"...I would leave feeling worse than I would going in"


“My name is Will Knight, and I identify as a cisgender gay man. I’m a third year Doctor of Physical Therapy, and I’ll be graduating this May. I was first exposed to the field of Physical Therapy at 12 when my grandfather was diagnosed with Parkinson’s. He was this very athletic person who taught me how to surf and got me into running and sports. But to watch this progressive disease just take a profound impact on his life and then seeing the impact that physical therapy had on his life really inspired me. So, I decided at 12 that this was the career path that I was going to take. 13 years later it’s kind of crazy to be getting to the finish line.

 

So I came out when I was 16, which wasn’t really the most pleasant experience, and when I turned 17 my dad kicked me out of the house. Fast forward a couple years to the winter of my junior year of college we finally met up, and after having not talked for quite a long time I basically told him, ‘you know what, dad, my life is great. It’s going to continue to be great whether you’re in it or not. And if not, then the door’s over there.’ Since then, he’s really stepped up to the plate and came around to understanding me a bit more. We’ve built a much better relationship and have reached a much better place now.

As far as healthcare experiences go as a gay man, the first positive memory that comes to mind is from my freshman year in undergrad. At that time, I was 18 and was going to study abroad, so I had to get clearance to go. That was the first time that I had been asked things like, ‘are you sexually active? Do you sleep with men? Do you sleep with women?’


I actually met with a very compassionate nurse practitioner who was really great and asked about my struggles with coming out. I felt comfortable enough to talk about the things that I had been through with my dad, and she recommended some mental health services from there if I ever needed it. Fortunately for me, I had already been involved in a therapy group at my undergrad institution that helped me come to terms with being out of the closet, explore my sexuality, and sort of guide me through the beginnings of adulthood. It also was able to help me navigate the relationship I had with my dad.


The first negative experience I had as an LGBTQ individual in healthcare was right after I had graduated from college. I was talking to my doctor about getting started on PrEP, and she looked at me like I was crazy. She told me, ‘I have no idea what this is’ and referred me to an immunologist. It was bewildering...like I did not need that level of care to get started on PrEP.


So I went to Planned Parenthood, and this was sort of where my trauma started resurfacing. At the age of 19, I survived a sexual assault by a man I met while I was in college. I legitimately felt at the time that the whole situation was my fault. You know growing up, our parents constantly preached, ‘be careful of people who you meet online. Always stay in a public place.’ But I went to this person’s house anyway, and the rest is history. I didn’t tell anyone about it for over 2 years.


Several months after the assault, my campus was testing for HIV, gonorrhea, and chlamydia which I went and got tested for. Thankfully everything was fine, and I just thought alright I’m just gonna put this behind me and didn’t think about other possible STDs that might’ve been in the mix. But when I finally went to get started on PrEP, I was informed that I had tested positive for syphilis. Based on the amount of antibodies that were in my system, they had told me that I had had this for quite some time - at least over a year. As I started to talk to previous partners, all of them were like ‘I've been tested, and everything’s fine.’


Even so, my visit brought up all of these feelings from the assault, and I went to a really dark place. I started abusing alcohol and drugs. Luckily, my mom and step-dad are amazing and supportive parents who recognized what was going on after a few months. I was living at home while I took a little bit of a break before starting grad school, which is when I started going into therapy and getting help for the things I needed. It was a tough time, but I'm in a much better place now.


Something that I still struggle with is the fact that while syphilis is quote, unquote ‘curable,’ I will always have those antibodies in my system for the rest of my life. So whenever I go get tested, my records are there. Any increase to my viral load means I’ve re-contracted it and would need to be treated again. But I guess one of the amazing things about being on PrEP is that I get tested every 3 months, and that’s given me more control over my sexual health.

 

Another experience of mine in healthcare was that of my therapist. My first therapist was good and bad in a lot of ways. He helped me reconcile my survivor’s guilt and kind of move past my trauma, but when it came to working with my alcohol and drug abuse issues he was very judgmental. When I told him how much I was drinking in the beginning, his face of judgment was something that I will never forget. That wasn’t what I needed when I was in that vulnerable and dark place. I needed someone who would kind of understand.

So it got to the point where I was lying to him about things because I didn’t want to feel judged, and I would leave feeling worse than I would going in. It got to the point where I was like this is not a good relationship, and I stopped going after about a year of sessions. But now I’m seeing a new mental health professional who I started with a few months ago, and he’s great. I don’t feel judged when I see him or have to lie, so that’s definitely much better than that first go-about.


I think that we have to realize that whenever we work with anyone, we have no idea how complicated their story may be. Something may be new to you...like new shoes that you haven’t walked in before. I just think that it’s important to treat every person with compassion and without judgment. I also think it’s important for all of us to recognize that we all have implicit biases. As great as I like to think of myself, I recognize that there are going to be patients I meet in my career that I have biases towards. So I think it’s also important for us to harness this and recognize when we need to refer a patient to someone who is going to be better able to help them. If a coworker has more experience or a better background in something I’m unfamiliar with, then my patient would benefit more from working with my coworker than with me." -Will Knight, Physical Therapy Doctoral Candidate, Washington D.C (he/him/his)


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