Do No Harm: Queer Patients and the Med School Closet


We’re often taught in gay culture that the act of coming out is a solely personal matter that no one is obligated to engage in. For many, this leads to only partial–if not non-existent–disclosure to family, friends, coworkers, or any other groups of people with whom we interact on a daily basis. While I agree that coming out is a personal decision, the notion that it “does not affect anyone else” may be misguided.

This article offers an interesting perspective on the climate of the medical field in regards to LGBT visibility. While gay dietitians are a dime a doze (trust me), finding other healthcare professionals who are out is a seemingly more difficult task. This can be particularly harmful to LGBT-identifying patients looking for clinicians who can be sensitive, empathetic, and understanding of their unique medical issues. Sure, high blood pressure in any patient is concerning, but how do you address this in the context of a trans* patient taking hormone replacement therapy? Unintentional weight loss is still unintentional weight loss, but how does a gay man’s body dysmorphia and eating disorder complicate his treatment? Either through lack of training or lack of interest, many healthcare professionals are ill-equipped to properly address these nuances and in turn may not be providing the most effective or appropriate interventions. Additionally, in the same way that some patients prefer doctors of their same gender or native language, some patients may feel more comfortable being cared for by professionals who are openly LGBT-identifying. And that feeling of comfort, of safety, can be all the difference in whether or not they will seek treatment in the first place.

So do healthcare providers have an obligation to come out? Yes and no. I do believe that coming out is a personal choice and that people should do it on their own terms, when it’s safe, and when they’re ready. However, I also believe that staying in the closet can be a disservice to our patients, who are often met with discrimination, violence, and malpractice when seeking medical care. This fosters a community-wide poor relationship between LGBT patients and clinicians, and may explain some of the health disparities that LGBT folks face compared to our straight counterparts. When the quality of treatment received visibly differs between LGBT and non-LGBT patients, it disincentivizes queer populations from seeking appropriate or timely medical care. Competent, approachable, out healthcare professionals can serve to bridge this gap and demystify the LGBT healthcare experience for both patients and fellow professionals. We employ the paradigm “Do No Harm” in our daily work, yet in our silence, in our invisibility, we may be having the opposite effect.

The only time I came out in a professional setting was with a LGBT patient. I saw that he was struggling with many of the same issues that I have struggled with, and I really wanted to tell him that I understood where he was coming from. It was not easy for me to share that part of myself at work, but I felt it really made a difference for him. It was worth it. 

Thanks to @gregasaurus for sharing the article and his thoughts. There should definitely be more discussions on LGBT issues in healthcare. 

– Fish

Do No Harm: Queer Patients and the Med School Closet


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