Oct 27, 2016
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Don't hurt me for posting this. I've seen it create drama in the past, and I assure you I am not here to do so.

Essentially I've built my "brand" around the LGBTQ community. I am gay, I volunteer at a youth center for LGBTQ kids, I'm trying to co start an LGBTQ science organization at school this semester. I am also trying, and failing, to shadow a doctor who works with transgender children... I cannot get her to respond to me...The reason I want to be a doctor has to do with my experiences being gay, my experiences working with transgender youth, and my friends' experiences being LGBTQ in the medical field... Every reason why I want to go into medicine is because I want to serve a population that is significantly underserved at the moment (transgender youth). It honestly is what drives me to keep going at times.

Is it okay for this to be the gist of my personal statement essay? I'm a Texas resident and I know it's controversial, but it is so important to me and something I am very passionate about. I wanted to know adcoms opinions on it as well like @Goro ... and any help in general. Thank you!

Edited for clarity.
 
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wholeheartedly

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Don't hurt me for posting this. I've seen it create drama in the past, and I assure you I am not here to do so.

Essentially I've built my "brand" around the LGBTQ community. I am gay, I volunteer at a youth center for LGBTQ kids, I'm trying to co start an LGBTQ science organization at school this semester. I am also trying, and failing, to shadow a doctor who works with transgender children... I cannot get her to respond to me...The reason I want to be a doctor has to do with my experiences being gay, my experiences working with transgender youth, and my friends' experiences being LGBTQ in the medical field... Every reason why I want to go into medicine is because I want to serve a population that is significantly underserved at the moment (transgender youth). It honestly is what drives me to keep going at times.

Is it okay for this to be my personal statement? I'm a Texas resident and I know it's controversial, but it is so important to me and something I am very passionate about. I wanted to know adcoms opinions on it as well like @Goro ... and any help in general. Thank you!

Have you checked out the LGBTQ forum? They do get into discussing aspects of this there and can offer some insight from people who've already been down the application path on how to approach your personal statement, etc. If you'd like, I can move your post/question there, just let me know.
 
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DarklingThrush
Oct 27, 2016
194
101
81
Status
Pre-Medical
Have you checked out the LGBTQ forum? They do get into discussing aspects of this there and can offer some insight from people who've already been down the application path on how to approach your personal statement, etc. If you'd like, I can move your post/question there, just let me know.
Ahhh! I haven't.... admittedly, I've been stuck on the Nontrad forum ever since joining SDN and hadn't even thought of that. I'll leave it up to your judgement. Wherever you feel it belongs and will have the best chance at gettting a variety of opinions! Thank you!!
 

wholeheartedly

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Ahhh! I haven't.... admittedly, I've been stuck on the Nontrad forum ever since joining SDN and hadn't even thought of that. I'll leave it up to your judgement. Wherever you feel it belongs and will have the best chance at gettting a variety of opinions! Thank you!!
I'll move it as I think you'll get some good responses there.
 

Crayola227

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I think in general this is great.

However, it does come up, that you can't just be focussed on one minority as a doctor.

You have to be prepared for all of humanity to pass through the clinic/hospital doors.

I would want to see balance, young Jedi.

I would want to see some assurance in your CV, LORs, PS, that this wasn't what defined you as a person or a provider.

Perhaps that's why that one physician hasn't gotten back to you? No offense, but the way you mentioned that smacked of entitlement. Just because you are LGBTQ doesn't make you more entitled to that experience than anyone. In fact, perhaps there are other students that could benefit more from such an experience.

I came from a really frakked up and impoverished background, just to give you perspective.

I also shadowed a psychiatrist closely before med school.

My background never came up nor was hinted at in my work with that doctor, until much later.

I think my background would have been more of a liability than an assest to medical schools if that doc had not been able to write to my clear sense of interpersonal boundaries.

You need to be *able* to leave who you are and what you've lived through, at the door as a doctor. It should inform what you do, never define it.

It was hard for me to relate to people who were "better off" and the silver spoon fed classmates, I'll admit. But learning to do so was necessary.

I think it's more important that you focus on yourself as a whole, and how your unique experiences in the LGBTQ community, will translate to an effective practice style for all comers.

Because that's really what the admission committee wants, and the profession needs.

Most of your patients, even in a tailored practice, will not be LGBTQ. Tell me how you offer something unique and effective in addressing their unique healthcare needs.

If the whole of humanity and its ugliness and its disease doesn't interest you, than I think careers besides physician might fit you better.

I'm not trying to discourage you; I'm trying to change your focus.

If you expanded to focus on the LGBTQ, ESL, impoverished, low health literacy, etc etc disadvantaged and other minority groups, than I think you could generate more excitement about your inclusion to the profession.

I've seen a few matriculants that met some sort of less represented diversity criteria, and the ones that really had no interest in patients outside a narrow niche, really caused themselves and everyone around them, head and heartache.

No matter who you are; rich or poor, cis or trans, white or other, those of you that have the greatest interest in humanity at large, do the best by your patients.

Given my observations about myself and my classmates, do I offer these thoughts.
 
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DarklingThrush
Oct 27, 2016
194
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81
Status
Pre-Medical
I think in general this is great.

However, it does come up, that you can't just be focussed on one minority as a doctor.

You have to be prepared for all of humanity to pass through the clinic/hospital doors.

I would want to see balance, young Jedi.

I would want to see some assurance in your CV, LORs, PS, that this wasn't what defined you as a person or a provider.

Perhaps that's why that one physician hasn't gotten back to you? No offense, but the way you mentioned that smacked of entitlement. Just because you are LGBTQ doesn't make you more entitled to that experience than anyone. In fact, perhaps there are other students that could benefit more from such an experience.

I came from a really frakked up and impoverished background, just to give you perspective.

I also shadowed a psychiatrist closely before med school.

My background never came up nor was hinted at in my work with that doctor, until much later.

I think my background would have been more of a liability than an assest to medical schools if that doc had not been able to write to my clear sense of interpersonal boundaries.

You need to be *able* to leave who you are and what you've lived through, at the door as a doctor. It should inform what you do, never define it.

