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"...it made me question whether I should enter medicine..."


"My name is Meg Quint and I use they/them pronouns, or just Meg is fine, and I identify as nonbinary! I am a senior in college and premedical student in Geneva, New York. When I first came out to myself, I was a sophomore/junior in high school and considered myself bisexual. However, my identity has shifted a lot since then. I began telling others about my identity starting my Junior year of high school. It was also that year where I began to see how identifying as queer impact experience with the healthcare system.


It happened through the typical questionnaire that pediatric doctors provide their patients which asks something along the lines of like, ‘Who are you attracted to/sleeping with?’ At that point I wasn’t sexual with anyone, but I was still open and honest about how I identified at that point in time. My understanding was the most robust purpose of that questionnaire was to properly manage birth control and STI/STD’s in adolescents and young adults. Which, I will say, did kind of make me feel hesitant to be open and honest because I wasn’t sexually active, so I questioned whether that was really the right time to say anything. Regardless, that particular doctor was very nonchalant about it saying, ‘you can get STI’s regardless of who you might become sexually involved with in the future, so just be aware of that and use protection with whomever you are with.’ That response was kind of shocking to me because I’m from a slightly conservative area of Massachusetts. It was also during this time that I was nearing the end of many years of recovery from a spinal ford injury. During recovery, I had doctor’s appointments multiple times a week, but it wasn’t until that particular instance with my primary care doctor that my identity had leaked into my experience as a patient. I really think that my intimate experience with healthcare around that time confirmed my passion for healthcare, but it also made me more aware of this other confounding factor [my identity] that would likely impact the care I could provide and receive.

 

Getting a little more into my personal health…so early on college I definitely realized I was ~mostly queer lol. Everyone once in a while a cis man finds his way into my dating life, but not frequently. That being said, I wasn’t sexually involved with men and I had no anticipation to be sexually involved with men. However, I do have a strong family history of endometriosis and was experiencing pain, so I finally took my own advice and made the decision to go see a gynecologist. At this point, I was still identifying as cis woman sleeping with other women and I made it very clear that I was not there for birth control but for pain control. I literally went so far as to verbalize, ‘I do not sleep with men, I do not need protection from pregnancy…what I need is pain control.’ Initially, that was very well received. They put me on oral birth control hoping it would help with pain symptoms, likely related to endo, but I had a very bad physical reaction. I called them after two or three weeks saying, ‘I can’t do this, my body is shutting down and we need to figure out an alternative solution.’ Then, I talked to someone from my doctor’s office which turned out to be a terrible 30-minute cyclical conversation of:

me: ‘I need pain control’
them: ‘okay how about a copper IUD, that would be great for birth control’
me: ‘I don’t need birth control. I’m not sleeping with men. I am not at risk for pregnancy, that is not the point of this, I need pain control because I likely have endo.’

But it did not stick, they just kept coming back with the same response and ignoring my need for pain control. Finally, I decided to end the conversation and the person on the other line ended the call by reminding me to use condoms. Even though the doctor was so great about my concerns, others on their team were not. This made me question my ability to receive adequate queer care from this facility. A facility which was within a large very reputable hospital.

 

I’ve been working pretty actively in the healthcare system for 5-6 years now through observation hours and scribing, so I would consider myself to have a good amount of experience for my age. I was working in a hospital one day when someone came into the emergency room after an accidental overdose. This person’s records said their name was Jacob* and their sex marker was male. We go into the room and the doctor sees the patient, looks at me a bit confused and said, ‘oh, this isn’t the right person.’ We went back to the nurse’s station and the nurse said, ‘oh no, this person is trans and the name that they use is Maria*.’ We go back in and the doctor says, ‘Are you Jacob?’ And Maria responds, ‘Well that is my birth name. I use Maria.’ The doctor then just looked at me and looked back at Maria and said, ‘Alright Jacob, let’s get started then.’

Immediately, you could just see Maria melt. You could see in her eyes that she went to a totally different place. I am just sitting in front of her, as a queer person with the passing privilege of a cis woman, trying to catch their eyes to tell them I am sorry. I just wanted to say, ‘I am so angry with you,’ but I couldn’t because Maria was in so much shock as to what happen that they could not tune back into reality.


What made me even more frustrated about the situation was that Maria refused to seek treatment. She refused to see a psychiatrist or see if there was an open bed for recovery. I could only imagine that Maria had similar experiences to that in almost every other healthcare interaction. This doctor could have been the difference for Maria. All he had to say was…’I respect you as a human being.’ That alone could have made Maria more apt to seek treatment for addiction. It was such a small thing that could have been done to make things better and provide the patient with the care they deserved and needed.


I think it is also notable that this interaction made it extremely clear that I would not be safe or welcome in that space as my true and authentic self. I want to stress that this was not my primary concern, but it did cross my mind. To be honest, it made me question whether I should enter medicine or if I should try to change the experience of queer patients by working in a field tangential to medicine.


When I think of how situations like that happen, I think we can attribute part of it to generational differences and not having the access to information that aids in understanding. I hope, for the most part, that doctors do want to do right by their patient and be respectful. I understand, however, there may be a lack of experience and knowledge of how to treat queer patients. This is a fault of our medical schools and our medical system as a whole. I also think, though, that there are some doctors that will say, ‘this doesn’t align with my beliefs, so I don’t really care.’ This is a really unfortunate reality in our healthcare system. Because we do have doctors, and all other kinds of healthcare professionals, that aren’t willing to approach their patients with an open mind and respect. This is infuriating because the golden rule of healthcare is “do no harm’. However, not respecting a patient’s identity is directly disregarding that rule. Though it may not be physical harm initially, it is producing mental harm that is longer lasting and can lead to detrimental effects of one’s physical health.

When I look back at that time with Maria, I think of how things could have been different. I have often scolded myself for not doing something to change that moment. But I remember how young I was and how I wasn’t secure in myself yet. I didn’t want to put myself in danger in anyway by coming out or showing my alliance with the trans community. Selfishly, I was scared of how the power dynamic could affect me if I said something. In that moment I was thinking about how any action could threaten my chances to get into medical school and I didn’t want to rock the boat. My family always told me, ‘don’t rock the boat. Just go with it so in the end you can make change.’ I had a genuine fear of losing my job, losing that experience, and threatening any chance I had at pursuing my dreams. So, I didn’t do anything. I see those actions today as selfish and naïve. Now I recognize that change 10 years down the line doesn’t necessarily matter as much because, who knows, I might not even be here in 10 years from now. You know? Why not be proactive?

 

My advice for the readers of Dx:Q is this: Take time for yourself to evaluate your situation. Where are you out? Are you safe to be out? What is the best move for you? No one else can make this decision for you. Make decisions to be true to yourself when safe and possible. If some person, some job, or some institution doesn’t accept you, that is not your fault. That is on them, not on you." -Meg Quint (they/them/theirs)



*The names used in this interview were altered to protect confidentiality.


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