ASME Celebrates Pride
by Dr. Riya E. George (she/her)
“Queer people don't grow up as ourselves, we grow up playing a version of ourselves that sacrifices authenticity to minimise humiliation and prejudice. The massive task of our adult lives is to unpick which parts of ourselves are truly us and which parts we've created to protect us.”
Alexander Leon
I still remember reading the Guardian article, ‘I’m a medical student and I’m gay. Work would be simpler if I were a heterosexual’, whilst on the train as the summer daylight began to fade. The author’s candour and insight into their personal quandary was intriguing, but what caught my attention was the word ‘anonymous’. The author had chosen not to be identified themselves. For me, the writer’s need for anonymity speaks of a bigger issue than those raised in the article. The dilemma of being able and comfortable to bring our whole, authentic self to work.
Alexander’s quote above draws upon this issue and was tweeted across various social media accounts. His message of growing up with conflicting identities, pressures of societal norms and journey from shame to authenticity resonated with many in the LGBTQIA+ community as well as other minoritised groups. Bringing our whole, authentic self to work means acknowledging all facets of who we are, that includes our various intersecting identities, values and even our vulnerabilities. It means allowing ourselves to be truly seen as the people we are. It is often common practice to differentiate between our personal and professional selves, but these are not mutually exclusive, they co-exist. Over-shadowing or masking one part of ourselves is arguably more likely to lead to confusion and conflict as opposed to collaboration and community.
Unity not uniformity
Much of our healthcare education focuses on the importance of diversity in relation to patients without addressing the importance of reflecting on diversity in relation to ourselves and our colleagues. This is despite research that suggests doctors as well as healthcare professionals are not immune from harbouring stereotypes and biases towards their patients and that their identity can significantly influence the way they understand and respond to patient experiences 1-2. Learning about who students and healthcare professionals are and supporting them in constructing a professional identity that intersects with and builds on who they are as people may help in enabling individuals to bring their whole, authentic self to work. Comments from students scattered in the literature illustrate that by the end of medical school, students can become “narrower people”3; their individualism and personal interests diluted over time, and their diversity so over shadowed that they graduate more alike than when they entered. The journey to becoming a healthcare professional or doctor should not be a process of erasure, whereby one gradually feels a sense of losing their diversity in an attempt to fit the so-called ‘professional mould’. Whilst appreciating the need for common values and a shared sense of what it means to be a competent healthcare professional or doctor, it is imperative that we recognise the value that each of us, with our respective differences, bring to the healthcare profession.
The challenges of coming out and being open about one’s sexuality and gender identity is well documented. LGBTQIA+ communities continue to face discrimination and stigma and are at a higher risk for mental health issues and isolation. Much of our healthcare interactions and curricula proceeds in a heteronormative manner; assuming all couples are male and female, all children have a mum and a dad and that everyone’s pronouns are she or he. Those who deviate from this heteronormative manner can often be ‘othered’; meaning to perceive or treat a person (or group of people) as different from the norm, creating an ‘us versus them’ mentality. Othering plays a significant role in the formation of discrimination and prejudice again people and groups. Unlike the Guardian piece I read, this ASME communication piece actively aims to identify, embrace, and celebrate our LGBTQIA+ colleagues and supports these communities in being seen, heard, and valued.
Embracing and celebrating our LGBTQIA+ colleagues
To celebrate the month of PRIDE, ASME has created an exciting resource that presents fascinating insights and inspirational work from national and international experts and advocates in the LGBTQIA+ community. This resource was a collaborative effort between ASME and the organisation GLADD. Many thanks to Duncan McGregor and Ciara Greer for supporting us in gaining valuable contributions. The contributions in this resource take time to recognise and celebrate the efforts, expertise, and experiences of LGBTQIA+ people and their contribution to the healthcare profession. Our contributors were asked to share their top three suggestions for where research and scholarship in the field of gender and sexuality should be advanced and to showcase five pieces of their work and/or work that has inspired them to learn more about the LGBTQIA+ community. ASME welcomed a variety of formats and asked for a description to accompany each piece of work, explaining why it is important or inspirational to them. This resource aims to promote a better understanding of the research needs and awareness of issues faced by people of all genders and sexual orientations. The views and/or opinions represented in this resource are personal to the individual contributors.
