' I don't blame him for having that response – I would've had that response too. Our solution has been looking really hard and getting on long, long waiting lists so he can find a gynecologist at a queer-specific practice. Still, he doesn't feel comfortable going if there's not a very femme person with him that can explain and make him not seem like he's doing something wrong. That has been a really present thing when I'm in a lecture and someone says women's health, pregnant women, moms, etc., – we don't ask about having menstruation issues unless they're a woman. We are missing so much. There are so many people who are not going to speak up in a doctor's office when someone forgets to ask for a menstruation history. If they don't feel safe outing themselves and the doctors made it clear what they believe, we're just losing patients left and right. I don't have the answers for what to do about that, but it's a conversation that's starting in our queer group chat, it's a conversation that starting in our student council – trying to make this language more inclusive. This is not just because of how we feel as students, but also how we'll be as future practitioners. Again, we come back to the labor – it's just more labor, again and again.


We're all trying to be doctors, we should be able to describe things accurately and precisely and not talk around them. And there's a lot of historical misogyny that underlies the reason we don't like to say 'vagina' out loud.

 

I've also been a rape crisis counselor and domestic violence counselor for almost 6 years now. I've worked in NYC emergency rooms where if someone was assaulted (even if they weren't recently assaulted but they talk about it during a larger visit for something else), they're asked if they'd like an advocate to be present. If I'm on call that night, I'm the advocate who shows up. So, I've had a lot of time in ERs with patients with sexual trauma. Many of them have told me how hard it is for them to seek gynecological care. There's many of them who then have to do follow-ups for STI checks or for DNCs or for whatever is going on, many of them feel very afraid of specifically seeking gynecological care. This is another population where I feel that there needs to be better OBGYN care that's trauma-informed, that's affirming, that's safe, that really puts consent at the forefront of the exam – because what an invasive thing to have happen. There's nothing more invasive to me than a pap smear, I find them triggering in so many ways. This in conjunction with all these experiences with that particular friend and many of my other queer friends – specifically many of my non-binary and trans friends have asked me to come with them to various appointments, especially reproductive healthcare appointments because they're afraid that they're going to get harassed, misgendered, dead-named, yelled at, arrested, who knows. I've been in a lot of these spaces that's allowed me to start tallying which populations need better OBGYN care. For example, the maternal mortality crisis in this country is absurd. Black women and disabled people face such problems in getting good sexual health care in general, but especially pregnancy caren and menstruation-related care. There's so many populations that I'm either a part of or adjacent to that all intersect at OBGYN – at a particular kind of vulnerability and a particular kind of marginalization, and if I could just get in there... that would be awesome.


I think a lot of it is finding ways to open these conversations in a way that doesn't make the old guard (older physicians) feel threatened, which is an extra layer of emotional labor for sure. I've had a lot of experience with this. I was a scribe in a cardiology office for a while and we had a trans patient come in whose chart indicated that they were trans and the providers were panicking. I've never seen grown adult doctors panic like this. They were all like 'What do I do? What do I say?' And I had to say, 'Woah, woah, woah let's all breathe. They're just a person. Also, they're here for cardiology, they're here for cardiology! You don't need to do anything about them being trans! It's just a heart... It's the same. It's going to be fine.' I was really grateful for my provider, she was a humble woman who was not too egotistical to ask for help from a lowly scribe. She had that concept of humility in medicine, she was great. She was telling me that she was having such a panic attack, 'What is wrong with me?' I asked her if she had ever treated a trans patient before and she said,'No.' To that I said, 'There's your first issue... you think you've never treated a trans patient before. You think you've never treated a queer patient before. You definitely have! You just didn't know, and if they had all of their documentation changed, they had no reason to tell you and maybe didn't feel comfortable doing so. Let's start by putting that myth aside, you've met a queer person, you've met a trans person, you've met an intersex person. You may just not know it – you've met every color under the rainbow.'