It was hard for me to relate to people who were "better off" and the silver spoon fed classmates, I'll admit. But learning to do so was necessary.

I think it's more important that you focus on yourself as a whole, and how your unique experiences in the LGBTQ community, will translate to an effective practice style for all comers.

Because that's really what the admission committee wants, and the profession needs.

Most of your patients, even in a tailored practice, will not be LGBTQ. Tell me how you offer something unique and effective in addressing their unique healthcare needs.

If the whole of humanity and its ugliness and its disease doesn't interest you, than I think careers besides physician might fit you better.

I'm not trying to discourage you; I'm trying to change your focus.

If you expanded to focus on the LGBTQ, ESL, impoverished, low health literacy, etc etc disadvantaged and other minority groups, than I think you could generate more excitement about your inclusion to the profession.

I've seen a few matriculants that met some sort of less represented diversity criteria, and the ones that really had no interest in patients outside a narrow niche, really caused themselves and everyone around them, head and heartache.

No matter who you are; rich or poor, cis or trans, white or other, those of you that have the greatest interest in humanity at large, do the best by your patients.

Given my observations about myself and my classmates, do I offer these thoughts.
Thanks for the response!

1. In regards to sounding entitled, I don't feel that sending one email asking to shadow like I would any doctor screams entitlement. That's typically how people ask... either that or a phone call, so that's not a fair accusation.

2. In regards to being well rounded, I certainly am. I volunteered at a hospital as a patient transporter, and am shadowing many different fields. It's just that I chose to have certain unique activities that make me stand out and all correlate to each other.

3. I think you're mistaken. Across the United States, there are specialty clinics popping up with focus on pediatric endocrinology for transgender children only. These clinic provide psychiatrists, psychologists, doctors etc... it's a major operation that follows the children to adulthood. It also helps the parents through it as well, which is something I think is so important in regards to the mental health of the child. It is a major need in the healthcare world, and while I am happy to serve the undeserved in any capacity, my dream is to be working as a pediatric endocrinologist with transgender kids, so it is a very real and necessary specialty. Right now, people are having to travel across the United States to major children's hospitals to receive that kind of treatment as opposed to having access near their home. Expanding that further, there is a major need for LGBTQ doctors in healthcare, and to say that I need to leave my personal self at the door, would be a detriment to patients in a way. Many LGBTQ people are searching for doctors they can relate to and trust, and I would be doing I disservice to them by not being open with it. I encourage you to do some research on this subject as you're treating it much like someone who only wants to treat car crash victims because they too were once a car crash victim. It's not the same.

4. While I appreciate your opinion, I do not appreciate you suggesting other careers nor questioning my commitment to helping people in general.

I can definitely see where it could be beneficial to expand my personal statement to include all underserved populations, which was essentially what my original question was. I'm not looking for advice on changing careers or editing my focus on long term goals.

In the end, I would argue that the transgender community, youth especially, is the reason I want to become a doctor. I have personally seen insane amounts of injustice brought against them, and they are arguably one of the most underserved populations in medicine. I want to change that

Thanks again!
 
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Goro

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Don't hurt me for posting this. I've seen it create drama in the past, and I assure you I am not here to do so.

Essentially I've built my "brand" around the LGBTQ community. I am gay, I volunteer at a youth center for LGBTQ kids, I'm trying to co start an LGBTQ science organization at school this semester. I am also trying, and failing, to shadow a doctor who works with transgender children... I cannot get her to respond to me...The reason I want to be a doctor has to do with my experiences being gay, my experiences working with transgender youth, and my friends' experiences being LGBTQ in the medical field... Every reason why I want to go into medicine is because I want to serve a population that is significantly underserved at the moment (transgender youth). It honestly is what drives me to keep going at times.

Is it okay for this to be my personal statement? I'm a Texas resident and I know it's controversial, but it is so important to me and something I am very passionate about. I wanted to know adcoms opinions on it as well like @Goro ... and any help in general. Thank you!
Absolutely! ! Write exactly what you have written here!
 
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DarklingThrush
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Absolutely! ! Write exactly what you have written here!
Thanks Goro! I have my 5000 count essay written... a first draft at least... and wanted to make sure I'm not shooting myself in the foot having this be the topic...especially with southern schools. Upon reading guidelines for writing your personal statement essay, it says to address why you want to become a physician, what experiences set you apart, and how do these experiences contribute to your overall ability to treat patients. I feel like not writing about my connection with the LGBTQ community does a disservice, as it was those experiences that pushed me to be a doctor in the first place.
 
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Goro

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Thanks Goro! I have my 5000 count essay written... a first draft at least... and wanted to make sure I'm not shooting myself in the foot having this be the topic...especially with southern schools. Upon reading guidelines for writing your personal statement essay, it says to address why you want to become a physician, what experiences set you apart, and how do these experiences contribute to your overall ability to treat patients. I feel like not writing about my connection with the LGBTQ community does a disservice, as it was those experiences that pushed me to be a doctor in the first place.
I agree. I also agree that some of the southern schools might have issues with this, but F'em if they do. My school and tons of others will take you. LGBT are considered as URM at a number of schools, including U Chicago, and JHU. Just saying.
 
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mvenus929

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I think you're mistaken. Across the United States, there are specialty clinics popping up with focus on pediatric endocrinology for transgender children only. These clinic provide psychiatrists, psychologists, doctors etc... it's a major operation that follows the children to adulthood. It also helps the parents through it as well, which is something I think is so important in regards to the mental health of the child. It is a major need in the healthcare world, and while I am happy to serve the undeserved in any capacity, my dream is to be working as a pediatric endocrinologist with transgender kids, so it is a very real and necessary specialty. Right now, people are having to travel across the United States to major children's hospitals to receive that kind of treatment as opposed to having access near their home. Expanding that further, there is a major need for LGBTQ doctors in healthcare, and to say that I need to leave my personal self at the door, would be a detriment to patients in a way. Many LGBTQ people are searching for doctors they can relate to and trust, and I would be doing I disservice to them by not being open with it. I encourage you to do some research on this subject as you're treating it much like someone who only wants to treat car crash victims because they too were once a car crash victim. It's not the same.
Given that I am on this path right now (going to fellowship in July, and transgender care and DSD are my primary interests), I will say that I agree some with Crayola. Yes, it's great that you have an idea of a niche that you want to practice in eventually. But, you have to get through medical school, and residency, and fellowship before you can actually have that dream, and along the way, you're going to need to take care of a wide variety of other patients. Even as an attending, though the field is booming, it is unlikely that you will be able to have a patient population exclusive to that niche--you will likely still need to see some other endocrine or diabetes patients to stay afloat. The bulk of the work in those clinics is done by the psychology folks, not the endocrinologist/adolescent med doc that only needs to see them every 3 months for a short visit to make sure their hormones aren't causing any serious problems.
 
