On being a gay mother in medicine

I was so excited to find this blog! I have been reading MiM [Mothers in Medicine, where I recently guest blogged] for a few years and always longed for posts from gay MiM. I am gay (as well as a third year med student in NY) and have not met any physicians who were openly lesbian (I know they are out there – but right now I am in [a place where there are apparently not a lot of out gay people]). Would you be willing to write a post or share your experiences on what it’s been like for you being gay in medicine, especially being a gay parent in medicine.  —  New reader extraordinaire

Dear new reader extraordinaire:

Thank you so much for reading! I am here to tell you that there are lots of gay and lesbian doctors. Come join us in the major metropolitan areas and we can be the objects of warm tolerance and slow political reform together! I was happy to get your request, but to be honest it made me a bit uncomfortable. But more on that later.

Let me tell you about a dinner I attended recently. I was lucky enough to have the opportunity to dine with an interesting and accomplished professor in my chosen field, neonatology. Attending the dinner were several of my co-residents and another faculty member. The topic of families came up and I proudly showed pictures of my little E (dear everyone: do you enjoy seeing these pictures as much as I enjoy showing them? i’m going to assume yes), which prompted the six words that are the having-birth(ed)right of gay mothers everywhere:

“So, what does your husband do?”

This question is both my favorite and least favorite moment of being a gay mother in medicine. It contains so much: an assumption about my sexual orientation. An assumption about my marital status. A probably subconscious attempt to locate my family in a class category. A friendly attempt to get to know me, which I appreciate despite what is about to be a very awkward minute or two.

Here is why I hate this question: It forces me to embarrass the other person and then in turn be embarrassed by their embarrassment. They have made one or more incorrect assumptions (what if I were a single mama? Awkward!) and unless I lie (I do lie sometimes when I just can’t do it), I am forced to expose that assumption. If people are “socially liberal” they often feel compelled to tell me about their gay sister who is getting married in Vermont or their favorite college roommate who is having twins with a surrogate. While I enjoy hearing these stories of my people far and wide, they are not necessary. I do not think you are a homophobe because you assumed I have a husband. Conversely, that you have a gay sister does not reassure me that you are not a homophobe. If you find yourself in a situation where you have made such an error, my suggestion is to simply switch pronouns gracefully and move forward with the conversation.

Also, I hate this question because I haven’t found the right way to answer it. Usually I do this shrugging thing with my shoulders and say “Actually I have a wife and she’s a filmmaker and a professor” where the first part is thrown out at the top speed and the end part is drawn out Southern-style. In the complicated but successful gender ecology of my marriage, “wife” is not really a term I ascribe to C, but it gets the point across more clearly than “partner”. Sometimes I say “Actually, I am married to a woman” but this is also not quite right and seems more intimate, too intimate. Sometimes I just say “She’s a filmmaker” but if the person isn’t really listening, it can prolong and exacerbate the awkwardness.

Here’s a fear that I have: when I am forced to come out to people I barely know in this way, I worry that it makes them think about the way I have sex. I’m not sure if this is true or not, just a hunch/fear that I have.

Mostly, I hate this question because it distracts people from the aspects of me that I want them to notice: my stunning competence as a doctor, my thought-provoking thoughts on science and society, my long brown curls which are having a really good day. In all seriousness, when you are trying to build your career in the EXTREMELY CONSERVATIVE field of medicine, you just don’t want your sexual orientation to be one of the main things that people remember about you.

Did I mention that medicine is an incredibly conservative culture? There are hierarchies. There are spoken and unspoken codes of conduct. There is little room for social error. Here’s a joke: What does a medical school applicant do to rebel? She wears navy shoes with her black suit! You get my point. Within medicine there are political gradations all the way from left of Marx to right of the wicked witch of the West but still there is a shared aspiration toward a kind of collective social perfectionism centered on benign neutrality. And here is a dirty little non-secret: Most major medical institutions (much like the world at large) are still run by straight (or permanently closeted) white men in their sixties and seventies who rose to positions of influence in a time when women, let alone gay people, were mostly absent. In this milieu, it is not comfortable to contravene prevailing social expectations.

On the flip side, medicine is also a world in which people are trained to maintain a calm and neutral expression regardless of what they are being told. As doctors, people tell us things that they probably wouldn’t tell their own reflection in the mirror and we are the custodians of their confidence and their positive self regard. We aspire that they feel comfortable telling us these things without shame or fear of judgment. As such, when I am inevitably forced to execute the big reveal at an awkward moment on rounds or better yet, in a pin-drop quiet OR while holding open a gaping abdomen, it is likely that I will never know what the receiver actually thinks about my sexual orientation. I usually count this as a blessing because it allows me to go about the business of surviving medical training without being forced to swallow huge anger hairballs.