Alban Low, a London-based artist who was inspired by our contributors’ pieces created an array of artwork and illustrations to further amplify the messages conveyed in this resource. Collectively Alban’s artwork hopes to capture a sense of ‘blue-sky thinking’, joy, positivity, and an uplifting atmosphere to add to this celebration of our colleagues in the LGBTQIA+ community and their inspiring accomplishments.
The contributions in this resource will be showcased throughout the month of June on ASME’s social media accounts. If you are on Twitter, join us using the hashtag #ASMEPride.
Gabrielle Finn (she/her), ASME’s Director of Events and Vice-Dean for Teaching, Learning and Students at the University of Manchester shares her recent, trailblazing research on gender identity, sexuality, and diversity issues more broadly, with a special mention of a new PhD studentship opportunity on gender and oppression within health professions education.
I’m Gabrielle Finn, Professor of Medical Education and Vice Dean for Teaching, Learning and Students in the Faculty of Biology, Medicine, and Health at the University of Manchester. I’ve worked in medical education since 2006, researching a range of topics from medical professionalism and innovative pedagogy to assessment. Over the last few years, my research has become increasingly focussed on several issues under the umbrella of Equality, Diversity, and Inclusion (EDI). EDI is a tricky space to research, especially as a cis-gender, white woman, but I have been fortunate to work with a number of students and academic colleagues who have educated me and shared their lived experience. My initial foray into EDI was working within selection and widening access. Subsequently, my research group expanded to include some fantastic then doctoral students, and intercalating medical students, who researched widening access, inclusive curricula and gender discrimination. Dr Angelique Dueñas completed her thesis on gateway programmes as a tool for widening access to medicine. From here, inspired by conversations with trans-gender medical students, Angelique and I worked with anatomy colleagues, Rebecca Quinn, Kat Sanders and Abisola Balogun, to consider the lack of representation of trans-gender health and anatomy within our field. We produced a book chapter considering these issues, but also intersectional issues such as the lack of representation of black people within anatomy. Our work on gender discrimination in clinical academic careers unearthed some awful inequities in access to careers for marginalised groups including women, ethnic minorities, and the LGBT+ community.
When discussing our work on inclusive curricula and discrimination, a colleague remarked, “It’s just alphabet soup”, in reference to the acronym LGBTQIA+. Yet, for many students, the representation of people with protected characteristics similar to themselves in the health curricula is absent. This spurred our research group on to further shine a light on a number of issues relating to EDI including, but not limited to, inclusive curricula, gender and racial discrimination, decolonisation, and the representation of LGBT individuals in healthcare education. Our work on LGBT issues would not have been possible without Dr Will Ballard, who so generously shared his experiences as a trans-man and helped us to reflect on the shortcomings of contemporary health curricula. Working with colleagues Dr Megan Brown and Prof Paul Tiffin, I am delighted to be taking this work forwards with a new PhD studentship, ‘Challenging the malestream curriculum: an exploration of gender and oppression within health professions education’. This new project hopes to build on recent work where we highlight the need to consider the umbrella of feminist theory, including intersectionality, within health professions education teaching and research, including from a philosophical perspective.
Please reach out if you are interested in learning more ( gabrielle.finn@manchester.ac.uk). We hope that our work offers a theoretical lens, but also practical tips on the implementation of positive action, and a call to arms for areas to address in research and teaching, particularly for LGBT+ students. Without educating our students, the health inequalities experienced by so many in the LGBT+ community will persist.
