Lauren’s Story
It was the first day of my third-year clinical placement in 2014 at MacLean Hospital. Immediately upon entering the clinic, I started smiling, shaking hands, introducing myself and accumulating data. I initiated that involuntary scan…. is anyone here not straight? I calculated where I should position myself along a continuum of options. At one end of the continuum was the decision to never share my sexual orientation. At the other end was the decision to live openly and without restriction, freely sharing with my new coworkers any aspects of my identity that felt relevant. The research question for the data at hand? What is the evidence for and against the safety of coming out as queer: The aim of my “study” was to take a scientific approach to predict the unpredictable and answer the question: how would things at this job change if I told people I have a wife? Let the inquiry begin.
Like any trainee I was sure to make multiple administrative and clinical errors, and initially my presence would be experienced as a net negative in the clinic. Coming out while being a net negative to the team might further amplify my deficits. If co-workers and staff felt uncomfortable about my sexual identity, tolerance of my bumbling, anxious, trainee status would be quickly exhausted. One point for staying in.
Later, on the first day of my final training year, I ascribed the label of “probably not straight” to one of the senior members of the team, admittedly based upon stereotypes related to the clinician’s mannerisms. With a bit of additional sleuthing, I confirmed that, indeed they were not straight. However, in addition, they were not out in the workplace. Identifying a staff member who, despite possessing seniority status and power within a hierarchical organization, was not out sent a clear message to me as a trainee: It’s not safe here. I had entered a social justice time warp.
Seeing my wedding ring, people asked about my “husband” and how we’d spent the weekend. Each and every time, my stomach dropped. Did I dare to share accurate details about my personal life knowing that doing so would unravel existing expectations and frameworks my co-workers already held about me? Dare I disclose that my wife and I had explored the Berkshires mountain range, know that doing so would embarrass the supervisor who had just inquired about my husband? That probably would not be great for my performance evaluations, which were pivotal for my future as a psychologist. Another two points for staying in.
My head was filled with so many conflicting thoughts: Coming out would definitely mean a loss of privilege. But coming out might also grant me more leverage to make changes. I could trust in the relationships I was cultivating, opt to disclose my identity and gain immediate credibility that my voice was worthy of being heard: I could express that how we approach LGBTQIA+ issues with patients and among our workforce needed to change. I might be able to make this clinic safer for the LGBTQIA+ patients. I might be able to improve the quality of care.
Across each clinical setting I entered, I eventually built up the courage to come out. It was not because I ever felt “safe” or supported per se; more because otherwise I did not feel genuine and I felt angry that I was not comfortable bringing my full self to the workplace. I began with my supervisors, weaving my sexual orientation into the conversation somehow – sometimes at work, sometimes at conferences or during happy hours. I had a little fun slipping “my wife” into a story about the weekend, observing the slight shock, then pausing while “recalculating, recalculating…” scrolled across their faces. I fake-smiled through the “random” follow-up stories, told to make me feel at ease, about their gay cousin, who was “just amazing,” and who I “would just love.” I sighed through the monologues of how appalled they were about the current political situation, followed by the requisite, “Well, at least things are so much better now for gay people.” I cringed through the awkward trailing off of some conversations that slumped through the letdown of coming out to a gay senior colleague who had minimal to no response – singlehandedly dashing my hope for that golden nugget of affirmation, a high-five, total acceptance. Still, some folks surprised me by jumping right in to suggest we go on a double date, saying they would love to meet my wife, and treating me like any other colleague. That felt affirming.
In each of these settings, I had the immediate increase in the number of LGBTQIA+ patients I was assigned. My peers started consulting me about their LGBTQIA+ patients. I was asked to present a seminar on the range of ways people might identify related to gender, which led to three more talks on other units. I was just a novice therapist; how did that happen? Seemingly overnight I’d been knighted the LGBTQIA+ expert. This conferring of expert status presented another dilemma. While I did not regard myself as an LGBTQIA+ specialist, I did know that I would be compassionate, accepting and culturally humble toward such patients. I did know some of the professional and casual LGBTQIA+ lingo. I did know I was comfortable exploring connections between identities and mental health symptoms due to practicing throughout my doctoral training. So I worked to earn expertise status, leaned into the growing demands of the organization and never protested. While it was complicated, I did build an appreciation and passion for this role, found deep connections to peers with similar values and experiences and, because of the “expert” designation, made measurable change throughout and beyond the organization.
Reprinted with permission form Did That Just Happen?!: Beyond “Diversity” ― Creating Sustainable and Inclusive Organizations by Dr. Stephanie Pinder-Amaker & Dr. Lauren Wadsworth, Beacon Press 2021, Chapter 4: Becoming “Experts,” pages 36–38