This year, the theme of LGBT+ History month is contributions to the field of medicine and healthcare. This got me reflecting on my own journey as a practitioner and as someone who uses healthcare services. 

I’m 52 now, I’m a lesbian and am cis gender (a person whose gender identity corresponds to their sex assigned at birth, i.e., someone who is not transgender), my pronouns are she/her. I’m a principal psychotherapist in the specialist psychotherapy service but I’ve done this kind of work nearly 30 years. My specialist area is working with people who have experienced trauma including experiences like childhood abuse, rape, military trauma, torture and violent assaults. This is challenging work and a trusting relationship is central. 

As a healthcare practitioner it’s not been easy to be a lesbian. I’ve had strong messages that it’s ‘inappropriate’ for me to be ‘out’ to clients. Supervisors have picked up on me using female pronouns to describe my partner. At the same time no comments were made to female colleagues who referred to their husbands frequently. For years I think I just swallowed that down and felt bad or ashamed. Now I can see that this is a clear example of a micro-aggression; the suggestion is that there is something bad and wrong about my identity compared to my straight colleagues. I know of a colleague who underwent a long complaint from a client who felt she should have been ‘warned’ that her therapist was lesbian as she had a history of sexual abuse and could have been harmed by seeing a lesbian. This still shocks me. The complaint took over a year to be dealt with and was eventually not upheld, but my colleague never worked again, she was just too bruised by this experience. It’s also been tricky over the years when I have experienced subtle, or sometimes not so subtle, homophobia from clients. Heterosexual supervisors have sometimes just not got this at all, and this has left me feeling unsupported and isolated.

Nowadays I manage this differently. With some clients I do ‘come out’. For those who also identify as LGBTQ+ this gives them permission to talk more fully about their lives. For others it gives a message that they can also bring all of themselves to our sessions and what we talk about. 

As someone who has used healthcare services it’s also been challenging at times. When I have a smear test and am asked what contraception I’m using for example (another micro-aggression as the assumption is that everyone is heterosexual), or when my wife who accompanies me for a difficult appointment is referred to as my ‘friend’, invalidating our relationship.

All of this said, I think we’ve come a long way! I notice the Rainbow Badges that the staff wear when I attend my regular hospital appointments and I feel safer. I feel supported by my colleagues in our rainbow staff network group and know there’s a source of peer support there when I need it. I love it when I’m asked about my sexuality on a demographics form, and I have a real sense that attitudes and awareness about LGBTQ+ people and our experiences have changed for the better. I feel hopeful and more determined that ever to offer affirmative therapy to the people I see and to bring all of myself to the healthcare providers who treat me.