By Adam Safdi, WCI ColumnistMany people might assume that LGBT folks come out of the closet only once in their life. (Doesn’t the whole world just know after the big reveal when we were 16? 18? 31? 61?) Nothing could be further from the truth. LGBT folks in medicine (and in general) are forced to come out over and over again. And as a doctor, the decision of whether to do so while doing our jobs could certainly affect our paychecks and our eventual wealth.
I can assure you, at least from my experience, that coming out does get easier with time, even if there is always some anxiety with the reveal. With each successful coming out, the LGBT person builds up their true family and support system. Sometimes, we are lucky enough that the new family is the same as our old “blood” family. Sometimes, we grow a chosen family—a group of friends who become our family who are unrelated to us by blood but who support us through thick and thin. With the growing family, we know that there is a pillar to lean on, so even if a new coming-out experience goes bad, we can move on knowing there is still love and acceptance in our lives elsewhere.
But what about in our lives as medical professionals? What are the situations where we might need to come out? And should we?
Do I Need to Come Out as a Doctor?
Here are some examples of when we might be forced to make a decision.
- Interviewing for residency or a new job? Family is not supposed to be asked about, but it often slips into the conversation.
- Working the day after Valentine’s Day (or substitute any other random holiday)? A patient might ask, “Did you and your wife do anything special?”
- Socializing with new neighbors, they might ask, “Do you know of any good churches in town?” There might be some LGBT-friendly churches out there, but the perception from some LGBT folks might be a feeling of unwelcomeness due to bad experiences with religion in the past.
Personally, I’m not shy about my gayness. I wear a rainbow caduceus lapel pin, I have a slightly more effeminate voice, and I flip my wrists and roll my eyes maybe a little too much. I wear a bow tie. I think most of my patients have figured out that I’m gay, and they either don’t care or they like me more for it. So, it surprises me still that some patients assume I’m straight and married to a woman.
How am I supposed to react when a patient assumes I’m straight? What do I say to the question, “Did you and your wife have a nice Valentine’s Day?”
For those readers not familiar with the medical profession, some doctors have short interactions with patients (such as emergency medicine physicians or some anesthesiologists), while other doctors might not have any face-to-face interactions with patients (such as some radiologists or pathologists). These providers likely don’t have to worry about coming out to patients because their meetings are so brief.
I am a nephrologist. My job involves continuing care of patients with kidney disease or kidney failure on dialysis. I know that part of a nephrologist's income is generated by seeing the same dialysis patients week after week, month after month, year after year. Seeing one hemodialysis patient for four visits in one month is 6.77 RVUs, which generates $338.50 per month (assuming a conversion factor of approximately $50 per RVU) or $4,062 per year.
If a patient finds out that I’m gay and doesn’t want me as their doctor anymore, that translates to less income for me. If a patient asks me a question about my personal life, should I stay quiet or pretend to be straight? How much is it worth to me to silence my truth?
Do I have an obligation to educate the patient on my sexuality? Am I supposed to say things like:
- “Well ma’am/sir, it’s more politically correct if you ask, ‘Did you and your spouse have a nice Valentine’s Day?’”
- “I try to use non-assuming language with you and my other patients. I would appreciate it if you did the same for me.”
Or am I supposed to be a radical justice warrior every time a patient assumes I’m straight?
- “What wife? I don’t have a wife.”
- “Oh, you mean my husband?”
How many of my patients would “fire me” for revealing my true self? How much money would I lose? LGBT folks in medicine are faced with this very fuzzy dilemma.
More information here:
A Q&A with QueerDoc’s Crystal Beal: How They’re Vital to the LGTBQ Patients Who Need Help
Being Gay as a Doctor
I wonder how many doctors stay in the closet because of this double bind. Or perhaps LGBT doctors choose to stay in the closet because medicine is a serious profession and being openly gay is treating it too frivolously?
Now, throw in the wrench if your family helps to pay for medical school. What if young student Dr. G knows he’s gay but doesn’t want to come out of the closet for fear that it will upset his mother? (My mother, may her soul rest in peace, thankfully loved my true self since she outed me when I turned 18. But that’s a story for another day.) How much pressure does student Dr. G feel to stay in the closet when he is in medical school? In residency? While still paying off loans? Even after the student loans are paid, because there might be residual guilt that mom helped pay for medical school? When Dr. G retires? Before mom dies?
As care providers, we ask patients about their sexual and gender identities as part of the necessary medical history, because it has health implications.
