Trans GP Dr Sam Hall describes the contrasting responses from colleagues that put him centre stage in a positive – and negative – way
Once I started telling my story about being a trans man, I discovered that my peers, who were almost all half my age (bear in mind I was a 45-year-old anaesthetist retraining as a GP), were both interested and sympathetic. I became something of a ‘celebrity’ on the shop floor and sensed that my colleagues were desperate to know more, but hardly dared ask. I became bolder with each new disclosure that was received safely, or even gave me affirmation.
Younger people around me were receptive, but I could not say the same for colleagues my age. Of course, I had chosen to slide down the hierarchical ladder that is so apparent in medicine, from consultant to lowly SHO. The power balance had shifted and this was compounded by my nascent shame. We know from sociological studies that LGBTQ+ folk suffer in the workplace if unable to ‘bring’ themselves wholly to work. A lack of authenticity breeds disingenuity and loss of self-respect, takes up emotional energy and detracts from our ability to do a good job. Yet the barriers to ‘coming out’ at work are manifold and sometimes feel insurmountable. Cis-heteronormative assumptions essentially fuel a sense of unworthiness that is internalised and difficult to spot.
This was most apparent when I met a consultant whom I had trained with at medical school more than 20 years earlier. I was delighted when I recognised him, but quickly realised the feeling would not be reciprocated. It felt too hard to tell him, so in six months of working in the same unit, I never did. I know now that I had nothing to be ashamed of, it is not my fault I am trans, and I had done what I needed to do to survive. I should have been proud of myself but this took time. A slow and painful process of self-acceptance began unfolding as I became a different kind of doctor. A kinder, more compassionate person, readier to listen to experiences and life stories with an open mind and forgiving heart. After all this is what I had had to do for myself. Be open minded, forgiving and compassionate.
I had my battles to fight. The transphobia I encountered was damaging, and sometimes left me reeling. A number of baseless accusations resulted in me (and my GP trainer) being singled out for scrutiny by the hierarchy in post-graduate medical training. Intrusive questions were asked and comments made about my suitability to train as a GP. Getting into the GP Vocational Training Scheme was easy, since it is a merit-based system that does not discriminate, but once I was in training a different attitude emerged.
This has its roots in the pathologization of trans people. Gender dysphoria was, until 2019, internationally classified as a mental health condition, much in the same way homosexuality was until late in the last century. Trans and non-binary people are not sick. We just are. Thankfully the WHO has recently depathologized gender incongruence, and my hope for the future lies in the hearts of those young colleagues who welcomed me with open arms.
Dr Sam Hall is a GP partner in Brighton
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