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Crayola227

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Thanks for the response!

1. In regards to sounding entitled, I don't feel that sending one email asking to shadow like I would any doctor screams entitlement. That's typically how people ask... either that or a phone call, so that's not a fair accusation.

2. In regards to being well rounded, I certainly am. I volunteered at a hospital as a patient transporter, and am shadowing many different fields. It's just that I chose to have certain unique activities that make me stand out and all correlate to each other.

3. I think you're mistaken. Across the United States, there are specialty clinics popping up with focus on pediatric endocrinology for transgender children only. These clinic provide psychiatrists, psychologists, doctors etc... it's a major operation that follows the children to adulthood. It also helps the parents through it as well, which is something I think is so important in regards to the mental health of the child. It is a major need in the healthcare world, and while I am happy to serve the undeserved in any capacity, my dream is to be working as a pediatric endocrinologist with transgender kids, so it is a very real and necessary specialty. Right now, people are having to travel across the United States to major children's hospitals to receive that kind of treatment as opposed to having access near their home. Expanding that further, there is a major need for LGBTQ doctors in healthcare, and to say that I need to leave my personal self at the door, would be a detriment to patients in a way. Many LGBTQ people are searching for doctors they can relate to and trust, and I would be doing I disservice to them by not being open with it. I encourage you to do some research on this subject as you're treating it much like someone who only wants to treat car crash victims because they too were once a car crash victim. It's not the same.

4. While I appreciate your opinion, I do not appreciate you suggesting other careers nor questioning my commitment to helping people in general.

I can definitely see where it could be beneficial to expand my personal statement to include all underserved populations, which was essentially what my original question was. I'm not looking for advice on changing careers or editing my focus on long term goals.

In the end, I would argue that the transgender community, youth especially, is the reason I want to become a doctor. I have personally seen insane amounts of injustice brought against them, and they are arguably one of the most underserved populations in medicine. I want to change that

Thanks again!
No problem!

1) I think the issue was the phrasing "I cannot get her to respond to me." Sounds different then, "I haven't gotten a response," "She hasn't responded to me." It's subtle, but there is a difference in meaning that could be taken there. I'm well meaning and hate to be like so many of my peers and nitpicky, but that's the peer group you're signing up for. In any case, no offense meant, and I assume you didn't mean any either. Just something to be aware of, that subtle turns of phrase can get you into trouble.

2) I'm very glad if your experiences have been diverse and some outside the LGBTQ community, that is just what I would hope for, for your success. I'm also glad that your app also demonstrates commitment and passion to a cause. Both are sought after.

3) I am not mistaken. I too have an interest in transgender medicine and have assisted in transitions and treating other medical issues related to the LGBTQ community. I was also heavily involved in this aspect of medical education and developing that curriculum while I was in medical school. I've also been involved in the admissions process for medical school. So while I am aware of the need for providers with very targeted practices, I am also aware of the training path and that while medical schools appreciate individuals with targeted career goals, they also are looking for adaptibility and suitably for more than one field. Many people start medical school stuck on neurosurgery, and most of them find themselves needing to pursue something else. That might not be you. Despite that, it is something adcoms think about.

I was definitely speaking in generalities about most practices. You describe the sort of extreme niche where one might only see the population you describe. Over a decade of your training will be with a broad swath of patients, and need to be successful with them, and adcoms also look at this big picture.

Many physicians I have known, such as general surgeons, urologists, ob/gyns, plastic surgeons, psychiatrists, endocrinologists, and primary care providers, who are considered preeminent in treating transgender patients, also see other patients as well. I will spare you in explaining why often a more diverse patient population can be essential in maintaining skills in one's specialty that allows one to continue to be most effective in a more narrowed area.

In no way do I deny the extreme need for more providers who can address the unique needs of a diverse or minority population. That has also been the goal of much of my career.

I am not trying to advise that it's not possible to see to it that you only ever see an LGBTQ patient ever again in your life as an attending. Just that it isn't terribly common, and as such, isn't wise to hang your hat on, if not in actuality, then in front of an admissions committee or any other physician evaluating you.

Even with a niche population in a niche field, medicine is a very broad field intellectually, and an open mind, adaptibility, flexibility, are key.

Many people for various reasons don't or are unable to practice in their desired field. In fact, this is a common admissions question, how you would handle that, and what else can you see yourself doing in medicine?

4) No where did I suggest that you needed to consider other careers. I suggested that if someone can't see themselves practicing more than one type of medicine, with a diverse set of human beings, then they might consider other careers, because such a view can he extremely problematic. I actually didn't assume that was you, unless, of course, it is. I was also trying to explain why it's important to let the committee know that one has an identity and interest beyond their own experiences.

If this comes off as a lecture, it is. Maybe you don't need one. That's not the point. If you don't, there's no need to get defensive. If some of this is educational, good, that's the spirit in which it's given. Otherwise, I also intend this not only with you as the audience in mind.

The way I see it, I want someone with your experiences to succeed over the next guy, from what I can tell. But I don't think I'll do you any favors just clapping my hands.

I don't mean to attack you, but I mean to challenge you. By sharing with you what I have learned about the field, and how adcoms and physicians think, to my knowledge, and as someone committed to diversity and the underserved.

You won't just get clapping based on what you've said from a lot of doctors. You'll get grilled. I did. I know others who have been. None of this from me is a value judgement of you. Or even from some of the grillers. They just want to know and be assured of certain things. Them's the game.
 