She then asked, 'Well, what's relevant? Am I doing a bad job if I don't ask about this person's transition?' And to that I said, 'What do you think could be relevant?' She responded 'medications, surgeries...' and so I responded, "Well if you ask about past surgical history, that will give you surgical history. If you look at their medication list then you can look and see if any of those medications have a cardiac impact. Sure, testosterone is a medication that can increase blood pressure, that's a possibility. But you could also check their blood pressure and just ask.' I told her that when speaking to the patient you could just ask, 'Hey, I see you're taking testosterone – how long have you been on that?' I had to then reassure her that this is a fine question to ask! At that moment, I realized just how much fear there was, that her fear wasn't of the trans person, but a deep fear that she was going to say something wrong and be a bad doctor.


That made me realize two things – first, my god, we need better education. This was not a very old person, this doctor did not graduate that long ago. The second is that there is so much room for non-physicians to be advocates for patients. After this experience, I had a queer and trans 101 workshop with the practice. They asked a bunch of questions, and I told them which of those questions were inappropriate to ask and they... stopped. I had to teach a lot of people that it's not okay to ask 'have you had the surgery?' One, it's medically inaccurate, there's no such thing as the surgery, and two, if they're not there for a surgical consult, you don't need to ask them if they've had the surgery. They will tell you their surgical history and we move on with our lives. We ask if there were any adverse effects, we ask if they have any allergies to contrast or anesthesia or whatever, and we move on! I was really grateful that I was able to do that because then they got all of their offensive questions out (well meaning, but offensive nonetheless) with me and not with trans patients. I taught a bunch of doctors that you shouldn't say, 'What's your real name?' They have a name on their ID and they're putting their preferred name on the chart – you call them by the name that they've indicated they want to be called by. If those names don't match, you call them by the name they've asked to be called by and you bill the insurance by the name that's on the insurance. Hopefully, you become an advocate and fight for an easier transition so that people can actually have their information match and not be dead named every time they go to the doctor.


There's a lot of curiosity that cis-het[erosexual] people have about queer and trans people, and sometimes there's an entitlement that comes with that curiosity that needs to be gently squashed. No, you don't get to use people as your textbook just because they're interesting to you. There are people who do this kind of education for a living that you could pay to take a workshop with, pay to take a class from. Go do a continuing education credit in queer and trans health, but don't make your patients into your educators because that sucks.


I've been that. I've had a physician once who just really did not understand why I wasn't using birth control. She did the whole,


'Are you sexually active?'

'Yes.'

'Are you using birth control?'

'No.'

'You really need to be using birth control.'


That was an interesting place to go with that... as opposed to asking 'why?' or if I use any kind of protection. I then said, 'I don't feel like I need to be on any kind of hormonal birth control, or non-hormonal birth control.'


To which she said, 'But you need to be, you could get pregnant.'


I responded by saying that that's not possible actually. The conversation continued.


'A lot of young women feel invincible and they feel like it's never going to happen to them.'


'No, no I'm not saying it because of a false cognitive pattern... I'm literally saying it's not possible.'


We went back and forth for a good 10 minutes before I was like: 'I'm going to give you a hint, it's physically, chemically not possible for the kind of sex I'm having to get me pregnant.'


She sat there for a minute and she went, 'Oh god! I'm so sorry! Your husband had a vasectomy!'


I had no idea what to say, I just started laughing. So then I had to explain, "So, I'm queer, and the partner that I'm having sex with does not have a penis. There is no sperm production in this relationship. It is physically impossible. If I get pregnant, you have to call the Vatican – that's the level of 'it's not possible' that I'm talking about here. Like, physiologically, the parts that are involved... there is no sperm anywhere to be found."


'Oh, I'm so sorry.'


I was 25 at this point, so I was not super floored. When I was a teenager and this happened to me, I would just keep my mouth shut. They would say, 'I'll write you a prescription for birth control.' I would take it and I wouldn't fill it. That was my routine for years. Then, I kind of just lost all of my shame and say things like, 'I'll give you a hint...it's an anatomy issue.'


