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As a member of the LGBTQ+ community, Cliff Sullivan, MD, F(ACHI), assistant professor at Emory University School of Medicine and Laboratory Director of the Cellular Therapy Laboratory, notes that he was fortunate to have attended a medical school and residency program that were progressive. While he saw many LGBTQ+ mentors flourishing in their careers, not everyone has had such a positive experience, and many in healthcare feel isolated or uncomfortable sharing their true selves with colleagues.
For patients, there are still barriers to acceptance, and subsequently LGBTQ+ patients are not always receiving high-quality care they need. As healthcare is meant to benefit all members of society, Dr. Sullivan notes, if LGBTQ+ are not recognized and their issues are not addressed, then healthcare is failing a whole sector of society. Here he shares his thoughts on inclusion and awareness, and how that translates to a healthier society overall.
In your experience, what obstacles does the LGBTQ+ community face in healthcare?
I think it is difficult for members of the LGBTQ community to find providers with whom they feel comfortable divulging their history, especially when it comes to personal issues surrounding sexual practices and sexual identity. On a personal note, I had to switch primary care providers as I felt that my original primary care physician was not knowledgeable nor up to date on LGBTQ health issues, and unfortunately, I could tell he was uncomfortable discussing issues related to my sexual history, which in turn made me feel uneasy.
How can healthcare providers in the U.S. get a better understanding of the needs of LGBTQ+ patients to provide better health care?
In today’s day and age, it is difficult for healthcare professionals to stay abreast on all areas of medicine. I think if a healthcare professional lives in an area with a large LGBTQ+ community, it may behoove the clinician to make an effort to attend meetings, watch webinars, and read papers on LGBTQ+ issues. However, I believe it just as acceptable for clinicians without the expertise on LGBTQ+ medicine to provide patients with referral to colleague(s) with the knowledge base and experience. What challenges have you encountered around LGBTQ+ diversity and inclusion?
When I was applying for jobs out of residency, I did interview with one physician who made a couple of disparaging comments about the LGBTQ+ community. The experience really upset me, and I could not concentrate for the rest of the day. Needless to say, I did not pursue an opportunity at that institution.
What important changes can healthcare systems make to improve LGBTQ+ medical care?
This is a difficult and complex issue, and I cannot claim to understand all the facets to give a comprehensive answer. However, I will take a personal approach, growing up it was difficult to deal with and come to terms with same-sex attraction. I felt isolated and as though I had no one in whom I could confide. Feeling like something is fundamentally wrong with you is damaging to one’s psyche. You try your best to be an overachiever because you feel like you must offset this other part of you that you believe is broken. You are constantly on guard and even the smallest slight can feel like a major blow to your sense of self. Looking back, it would have been helpful to have confided in my pediatrician or family medicine physician, who may have been able to recommend a counselor who could have helped me deal with my feelings. Integrating LGBTQ+ medicine into pediatric and primary care/family medicine would stand to benefit future generations of children who are struggling to understand and deal with their sexual orientation.
What can healthcare systems do to be a better ally for the LGBTQ+ community?
Presently, there is so much division among different factions of society and allyship is a key factor in overcoming this discord. In order to be a better ally, it is important to listen to each other. Listen to each other's experiences and not judge or react—just listen and process then ask questions.
How did you learn about Pathology and Laboratory Medicine, and what do you enjoy the most about working in this field?
I first learned about Pathology from a medical school pathology faculty instructor. He was a pathologist who taught all the medical student pathology courses. He was a wonderful orator; you could listen to him read the phone book and you’d be captivated. I was in awe and aspired to be just like him.
Why did you pick the areas in which you focus in your professional life?
Prior to residency, most of my experience in pathology had been in anatomic pathology, so naturally I thought I was going to be an anatomic pathologist. However, my first rotation in residency was Transfusion Medicine. Initially, I was trepidatious because I knew I would be paged throughout the day and be required to answer clinical questions, and in some cases make important decisions that could affect patient outcomes. After my first week, all my hesitations had been replaced with excitement. I loved all the calls I received, even the high-pressure ones. I enjoyed being consulted and acting as a conduit between the clinician and the laboratory. I knew from that first month, I wanted to be a Transfusion Medicine Physician. Later in residency I discovered HLA and found many parallelisms with transfusion. The gratification I get from knowing that I helped allocate a compatible organ to a recipient in need makes me love my job.
How have attitudes/perceptions of the LGBTQ+ community changed over the past decade, both for patients as well as those of the community working within healthcare?
As a whole, I believe society has grown to accept LGBTQ+ members. There is still a long way to go; nonetheless, I am hopeful. I have many friends with kids who state that they have many LGBTQ+ kids in their school. When I was in high school, I only knew of one out student. The fact that more students are coming out speaks to the fact that they feel more comfortable expressing themselves in their microsphere of the world. Given that healthcare is its own microcosm of society, the societal acceptance for the LGBTQ+ community has infiltrated its way into healthcare; and I believe it is much easier to be a LGBTQ+ patient or healthcare worker now than in the past. Hopefully, it will be even easier in the future.
This Q&A is part of June's PRIDE in the Laboratory campaign. Read more here.