Gabriel Sarah (he/him), an Associate Professor at the University of California, San Francisco provides an international perspective on educational and research initiatives concerning the LGBTQIA+ community. Gabriel shares his attempts to make the healthcare curricula more inclusive and relatable to the students’ lives, to foster an acknowledgement of the way students have been influenced by the social contexts in which they are embedded.
Greetings from across the Atlantic – It is an honour to be included in this ASME PRIDE celebration! As a new, international member of the ASME, it has been wonderful to learn of your programming for, and dedication to, equity for members of our LGBTQ+ community. I am an Associate Professor of Anesthesia, in the Division of Pediatric Anesthesia, at the University of California, San Francisco (UCSF).
I served the UCSF School of Medicine as its LGBTQ+ Topic Curator – a role dedicated to increasing LGBTQ+ health-related content in our curriculum. I currently have an expanded role that focuses on this topic and others. Contributing to equity and justice has been one of my career’s highest honours and I’ve dedicated myself to not only improving the health of our patients but also supporting those members of this community who are on the front lines providing care.
I suffered incredibly negative consequences secondary to the disclosure of my sexual orientation and experienced a dearth of support and mentorship from the profession of medicine – it is of the utmost importance to ensure that no one experiences the same.
Please review my article, published in your own The Clinical Teacher, Integrating LGBTQ+ health into medical education. I hope it will shed some light on my work and offer some insight into potential growth within your own curricula. We are far from perfect at UCSF, and constantly growing and learning along the way.
When focusing on an approach that empowers health care providers, I’d like to share some programming that I have created or been a part of. Within our anaesthesia residency, I serve as the Associate Program Director for Guidance and Development where I steward the growth of our residents throughout their time with us. We have created a novel mentorship program within our department where all LGBTQ+ identifying residents may choose to be paired with a faculty member of concordant sexual orientation or gender identity (SOGI). This mentor’s role is to guide the resident through their training and focus on helping them navigate the colliding worlds of their personal and professional lives and how their SOGI may impact their movement through the spatial world of medicine.
Another group I love being engaged with is Building the Next Generation of Academic Physicians. I’ve had the pleasure of organizing and moderating a panel at their annual National LGBTQ+ Health Workforce Conference for the last five years that focuses on “Best Practices for Applying to Residency and Fellowship as an LGBTQ+ Applicant.” Here, we focus on the sensitive nature of coming out during the application process, how this may impact your application process, and explore the nuanced nature of embracing your SOGI for each individual person while offering guidance and support for applicants through an expert panel.
I wish all of you a wonderful PRIDE! As queer people, it is often hard to find joy within us – I hope you too celebrate the beauty that is you! I can be reached at gabriel.sarah@ucsf.edu.
Encouraging research and scholarship on gender identity and sexuality
Promoting diversity and inclusion cannot be a one-time action, it needs to be something that is continually repeated, embedded, nurtured, and practiced. The ASME Pride resource revealed several common areas where research and scholarship on gender and sexuality should be advanced. To actively encourage further research and scholarship on gender identity and sexuality, ASME is proud to announce that a new Equality, Diversity, and Inclusion (EDI) category for the ASME & General Medical Council (GMC) Excellent in Medical Education Awards will be added to our awards portfolio in the coming weeks.
This category will be an annual occurrence calling for research on a range of diversity issues. This year ASME is specifically looking to attract research on gender identity and sexuality. Details on how to apply coming soon!
ASME’s role in changing systematic practices
To help educate and raise awareness of the importance of LGBTQIA+ issues and why pronouns matter, the Directors of ASME, Chairs of ASME Groups and office staff all participated in a continuing professional development session facilitated by Debbie Aitken, MSC Medical Education Course Director at the University of Oxford. A pronoun is a word that refers to either the people talking (for example I or you) or someone that is being talked about (for example she, her, or they).