Some doctors did not have that issue, I've had many great physicians who are just like, 'Oh, are you sexually active? Who are you sleeping with? Are you sleeping with men, women, neither, both?' And of course I would think, 'We could work on the language, okay sure... but love it!' Then I was able to say, 'I don't sleep with men.' That usually is enough for them to understand that I don't need the birth control lecture, which is annoying because there are people who are not men who could get someone pregnant – but that's not the kind of conversation that I always have the time to have in a 15 minute exam.


I'll never forget the woman who was like, 'Your husband must have had a vasectomy, that's why you don't use birth control.' I mean, the leap that she had to have! I'm not married, I never mentioned a husband, I was using they/them pronouns about my partner the whole time – the whole thing just 'whoosh' over her head. And she told me, 'Thank you so much, it's so helpful that you educated me instead of getting upset.' I said, 'You know, if I had gotten upset, that really would've been my right' – and she was like, 'Well all I mean was that you were really nice about it.' To that I said, 'I was really nice about it because I'm a brown person and I was taught that it's dangerous for me to scream at white people who have power over me so I didn't yell at you. I didn't yell at you not because I was being nice. I didn't yell at you because I value my safety. I was alone in a room with you and you have an MD. If you said I did something wrong that could go on my record forever. I could risk not getting medical care for a long time. I was being kind out of self-preservation, not because I actually feel that this was the appropriate way to handle such ridiculous assumptions being made about me. I appreciate that you're thanking me but don't expect your patients to be this gracious when you make a huge mistake.' That's not fair, that's not a fair assumption to have and that is summing up what it means to be a minority of any kind – having to educate people, having to play nice. Because if they get their feelings hurt, they don't want to help you anymore. And you need them to help you because there's more of them than there are of you, and that is an incredibly demoralizing experience to have. I never saw that physician again.


But, that interaction really stuck with me because she could have just said 'thank you' but she tried to play the 'you're one of the good ones, thanks for not getting mad at me like other people.' I hate that, and that was really scary to have to stand there and say, 'It would've been okay if I got angry and patients who get angry at you have a right to be angry. That's just what it is, if you screw up, people have a right to be angry with you.' I think that's really, really hard for a lot of people to understand – that sometimes it is their fault, and they did something wrong and someone is mad at them, they may not get forgiveness immediately. People really want to be absolved just instantaneously.

 

I've had a lot of people say to me that queerness is a white thing. Not to be queer, but to be out about it – that's a privileged thing to do and only white people can do that. I've been told, 'Don't give them another reason to make you a minority, don't give them another reason to count you out. You're making life harder on yourself.' Those are all things that I heard from loved ones in my life who meant well. They were being protective. It was still invalidating and harmful, but I also understood why they said it. That's a protective thing to say to someone. 'You're already brown, you already have a Muslim last name, people already make huge assumptions about you – don't give them another reason to cast you as a supporting character when you ought to be the protagonist. Don't let them count you out.' I never really believed that. I thought that if they were going to count me out anyways, might as well go down swinging, right? But it's definitely been a challenging line to walk, there are a lot of really white dominant queer spaces. And there are a lot of tensions in terms of what to do with extended family when you're queer and Bangladeshi and you don't know the word for 'queer' in Bangla. I couldn't come out to my extended family if I wanted to. I literally don't have the language. I don't know who to ask! I can find slurs on the internet, but I don't know the words! All of my other queer South Asian friends – they don't know the words either. It's this really awful feeling of, 'If I can only come out in English, does that mean that my cultural identity is inherently split from my orientation? Does that mean that there's an irreparable rift?' I don't have the answer to that, but I want to believe that the answer to that it's no. But, I don't know any out queer people in my family, I don't know where to find them. I'm sure that there are other queer people in my family, statistically speaking. But I don't know who they are, I couldn't ask them if I wanted to, I don't know how to explain any of it, and that's a really tough feeling. I know a lot of people who feel that way in various cultures, especially ones that have a linguistic barrier in them. What do you do when you can only say all of yourself in one of the two languages that you speak? What do you do with that? I don't have an answer to that. I'm trying to be okay with living in that grey space of not having to pick.


