"I really wasn’t expecting that, it was a surprise to me and I didn’t know how to respond.."


"I moved to Fayetteville, North Carolina last summer and was trying to establish a relationship with a new PCP. I got recommendations from some of the students I was working with and I ended up going to this one particular PCP and I explained that I am trying to get a prescription for PrEP. The provider took a full sexual history but when I mentioned PrEP she didn’t really know what it was or how to even pronounce it correctly. She then expressed that she was not willing to prescribe it and instead just gave me some counseling and said “I will give you a referral to an infectious disease specialist.” I really wasn’t expecting that, it was a surprise to me and I didn’t know how to respond so I was like “I guess that’s it then” and I left. I was still responsible for the co-pay of that visit even though nothing was done and I had to do it a second time. As a medical student I had to take time away from rotations to go see a second PCP about a prescription I already have that is now running out at this point. I was kind of freaking out because I didn't think I was going to find someone to renew it. It was all very frustrating. It was my first time experiencing this, and it made me really think how this is a barrier to the LGBT community receiving healthcare, especially in more rural settings. The American Academy of Family Physicians has endorsed USPSTF recommendations that clinicians should be counseling, comfortable prescribing, and recommending PrEP for populations where it’s warranted. Learning this just reaffirmed how frustrating and surprising that experience was. I am trying to remind myself that it’s one thing to be outraged by the ignorance we witness, but the approach I try to take is to be productively outraged. What that means is, now I try to use my frustration and use the opportunity to actually make a difference in that moment. We could be cold and write them off, or we could see it as an opportunity to help change their mind, give them a new perspective, plant a seed. Since then, one thing I have done as a result of my experience is that if I hear my classmates or residents talking about their interest in family medicine or primary care, I will talk to them about my experience. I will say “this is what happened to me, and I hope you can think about that as a future family physician so you are aware of what you can do to help your future patients that are in my shoes.”


-Kyle McKinley, 4th Year Medical Student, North Carolina (he/him/his)

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