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DarklingThrush
Oct 27, 2016
194
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Pre-Medical
Given that I am on this path right now (going to fellowship in July, and transgender care and DSD are my primary interests), I will say that I agree some with Crayola. Yes, it's great that you have an idea of a niche that you want to practice in eventually. But, you have to get through medical school, and residency, and fellowship before you can actually have that dream, and along the way, you're going to need to take care of a wide variety of other patients. Even as an attending, though the field is booming, it is unlikely that you will be able to have a patient population exclusive to that niche--you will likely still need to see some other endocrine or diabetes patients to stay afloat. The bulk of the work in those clinics is done by the psychology folks, not the endocrinologist/adolescent med doc that only needs to see them every 3 months for a short visit to make sure their hormones aren't causing any serious problems.
I totally get where you're coming from, and that makes complete sense. I think part of where I was coming from was programs like the Genecis program in Dallas, which is specific to children with gender dysphoria, however like you said it is a very niche field and even the head MD there did not specialize in gender dysphoria. Foreverbull had some good suggestions on broadening the definition of underserved, and I think I can do that in my personal statement essay, while still holding true to what inspired me to be a doctor in the first place. Thanks for the insight and that's really awesome that you're considering transgender care! Congrats on your fellowship too!
 
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Crayola227

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Lastly, you are definitely wrong about often needing to leave your own stuff at the door when you treat patients.

Ask psychiatrists. It has to do with interpersonal boundaries, projection and counterprojection.

It is really important and without measure extremely valuable to use one's personal and unique experiences to help patients. I'm not saying one doesn't or shouldn't.

But one absolutely needs to be able to put that aside frequently to help oneself be objective for the sake of the patient, many times.

There's not a single medical school curriculum that doesn't address this, it's that important an aspect of good practice.

I think there's a real issue with ego that some people seem to think they are automatically better for treating a certain type of patient because they have a similar background. There's definitely clear benefits, but those can only be maximized if one can avoid the dangers present in the greater possibility of over-identifying with the patient, projection, when one has so much in common with a patient.

This isn't an accusation towards you. This thing about ego was something *I* dealt with, and saw others as well. In some ways, I was more effective in treating patients with substance use disorders because of my family background. In other instances, other providers without that handled things better.

This is all part of the learning process, as I strove to learn how to use what was useful, leave thenrest at the door, and learn to distinguish each.

In fact, many of my medical school AND residency interview questions were about this concept.

I'm trying to pass on what I have learned.

I can tell you, that acknowledging these points, will be well-received as a mark of maturity, perspective, and humility, and more importantly, good for your patients.

At least that's the party line. But don't believe me. What am I? Just another physician's 2 cents.
 
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DarklingThrush
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No problem!

1) I think the issue was the phrasing "I cannot get her to respond to me." Sounds different then, "I haven't gotten a response," "She hasn't responded to me." It's subtle, but there is a difference in meaning that could be taken there. I'm well meaning and hate to be like so many of my peers and nitpicky, but that's the peer group you're signing up for. In any case, no offense meant, and I assume you didn't mean any either. Just something to be aware of, that subtle turns of phrase can get you into trouble.

2) I'm very glad if your experiences have been diverse and some outside the LGBTQ community, that is just what I would hope for, for your success. I'm also glad that your app also demonstrates commitment and passion to a cause. Both are sought after.

3) I am not mistaken. I too have an interest in transgender medicine and have assisted in transitions and treating other medical issues related to the LGBTQ community. I was also heavily involved in this aspect of medical education and developing that curriculum while I was in medical school. I've also been involved in the admissions process for medical school. So while I am aware of the need for providers with very targeted practices, I am also aware of the training path and that while medical schools appreciate individuals with targeted career goals, they also are looking for adaptibility and suitably for more than one field. Many people start medical school stuck on neurosurgery, and most of them find themselves needing to pursue something else. That might not be you. Despite that, it is something adcoms think about.

I was definitely speaking in generalities about most practices. You describe the sort of extreme niche where one might only see the population you describe. Over a decade of your training will be with a broad swath of patients, and need to be successful with them, and adcoms also look at this big picture.

Many physicians I have known, such as general surgeons, urologists, ob/gyns, plastic surgeons, psychiatrists, endocrinologists, and primary care providers, who are considered preeminent in treating transgender patients, also see other patients as well. I will spare you in explaining why often a more diverse patient population can be essential in maintaining skills in one's specialty that allows one to continue to be most effective in a more narrowed area.

In no way do I deny the extreme need for more providers who can address the unique needs of a diverse or minority population. That has also been the goal of much of my career.

I am not trying to advise that it's not possible to see to it that you only ever see an LGBTQ patient ever again in your life as an attending. Just that it isn't terribly common, and as such, isn't wise to hang your hat on, if not in actuality, then in front of an admissions committee or any other physician evaluating you.

Even with a niche population in a niche field, medicine is a very broad field intellectually, and an open mind, adaptibility, flexibility, are key.

Many people for various reasons don't or are unable to practice in their desired field. In fact, this is a common admissions question, how you would handle that, and what else can you see yourself doing in medicine?

4) No where did I suggest that you needed to consider other careers. I suggested that if someone can't see themselves practicing more than one type of medicine, with a diverse set of human beings, then they might consider other careers, because such a view can he extremely problematic. I actually didn't assume that was you, unless, of course, it is. I was also trying to explain why it's important to let the committee know that one has an identity and interest beyond their own experiences.

If this comes off as a lecture, it is. Maybe you don't need one. That's not the point. If you don't, there's no need to get defensive. If some of this is educational, good, that's the spirit in which it's given. Otherwise, I also intend this not only with you as the audience in mind.

The way I see it, I want someone with your experiences to succeed over the next guy, from what I can tell. But I don't think I'll do you any favors just clapping my hands.

I don't mean to attack you, but I mean to challenge you. By sharing with you what I have learned about the field, and how adcoms and physicians think, to my knowledge, and as someone committed to diversity and the underserved.