For a long time I felt that I would have to pick between my culture and my orientation and the thing is, queer culture is a thing that I feel really attached to as well. I feel that there's a lot of really rich cultural practice within queer communities and things that we've built and things that we do that are unique and emphasized differently. I never heard the phrase 'chosen family' understood as deeply as it is in queer communities until I became part of one. There's something really strong and validating about that phrase.


In terms of medicine, I find myself always wondering what people are assuming about me when I walk into a room. I think it'll always be my gender that walks into the room first. I'm going to be a woman to people who see me, pretty unequivocally. That's painful sometimes because I would like that not to be the thing that always identifies me... but it does. That happens in queer spaces as well. There's a lot of binary understandings of gender, even in queer spaces and an assumption that non-binary-ness equals androgyny – which is also a very white-coded thing in a lot of spaces, it's a whole thing. I have a badge reel with a pride flag on it, and sometimes I wonder, 'Does someone who sees that think that I am queer too or do they thing that I'm a straight ally? And which one of those is worse, with a given patient or with a given professor?' I don't know because I look straight to a lot of people.


I've heard that a lot in the past month: 'I would never have guessed you were gay! You look... like a girl!' What a gender nightmare of a statement to unpack! I've had multiple people say that to me in that class, 'I didn't think you were gay! You are so pretty.' To the person who said that I asked without shame, 'What does that mean exactly?' He said, 'Oh, I don't know, I guess I just thought lesbians shaved their heads?' I mean, woah... yes there are lesbians who shave their heads, but we've also jumped over so many different words – none of which are the words that I used. It’s so fascinating when people choose to identify you with the words they want and not the words you say. I've never identified as a lesbian and it's very interesting to me that I'm a lesbian all the time. I'm not a lesbian, never been a lesbian, it's very interesting.


I think about that a lot in medicine. I'm relatively racially ambiguous when you don't know my name and I get read very differently by patients, by providers, by random people. It's a very ambiguous space to be in. It really changes the interactions that I have with people, based on what they think of me in a given moment – how long my hair is, if I'm wearing earrings, if I have a mask on. It could be anything, I've been mistaken for Russian, Indian, Mexican, Filipina, Chinese, Italian, and Black all in one day. I was just so dizzy at the end of it – I don't even know what to do with that information. Especially with a mask on, people have no idea what's going on here.



I think about how I present a lot when I walk into spaces and when I interact with patients or professors or doctors. What do they see when they look at me? How much of me do I want them to see? How much control do I have over what people see of me? I chose to wear the pride flag badge reel for a number of reasons. One of them is for me fellow students, whether or not they assume I'm queer because of the reel or an ally, there is an added layer of safety for them to talk to me just by virtue of seeing someone else here who knows what a pride flag is. That is comforting! I had that experience during orientation where a queer professor (A queer professor! I've never had one before!) got up on stage and he was wearing a rainbow lanyard, not just rainbow but the progress flag with the black and brown and trans stripes, and he started obliquely referencing something. At that moment, me and one other queer person in the room looked at each other and we both almost cried! I've never ever had that experience – there is a queer professor here! There's someone who gets it – that's huge! When people say representation matters, I feel like that's become just a catch phrase, but in that moment for me it was everything. It was everything for me to see this man, this attending physician, this doctor, with his bright rainbow lanyard just standing there being gay with an M.D. I know that it's possible but I had felt so alone that week, I hadn't met enough queer people yet, thinking maybe there was just two of us – and seeing him was such a huge thing. That's part of why I choose to use some visual identifiers. I think perception is such a big part of medicine – how people perceive you, how you perceive them, what that does to the relationship you build. Is anyone seeing me the way I see myself? I don't know the answer to that, and the answer is probably no.


