“My name is Larry and I am a pediatric sub specialist on the East Coast. Over the years, through my journey from medical school to residency and fellowship, to my current role as an attending physician and medical school faculty member, I’ve had quite a few LGBTQ experiences that I want to share.
Over the years, I have seen kids, younger and younger, are starting to question and confront their sexualities. It’s good to see that they feel safe enough to actually bring these ideas up and start asking questions like, ‘who am I?’ as part of their typical childhood development.
You see, I work a lot with children. I have one patient in particular whose parents came in one day and told me that their daughter had something she wanted to tell me. It was totally unrelated to anything I was treating her for—she wanted to tell me that she was bisexual. She was 10yo at the time.
The next time I saw her, a few months later, she had shaved half her head, and had dyed the other half blonde. Mom told me that her daughter had something else to tell me today—she has chosen the pronouns: they/them/their. She feels that she may be transgender. And again I go, ‘that’s great! Well whatever they need, the place where I work has a Transgender reassignment clinic. I mean, I’m not at all pushing one way or the other, but if this is something that you would want to pursue, just know that we have resources for you.’
I wanted to share this story because it’s really good to see kids now are able to grow and explore their sexual identity; and even if my patient ends up being a straight female using she/her pronouns, then that’s fine, too. People who are just beginning to question their sexuality should have the opportunity to do so in a safe, supportive environment.
I am one of the two open LGBTQ+ physicians in my division , and I have somehow become the ‘defacto expert’ on LGBTQ+ anything even though I don’t know necessarily more about being LGBTQ+ myself. Now this story is about a colleague of mine. He is probably about 10-15 years older than me, an outstanding physician, has a good relationship with all of her patients, and he is one of the brightest people I know. English, though, is not his first language, so understanding gender in the English language was something he has always had some difficulty with. One day he came to me for advice. It was about one of his patients that he had been taking care of for 10 years. The last time they saw each other, his patient started identifying as gender non-binary and used they, them, and their pronouns.
My colleague was having a hard time addressing the patient in front of the family, saying things like ‘oh she needs to take her medicine,’ and the parents responding with ‘no, no, no they need to take their medicine’. And it became this whole back and forth. He truly did not care one way or the other how her patient identified, but he just kept tripping up on the pronouns because, again, English was not her first language. He came to me because she felt so bad, and she didn’t know how to address it.
And I told him, ‘As long as you make it clear to them that you mean no disrespect or ill will, and that a lot of fumbling is because the language barrier makes it difficult for you to get their pronouns correct, they will understand.’
I wanted to share this story because I think it is important as an LGBTQ individual to be aware that heterosexuals may make mistakes with pronouns, even though they mean well. Not every slip-up is an intentional affront.
I actually have a funny story that’s about not judging others, and I’m happy to share that one since it’s also a personal favorite of mine.
So a couple of years ago when I was in the middle of my fellowship, I was applying for my first “real” job as an attending physician. I had responded to a job posting for a well-regarded medical center in a very rural area. I didn’t know what to expect about their LGBTQ views. By this time, I had already been married for a very long time - over a decade, in fact - so I had a wedding band on and everything. This was actually a very conscious decision on my part. This was the only interview that I had actually left it on.
My first interview was with an older presumably straight, white dude. We were having a nice conversation when he asked me, 'what does your wife do?' He caught me off-guard. I was like, ‘Uhhhh… Well, my significant other—they…,' and spent most of the day dancing around the topic. The chair had actually offered me the position earlier in the day, but I still had to slog through the myriad of interviews. After 6 or 7 interviews, though, I had lost it, I couldn’t keep saying “they” anymore because it was just so intense. During one of my interviews, I slipped, and said “He.” After another couple of interviews, the chair calls me back into his office for an additional interview, and I thought “what the heck is going on?”
In his office he said to me, ‘Lawrence, I just want you to know that we want you to be happy here, and I don’t care who you love. I don’t care about any of that. You have to pick a place where you think you’re going to be happy, and I hope that you think you can be happy here. We really like you, and I think you would do a great job here. And in a couple years, if you wanted to, I think you would actually be a great candidate to take over for me and become the chair for the division. But you have to be happy.’