Assumptions about one’s gender identity and sexuality can be made based on a person’s appearance, name, and behaviours and like many assumptions these aren’t always correct. Debbie, skilfully explained through providing knowledge, facilitating a safe space for discussion, and sharing the lived experiences of transgender and non-binary individuals, why using someone’s correct pronouns is a way to show respect and sensitivity.
Check out Debbie’s training slides, videos, and resources below. I particularly encourage you to check out Al’s, Alex’s, and Ethan’s stories.
Normalising the usage of pronouns is an impactful way to show your advocacy for the LGBTQIA+ community. As well as making transgender, non-binary and gender non-conforming individuals feel safer and more comfortable, they are also great conversation starters about gender identity.
For the first time ASME has included the option of providing pronouns for conferences delegates attending the annual ASME conference. We are proud to say that this year 99% of conference delegates gave their pronouns.
Furthermore, ASME’s high profile journals; The Clinical Teacher and Medical Education, both published by WILEY are now actively supporting author pronouns.
Check out their statement and visit https://www.wiley.com/network/societyleaders/research-impact/it-s-time-the-option-to-publish-author-pronouns-becomes-business-as-usual for more information.
Normalising the use of pronouns throughout ASME
Normalising the use of pronouns throughout ASME is our way of showing allyship and respect to the LGBTQIA community. There continues to be on-going discussions around how to better articulate gender identity and sexuality as their meanings are so varied, nuanced, and complex. Join us on Twitter on the 06th of June 2022 at our next MedEd forum to discuss and explore these issues further and how they relate to medical education.
Stay tuned for more …
Later this month on the 20th of June, stay tuned for more exciting content, updates, and resources to celebrate the LGBTQIA+ community and their contribution to healthcare. I will be launching and sharing a new channel I have created called Meaningful Conversations in Healthcare where the stories of Ethan Wilson, a transgender medical student from the University of Glasgow and Duncan Shrewsbury, a general practitioner from Brighton and Sussex Medical School will be showcased. Further, a thought provoking and informative panel discussion with three of my colleagues exploring myths around gender and sexuality will be included as well as a podcast on LGBTQIA+ issues by the ASME group – Trainees in The Association for the Study of Medical Education (TASME).
PRIDE months offers us the opportunity to celebrate the incredible contributions and achievements of our LGBTQIA+ colleagues within our healthcare profession, to reflect and acknowledge the challenges that still exist and to renew our commitment to challenging discrimination and promoting inclusion now and in the future. ASME is for everyone, and it values all our members, not in spite of our differences but because of our differences. Join us this month in celebrating PRIDE.
References
- Frost, H. & Regehr, G. (2013). “I AM a doctor”: Negotiating the discourses of standardisation and diversity in professional identity construction. Academic Medicine. 88 (10): 1570 – 1577.
- White, A.A, Logghe, H.J, Goodenough, D.A., Barnes, L.L, Hallward, A, Allen, I.M., Green, D.W, Krupat, E., & Llerena-Quinn, R. (2018). Self-awareness and cultural identity as an effort to reduce bias in medicine. Journal of Racial and Ethnic Health Disparities. 5; 34-49.
- Finlay, S.E. & Fawzy, M. (2001). Becoming a doctor. Medical Humanities. 27; 90-92.
As part of ASME’s Equality, Diversity, and Inclusion strategy we actively aim to start and continue meaningful conversations about diversity issues in medicine and healthcare. Throughout the year we will be exploring how we can celebrate and support individuals from culturally diverse, under-represented and marginalised backgrounds. If you would like to find out more information about ASME’s Equality, Diversity, and Inclusion strategy, please contact us on diversity_inclusion@asme.org.uk
Read on: Meaningful Conversations in Healthcare
When was the last time you had a meaningful conversation? The abundance of technology that now saturates our daily lives means we are less likely to have the time for meaningful conversations. Following on from our last ASME communication piece, to celebrate the month of Pride, ASME has created a collection of interesting resources that aim to start and continue meaningful conversations about gender identity and sexuality.