You won't just get clapping based on what you've said from a lot of doctors. You'll get grilled. I did. I know others who have been. None of this from me is a value judgement of you. Or even from some of the grillers. They just want to know and be assured of certain things. Them's the game.
Thanks for clarifying... No need to lecture, but your insight has helped as well. I do see the narrowness of such a niche path and also recognize that my path could change... Heck, that's how I ended up as a nontrad because my former career wasn't what I wanted out of life, so I'm no stranger to changing plans. I think it is definitely smart to open up my personal statement essay to more than just the LGBTQ community, and add diversity and underserved as a broad group... and of course I have volunteer experience with other underserved groups as well to back it up. I definitely see the benefit in keeping an open mind, while staying true to my roots as well. Thanks for the insight and active discussion! I enjoy learning from others.
 
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DarklingThrush
Oct 27, 2016
194
101
81
Status
Pre-Medical
Lastly, you are definitely wrong about often needing to leave your own stuff at the door when you treat patients.

Ask psychiatrists. It has to do with interpersonal boundaries, projection and counterprojection.

It is really important and without measure extremely valuable to use one's personal and unique experiences to help patients. I'm not saying one doesn't or shouldn't.

But one absolutely needs to be able to put that aside frequently to help oneself be objective for the sake of the patient, many times.

There's not a single medical school curriculum that doesn't address this, it's that important an aspect of good practice.

I think there's a real issue with ego that some people seem to think they are automatically better for treating a certain type of patient because they have a similar background. There's definitely clear benefits, but those can only be maximized if one can avoid the dangers present in the greater possibility of over-identifying with the patient, projection, when one has so much in common with a patient.

This isn't an accusation towards you. This thing about ego was something *I* dealt with, and saw others as well. In some ways, I was more effective in treating patients with substance use disorders because of my family background. In other instances, other providers without that handled things better.

This is all part of the learning process, as I strove to learn how to use what was useful, leave thenrest at the door, and learn to distinguish each.

In fact, many of my medical school AND residency interview questions were about this concept.

I'm trying to pass on what I have learned.

I can tell you, that acknowledging these points, will be well-received as a mark of maturity, perspective, and humility, and more importantly, good for your patients.

At least that's the party line. But don't believe me. What am I? Just another physician's 2 cents.
I think the part where I disagree about leaving yourself at the door is because many people in the LGBTQ community, including myself, are hesitant and uncomfortable to reveal the truth to doctors and it sometimes can impact their health. I recently learned from another doctor of an app that is being made at Harvard (I think), that will essentially be a database of LGBTQ and Ally doctors. Patients can then select their doctor from there, and feel comfortable attending and being open about their history. That is where I was in disagreement with you. It's not about being "better than someone else" or having an innate ability to treat the queer community because I am too, it's about providing an environment in which LGBTQ patients are comfortable disclosing their sexual history in order to benefit their health. There is absolutely no denying that is a current, past and future issue for the queer community.
 
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Crayola227

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I think the part where I disagree about leaving yourself at the door is because many people in the LGBTQ community, including myself, are hesitant and uncomfortable to reveal the truth to doctors and it sometimes can impact their health. I recently learned from another doctor of an app that is being made at Harvard (I think), that will essentially be a database of LGBTQ and Ally doctors. Patients can then select their doctor from there, and feel comfortable attending and being open about their history. That is where I was in disagreement with you. It's not about being "better than someone else" or having an innate ability to treat the queer community because I am too, it's about providing an environment in which LGBTQ patients are comfortable disclosing their sexual history in order to benefit their health. There is absolutely no denying that is a current, past and future issue for the queer community.
Ohhhhh, well that makes total sense.

I take it for granted, because where I trained, we had openly gay doctors that would wear things saying as much on their hospital badges, at work, in a Catholic hospital!!

No I don't think it's something to hide, anymore than a black doctor would hide being black from white and black patients alike.

I meant more like it can be easy to let experiences bias you and affect your decision making.

Example: my attending would "punish" an IV heroin user who was s/p above the knee amputation by not increasing his pain meds, even when he was visably in pain when he didn't know he was being watched, and his dose was only appropriate for the opiate naive. I upped his dose and he was much more comfortable and grateful.

I know I have some examples where my background biased me in a way that didn't help the patient, even though that was my intent.

I'm sure there are examples in the LGBTQ community. There is a provider I worked with to do education in school, that was themselves transgender, and they spoke about the advantages and challenges of relating to their transgender patients.

No one is free from that.

As long as no one loses sight of the principles I discussed, I'm all for diversity. It takes all types of doctors to treat all sorts of patients.

Sometimes you need differences! I prefer male ob/gyns, for example. That's not typical I guess, but I'm glad they're there in the field!
 
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Nathan17182

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You've gotten some great advice here, so I won't add too much but I'll just let you know I mentioned coming to terms with my sexuality in my personal statement and most of my secondaries and I don't think I've gotten any negative reactions from it (that I know of lol). Granted I did apply to more liberal schools and no southern ones - but at two of my interviews, interviewers specifically brought up my sexuality because I briefly mentioned it in my statement and they wanted to know a little more about my journey.

I mentioned being gay in my PS because I want to go to a school that is not only accepting, but supportive of the LGBTQ+ community. As Goro said, F schools who aren't supportive and you probably wouldn't have wanted to go there anyway. If being LGBTQ+ has been a big part of your joinery in medicine, then I would say 100% you should mention it! Good luck!
 

radoncologyhopeful

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I agree. I also agree that some of the southern schools might have issues with this, but F'em if they do. My school and tons of others will take you. LGBT are considered as URM at a number of schools, including U Chicago, and JHU. Just saying.
Medical school checklist: LGBT - you're in. No more questions. Really pathetic our country is in a place where this allows easier admission into medical school.

We'll take you?? Wouldn't you want to see the rest of the application?
 

radoncologyhopeful

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Don't hurt me for posting this. I've seen it create drama in the past, and I assure you I am not here to do so.