- Men who have sex with men and transgender women who have sex with men should receive the HPV vaccination and should be offered PrEP, DoxyPEP, and an HIV/STD screening.
- Men who have sex with men can be offered screening for anal high grade squamous intraepithelial lesions.
- Women who have sex with women should be informed they still need screening for gynecologic cancers.
- Transgender patients might need management of cross-gender hormone therapy, or their hormone therapy needs to be considered when other medications are being prescribed.
Yet despite our knowledge, many LGBT patients feel ashamed or scared to come out to their doctor for fear of being discriminated against, judged, or turned away. In the case of these patients, it might be especially helpful if their providers come out to them, because it allows an understanding that might evade other providers.
Let’s get back to the original question, though: do patients need to know when their physician is LGBT? I don’t have the answer. I think every LGBT provider out there needs to figure it out for themselves.
But what did I do last year when my patient asked, “Did you and your wife have a nice Valentine’s Day?” I stuttered for a moment and simply said, “Yes, we did, thank you.” Some days, I feel brave. Some days, I don’t feel particularly brave, or I simply want to avoid conflict. Am I proud of my response? No. But I just didn’t feel like making a big deal of it at the time.
What I love about the pursuit of financial independence is that I am taking the steps to not be bound by golden handcuffs or the dilemma of whether to come out to a patient. We are not financially independent, but we are more secure this year than last year. Going forward, if my patient asks if I took my wife out for Valentine’s Day, I’m going to come out and say:
“My husband and I had a lovely dinner at the fancy Italian place in town; it was so romantic. Thanks for asking. I hope you had a nice day as well.
“Now, how is your dialysis treatment going today?”
If you're part of the LGBTQ community, how does it affect you as a doctor? In what ways has being out of the closet affected your finances?
I am gay; I came out in 1976 – yes, I’m old! On my part, I think it was ignorance of some of the hurdles I might face; but frankly, I was lucky with a supportive family, friends and a friendly work environment. If asked about your “wife,” or other personal aspects, then they have opened the door and tell them. If your experience is relevant to a patient then tell them so they can open up.
If you closet yourself for income loss, that will take a toll mentally as if you are selling yourself out; people suffer more severe consequences for being gay including death and torture. With the shortage of physicians, I doubt there would be any or much income loss; on the flip side, knowing you are a caring physician might generate more patients. In the end, it’s about not just the money, but the quality of one’s life. Living rich and in the closet isn’t a price I would pay.
On a personal note, I was subjected to “aversion” therapy when I was 13 in the 1960’s; today it would be considered torture in some countries. I wish I had understanding physicians when I was 13.
Be proud of who you are in your personal and professional life. You will be a better man and physician.
Thanks Will for your comment. I’m so sorry for your experience when you were younger. I’m glad you were able to overcome and find acceptance with your family and in your career. I agree that it’s best to be honest and proud of yourself, and that’s what I’m trying to do moving forward.
I do not have any wisdom to add, but this was a very nice article. Thank you for sharing.
Thank you for reading! =)
Welcome Adam! And thank you for this great post.
Thanks Margaret! =)
As a physician and patient many times, I will say gender, race, sexual preference, what foods you like, etc., does not mean a damn thing!! Are you a good nephrologist? Because if I need one, that is simply all I care about. There will always be some crazy people out there, but if you’re good at what you do, you will have no worries!! Just be yourself.
Thanks Sportsdoc. I agree, I try to be the best nephrologist I can be. I hope my patients see my effort and care.
I would suggest first discussing with your husband. How does he feel, or doess he care about how you respond? I suggest starting with the longer term and closer relationship in choosing how to respond.
I was pleasantly surprised to see this article in my inbox today. Thank you for explaining to readers that coming out is an ongoing and lifelong process. It can be easy and simple, but it can also be awkward, hard, and/or scary, no matter what stage of development you are in. I think it’s important for LGBTQ people to be visible and share when the situation arises. There is still alot of anti-gay sentiment in all parts of our country. People should realize that they already know someone who is gay – be it their family member, friend, work colleague, or their doctor.
Thanks AHA for your comment. Representation matters. I’m grateful to the WCI team for allowing me to share my voice.
Would love to see more articles like this, addressing the experiences of women, POC, LGBTQ folks regarding the independent financially related challenges. Mainly to help educate the not-small contingency of white males on here who subject others to damaging false beliefs.
