In an exclusive interview, specially extended and published in full at www.imt.ie, a senior consultant talks for the first time about his sexuality while the younger generation of gay doctors assess the future for Irish LGBT physicians. Pat Kelly reports
Different experiences: Dr Cathal O’Sullivan, Consultant Microbiologist, Midland Regional Hospital, Tullamore; Nicola English, final-year medical student, UCC; and Dr Conor Malone, surgical SHO and PhD student, RCSI — pictured at the RCSI
There is a new generation of doctors and medical students in Ireland who are not afraid to be open and honest about their sexuality. Bringing Ireland into line with many other countries, the establishment of Gay Doctors Ireland (GDI) has provided a formal organisation for lesbian, gay, bisexual and transgender (LGBT) doctors in Ireland and provided the support they need, allowing them to be comfortable enough to be honest about their sexuality in a professional environment that has been traditionally regarded as intolerant on such issues.
However for the older generation of doctors, particularly at senior levels, being openly gay would have presented unique problems and sometimes was not even a viable option. Bucking this trend, one hospital consultant in the Mid West spoke exclusively to IMT about ‘coming out’, the reaction he expects from colleagues and the past, present and future for LGBT doctors in Ireland.
Dr Cathal O’Sullivan specialises in both clinical microbiology and infectious diseases and has been based in the Midland regional hospitals of Tullamore, Mullingar and Portlaoise for the past 18 months. On the subject of openly discussing his sexuality for the first time, Dr O’Sullivan told IMT: “At this stage, it’s no big deal to me and I feel, ‘Let’s just do it’,” said Dr O’Sullivan. “Having done postgraduate education in the US and the UK, where there were gay doctors’ organisations in both places, when I came back here I wondered if there was an Irish one and if not, why not?”
On the subject of whether GDI and an increased societal awareness make it easier for younger doctors to be open about their sexuality compared to previous generations, Dr O’Sullivan said: “Let’s hope so. I’m clearly not a medical student anymore but in terms of the membership of GDI, it’s obvious that there are greater numbers of younger medical members and they are more open in general so there seems to be an increased acceptance.”
However this was not always the case when Dr O’Sullivan was training. He described attitudes that were based on “ignorance”: “Most of the medical staff would tend to be from what you might call a relatively narrow strata of society, if I can put it that way,” he said. “Homosexuality just sort of bypassed them as a group, as it were; it just didn’t seem to be on their radar and this is why I say ignorance would be the main characteristic of them.” While the effects of this ignorance were often benign, this was not always the case.
“The few episodes in medical school and in the first couple of years of practising were cases where either gay patients or gay tutors would be recognised and in general it was a negative response; cheap sniggering, implied criticism; that type of thing. It couldn’t be described as a positive response in any way, shape or form. When the issue of homosexuality arose, there was certainly very little attempt to understand it.”
While he said that revealing his sexual orientation “shouldn’t be a big deal,” many will see his openness as a brave step. Dr O’Sullivan said that he spoke to IMT on the issue in the hope that it will encourage other doctors – at all levels but particularly of senior grade – to open up. “On the old idea that ‘a problem shared is a problem halved’, the more gay doctors of all grades who know that there are others who share such a common characteristic, I think it reduces the level of isolation and increases their sense of belonging. In general, I think it just gives them a feeling of strength and they can concentrate on their careers without having to worry about it – just dealing with it and moving on.”
Secrecy around sexuality is an extra burden on students and doctors who are already under enormous pressure, he explained: “It can become an additional burden, as it were. Life is stressful enough and medical training is stressful enough, and it doesn’t get any less stressful afterwards, where a doctor may be moving around the country or perhaps emigrating,” said Dr O’Sullivan. “On top of all that, trying to conceal your sexuality can be very energy-sapping.”
He expressed his concern that LGBT doctors may even be influenced in their career path because of secrecy around their sexual orientation. “I suspect sometimes that gay doctors sometimes choose particular areas of medicine not based on their areas of interest, but on their perception of how gay-friendly it will be. I can’t speculate, but you could say that something like general surgery wouldn’t be viewed as being exactly friendly to gay people; although there are obviously gay general surgeons, it wouldn’t necessarily be viewed as a gay-friendly speciality in medicine. That’s a shame because I don’t see why gay doctors shouldn’t be interested in surgery or indeed any other area of medicine. It’s totally divorced from their sexuality.”