Essentially I've built my "brand" around the LGBTQ community. I am gay, I volunteer at a youth center for LGBTQ kids, I'm trying to co start an LGBTQ science organization at school this semester. I am also trying, and failing, to shadow a doctor who works with transgender children... I cannot get her to respond to me...The reason I want to be a doctor has to do with my experiences being gay, my experiences working with transgender youth, and my friends' experiences being LGBTQ in the medical field... Every reason why I want to go into medicine is because I want to serve a population that is significantly underserved at the moment (transgender youth). It honestly is what drives me to keep going at times.

Is it okay for this to be the gist of my personal statement essay? I'm a Texas resident and I know it's controversial, but it is so important to me and something I am very passionate about. I wanted to know adcoms opinions on it as well like @Goro ... and any help in general. Thank you!

Edited for clarity.
I'm glad you want to give children hormones. It is certainly controversial to do this to children and teenagers. This type of behavior should be criminal. It hasn't been proven safe, but when it comes to transgender stuff we'll ask questions later. Absolutely disgraceful. Leave kids alone.

The shortage of healthcare in this country is low enough, we don't need to waste providers who specifically address transgender, the state of confusion.
 
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I'm glad you want to give children hormones. It is certainly controversial to do this to children and teenagers. This type of behavior should be criminal. It hasn't been proven safe, but when it comes to transgender stuff we'll ask questions later. Absolutely disgraceful. Leave kids alone.

The shortage of healthcare in this country is low enough, we don't need to waste providers who specifically address transgender, the state of confusion.
I know this person is banned now, but for clarification, children who suffer from gender dysphoria are given hormone blockers to delay puberty until they reach the age of 18. Once they are adults, they can then decide whether to proceed with the appropriate hormone and continue as transgender, or reverse their decision and go through puberty as their born sex.
 
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You've gotten some great advice here, so I won't add too much but I'll just let you know I mentioned coming to terms with my sexuality in my personal statement and most of my secondaries and I don't think I've gotten any negative reactions from it (that I know of lol). Granted I did apply to more liberal schools and no southern ones - but at two of my interviews, interviewers specifically brought up my sexuality because I briefly mentioned it in my statement and they wanted to know a little more about my journey.

I mentioned being gay in my PS because I want to go to a school that is not only accepting, but supportive of the LGBTQ+ community. As Goro said, F schools who aren't supportive and you probably wouldn't have wanted to go there anyway. If being LGBTQ+ has been a big part of your joinery in medicine, then I would say 100% you should mention it! Good luck!
Thank you for your insight and story! You are definitely right about not wanting to be at a place where I am not accepted.
 
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mvenus929

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I know this person is banned now, but for clarification, children who suffer from gender dysphoria are given hormone blockers to delay puberty until they reach the age of 18. Once they are adults, they can then decide whether to proceed with the appropriate hormone and continue as transgender, or reverse their decision and go through puberty as their born sex.
That's not accurate. The Endocrine Society guidelines state: "Clinicians may add gender-affirming hormones after a multidisciplinary team has confirmed the persistence of gender dysphoria/gender incongruence and sufficient mental capacity to give informed consent to this partially irreversible treatment. Most adolescents have this capacity by age 16 years old. We recognize that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years, although there is minimal published experience treating prior to 13.5 to 14 years of age."

Generally, once a child is 16 and both the parent and the child is able to give consent, gender-affirming hormones can begin.

Most surgeons won't touch adolescents until they're 18, with a very few being willing to do mastectomies at age 17.
 
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That's not accurate. The Endocrine Society guidelines state: "Clinicians may add gender-affirming hormones after a multidisciplinary team has confirmed the persistence of gender dysphoria/gender incongruence and sufficient mental capacity to give informed consent to this partially irreversible treatment. Most adolescents have this capacity by age 16 years old. We recognize that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years, although there is minimal published experience treating prior to 13.5 to 14 years of age."

Generally, once a child is 16 and both the parent and the child is able to give consent, gender-affirming hormones can begin.

Most surgeons won't touch adolescents until they're 18, with a very few being willing to do mastectomies at age 17.
So I retract and say age 16 instead but of 18, however I read the rest directly from a children's hospital website that has a specialized clinic for gender dysphoria/transgender patients. The norm used to be the age of 18, however 16 is becoming more common. Puberty suppressants are absolutely used to help patients with gender dysphoria. I didn't say anything about surgery and my response was in direct response to the person claiming the "brutality" behind giving children hormones.


"Forms of gender affirming medical care include use of hormones and gender affirmation surgeries (e.g., “top” surgeries, “bottom” surgeries, facial feminization, and laser hair removal). Historically, transgender individuals were required to wait until age 18 to receive gender affirming medical care of any kind. Increasingly, transgender individuals are requesting care at earlier ages due to larger social shifts in visibility and acceptance that have resulted in earlier ages of “coming out.”

As a result, gender clinics specializing in the medical treatment of transgender individuals are offering cross-sex hormone therapy at younger ages (16-18 years old). In addition, a number of doctors are now prescribing puberty blockers to adolescents with strong physical dysphoria that persists or emerges with the onset of puberty. Puberty blockers are prescribed after an assessment process with a multidisciplinary team and adolescents are tracked over time and provided with support during the transition period."
 
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mvenus929

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So I retract and say age 16 instead but of 18, however I read the rest directly from a children's hospital website that has a specialized clinic for gender dysphoria/transgender patients. The norm used to be the age of 18, however 16 is becoming more common. Puberty suppressants are absolutely used to help patients with gender dysphoria. I didn't say anything about surgery and my response was in direct response to the person claiming the "brutality" behind giving children hormones.
And I didn't refute anything you said about puberty blockers... just about starting gender affirming hormone therapy, which I learned after having actually seen patients in a gender clinic at a large children's hospital. I pointed out surgery because that's generally what people have to wait until 18 for. Also, puberty blockers may be used before an assessment if the child's distress over their physical body is severe enough. :)
 

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This discussion thread is very helpful. =) Thank you everyone who have contributed to this thread.