I come home to my partner and I'm like: 'You know who I am... entirely. And I don't have to explain any of it.' That is, bigger than what I thought it was going to be. Because I'm spending so much energy everyday bouncing between perceptions and making sure that I'm portraying myself in a way that's safe and acceptable and professional and also not censoring myself but censoring myself just enough... It's just such a balancing act to do all the time. There's so much about being a brown woman that informs the way that I handle conflict and the way that I handle whether or not I raise my voice, whether or not I raise my eyebrows, whether or not I sound aggressive or sarcastic or 'bitchy' or whatever. There's so many things that I have to balance all the time that I've had the privilege of not having to balance this much for the last few years. Now, I'm in a space where almost all the time, everyday, I'm on tenterhooks the whole time. I wish people who don't have that experience understood the amount of mental and emotional energy that goes into balancing on what feels like a knife edge all the time.

 

I think the biggest piece of advice that I would give myself about being queer in medicine is: do it anyways. I spent so many years doubting it, not coming out in moments where I wish I had later, not speaking up in moments where I wish I had later, and feeling so silenced. I chipped away at so much to unearth a voice – the stories that I told you about standing up for my friend and standing up to this doctor and all of that, those are all in the past few years. But the decade before that had none of that self-assurance, and it was hard-won, it always is. Just, 'do it anyways and do it sooner' is something that I would say to myself. I didn't need to swallow myself for as many years as I did. It is worth it to be an educator, it is worth it, but it's not required. On one extreme, I kept my mouth shut for too long and to that person I say, 'say it, stand up for it, speak up for it – you're going to regret it later, just do it (safely, but do it)." To the next five years, where all I did was speak up and educate and take care of people and not show how much their ignorance hurt me. But you can take a step back. It is worth it to be an educator, but it's not required. It's okay and in fact encouraged to protect your peace sometimes. It is okay to say 'I don't have the bandwidth to do this educating right now. I appreciate that you mean well, I appreciate that you want to learn, I do not have anything left to give you right now. I am tapped out and I'm going to direct you somewhere else – here's a resource, here's a podcast, here's an article. But it's not going to be me, not today.' And I think that's something I'm still learning – when to say, 'I can't be your big gay educator today, I can't do it.' I think that's something I'm going to have to keep giving myself as advice, moving forward. It's really important, just to prevent my own emotional burnout and to prevent feeling like the only thing I was worth was the minority education I provided. If I wasn't queer, if I wasn't brown, if I was just a brain in a jar walking around doing things... I would still deserve my place in medicine. I want other people to hear that too, especially people who feel or have been told, 'you're just here because you're a minority, you're just here because they're checking a diversity box. When you take all that away, you're not worth it.' That's a message that I heard so often – I heard that in elementary school through high school. 'You're just an affirmative action admit, you're just a diversity hire' – whatever the case may be. If someone were to suck my brain out with a tube and upload it to the cloud, that brain would be competent and able to do this work without anything else. Standalone, I can confidently say now and I want my younger self to know that I am smart enough to do all the things and that's fine. But everything else adds so much more, and adds so much depth and so much perspective and nuance and compassion and care and it's not enough to say, 'Oh, this person is smart and has these identities.' Those things go together, even if they also exist apart. That's important to hear – I am a queer medical student, but that's not all of it and that's not a pejorative and I don't want people to think that it is. I think a lot of people are afraid of being pigeonholed as the 'queer ___,' and I think I've been afraid of being pigeonholed as the 'queer ___.' But owning the 'queer' and saying 'that's not a pigeonhole, and if you think that's a pigeonhole then you are very much mistaken and you should look again.' I think that's really important." -Joya Ahmad -Brooklyn, NY (she/her/hers)


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