Ah, the last words I wanted to hear at the end of a yearly physical exam with my primary care physician.

 

"She" was a nurse on his team. A woman who, a year prior, learned my honest answer to the ‘are your partners male, female, or both’ prompt amidst a series of questions regarding my admittance to the hospital…for heel pain [case similar to mine]. As with all medical screening tools, the questions have been tailored for reasons which have likely saved lives or improved the care of thousands of patients in some way or another. But why was I being asked about my sexual preference while my heel was broken? I couldn’t help but feel defensive. I guess I was afraid that someone would say something when my answer was male. Coming out to anyone as gay in west Michigan is a really complicated, terrifying feeling. Yet, she reacted in a neutral manner as any healthcare provider should. It wasn’t until my physical a year later when I realized she did tell someone, the last person I wanted to know: my primary care physician.

 

“She told me, she told me about your sexual preference,” he said.

 

Sinking in my chair I managed to respond, “What about it?”

 

“That you’re a homosexual.” 

 

“Yes, ok and?” 

 

“And well are you? A homosexual?”

 

My immediate wonder was if I could react with a joke, try to avoid the very cringe gay conversation with my conservative right-wing catholic doctor.

Maybe blame it on that Dilaudid the nurse gave me? 

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But I looked at him and said: “Yes, I am.” 

 

“Oh…are you sure? Is this a life long decision you have made?” 

 

Avoiding the choice statement he bulleted my way, I shrouded, “Yes, I have.” 

 

“Ok, and you are sure? If you are I have to put that in your chart as it is a medical condition, because you are choosing a higher risk lifestyle. Is that ok with you?” 

 

I thought, am I a medical condition? Why, am I sick? Am I diseased and in need of treatment? Am I wrong? I responded, “Yes, just please do not tell my family or my grand father. My mom knows but no one else.” 

 

“Ok I will do that. You know, I have 14-15 other patients like you.”

 

After finishing the session, I walked into my car and put the keys in the ignition. Before I could turn it, I saw a tear hit the steering wheel. Was I just diagnosed with homosexuality? 

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It certainly felt that way. Not because I was offered treatment for my homosexuality, or given a pamphlet with potential symptoms and plan of care (which many queer people have [conversion therapy]). It was a feeling confirming my greatest fear: An intelligent, well respected physician telling me that the thoughts and behaviors I have always had are a result of a medical condition. I am wrong, diseased, and disgusting.

 

With my forehead pressed into my crossed arms on the wheel, I cried for a bit. I looked at myself in the mirror and hated myself for who I was, that I’d be better off lying for the rest of my life. I asked myself, would I let this man push me under? To sink where no one could see me and who I really am? Well…yeah. Might as well. For now, not only does the rest of society think you’re disgusting but the faction of meritocracy’s elite, the ‘compassionate intellects,’ have deduced that your difference in ability to love is unnatural, and therefore formally classified as such. I put my car in drive and left.

 

This happened in 2016, in my last year of college, before I moved for my masters. It took me a while to understand what happened during that interaction. I kept playing it over in my head, dissecting every word. After a couple years, I was able to understand that it was morally wrong and ethically violating to my patient experience. I learned that I shouldn’t ever feel shame about my identity from my physician, let alone of primary care.

 

Doctors should not have the ability to degrade their patients on the basis of gender identity or sexual orientation. Human life is not theirs to determine, only to prolong.

 

Healthcare is meant to be a system centered around human beings, where physicians are burdened with the greatest responsibility of understanding what that means, fully. Yet, so many of us are still asking ourselves: Why does our healthcare system allow physicians to talk to their patients with such a lack of patient centered intention? How, as a physician, is it permitted for you to pick and chose the degree of empathy you are able to give to each patient based on factors like personal bias, religion, and stigma? How can you take care of people and truly believe that you have the right to do more than educate about their health, but to impose your beliefs?

 

The answer: lack of education. Our system has failed to provide physicians the with proper tools and belief systems to fulfill their hippocratic oath. Institutionally, our healthcare system has made attempts to recognize its failures, such as steps toward depathologizing homosexuality and transgendered individuals [Jack Drescher, Depathologizing Homosexuality, BBC News]. Yet, even after these changes are made, there are still physicians using terminology that doesn’t align with the beneficence of queer patients. Especially for trans gender and gender non-conforming individuals.

 

Yes we can make changes within the institution of healthcare, but its effects often take years to decades. It is education that has the power to have the greatest chance at improving the system. Every currently practicing physician was trained, in medical school and residency, through an educational model which did not emphasize human connection, they had to figure it out on their own. Yes, a lot of empathy is based on something you feel, but it’s hard to feel true empathy for something you haven’t experienced yet. Because of this, physicians are at a huge deficit with a greater chance of negatively effecting their patients, even with the best of intentions. Older generations of physicians have much wisdom to gain from current students of medicine who were raised in this new age of technology and exposure. Our thoughts and ideas have been conceived in a time where the words you chose matter deeply and have implications that amplify into many dimensions of the human experience. The vision this generation of healthcare professionals sees, will be the future; where patients will be treated as a whole, no matter who they are, what they look like, or who they love. The beginning of a new era, determined by inclusivity and humanity.

 

So here I am, telling you that there is a problem in healthcare and it’s effecting millions of people. Gay, lesbian, bisexual, transgender, queer. We are real, we are beautiful, and we are human. It is the goal of this platform to learn as much as we can from all of YOU and share what we have learned. 

 

I look forward to our brave new world, where a queer patient’s autonomy is nourished, well-researched, and welcomed.

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I have been diagnosed with homosexuality and this…is just the beginning.

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Peace and Love,

-Nick