He pointed out that many physicians in the US, for example, tended to care for HIV-positive patients and used this as an example of how gay doctors are sometimes drawn – consciously or unconsciously – to areas they perceive to be more LGBT-friendly. “It’s a shame. What happens then is that often, doctors end up in the wrong specialty and regret their choice.”
While there is a perception that general practice is an area where gay GPs strive to keep their sexuality secret, Dr O’Sullivan described this as “bizarre in the extreme”. He said: “I’m not a GP but the fact that they do not have to deal with a huge number of medical colleagues, such as in a teaching hospital, should in fact make it easier [in terms of disclosure]. The general public is probably ahead of the medical profession when it comes to accepting and understanding gay members of staff.”
He pointed to the fact that medical students and trainees are now more comfortable with revealing their sexuality but when it came to consultant-level LGBT doctors, there was a dearth of such physicians. “They didn’t ask me to change my sexuality when I signed my contract,” said Dr O’Sullivan, “so it’s ridiculous to assume that doctors stop being gay when they get to a certain level. There are also a large number of retired gay doctors in Ireland and to assume otherwise would be ridiculous.”
So does he expect any reaction when his colleagues now know that he is gay? “I don’t think so,” he said. “I suppose a couple of old friends that I haven’t seen in 25 years or something might say ‘hello’ to me in a different way, possibly. I might actually expect a couple of gay doctors to actually say ‘hello’, people who previously wouldn’t or didn’t try to find you and chat with you at a meeting, so I suppose that might happen. Part of the purpose of doing this interview is to show that there are doctors at all grades out there who are gay.”
He pointed to an issue that is constantly overlooked in terms of people’s attitudes to LGBT doctors and emphasised a hidden consideration: “It isn’t really specific to medicine but if you asked a heterosexual person what their top 10 life events were, I think most of them would relate to their heterosexuality in terms of marriage, in terms of their children being born, in terms of their children graduating and marrying – all of these issues are largely off-limits to gay members of society and I think it would be useful if heterosexuals bore that in mind or at least took cognisance of it, as opposed to saying, ‘We’ll tolerate gay people, but that’s all we’ll do’, which tends to be their attitude.
“Let’s put it this way,” said Dr O’Sullivan. “If a woman or a couple are infertile, they have a huge deal of sympathy provided by their family members and friends. I have yet to come across a heterosexual person who had sympathy for a gay man or woman because they couldn’t have children but there is this idea that, ‘Well, they wouldn’t want them anyway’ or ‘It’s no loss, really’. So it should be possible for heterosexual individuals to have a slightly better understanding. Hopefully we can increase people’s awareness and understanding and provide some sort of network for career advice and general social support for gay doctors and gay medical students in Ireland.”
Dr O’Sullivan returned to what, to him, is the central issue he wanted to convey: “Doctors can achieve their full potential if they deal with their sexuality rather than carrying an extra burden. That would be a key issue from my point of view, that they select their area of interest without reference to their sexuality and then get on with achieving their full potential. From my point of view, that would also be a key function of GDI, to help any members coming up the ranks to achieve this.”
He concluded by saying that he hoped his disclosure would encourage other doctors, particularly senior ones, to follow suit: “I think it’s very important that doctors at consultant level demonstrate that you can have a fulfilling life in Ireland as a gay doctor, and in your chosen specialty,” he said. “For medical students and trainees, I think the lack of openly gay consultants is a very notable characteristic of Irish medicine.”
At the other end of the medical spectrum, Nicola English is a gay medical student in her final year of studies in UCC, hoping to eventually specialise in cardiology. Unlike some of Dr O’Sullivan’s experiences as a student, she told IMT that being gay is simply not an issue for most medical students in Ireland today. “We are really very lucky. There are so many youth groups around that anyone who came ‘out’ as a teenager had a lot of support and medical people I’ve known have been generally pretty tolerant,” she said. “I think college students tend to be pretty tolerant in general anyway, but we definitely are much luckier than medical students even five or 10 years ago.”
