Coming out to Patients | Benjamin Margolis, MD

Benjamin Margolis, MD

I probably shouldn’t comment on what my patients are wearing, but when I teased one of my patients with ovarian cancer about her mismatched socks, it led to laughter and connection. We hatched a plan to both wear mismatched socks to her surgery. As we were about to sign consents, her husband looked over and said jokingly, “We’ll sign anything as long as it’s not for [insert political leader here].” My heart sank a little, not because of the political placards that may or may not line their lawn, but because maybe these folks whom I spent months getting to know wouldn’t be so happy their doctor was gay. One surgery and a few cycles of chemotherapy later, it was time to come out. During one of her first surveillance visits, she spoke of her grandkids, and I spoke of my new child. Phones emerged, and I showed her and her husband a photo of myself, my husband, and our newborn. Many of us became gynecologic oncologists to be the type of surgeons who also share these tender moments with our patients with whom we create lasting bonds. They smiled, embraced me and my family, and many more photos have followed since.

I’ve previously sat on LGBTQ+ faculty panels for medical student education and stated that I don’t routinely bring my LGBTQ+ identity into the exam room. As I heard myself talk, I cringed and felt a sense of unease. With time, I have become more comfortable sharing moments of human connection that inevitably out me, while keeping the focus on my patient and their cancer journey. The ability to connect on a human level with patients is part of the job for me, and time has helped me navigate that extra layer of complexity my identity brings to the table. Some patients notice the rainbow sticker I have on the back of my phone, which has led to moments of trust and connection. If current or prospective patients have not been accepting, I don’t know about it, and I accept that reality as the price of bringing my full self to work.

I wish it were this simple for everyone. As a white cisgender man living in the Northeast, being out personally and professionally has been relatively easy, with moments of hesitation but positive reception (to my face at least). For people who are transgender, nonbinary, or have other gender-expansive identities, the coming-out process can be more difficult, and can bring up issues of harassment, safety, and employer-based discrimination. For those without a partner, or for LGBTQ+ folks in a relationship that appears heteronormative, coming out can be more difficult to navigate. For many, being LGBTQ+ is an integral part of our identity, and purposefully not disclosing it can feel like a perpetuation of dishonesty, or an attempt to hide when we otherwise wouldn’t want to. To facilitate representation and transparency, medical schools and institutions across the country are creating Outlists (props to NYU, Penn, Brown, Northwestern, Yale, and more) where providers can self-identify as part of the LGBTQ+ community.

For me, being out to patients is worth the risk. I can’t help but share my life with those around me, especially with patients. That lack of distance keeps me feeling human and engaged during tough days. Select patients seem to enjoy a few baby photos to break up the seriousness of our visits, and a few won’t leave the visit without one. For patients with less open minds, I hope knowing how much their gay doctor cares about them might expand their worldview just a bit, and that it may trickle down to more acceptance outside of the exam room. For providers in less supportive environments and with more marginalized identities, it takes even more courage, more support, and a bigger leap of faith to live authentically. We should all help create environments that welcome all people to bring their full selves to work for their colleagues and their patients.

As we look outward to help foster inclusive and welcoming environments, I believe it’s just as important to look inward to promote growth—why did I conflate my patient’s political beliefs with their acceptance of LGBTQ+ people? Shouldn’t I have given them the benefit of the doubt and refrained from extending all values of “social conservatism” to my patient and her husband based on one comment? Ultimately, I’m grateful I didn’t.

Benjamin Margolis, MD, is a gynecologic oncologist at Albany Medical College and assistant professor of obstetrics and gynecology in the division of gynecologic oncology. He specializes in the surgical and medical management of patients with uterine, ovarian, cervical, vulvar, and vaginal malignancies. He also specializes in the surgical management of complex gynecologic cases. Dr. Margolis values holistic care of patients with gynecologic malignancies, including personalized oncologic treatment planning, management of treatment toxicities, evaluation of sexual function, advanced care planning, and attention to the difficulties of coping with cancer treatment.