Coming Out Day 2023: Celebrating pride and recognizing the complexities of identity

National Coming Out Day is celebrated on Oct. 11. This day holds much excitement, nervousness, doubt and empowerment for many. Many recall the grief, happiness, peace and yearning for belonging they felt all at the same time as they remember their experiences of revealing who they are within. It can be empowering to see someone step into their identity, proudly existing as they are amid uncertainty of how it may be received.

This month, we celebrate each and every one of you who are standing together in solidarity with the LGBTQ+ community. We celebrate people who come in all shapes and sizes and those who have experienced the defining or dissolution of their identities within the LGBTQ+ community.

What does it mean to step into one’s authenticity? What can it look like and mean for you? A person’s sexuality can be a large part of someone’s identity or perhaps a small slither of it—it depends on how much emphasis you place on it or perhaps on how much it has impacted you.

We (Miko Rose, DO, and Stephanie Lee, OMS IV) ponder these questions in this article, share a bit about our own stories of struggle and finding our own identities, and also discuss ways health care professionals can create a welcoming space for LGBTQ+ individuals.

Complexities within identity

For some, identity can be constricting. Terms like LGBTQ+ have expanded over decades of queer culture evolution and identity. The concept of evolving boundaries that shift based on cultural norms or standards is not new. For example, in medicine, decades ago hypertension had very clear boundaries regarding identification, diagnosis and treatment. Since then, the criteria for this condition has changed. Even demographic information that we in the medical profession reference as “objective” data (such as ethnicity or culture of origin)  has boundaries with histories of shifting, including a country’s historical boundaries.

What we do know is that for those of you who identify within any elements of the non-heterosexual identities, being comfortable with that identity helps patients. 

Knowing when and how to disclose our identities can be helpful and empowering for ourselves as clinicians, as well as for patients. “Coming out” is not a one-size-fits-all, one-time experience. For each person, the experience is unique. In each setting, coming out is also often addressed on a case-by-case basis. As clinicians, the choices we make in patient care settings may be very different from our social choices.

As clinicians and medical students, learning to connect with people identifying as LGBTQ+ is important in developing trust with both patients and families. Even more important is creating a cohesive environment where we feel safe to express ourselves within the confines of health care and beyond. While it may seem miniscule to perform certain actions to provide safety and empowerment for patients and families in the LGBTQ+ community, the impact it has on those who feel insecure about their identity is profound.

Moving through the discomfort

Shame is often a feeling that is evoked upon speaking about one’s identity. From our experiences with both friends and patients, we’ve seen the journey toward self-acceptance and love carry much weight and fear of being outcasted. For some, cultures and other societal conditioning play a huge role.

“In my experience, sexuality was not talked about much in Asian culture,” said Lee. “Many times, I’ve struggled to find grace knowing I deviate from the ‘norm’ of what is acceptable in our current culture. Some days I believe I am heterosexual; however, many days I feel powerful accepting I am otherwise. Because finally, I am choosing to see myself for how I am rather than choosing acceptance from others over myself.”

Lee has found much strength in standing in solidarity with herself during these moments of doubt and is hopeful that we are evolving toward a more loving society.

“When I lay in bed at night, I want to know that I am everything I feel myself to be, no matter what people think,” said Lee.

Delving into these topics can be uncomfortable for many, despite the desire to share with loved ones.

“When my gay friends asked about ‘my coming out story,’ there was always this awkward silence,” said Dr. Rose. “My mother is an immigrant from Japan, growing up very much immersed in that culture—we didn’t talk about sexuality or dating at all, much less if deviated from the traditional cultural norms. How could I tell my mom I have been dating women for years when I never spoke with her about any dating?

“Eventually, I did tell her I was gay, and at first it did not go well for either of us on multiple fronts—it became a pivotal moment to cross cultural barriers to understand each other on a very deep level.”

What we have come to understand over time is that how deeply someone can meet us where we are at is reflective of how deeply they are able to meet themselves. While this doesn’t always lead to a positive experience for everyone, it can be eye-opening as we work to see and accept ourselves as we are, and gives us more space to have compassion for others who aren’t able to.

We both grew up in Asian cultures where we didn’t share many details about our love lives with our parents. The concept of dating the same gender is also relatively foreign to the older generations.

Strengthening knowledge of awareness

In a health care setting, seeing clinicians or the administrative staff partake in sharing their pronouns can allow us to feel a stronger sense of belonging and innate awareness by the hospital team. The act of sharing pronouns implies that there is a knowing of boundaries, diversity and acceptance.

Another way of building safety and empowerment for patients and families is to provide an option for transgender in the spouse/partner section of intake forms, as well as leaving the gender identity and sexual orientation sections blank rather than a drop-down menu of set options. This allows the patient to fill out the forms in a way that gives them room to feel expressive.

It’s also beneficial to include LGBTQ+ magazines in the waiting room, or participate in referral programs such as GLMA or a resource page such as NAMI for the LGBTQ+ community.  Stickers, flags and pins of pride symbols at the front desk are also inclusive ways of sharing support for diversity and helping the patient feel more comfortable and safe.

By slowly integrating aspects of our diverse culture into our practice of medicine, we will allow patients and families to feel more safe opening up to the health care team about their identity and health concerns.

Although pride is proudly celebrated each year in various cities where those who have felt suppressed in their identity can fully enjoy their freedom, the transformation within to reach this point can take many years. For many of us, we could be in the in-betweens of finding peace and acceptance within ourselves. If this is you, know that you’re not alone. 

We continue to celebrate each and every one of us and embrace our most authentic, truest selves. At the end of the day, the greatest disservice we could ever do to ourselves is to suppress our highest potential. This, whether spoken or implicit, will allow your patients in turn to do the same.

Shine bright and be true. Be you. Happy Pride!

Related reading:

Why I won’t base my specialty choice on my personality

How to find your identity online and be authentic