I am also a member in LGBTQ community, and have been a medical social worker/counselor since 2000, working with LGBTQ community and in AIDS care. I won't be able to hide, as all of my track record is nothing but LGBTQ health and AIDS care/prevention (with a few writings in developmental disability). I totally believe that anyone who ever comes through my CV can see a rainbow ... haha

However, I don't know, as I have been contemplating my personal statement lately, I am thinking perhaps I would highlight my work more than who I am? and How these career paths have opened me up to a wider and more general human suffering experiences and humanity. Because, no matter what, we can have passion to work with LGBTQ community and in AIDS care without being a sexual/gender minority or HIV+ ourselves, right? (Although it is also very amusing that we too often assume that people who work with these communities/do research about these communities are community members themselves.)

As an old nontrad (getting close to 40), I do have this privilege to focus on my past achievements without giving too much weight on my personal experiences. However, I also understand that it is a really fine balance to make. I can only do this to a degree that not let others feel I have something to hide/not being candid about myself.... alas, it is really an art......
 

Cheenghee Koh

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I think in general this is great.

I'm not trying to discourage you; I'm trying to change your focus.

If you expanded to focus on the LGBTQ, ESL, impoverished, low health literacy, etc etc disadvantaged and other minority groups, than I think you could generate more excitement about your inclusion to the profession.
I agree with this point and I also want to respond to this too.

As I have been working closely with LGBTQ community, I can share that, LGBTQ community is also very diverse. LGBTQ community doesn't only have white cis-gay men. LGBTQ community (if we can really say there is "a" such community, instead of communities) has all types of people with distinct life trajectories. When I was a front-line social worker, I mainly worked with LGBTQ youths who were HIV+ and homeless (as they got kicked out of their home), and many of them did survival sex and had comorbid mental health conditions (mostly depression/anxiety/substance use). This is the real life. Relative few people had only one disadvantage (in this case, being LGBTQ). For many of them, the challenges are multi-layered and compound.

Perhaps the author of the original post can also reflect on this too? In your clinical experiences, maybe you can recall that some of the children you serve also have other disadvantages that intersect with their LGBTQ identities?
 
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I agree with this point and I also want to respond to this too.

As I have been working closely with LGBTQ community, I can share that, LGBTQ community is also very diverse. LGBTQ community doesn't only have white cis-gay men. LGBTQ community (if we can really say there is "a" such community, instead of communities) has all types of people with distinct life trajectories. When I was a front-line social worker, I mainly worked with LGBTQ youths who were HIV+ and homeless (as they got kicked out of their home), and many of them did survival sex and had comorbid mental health conditions (mostly depression/anxiety/substance use). This is the real life. Relative few people had only one disadvantage (in this case, being LGBTQ). For many of them, the challenges are multi-layered and compound.

Perhaps the author of the original post can also reflect on this too? In your clinical experiences, maybe you can recall that some of the children you serve also have other disadvantages that intersect with their LGBTQ identities?
Well considering that I am not a "white cis-gay man" but rather a Hispanic lesbian, I am aware that the LGBT+ community is not limited to gay men. In regards to experience, I can only write about what I have encountered. At this time, I have worked with LGBT+ youth who come from various backgrounds. Some are at gifted and talented magnet schools, some are attending public schools and some are completing school online due to the extreme bullying they've faced. I also spend a fair amount of time with the transgender youth group, and while it's not appropriate to discuss their financial situation, what I do know is that they are a repressed minority who suffer greatly whether that be bullying from their peers, low self esteem, dysphoria (obviously), a general unacceptance from their family, or ignorance from their school. We talk openly about binders, hormones, their "dead names" (former names), and how they wish certain body parts didn't exist. I speak with their parents and hear the difficulty and frustration of waiting for months to years on a waitlist for the only youth transgender clinic in the region and listen to their concerns about their 14 year old transitioning.

Being LGBT+ might not be their "only disadvantage," but it certainly doesn't make their life easier and it absolutely is a catalyst for other hardships. While I have already noted that expanding my personal statement to other underprivileged communities is wise, the transgender community is incredibly underserved at the moment (from what I have gathered from personal experience.) The fact we are having conversations about people not being able use the bathroom of the gender they present as speaks for itself.
 
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ed*26

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My application was extensively queer -- my personal statement included an experience working with a transgender patient, two of my most significant experiences were LGBT-related, and for almost every school I wrote more about those experiences and my identity in the secondary. For two schools, both of which I got into, I wrote extensively in the secondary app about how coming out to my mother affected me. I got into several schools and have a nice scholarship to boot. I have LGBT friends who had similar outcomes. Don't listen to anyone who says you can't highlight that part of your life in your application. It should be one of a variety of reasons for why you would make a good candidate, but it's valid nonetheless.

I think medical schools appreciate clarity of purpose. I came into medical school saying that I felt very connected to my community, that I thought it was deeply important for LGBT patients to have providers that can advocate for them, and that I knew that this was going to be an important part of my career. I think that resonated -- medicine is built around service to patients, after all. What is less appreciated is when students are perceived to be narrow-minded about specialty choice, so just be aware of that to avoid reactions like Crayola's. I'd maybe state it more along the lines of that seeing how pediatric endocrinologists were able to incorporate that into their careers energized you to be able to do a similar thing with your career.

If you have any questions feel free to PM me! There's a bunch of ways to incorporate LGBT identity and advocacy into your career. I would love to hear more about ob/gyns doing that, personally.
 

Mad Jack

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Don't hurt me for posting this. I've seen it create drama in the past, and I assure you I am not here to do so.

Essentially I've built my "brand" around the LGBTQ community. I am gay, I volunteer at a youth center for LGBTQ kids, I'm trying to co start an LGBTQ science organization at school this semester. I am also trying, and failing, to shadow a doctor who works with transgender children... I cannot get her to respond to me...The reason I want to be a doctor has to do with my experiences being gay, my experiences working with transgender youth, and my friends' experiences being LGBTQ in the medical field... Every reason why I want to go into medicine is because I want to serve a population that is significantly underserved at the moment (transgender youth). It honestly is what drives me to keep going at times.

Is it okay for this to be the gist of my personal statement essay? I'm a Texas resident and I know it's controversial, but it is so important to me and something I am very passionate about. I wanted to know adcoms opinions on it as well like @Goro ... and any help in general. Thank you!