Of course, afterwards I felt very silly. I had just assumed that they everyone was bigoted out there, that this one random woman with short hair was a lesbian. It just goes to show that everyone makes assumptions. In this case, I was totally in the wrong. Completely and utterly in the wrong. I ended up not taking that job for other reasons. Professionally, it would have been a great position that would’ve led to great advancement opportunities.
The way the chair handled my sexuality was very professional, and truthfully, he gave the best answer that I could have asked for. I felt this was an important story to share, because we all need to be careful not to make assumptions about others.
By the time I joined the faculty at my institution, my husband and I had been thinking about having kids for a while. As a gay man, I knew this wasn’t going to happen naturally or too easily. We were looking into different options like adoption or surrogacy. Ultimately, we decided we wanted to have children who were biologically ours through IVF, and I was looking through the health benefits brochure, and it mentioned IVF benefits were available to heterosexual couples with a medical need. So I was like 'huh, well that’s funny. Shouldn’t we all have that?'
A few weeks later I received an email that my university was having some sort of annual open forum to raise any particular issue or concern. As a new faculty member, I was part of that community, so I thought 'oh, well, you know this is probably a good chance to say something about IVF.'
So I replied to the e-mail with a little blurb about the IVF benefits, and they said, 'great! You’ll have 5 minutes to speak.' I figured it would be a small little room with like 3 people or something. But no—it actually turned out to be a giant auditorium filled with a million people, and I was standing and speaking directly in front of the university president. At that, my first thought was 'whelp, here goes nothing.'
I made my case for why the university should extend IVF benefits to same-sex couples, and I simply said that a lot of forward-thinking companies have already started doing this. Providing these benefits would really enable the university to continue to recruit the best and the brightest. The university already has a pretty liberal, accepting policy towards sexual identities, racial identities, everything; and to me this just seemed like a natural extension.
I spoke, and that was the end of that. They thanked me for my time, and a few months later, I got a random email from the head of the university benefits program that said, 'hey I just wanted to give you heads up that we have decided to extend IVF benefits to same-sex couples, and you should be seeing an official announcement within the next few weeks.'
When they sent out the benefits brochure, they always include a highlights page. This time, it mentioned that one of the changes they were making was that they were now thinking of infertility benefits as a fertility benefit that everyone who wants to have a family should be able to start one, which was pretty slick (and I thought was pretty cool). I was really impressed that they were owning that decision, and it was just very exciting overall.
This was in 2017 and to date no one had really taken advantage of that benefit. My husband and I are now finally going to be the first ones to use this. I tried to find out exactly what the details of the coverage were through my insurance company, so I called them and they told me I had to enroll in their infertility program. I figured, 'whatever, no big deal.' So I was doing that over the phone, and I was talking to this person who was just going through a script. She was asking me:
'How long have you and your partner been trying to conceive?'
'Well, I’m gay so we can’t have kids.'
'Oh, um. Okay but like how long have you been trying to conceive?'
'Well, again I’m gay, so that’s not happening.'
'Well, I-I, I need to put something down.'
'Okay. . . Well, I guess you could say I’ve been trying since I was 18.'
There were a lot of other questions that kept getting more and more offensive. As a physician in healthcare, I have had enough experience with insurance company bureaucracies dealing with my own patients that I knew it wasn’t this particular woman who was being offensive. She simply had to go through the script, but I took it upon myself to escalate this to the university benefits office and the individual supervisor saying that, ‘this is unacceptable. If the university already extended these benefits to be more inclusive, then these questions are too heteronormative. It’s just inappropriate. It’s just wrong. You guys have to change the script.’
In the end, they told me that I didn’t need to enroll in the infertility program, which was nice. It just goes to show that every step of the way, you have to advocate for yourself whether gay, straight, or whatever. I was not expecting to a) get the coverage and b) have to go through these really embarrassing questions about my sex life.
It’s one of the things I’m most proud of.
So...what I have taken away from my journey in medicine thus far is that LGBTQ+ patients should feel comfortable bringing issues up with their doctors. It is simply a key component to their health. It is important, as healthcare professionals, that we continue to create this space for our patients and make the right moves to keep progressing. We also need to advocate for ourselves, as LGBTQ individuals in the workplace." -Larry, MD – Philadelphia (he/him/his)