I’m a medical student heading into my sixth and final year, and I am a gay woman. I feel like my work as a healthcare professional would be much simpler if I were heterosexual.
When medical students (and the wider medical community) work on a ward, getting to know the patients is important. We have time to sit and chat with patients about their grandchildren, their dogs and where they went on holiday when they were young. In turn, most people like to know a bit about us. Forming a human connection with people under your care, especially those who are older or prone to loneliness, is essential in building a trusting patient-doctor relationship. I hit a sticking point time and time again. I’m asked if I have a husband, a boyfriend, children, or plans to marry someone soon.
It’s hard to explain how it feels. A knot forms in my stomach and I choke on my words. Usually I end up denying the existence of my partner, who is one of the most important people in my life. And then I wonder what I will do when I am (hopefully) wearing a wedding ring. Will I pretend I have a husband, or not wear my ring to work? Or just tell the truth, and run the very real risk of encountering homophobia and losing patient trust?
I mull over whether the pledge for doctors to be honest extends to telling someone your partner is a woman, and whether patients have the right to know about our sexuality or gender identity. Patients have made disparaging comments about their LGBT family members in front of me and the rise in hate crime definitely makes me think twice about telling the truth.
There are other situations where I’m unsure what to say. We offer women the opportunity to be seen by a female doctor for intimate procedures such as smear tests, at least in part because we assume it may have less sexual or intimidating connotations than a man. So would I be in the wrong for withholding information about my sexuality? The moral quandary goes on and on.
There is no guidance for medical professionals about coming out and being open with patients.
I want to make myself available to the LGBT community, since it is a group who are known to be underserved and forgotten by our health system. Being completely open is one way to do that, by making patients feel comfortable enough to talk about anything they need to in a welcoming and inclusive environment.
Then there’s what to do about colleagues. When I came out to a fellow student, they told me in no uncertain terms that I was going to hell. Other more minor things can be just as hurtful – confused looks, raised eyebrows and deliberately changing the topic are just a few I have encountered. And while it is easy to confront your peers about their behaviour, the hierarchy in medicine makes it incredibly difficult for a student to challenge a senior doctor.
Some of us are working to create a safe and inclusive environment. NHS rainbow badges identify staff who are educated on issues surrounding LGBT health. It is a step in the right direction, but we still need to go further.
We’re working to integrate LGBT issues into the curriculum, so that it is simply a normal part of medical education. At my university, there is currently a single afternoon of teaching on transgender health issues, and the rest of the curriculum proceeds in a completely heteronormative manner – assuming all couples are male-female, all children have a mum and a dad, and that everyone’s pronouns are she or he.
Some of us are working to introduce basic education for students on how to ask about pronouns, or talk about relationships without making any assumptions. In medicine this is especially important as we ask our patients to trust us with so much personal and sensitive information.
Talking about these issues will create a generation of future doctors who are ready to be allies of the LGBT community. My wish is that in 10 years, we won’t have to worry about asking these questions anymore. We’ll just have to worry about being good, kind and safe doctors.
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