On October 30, 2019, the McGill Faculty of Medicine, Post-Graduate Student’s Society (PGSS), and Social Accountability and Community Engagement Office (SACE) hosted the panel “What is it Like in the Inside?” to discuss the experiences of 2SLGBTQIA+ individuals working in healthcare. Topics discussed included the difficulty of continuously having to come out to both colleagues and patients, the difficulties of reforming the healthcare system to be more trans-sensitive, and the impact which the intersection between race and sexuality has on one’s identity.
The event began with a presentation by Saleem Razack, pediatrician and Director of the Social Accountability and Community Engagement Office at McGill, which defined the goals of the panel: namely, to provide a space for 2SLGBTQIA+ identifying students and faculty, as well as allies, to gather, to encourage fostering an intergenerational dialogue about issues impacting the 2SLGBTQIA+ community, and to assess interest in forming a Queer Health group at McGill. According to Razack, the event was the first Queer History Month event hosted by the Faculty of Medicine. Dr. David Eidelman, VP-Dean of the Faculty of Medicine, also expressed his support for Razack’s efforts in creating a space for such discussions, and stressed the importance of diversity, especially given McGill’s historical lack of tolerance in the Faculty of Medicine.
Razack continued his presentation with a history of the attitude towards the 2SLGBTQIA+ community in the medical profession. He referred to the significant advancements in the treatment of HIV-AIDS made in his lifetime as well as historic psychiatric “diagnoses” of 2SLGBTQIA+ people to illustrate the positive influence which members of the 2SLGBTQIA+ community can have on health care. Razack emphasized the activism which took place to make this progress, from psychiatric professionals advocating against conversion therapy to activists outside of healthcare seeking to hold the medical profession accountable for its treatment of 2SLGBTQIA+ individuals. Such history plays an important role in how Razack teaches medicine; he advocates teaching that “owns” the intolerant history of medicine. “We aren’t discontinuous with that history […] the way to own it is to bring it out, make it be known.” He concluded his presentation by stressing the important role that he believes expressing his sexuality plays in his practice: “I’ve been a doctor who was not out […] there’s no going back for me. Being gay and being out as gay has made me a much more authentic and real doctor.”
“I’ve been a doctor who was not out […] there’s no going back for me. Being gay and being out as gay has made me a much more authentic and real doctor.”
– Saleem Razack, pediatrician and Director of the Social Accountability and Community Engagement Office at McGill
After the presentation, members of the panel introduced themselves and briefly described their experience in healthcare as a 2SLGBTQIA+ person. Many of them emphasized the need for a queer community amongst medical professionals – Donovan Duncan, a pediatrician who identifies as a queer male, characterized his experience in medicine as “empowering,” thanks to the community of queer students which he found in his first year of medical school. Paul Lerner recounted his time as a trans man in college who was not out, saying that he had no support and felt isolated. Eventually, he concluded that he needed to be “out” at medical school to access a supportive community.
Panelists also acknowledged the difficulty of coming out; each described coming out as a continuous process. “One of the weird things about your third year of medical school is that you’re essentially starting a new job every few weeks […] how are you going to signal being out to a new group of people?” Lerner wondered. In the context of working in an international capacity, coming out became even more complicated for Hiba Zafran, occupational therapist-psychotherapist. She recalled working in Lebanon, where she didn’t come out to her colleagues for fear of her own safety; Razack had a similar experience in Siberia. Each emphasized the importance of ensuring one’s own safety when making the decision to come out.
Zafran and Razack emphasized the importance of ensuring one’s own safety when making the decision to come out.
Zafran and Razack also spoke about the intersectional nature of their identities – Zafran identifies as a queer person of color, and Razack is a gay man of South Asian descent. For Zafran, it is difficult to reconcile these aspects of her identity with her teaching demands: “the curriculum is straight, and the curriculum is white, and even though I’m not those things, I represent the curriculum,” she remarked in a comment concerning a class she held about sex and gender diversity. Razack encourages embracing all aspect’s of one’s origin, even if at times they may conflict; being Muslim and gay has allowed him to appreciate aspects of Islamic culture which he otherwise might not have, he says.
The panel also speculated as to how medical professionals could be trained to be more trans-sensitive, especially in light of the recent death of Hayden Muller. Muller was a non-binary trans activist whose death in September was attributed to the transphobia of their health care provider – their doctor advised against a double mastectomy – despite Muller’s desire to have the procedure done – to combat stage 3 breast cancer. Panelists stressed the magnitude of work needed to be done regarding trans-sensitivity in healthcare. They pointed out that not only doctors, but also secretaries, orderlies, nurses – anyone the patient might encounter during their treatment – should all be educated on trans issues, but this would be a monumental feat. Furthermore, in a healthcare system which is simply not built to be trans-sensitive, there is work which needs to be done on a systemic and legal level to encourage trans-sensitivity.
Anyone the patient might encounter during their treatment should be educated on trans issues.
Razack concluded the event by emphasizing the importance of providing good healthcare above all else. “We’re here to build community, but we’re also here to serve patients well,” he said, stressing how including the 2SLGBTQIA+ community in discussions around healthcare would ultimately improve quality of care for patients.