I am very happy and surprised WCI published this and look forward to more.
Thanks KS for your comment. I’m grateful to the WCI team for letting me share my voice on the blog. I hope I don’t let you down.
“Mainly to help educate the not-small contingency of white males on here who subject others to damaging false beliefs.”
If you want it, create your own blog. Stop ruining financially focused blogs with identity politics. We don’t need to be educated. Another kindness is everything person who hates white men. Go elsewhere.
I’ve been in private practice for 22 years and have yet to feel the need to discuss my sexual preferences with a patient or wear a pin suggesting who I prefer to have sex with. If someone asks me if I had a good Christmas and I’m not Christian I simply say yes, it’s a polite non-true answer that is considered acceptable given the question itself was merely a politeness. I don’t go into a discourse about how I am Jewish.
As a Jew, I will sometimes say, “Actually, I had a nice Hannukah” or something along those lines. No big deal. But sometimes I don’t mind reminding people that not everybody celebrates what they celebrate.
Thank Rod for your comment. I think everyone has to find their own comfort level of how much of one’s self do they disclose to patients. Obviously my interaction with my patient assuming I have a wife irked me enough to write a whole article on it. And it led me to want to be open with patients IF they ask me about it. With religious holidays, I agree with you, sometimes it’s best to just say “yes, it was a nice day” and move on.
Agree with the Jewish analogy to some degree. When a patient would ask how my Christmas was, rather than tell them that I pulled a 14-hour shift in the hospital so that my gentile partners could be off and that it was lousy I would just say, “Wonderful!”
Yeah I thought the same thing about the article. I really don’t want to know who my doctor has relations with. If he’s sexually active or not. I don’t care. It’s 2024. NO ONE CARES. just do a good job. Someone asks did you have a nice Valentine’s Day? Sure. Christmas? I’m Jewish. Sure. Kwanzaa? Sure. There’s no reason for a patient to ask a doctor about his sexuality and no reason for a doctor to discuss his sexuality with a patient. It’s inappropriate to say the least.
It’s interesting that blogs coded as “conservative” must include the alphabet mafia but you never see blogs coded as “progressive” include social conservatives. The pressure only goes one way.
I, for one, am sick and tired of the constant politicizing of every single facet of life, including the doctor’s office. It’s like the forms that ask my gender identity and I must fill it in or I cannot get to the next webpage. Another issue is that people are led to believe they must announce themselves to everyone. No one cares. I expect most patients know you are gay without you having to tell them. Truth is, most people don’t care. They just want a knowledgeable, competent doctor with good bedside manner.
The reality is most people are straight so that is the default assumption. Same with most people being Christian. It’s not an erasure or some offense when someone uses the default assumption. I say Merry Christmas to people despite not being Christian and when asked how my Easter was, I say good. No big deal.
Gay people don’t want to be equal, they want to be special. Also way to make a slight against church-going people.
Sad to see the direction WCI is going.
That’s an awfully generalizing statement to make. Whenever referring to an entire group of people at once maybe take pause next time.
As for the church comment, I (Jewish) had the same experience verbatim when moving to the south. “Have you found your new church home yet”? Is this the part where I generalize against all southerners? 😉
Thanks for the article Doc and to WCI for providing perspective from all angles.
I imagine Jim is getting enormous pressure to include “diverse” voices who want to focus on sexuality. It’s very tiresome and difficult to see every website fall to the rainbow mafia who insist on making everything about LGBTQIA+++.
The South is Christian. That’s the reality. Someone asking about finding your church is no more offensive than moving to Israel and being asked about your synagogue.
Alabama is 86% Christian. Nevada is 40% Christian. Israel is only 74% Jewish. Interesting stuff.
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[A fourth name for the same sock puppeting troll.]
Gay and lesbian people don’t want to be special, we just want to be treated fairly and not demeaned because of who we are. My identity is much more than “who I have sex with” as one commentator here said.
I came out in anesthesia school 30 years ago. I agree it is a continual challenge to be out in the workplace especially as an older female who is assumed to be a conservative heterosexual person.
When I have reason to I do come out. My LGBTQIA appreciate it when it is germane to the conversation. It does increase their comfort level.
And if people are uncomfortable after asking a leading question they will have learned not to ask questions they don’t want answered. I am blessed to work in an affirmative environment.