Nicola explained that she feels “lucky” to be one of the younger generation of gay doctors: “I can’t imagine what it would have been like not to feel comfortable being yourself and have to lie at work and live a double-life, really. That’s not good for anyone.”
On the subject of GDI, she said: “They are definitely doing something important but any straight people I have spoken to, their main criticism is kind of, ‘Well, why do you need a gay society when there is no straight doctors’ society?’ Is that a sign of more tolerance, if that is their main criticism? Maybe that shows that it’s not such a big issue for a lot of younger people.”
She also pointed to the social support GDI offers to LGBT doctors. “I suppose for medical students, what we enjoy most about GDI is the social aspect,” she said. “It’s enjoyable to meet up with like-minded people. I suppose GDI meets different needs for different levels, be it medical students, consultants and so on.”
She said she has seen “a huge shift” in attitudes: “People just don’t care,” she said. “I certainly have not experienced any negative attitudes.” She also pointed to the different challenges faced by male and female LGBT doctors and the different attitudes they encounter. “It’s very different for males, I think. There is a kind of macho thing, where gay male doctors might fear being ostracised in certain ways. There is a very masculine stereotype out there and men are expected to act in a certain way, whereas that isn’t clearly defined in women,” she said. “Some women can be pretty tomboy-ish and it’s not looked on in a negative way than, say, if a male was to act in a feminine way.”
She plans to take a year out of medicine when her studies have finished and taking a break from medicine is important in achieving a well-rounded personality and improving a doctor’s ability to cope with the pressures they face, she said. “I think we are very much consumed by medicine, so that it can be difficult to see the world around us. We are going to be treating real people who live in the real world who have different perspectives.”
Despite more enlightened attitudes prevailing for younger doctors and students, there are still what she sees as essential barriers that will compel her to live abroad when her studies are concluded. “I will be just turned 23 when I qualify but I plan to take a year out before entering into a medical scheme,” she said. “But I don’t think I will stay in Ireland. I was in Australia in the summer and it just seems like a better place to live – for anyone, but especially for lesbian and gay people. It seems very open there and a bit more tolerant. Where gay people are treated with more worth, and where gay marriage is allowed, is absolutely going to influence where I am going to work and live in the future.”
But is the long-term plan to return to Ireland at some point? “At the moment, I would say no. If there is a place where I can get married and have children with a partner, then that’s where I’m going to go.”
Dr Conor Malone, Inaugural President of GDI, spoke with IMT ahead of the organisation’s forthcoming EGM. Referring to Dr O’Sullivan, he said: “It’s vital that people in his position show this kind of leadership. Traditionally, medicine is quite hierarchical. We look to our seniors for guidance and hope to follow in the footsteps of our consultants. Especially when you are a student, when you meet a consultant that you click with or who you think is particularly good, you will remember them for years so if you have an ‘out’ consultant, that lets a student know that you can be ‘out’ at any level, all the way up,” said Dr Malone. “But even if you have a straight consultant who is open and treats everyone the same, that’s as important – and in some ways more important – that you know you have the support of your colleagues, regardless of your sexuality.”
“A lot of people say, ‘Ah, sure, no-one really says anything negative and I don’t really come across people shouting at me or showing outright hostility’ but I think there are still an awful lot of people who feel they can’t engage in a social way in the same way as their colleagues would. Junior doctors go out together, go out to dinner with their consultants and so on, and they have those social outlets,” said Dr Malone.
“I think, for many, if not the majority of gay doctors, you can’t talk about your social life in the same way as others would. You have your seniors coming in and talking about how they have just got married, for example, or had a child, and they are very open about it. I think a lot of gay doctors, certainly junior doctors, would feel very uncomfortable talking about it with their team for fear that they would be seen as inappropriate, which is strange. It’s as if it’s okay for straight doctors to talk about it but not gay doctors. So having a consultant who is open about it and doesn’t see it as an issue will definitely make people feel more comfortable.”
He concluded: “Having a consultant who is open about his sexuality is very positive and it models something very positive for both gay and straight doctors, in that the gay doctors know it’s okay to be ‘out’, and straight doctors know consultants are out, so it’s alright for them to talk about it and know that it won’t be embarrassing for anyone.”
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