When my wife and I were successful in conceiving our first babies within a week of each other, I knew we would face a lot of curiosity and questions by friends and medical professionals alike: our journey was unique, and not many married queer couples are crazy enough to try to do two pregnancies at the same time!
What I didn’t know was that at every new doctor appointment my wife or I would have, we would experience the assumption of heteronormativity.
It was nothing so obvious as medical professionals being explicitly homophobic or judgmental, and I feel very grateful for that. I have so many queer friends who have experienced overt homophobia in their medical appointments, or have experienced worsened care due to their sexual identity.
None of my doctors were homophobic, but it was very clear they all assumed I was straight until proven otherwise. At every appointment, they asked about the nature of our relationship, or just assumed that my wife was actually my sister.
Seemingly benign enough, except that these questions were not asked when the baby’s bio dad would attend appointments with me if my wife was not able to get off of work. In a circumstance where the person with me was a man, the medical professionals all assumed that he was my boyfriend or husband until they were explicitly told otherwise–the very opposite of when the person with me was another woman.
It takes a lot to offend me, so I didn’t mind dealing with the assumptions and correcting the nurses and doctors. However, it was an expectation I knew I’d have to counter at every new doctor and specialist appointment — and having a high-risk pregnancy meant I was seeing new medical professionals every week. And on the days where I was feeling miserable and exhausted, it became just one more thing that I either would need to just let slide (and risk needing to explain more later), or put in the energy to explain the situation.
The assumption of heteronormativity is homophobic. I will grant you that it is more subtle than blatant homophobia. However, assuming that everyone is straight until proven otherwise can be harmful, make both straight and queer people feel that there is something abnormal or wrong about not being straight, and promote discrimination.
Having to explain yourself or your situation over and over again can be annoying or exhausting at even the best of times–and usually when we’re at the doctor’s, we are not at our best of times. According to a 2020 study, queer folk who want to become parents often feel like they are the ones being the “information centers” for physicians, rather than being able to be educated by their physicians themselves.
Discrimination against queer individuals is unfortunately a reality for many (if not all) queer people in their everyday lives, so it stands to reason they will encounter this in a medical capacity too.
A nurse in Ann Arbor who has two Master’s degrees in stem cell biology and in nursing and asked to be identified as M. said,”The biggest faux pas that predominantly exists (in the medical field) is an assumption of gender and heterosexuality. I’ve been in very progressive facilities, and once they know how someone identifies, they make sure the patient feels seen–but getting to that point is still incredibly flawed.”
M. points out that the medical world is deeply influenced by the research world, which functions far more slowly.
“Societal issues go faster than research goes a lot of time,” says M., “so we don’t have much historical data on trans people who are undergoing hormone therapy and are also pregnant. The medical field basically just takes the research field and puts it into action — and if the research field doesn’t have anything, everyone is blundering around. It’s with good reason that the research field is slow, because you do want to see the long term results, but it has immediate impacts on people now, and that’s problematic. We do need to respond quicker to social change, and I think the medical industry IS noticing that now.”
Emily Otto, an Ann Arbor business and lifestyle mentor for rebel healers, priestesses, witches, and wild women who founded and runs the wildly successful Rebelle INC, lives with her husband and her 2 year old and 5 year old.
Otto has a different experience than I do in how her situation presents to other people, as she is married to a man, whereas my spouse is a woman. She said she has definitely experienced constant heteronormative assumptions from people in the medical field.
“I’m a cis het passing married white woman…so every question from medical professionals becomes about a female/male monogamous relationship,” Otto said.
In Otto’s circumstance, it’s easy for her to pass as heteronormative, and she says she can choose to pass that way and just leave it alone if she wants.
“But, it feels really nice and trusting and I feel very seen if I get to talk about all of who I am with my medical practitioner,” Otto said. “Gratefully, most adult humans I now know have good access to quality medical care, but that’s because of where we live. Where I grew up in Northern Michigan, anything other than heteronormative monogamous relationships, didn’t appear to exist.”
With heteronormativity still being so much of a, well, norm, I asked M. for any recommendations she might have for queer people to advocate for themselves within the medical system.
M. does feel that there are positive steps being taken within the medical system, from lectures and presentations, to displaying Pride flags or allyship pins, to focusing on patient-centered care and proactively asking about how the patient identifies.
When asked about ways for queer people to self-advocate, M. said frankly that she hates to put it on queer people to advocate for themselves, but until there are better protocols in place, it does often fall on queer people to be forthcoming about their pronouns, name, and identity — which M. points out is unfair to the patients, but unfortunately is still where the medical system is at.
“In the facility I’m working in, when there’s a handoff between nurses, we tell the incoming nurse about the patient’s pronouns and preferred name,” M. said. “We can put a patient’s preferred name and pronouns in their medical chart so that it comes up right away when you look at the patient. However, our cafeteria doesn’t do that — so when the patient’s food comes up and it has a receipt, it’s the legal name. As nurses, we often try to cross out the name and write the patient’s preferred name, but sometimes if we’re busy that doesn’t happen, and then the patient will get their food in a name that’s not their preferred one.”
M. feels this is a problem that could be easily solved.
“Why is this little thing such a hangup? Maybe they’re worried about mixing up patients’ plates, which can be dangerous with allergies, but you could put both the patient’s names on there. And if enough patients said, ‘Hey, this is upsetting us–can we have our preferred names on our receipts?’, this could probably be changed,” M. said.
Otto shares an anecdote about how she personally advocates for her children at medical appointments.
“My children are both boys and both uncircumcised, and it’s shocking how often this was suggested at the hospital my eldest was born at,” Otto said. “Three times. I had to say no three different times. It got very frustrating and I was getting very angry by the end of it. As a mom of two little boys, who can have any sex and gender expression that they choose, I talk about that openly with the doctors and with all educational professionals. My children know their body parts and their names and are not afraid to use them. This has absolutely come up at daycare, when my son used the word penis, and was encouraged to whisper it. We don’t do that in this family. Body parts are body parts. I didn’t think this was a queer thing, but I think it’s part of it. Openness. Acceptance.”
Ann Arbor is often a very queer-affirming town, but even in such a positive and accepting space, there is work to be done in the medical system to improve its experience for everybody.
If you want to unpack some of your own heteronormative assumptions, it’s easy to find online resources that provide suggestions or questions to consider!