Edited for clarity.
Transgender kids tend to be very cagey when they're getting medical treatment of any sort. Having a stranger around upsets the balance and trust even more. I would be very, very reluctant to bring someone on board to shadow me if that were my particular population.
 
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Crayola227

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My application was extensively queer -- my personal statement included an experience working with a transgender patient, two of my most significant experiences were LGBT-related, and for almost every school I wrote more about those experiences and my identity in the secondary. For two schools, both of which I got into, I wrote extensively in the secondary app about how coming out to my mother affected me. I got into several schools and have a nice scholarship to boot. I have LGBT friends who had similar outcomes. Don't listen to anyone who says you can't highlight that part of your life in your application. It should be one of a variety of reasons for why you would make a good candidate, but it's valid nonetheless.

I think medical schools appreciate clarity of purpose. I came into medical school saying that I felt very connected to my community, that I thought it was deeply important for LGBT patients to have providers that can advocate for them, and that I knew that this was going to be an important part of my career. I think that resonated -- medicine is built around service to patients, after all. What is less appreciated is when students are perceived to be narrow-minded about specialty choice, so just be aware of that to avoid reactions like Crayola's. I'd maybe state it more along the lines of that seeing how pediatric endocrinologists were able to incorporate that into their careers energized you to be able to do a similar thing with your career.

If you have any questions feel free to PM me! There's a bunch of ways to incorporate LGBT identity and advocacy into your career. I would love to hear more about ob/gyns doing that, personally.
Yes!! Queer is good! Narrow is not.

It's hard to describe, it's like you want to be someone special and unique, but with universal appeal and applicability
 
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Transgender kids tend to be very cagey when they're getting medical treatment of any sort. Having a stranger around upsets the balance and trust even more. I would be very, very reluctant to bring someone on board to shadow me if that were my particular population.
I volunteer 10+ hours a week with transgender youth. You'd be surprised at how much they're willing to share and how open they are, even when I first met them. I don't know if that's unique to the 20+ I spend time with, but that's been my experience. I can see how it would be a sensitive situation and get what you're saying though.
 

Cheenghee Koh

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I volunteer 10+ hours a week with transgender youth. You'd be surprised at how much they're willing to share and how open they are, even when I first met them. I don't know if that's unique to the 20+ I spend time with, but that's been my experience. I can see how it would be a sensitive situation and get what you're saying though.
Form my own experiences, I will say, as long as we (healthcare workers) show them our genuine interests in their stories, and are willing to listen to what they want to say, I never met single one who refused to share. Of course, there are always somebody who is yet ready to share. But it only means it takes time for them to sort out their thoughts, feelings, and their stories. We just need to wait, and let them know that we are there for them.
 

Crayola227

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I think the point MJ was making wasn't so much how much transgender patients would not appreciate a doc having a pre-med shadow, but more that you can see reticence from providers from taking one on, and perhaps what their thinking might be on that

there's a lot of things people don't always appreciate at play when a provider hesitates taking on a pre-med student

not the least of which is the patient population, although that is one

but hey, what do we know

for those of you that were able to find those experiences and had good ones, kudos to you
 

Crayola227

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Form my own experiences, I will say, as long as we (healthcare workers) show them our genuine interests in their stories, and are willing to listen to what they want to say, I never met single one who refused to share. Of course, there are always somebody who is yet ready to share. But it only means it takes time for them to sort out their thoughts, feelings, and their stories. We just need to wait, and let them know that we are there for them.
I support unconditional positive regard and support, and maybe this is semantics, but I would not say "it only means it takes time." Some things patients will never be ready to share. That's OK. I think it is important not to have too many expectations and provide support.

Especially in patients that may have a history of trauma/abuse etc, (not just transgender), it's all the more important to respect those boundaries as a physician and not expect that patients will lower their walls. Doing so doesn't mean those walls will come down, and that's hardly the point.

Not that I am saying that as a criticism of you or anyone here. Just more an important point of good doctoring to teach that I wanted to get out there, that applies to really any patient/doctor relationship. :)

This relates to some of the ethical principles of what medicine is founded on. Topics to look at include patient autonomy, beneficence, unconditional positive regard, transference/countertransference, projection, and boundaries.
 
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Crayola227

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I've picked up a couple of things psychiatrists taught me in my training.

One, is that part of typical psychiatric interview (and something that comes up frequently in many fields, like primary care, EM, etc) is to ask about trauma history.

The idea is that it is important to ask about trauma history, but more important than trying to elicit details about trauma, (the exception being when data is needed to direct medical care such as STD testing, etc) is more importantly, how the patient feels that has affected their life and how addressing that as the patient needs.

An example of an exchange, "Have you been the victim of sexual abuse?"
"Yes."
"We don't need to focus on details unless you think it would help you. You can share as much or as little as you wish. What I really want to help you with is how you think that has affected you, if that is what you want to do."

It's a little off topic, but I wanted to address this teaching point since it has come up.
 
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DSM_302.0

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My activities ultimately out me. And my identity (and attending struggles) have shaped so much of who I am, that I also wrote about it head on in my personal statement. I didn’t make mention that I’d like to focus my time as a doctor on lgbtq communities, just that being queer shaped by my worldview and my compassion for my fellow human.

My approach was: if a school cares about my queerness in a negative way, then good riddance. I wouldn’t want to go to that school anyway.

Good luck!
 

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would being out in the personal statement ever be a deciding factor for being rejected?
Not legally. But theoretically if someone doesn't like you being gay they can find a different reason for rejection. But my guess is this would be exceedingly rare, and you don't want to be there anyway.
 
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For what it's worth, I was effectively out in my personal statement through my list of organizations I volunteered with, student organizations I was apart of, and conferences that I attended. I got a comfortable number of interviews and most PDs asked me questions about one or more of those things, and would even mention the strives the program/institution was making to provide better care for their LGBTQ patients. I never felt it held me back, and if anything offered me a few more unique conversation topics during my interviews. To be fair, I applied and matched into Family Medicine, which I would definitely say is one of the more open minded specialties.