I work in a smallish town in the Midwest close to a major city. I’m also in a specialty with ongoing patient relationships, and I also continually encounter this question about when/where/how to come out to patients when asked about a spouse or family. The only thing I really care about in my patient interactions is their well-being, so when asked a question like this, I always have to make a snap judgment about how comfortable the patient would be if I told the truth vs. the utility of vagueness (or outright lying) if I feel that the truth would make them uncomfortable. I grew up in a small Midwestern town, so I feel I’m able to trust my instincts in deciding how any particular person would respond. I’m always aware of how vulnerable my patients are and how much power I have in their lives, so it never bothers me to stay closeted with them in the way it would bother me in any other context in my life.
Thanks Luke for your comment. Indeed patients are vulnerable and we ask them to reveal a lot of themselves to us as their doctors. I’m glad you found your balance and can trust your instincts. I was struggling with my snap judgement decision, which led me to writing this article.
As a gay doc myself, this is exactly how I approach this as well. I gauge whether my coming out to a patient would in any way help them. I can anecdotally say this has in some cases enhanced a patient’s trust in me, and I know LGBT patients feel more comfortable knowing. However if there are no “green light” vibes then I don’t come out. At the end of the day it’s all about the patient and whatever makes them most comfortable, whether that means coming out or staying in the closet. It’s like if a patient ever asks me, like at a surgical consultation before their surgery, “are you Christian” (I’m not), I’ll just say “I’m as Christian as you need me to be” and it’s always received well.
Why should being gay too make a patient feel more comfortable? If someone straight felt more comfortable with their doctor being straight too, would you feel the same?
Alas, not all physicians are compassionate and understanding. A good connection with one’s physician is key to communication. Feeling respected is also part of that as one shares their health concerns. The right doctor makes a patient feel comfortable and respected with sharing their health concerns.
When it comes to building a practice, my diverse group of friends and family (all races, sexual orientations, ages and so forth) all agree that they seek out doctors who show this and avoid those who don’t.
It’s just the way lots of people work. I get asked my religion all the time by patients. It matters to some of them. I’m sure in the same way a doc’s sexual orientation matters t some of them. You might wish that nobody cared, but it’s just not true. Some do care. And sometimes it does matter to their health. For example:
https://psdconnect.org/journal/the-critical-need-for-more-black-physicians
One widely reported study found that Black men who visited Black doctors were more likely to follow preventive health guidelines than when they saw white doctors.
What if I replace words here?
One widely reported study found that Christian men who visited Christian doctors were more likely to follow preventive health guidelines than when they saw Jewish doctors.
One widely reported study found that White men who visited White doctors were more likely to follow preventive health guidelines than when they saw black doctors.
That’s racism! Everyone straight to jail now!
Also- WCI, white do you capitalize black and use a lower-case “w” for White?
I bet if that was studied it would be true too, both for Christians and Whites as well as christians and whites. Identity matters to lots of people, whether we think it should or not.
The B in Black is from a quote. I confess though that I have no idea whether Black and White should be capitalized or lower case. I’d guess lower case, but I’m no English major.
Lea, one way, among many others, is that patients with same-sex partners are often very nervous about whether their doctor is going to judge or respect their relationship. They’re putting their lives in our hands, and they’re worried that if I have personal beliefs that there is something wrong with their relationship, I won’t treat them the same. This puts them through the anxiety of having to decide whether to even come out to their doctors at all, or whether they should disguise the real nature of their relationship. In my rural area, same-sex partners will often just be introduced as “friends,” meaning they don’t get to be treated the way a spouse should be treated in serious medical conversations. I know it’s a huge relief to them if they know I’m gay and that I’ll respect and understand their partnership/marriage.
I really love the way the author of For Goodness Sex frames this conversation. He uses sweetheart. Now, instead of asking about a boyfriend/girlfriend/husband/wife, I ask about sweethearts. “Yes, my sweetheart and I had a great Valentine’s Day!” That might feel a little more authentic but still not making you feel like you have to correct someone?
You don’t owe anyone education on how to be inclusive or sensitive to others, so I hope you feel safe and supported with whatever language you choose.
Thanks TM, that is a wonderful suggestion. I might be using “sweetheart” in the future.
Love this idea, TM!
Feels authentic while avoiding unintentionally making the patient uncomfortable for a pleasantry.
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I don’t take seriously casual questions that make assumptions about any particular aspect of me and my life. Usually these are not serious inquiries deserving detailed answers. I respond casually, akin to when someone says “Hi, how are you?”. As a psychiatrist when such questions arise in a more serious way, I may find they are deserving of inquiry.