Here’s where I will tell you about the worst gay joke moment of my medical training thus far. I was once in the OR of a renowned cardiac surgeon who asked me what field of medicine I had chosen. I was on an anesthesia elective at the time, on the happy side of the surgical drapes, so I was honest and told him that I was going into pediatrics. He proceeded to tell the following anecdote which I’ll partially redact to eliminate the boring parts: His colleague in medical school went to his surgeon father and disclosed that he had decided to become a pediatrician. His father sighed and said: “Well, at least you’re not a homosexual.” Har har har, the surgeon laughed uproariously as he made a small incision in the patient’s aorta. (He didn’t know I was gay. It’s like double word points in Scrabble. Double douchebag points!)

Thankfully, these moments are rare. Mostly, people are openly supportive or just don’t care one way or the other. I am lucky to have amazing colleagues in my residency program who ask about C and E and understand how important my family is to me. Maybe there are people who are secretly grossed out or who are praying for me or who wouldn’t want their kids to have me as their pediatrician. Maybe there are potential mentors who decide to invest their efforts elsewhere, but I have always been able to find spectacular, generous mentors (all women thus far…. discussion for another day). In short, I do not feel that my daily experience of being a doctor or my career development are negatively impacted by homophobia. But you have to make smart choices about where to train, practice, and reside.

Here is one thing, though: I never, ever talk about my partner with my patients. I don’t know if straight people do this. Usually I don’t talk about myself or my life with patients at all. Our time together should be about them, not about me. Sometimes I invoke my daughter when I am reassuring new parents about newborn things, but that’s as far as it goes. If they asked me about my “husband,” I would just use masculine pronouns. In part I fear their reaction and the possibility that they would see me as a threat to their children. In part I don’t want to use up our time and risk them feeling embarrassed or uncomfortable. I’m there to take care of their kids, not win over hearts and minds. Patients have made derogatory comments about gay people (not to mention black people, East Asian people, Mexicans, women, men, old people, mentally ill people) in my presence and I usually say nothing or muster up a weak “now, now” and redirect the conversation. I’m not sure if this represents cowardice or good therapeutic judgment, but I’d be curious to hear how other people handle these moments.

But back to the question. “So what does your husband do?” Here’s the thing I love about it: It forces me to be myself. I said at the beginning of the post that your request made me uncomfortable and the reason is that I am generally a person who doesn’t like to ruffle feathers (social anxiety: maybe a little. Maybe a lot. Y’know.). Though I am out everywhere I go in medicine and otherwise, I handle the issue by normalizing it as quickly as possible and moving on. When you asked me to write about my experiences as a gay mama in medicine, I had a feeling similar to the one I have when someone asks the aforementioned question: Oh lordy, here we go. But then, for a minute or two or in this case on the internet which is forever, I give myself permission to be important to myself, if not to anyone else. For that moment, it’s not about everybody else’s expectations and value systems. It’s not about what they want to hear. It’s about my right to exist. And if there’s one thing I’m passionate about, it is the right of every person (and animal and plant for that matter) to have singular importance. It’s one of the reasons I went into pediatrics, to defend the right-to-exist (and thrive) of children, whose singular importance is often overlooked. So every time I say “Actually, I have a wife”, I hope that more space is created for everyone to be themselves, to fulfill their own potential without fear of being bullied, or fired, or, in some places, stoned to death. This applies not only to being gay, but also to all forms of difference from what everyone else expects. At the minimum, I hope that if there is anyone else in earshot who is gay but afraid to be out, that they might email me or find me in the halls or at least feel less alone. This may all sound super lofty, but it is what gets me through the awkwardness every time.

To recap: Being gay in medicine is better than being gay in many other professions. It’s better when you live in a place where lots of other gay people live and where there are other gay doctors. It does take some courage but it also teaches you courage.

You didn’t ask for advice, per say, but I can’t resist. At the risk of repeating myself for the nth time: Choose a residency program in a gay-friendly place. Once you are there, be out to everyone. At least you will know who your true allies are. Don’t be afraid to be important to yourself, even when being liked or accepted or hired or promoted feels more important. This applies not only to being out, but also to shaping the kind of career and family and life that will make you most happy. It will serve you not only when someone asks you “So what does your husband do”, but also when you want to craft a part-time position to be home with a young child, or leave a good-on-paper position for one that excites your curiosity but pays nothing. Medicine will always try to be more important than you, but it isn’t. Patients are, but medicine isn’t. Be a strong advocate for your patients and for yourself. Do I worry as I write this that it may affect a future fellowship application or job offer? A part of me does. But would I want to be part of a club that wouldn’t have me as a member? No, I would not.

A picture of E? I thought you’d never ask! What I love about this picture are the accessories, and the tummy, and the feet, and the off-the-shoulder Salt-N-Pepa-in-the-early-nineties hoodie look.