My husband and I have just returned from a gay cruise in the Caribbean. Like all cruises, this one was no exception—full of sensory overload and a refreshing, guilty-pleasure break from disciplined and healthy living. There were a number of physicians on the trip and the diversification was akin to who we see practicing medicine in today’s America. There were residents and early career doctors, mid and late career physicians, and some retirees. Many were international medical graduates and a lot of the US grads were minorities—both ethnic and racial. Lots were couples and others were traveling on their own or with a friend.
I want to share some observations with readers of this blog, especially those who treat gay physicians. First, despite a lot of progress, there are vestiges of homophobia across this nation. Some of the doctors I met are not “out” at work and those who are describe a sense of otherness that is alienating and painful. As one man, a trauma surgeon, said “My colleagues know I’m gay and married but I’m still not myself. When asked about my day off, I pause and censor myself before I tell them that Stan and I just went to a movie and out for dinner. I’m not blaming anyone—or if I am, it’s myself. I just need to calm down and not jump to the conclusion that I’m being judged.” Some other doctors I talked to feel just the opposite; they have very little internalized homophobia but describe being surrounded by all kinds of bigotry and ignorance in the medical communities in which they practice and live. A Korean physician said to me “Being on this ship is incredibly liberating. You can sense the acceptance and security. I see it on the faces of strangers, I hear it in their laughter, I feel it in my soul. My mind is clearer and I’m breathing differently. In my culture, this is tongzhi, or ‘coming home,’ where I belong, with comfort and support.”
Second, increasing numbers of gay physicians are marrying or, if not, have exchanged rings in a formal commitment ceremony. Our society has not quite caught up with the meaning of that band on the man’s left hand ring finger. Gender assumptions fly out the window. The refrain is like this: “I see you’re married, what’s your wife do?” One doctor told me that it’s easy for him to correct the person with “My husband’s a doctor” but too many are lost for words, stumble over a response, or decide not to “come out” to this person. Two internists, married with twins, told me that they are frequently mistaken when out with the kids on their own as divorced fathers or giving their wife a break at home or taking the kids while she’s at work. And once at a restaurant when all four of them were dining as a family, a well-meaning stranger, himself with kids, asked “Are you guys brothers or friends?” Before either had a chance to respond, their young son spoke up and said “No, they’re married. This is daddy Josh and this is daddy Zach.” A very sweet moment for all.
Third, love is love. Jennifer Holliday, singer and actress of Broadway’s Dreamgirls fame, performed one evening. Mid-show, between songs, she gave a brief riff on stigma and marginalization (she has suffered from depression and an eating disorder). Then she invited all couples who had been together 20 or more years to come up on stage. She asked them to slow dance in celebration as she sang a beautiful love song and her band played. One couple, together 51 years, danced with their canes. Everyone in the theater was on their feet, swaying in solidarity, wiping moist eyes, or not, simply letting their tears linger with the moment.
Flying back home I reflected on the many things that we can do as mental health professionals when that patient opposite us is a gay physician. We can avoid binary thinking and try to gauge where he is on a continuum of self-acceptance. We can ask about key figures in his life – family members, friends, and medical colleagues – and get a measure of the support and unconditional caring he receives. The parents of some IMGs and minority physicians struggle with or reject their son’s gayness; denial and rationalization do not always protect him from interior sadness, disappointment, and a longing for intimacy with his mom or dad. We can ask about any microinequities and microinsults that he is subject to at work, not just about sexual orientation but about race, ethnicity, and religion. We can try to find out if any of his symptoms or troubling behaviors are rooted in shame, trauma, or loss. But most importantly, we can create a safe place, a welcoming atmosphere of acceptance where he can dig deep, probe, excavate, heal, and grow. Where he can come home.
Dr. Myers is Professor of Clinical Psychiatry and immediate past Vice-Chair of Education and Director of Training in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, NY. He is the author of 8 books, the most recent of which are "Why Physicians Die by Suicide: Lessons Learned from Their Families and Others Who Cared" and “The Physician as Patient: A Clinical Handbook for Mental Health Professionals” (with Glen Gabbard, MD). He is a specialist in physician health and has written extensively on that subject. Currently, Dr. Myers serves on the Advisory Board to the Committee for Physician Health of the Medical Society of the State of New York. He is a recent past president (and emeritus board member) of the New York City Chapter of the American Foundation for Suicide Prevention.
The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.