Thanks Antares. You make an interesting point. I agree with you that the patient’s question to me was not meant to be a serious probe. But it was so jarring and in contrast to my life (asking about a wife, rather than a husband) that I had a reaction and some inner turmoil, and it led to this article. If we answered the “hi, how are you” question honestly and truthfully to each person and interaction, we would probably be met with “whoa, TMI” quite a bit. I agree it’s important to hold back some of ourselves when we can so that we don’t overload our conversational partners.
I can only imagine how jarring it was to be asked that, and to deal with patients’ assumptions in general. Just in case I was unclear, I wasn’t suggesting that there was anything off or inappropriate about your reactions. You are entitled to them and come by them honestly. I was just reflecting on my own tendency to be rather unreactive to questions and assumptions in general. This works for me, and happens to be something of my “default setting”, so to speak. I recognize that I don’t walk in your shoes, and for a variety of social and personal reasons, I am not called upon to respond to some of the things that you are. It is both a blessing and a privilege to navigate the social world with relative peace about how I’m perceived. Thank you for your piece. I’m glad you posted it here.
Thank you for the thoughtful blog post. In the course of my medical career (and life, more generally), I have seen much greater acceptance for the LGBT community, and doctors in particular. Nonetheless, I am sorry that you struggle with this to some degree in your professional life.
As the father of a somewhat still not completely out young adult gay son, I wondered for the first time how (if at all) this affects his career. He lives in a big city, is in a sales job, is very good looking (adopted 😉 ) with a big, likable personality and lots of friends. It never before occurred to me that this could be holding him back. Shame on me.
I also appreciate that the WCI is supporting your work. To those who are “surprised”, I think that the WCI has made it very clear that he DOES support a healthy diversity of opinions and viewpoints. Kudos to all.
Thank you VagabondMD for your comment. Thanks for reading my article and thinking about your son. There is no shame in not knowing what you didn’t know. I hope my article can serve as a springboard for a nice conversation and deeper connection with your family.
I have thought about this all day. I would no more hide being gay than I would hide being Jewish. If someone doesn’t like me for it, so be it. I’ve seen many stereotypes and prejudices disappear as folks saw me for who I am and at the risk of reverse stereotypes, I live in the rural south.
At the risk of thread drift and perhaps having this post deleted, I’m getting up in years, though not so old that I knew General Washington (and had to get my great niece to stop telling people I knew him). But as a history nut, I often look to him for insight. If he did not care that General von Steuben was homosexual (to use a word not invented yet), those who do care about my sexual orientation – well that’s their problem.
In the end, a person’s honor and dignity should not be for sale. If patients are lost, well, that is their loss.
Thank you Will for your comment. I will take it to heart.
Adam,
Thanks for the article regarding coming out as a physician . I’ve been a physician for 38 years and i applaud you for writing the article and for WCI sharing it. I am a practicing orthopedic surgeon and have take care of many members of the LGBTQ community during my career. I treat all people well and at times it becomes evident they are gay. It doesn’t bother me one bit. At times i will ask the question about holidays , parties or events and i make no assumptions. I ask the questions in a generic manner not to assume anything . Life is short and you deserve to be happy! Live life like there is no tomorrow . Keep the glass “half full”
Thank you Gregory for your comment. Thank you for being non-assuming with your patients, you have probably helped a queer person feel more comfortable in your presence. You keep up the good work too.
White coat investor jumped the shark with this post.
How so Harris?
Thanks for the feedback.
If you’re going to use that phrase you have to at least link to the Fonz doing it:
https://www.youtube.com/watch?v=ahxG3iPeVcU
This is a classic piece of cinematic history. Love it.
It’s funny how the Fonz jumped the shark, but in the nearly 50 years since that episode aired, Henry Winkler has gotten more and more beloved.
Thank you for sharing your perspective. My policy has always been to keep things such as politics, religion, and sexuality (of the clinician but not the patient) out of the exam room as much as possible. I try to keep the focus on the medicine. However, it is reasonable to be yourself in the presence of your patients, whatever that means to you.
Thank you Ziggy for your comment and for reading.
As nonreligious in the South I experienced the church home comment EuroT writes about. However the time I most wanted to out myself was when a patient said “You are so helpful and nice. I know you must be a Christian.” Instead I saved my ironic thoughts about this for my gathering of freethinkers. I resisted correcting the sweet if oblivious patient- not the time or place to educate. