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"Trust yourself and things will be okay. You will be okay."


"I first came out when I was 17 years old. I grew up in NYC and I went to an art school. So, being queer in my friend community, even in 2010, was pretty common. At the time I identified as a lesbian and was dating a girl. There was some stuff that happened between our families, including some unsafe situations. Essentially, my parents did not know that I was dating a girl and it was being held against my partner. So I decided to come out to my family. It did not go over that well, which was a bit shocking. I actually was removed from my apartment.


I spent a lot of the second half of my senior year of high school moving between my friends' houses and my mom’s house in New Jersey. It was pretty difficult. Since then I have worked to rebuild trust and communication with my family who was not as accepting when I originally came out. So, I have been out since 2010.

 

I grew up as a type 1 diabetic, which immersed me in the world of endocrinology. I do not come from a family of doctors. I actually come from a family of artists and English teachers. I spent a lot of time in the hospital and around doctors. I found a lot of comfort in finding answers and solutions for problems. It really attracted me to the world of science. I decided to major in Biochemistry as an undergraduate.


Given all of that, I am still interested in endocrinology. The hormone system is so complex, it is like a puzzle you have to try and fit together to find a suitable treatment plan. You can also do hormone therapy, which I would love to be able to do in my future practice to treat patients who belong to the intersections of my own identity. Endocrinology is such a fascinating system of the body!

 

I did not apply to medical school for years because I did not feel like I was ready.


I graduated in 2015. Since I was 7 years old, I have had accommodations for testing. I applied for accommodations on the MCAT, and they gave me a lot of push back. I had to go through a year-long process to convince them to give me the same accommodations that I have always had and needed – to be on the same playing field as other people. This looked like multiple appeals and using every bit of evidence that proved I have received these accommodations in the past.


A lot of those accommodations are related to my type 1 diabetes. For example, I need snacks available throughout testing. Also, I have machines attached to me that beep constantly, and I don’t want to be a distraction to others so I need a separate room. Being that distraction to others makes me anxious and can induce panic attacks.


Between having a bit of a rough coming out story and being denied accommodations multiple times in 2016, my self-esteem had gotten pretty low. I took a few years after that to learn how to be confident in myself despite any external setbacks. I value the time I took off between undergrad and medical school. I worked as a teacher, as a grounds keeper and worked in various health care positions – as a scribe, medical assistant, phlebotomist, and urgent care clinic manager. But most importantly I started therapy and took time to unpack the trauma I had experienced. I think this time was immensely helpful.


Since I started medical school I have experienced a lot of those same setbacks, which is unfortunate. The system that we are in is slow to change, but I still see little, great changes. We just still aren’t at the point where becoming a doctor is accessible to differently abled people. It is not accessible for a lot of queer people, people of color, people who had upbringings that were not 100% traditional.


Essentially, my medical school application process was delayed because of many reasons, one of them definitely being my queer identity. However, I am thankful for the time I took for myself before applying to medical school because it helped me become a stronger, well rounded person.


Currently, I attend a medical school in rural Washington. Prior to attending medical school, I have never lived in a rural setting. I definitely chose it because I thought it would be a good life experience so I could relate with my patients better. I have lived in cities and suburbia, but I didn’t know what rural life was like. I wanted to be able to connect with people. Lived experience is the best way to understand my patients – some examples are why people might not be able to make an appointment with their doctor or pick up their medicine in the only pharmacy in town that also happens to be closed on the weekends.


Being a queer person in rural America during the Trump administration has been terrifying in some ways. During the pandemic, especially as a person living with chronic illness, I really did isolate myself outside of my school. My school took all the proper precautions, but the community I was living in spread a lot of misinformation and there was a lot of disbelief in the legitimacy of COVID-19 as a virus. There were very high rates of positive COVID-19 deaths. I spent about a year isolated by myself with my dog.


For my own safety as a queer person, going outside looking queer would make me uncomfortable. I would walk around and see trucks with flags for extremist right-wing groups. I would be in my car after picking up groceries and I would see that flagging to us – that we are not welcome. Living in a rural environment during the Trump administration, the COVID-19 pandemic while being queer has shaped my medical school experience.


My medical school has always been extremely supportive of who I am. When I got to medical school I was the first openly trans person there. I might have been the first person to use pronouns (they/them) outside of people’s typical comfort zone. One of my classmates, who was my “big-doc” (a peer-mentor one year above me in school), helped me create educational sessions for students about how to use pronouns and why it matters. We presented this during my first semester in medical school. Then, the faculty and staff invited us to give the presentation, and many of my teachers started to incorporate this curriculum into their lesson plans. They then started using terms like AFAB (Assigned Female At Birth) and AMAB (Assigned Male At Birth) as an indication of sex, instead of gender, in question stems. I have teachers that now use pronouns in email signatures. Since day one I have been working with my school to add the option of adding pronouns to ID badges, and this is the first year that the school has offered that! My school has been really willing to work with me on how they can be even more inclusive. There are more and more queer medical students who go to my school every year. I have had a lot of them reach out to me. It is just really nice to see that they are so amicable to change and that it is a close and tight knit community.


That is actually what drew me to my school – why I chose my medical school. I saw the community and how progressive they are. They want to be better and I saw an opportunity in that.

 

I was living in Yakima, Washington during my didactic years (from 2019 to 2021) and there is a beautiful, semi-underground LGBTQ+ community there. I am a pretty outspoken person. So, before the pandemic, I would go to any event that seemed like there may be queer people there that I could connect with. And I absolutely found a beautiful community of people that wanted to bring equal rights. During my time at school, I got my school to work closely with the local LGBTQ+ community organization, Yakima Pride (https://www.yakimapride.org/). We definitely had a very solid partnership. I was president of the MSPA (https://www.medpride.org/) chapter at my school, and I was able to foster that relationship. Now, the new president of the chapter is carrying that relationship on. I hope that connection stays strong so our school can continue to work closely with the local rural LGBTQ+ community.


Another place I volunteered with in Yakima was a homeless youth shelter for LGBTQ+ individuals. It’s not necessarily a place that you have to be kicked out of your home to go to, but it is a safe place for kids who are LGBTQ+ in a rural setting. It is a place where LGBTQ+ youth can go and just be themselves when they normally can’t throughout the day. The shelter has excellent resources. So, there are just these “little gems” throughout the community.


One of my favorite “gems'' I found while I lived in Yakima is Collaboration Coffee (https://www.collabcoffeeyakima.com/). I met the coffee shop owner, Maddie, shortly after starting medical school, while accidently attending a networking event for business women. Over the years I have been extremely impressed by Maddie because she uses her café as a safe space for all marginalized people. The coffee shop is a well decorated, fantastic place to get an almond milk latte, AND it is also a community center created for LGBTQ+, POC, artists and activists in Yakima. I have seen Maddie host art shows and concerts, create community conversations, and use her storefront as a fueling center for BLM protests. She has been kind enough to extend her community to my LGBTQ+ club in medical school where we have been able to host numerous events to help educate our local community and bring us all closer together.


I think a few things that have become clear to me about living in a rural setting. No matter where you are in this country there will be these “little gems.” A “gem” to me is something that is rare, beautiful and especially pleasing, good and hopeful. All of these “little gems” I found while living in Yakima are built by people who care so much. It is so hard to live somewhere where being different can cause you emotional, physical and potentially life-threatening harm. Being proud and public as a part of the LGBTQ+ community in rural America is hard. My time here has shown me that I know I want to do all that I can to help support my beloved communities – to support the rural LGBTQ+ community.


I have been influenced by my time in Yakima and now in Richland, WA. My experiences are definitely going to influence how I take care of patients in the future. In the past I imagined myself going back to a city and only practicing medicine in a city, but now I know after I finish residency, I cannot imagine myself practicing only in a city. I would have to at least split my time between rural and urban communities.


From my life experiences I would say it is easier to live in a city as an LGBTQ+ individual. At the same time there are a lot of people who are not in cities who belong to the LGBTQ+ community and need medical care from professionals who understand their life experiences, won’t judge them, and will actively make safe spaces for them. I still don’t know what exactly will go into my future practice, but I can certainly imagine myself either working part or full time in rural medicine. I have even thought about learning to fly so I can fly out to medically underserved rural areas on weekends and provide free-of-charge medical care.

 

The Latin root of the word “doctor” is to be a teacher. Before medical school I tried the career path of education. For example, I took part in an AmeriCorps program and I did homeschool teaching. I realized that being a medical doctor is synonymous with being a teacher; as a doctor you teach your patients how to best take care of themselves. You can give them all the tools, but that doesn’t necessarily mean that they will use those tools if they don’t feel empowered and educated enough about how and why to use them.


I think it is the same for LGBTQ+ rights and specific intersections of identity. A lot of the work I have been involved in throughout medical school is improving the lives of future LGBTQ+ patients that my classmates might see. I actually just finished a fellowship with Building the Next Generation of Academic Physicians (BNGAP) (http://bngap.org/ ). It was an educational research fellowship for medical students and medical professionals at all levels of their careers. That is still in process of its final steps for publication, but that publication will be about best practices in reproductive health care for transgender patients with a focus on transgender men, non-binary/gender non-conforming, and AFAB individuals who have used some amount of hormone affirming therapy. Doing things like that [i.e. getting publications out to further the knowledge of the medical community and working with my medical school] is definitely a nice way to induce and see change. It is nice to know that I am making an impact that will hopefully influence the lives of some rural queer people in the future.


As far as the amount of the effort I’ve put in throughout my medical school education, I have been on student council, written letters to local senators here, and set up the diversity, equity, and inclusion department at my medical school. While these opportunities have been huge and I have been so proud to be part of them, when I do go to residency I would really like to be part of a program where I can learn from my peers and educators. In my future I will definitely be looking for opportunities where, when it comes to LGBTQ+ specific healthcare, there are other people around me that I can learn even more from – beyond my own knowledge. I still am willing to help educate and be part of change and growth, but I would really like to find a program that can support me with institutionalized inclusivity previously established.

 

I would tell my younger self to trust myself. No matter who you are, there will be people along the way telling you that you can’t do it. If you are a member of the LGBTQ+ community, then that is probably something you are going to hear more often.


The most difficult times in my life were when my trust in myself waivered. When I keep promises to myself and take time to reflect on who I am, what my goals are, and what I want, then things just become clear. I have to just keep telling myself to trust myself.


I wish I could tell my younger self that it is okay to be angry and to feel frustrated. Your feelings are absolutely valid. It is okay to be hopeful. It is also okay to be scared.


Trust yourself and things will be okay. You will be okay." -Oak Sonfist, Richland WA (they/them)\




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