As a gay PA student, I was deeply impacted by PAEA’s recent article acknowledging the critical role that queer Black, Indigenous, and People of Color (BIPOC) have played in advancing LGBTQ+ rights throughout our history. This article resonated with me not only because it took a strong stance on the issues around us today, primarily that of the movement for Black lives, but also because it asked our PA community to reflect on a number of questions. I felt the most important among these was, “What does it mean to stand in solidarity [with BIPOC individuals], both within PAEA and PA education more broadly?” For me, beginning to answer this question requires me to use my own story within a marginalized group to build understanding around the LGBTQ+ experience this Pride month, while also harnessing my many privileges to help build a more robust space for the BIPOC community to share their stories.
I must acknowledge my own privilege as a white, cisgender, bilingual male — these aspects of my identity afford me enormous advantage in our society. However, as someone who is gay, became an orphan at a young age, and came from a low socioeconomic background, I’ve also faced adversity. My hope is that publicly sharing my experience will foster a safe and brave space for faculty, staff, and students to reflect on marginalized identities in health care and, ultimately, take action toward dismantling systems of oppression and racism in both the classroom and clinical setting.
I grew up in a small town in Oklahoma where being gay was incompatible with the beliefs of the majority of my community. It wasn’t until I moved to Vermont for college that it finally felt safe to come out. I specifically remember the first time I told someone at college that I was gay, and it was met with celebration and support rather than shock and judgment. At 18 years old, I was finally able to go to a restaurant on a date or hold hands with a guy in public without fear for my safety. While it was liberating to finally live openly, it was relatively short-lived.
As I wrapped up my undergraduate career and began my journey to PA school, an advisor recommended that I remove all mention of LGBTQ+-related topics from my applications. They insisted that admissions committees would not view my sexual orientation as “diverse” and that showing support for the LGBTQ+ community could negatively affect my application depending on the reviewers’ beliefs. As a young adult eager to break into the world of medicine, I already knew the power imbalances that existed between the oppressed and the oppressor and was afraid that being my authentic self could derail my professional plans. I regrettably took my advisor’s recommendation and withheld my identity as a gay man throughout the entire application process.
To some extent, my advisor was right. I searched for PA programs that specifically mentioned support of the LGBTQ+ community on their program website either through promoting education or student support. Some schools mentioned sexual orientation and gender identity as part of their affirmative action or equal opportunity statement; otherwise, written support was non-existent. Before interviews, I checked the Human Rights Campaign’s State Maps of Laws & Policies and was fearful of being openly out in the majority of states due to lack of state discrimination protections in education, employment, and hate crimes.
It wasn’t until I interviewed at the University of Southern California (USC) in Los Angeles that I finally felt like I could be myself. Besides LA generally being viewed as a welcoming place for the LGBTQ+ community, the faculty, staff, and students at USC made the interview experience actually enjoyable. They were friendly, made eye contact, asked me about myself and how I was doing, and it felt genuine. For someone who was used to feeling the extra tax of minority stress during an already stressful interview experience, interviewing at USC was like a breath of fresh air.
USC specifically emphasizes appreciating and understanding diversity in their mission statement, and their faculty, staff, and students were clearly reflective of that diversity. At many schools, I found the term “diversity” to be exclusive to racial and ethnic diversity, so the real test was when I felt comfortable enough during my interview to reference my boyfriend, and it wasn’t met with a change in facial expression or uncomfortable shuffling.
But this experience led to a challenge that so many LGBTQ+ people, as well as other marginalized communities, often face. I had to make a decision to either attend the school in Los Angeles where I felt welcomed and able to be my true self, but which was also an expensive program, or attend another program for half the price where the LGBTQ+ community is far less welcome. While I believe I made the right decision to attend USC and feel that it’s been worth every penny, the reality is that these kinds of decisions continue to pile more economic burden onto groups that are already facing economic insecurity. Many LGBTQ+ people feel safer in larger cities like Los Angeles, San Francisco, and New York City, which are much more expensive to live in. Yet, LGBTQ+ people, especially LGBTQ+ people of color, are disproportionately more likely to be unemployed, experience poverty, and struggle economically.
If our profession, especially the educational side, is serious about inclusion and equity, then we must do more to explore these types of challenges for students and how we can do better.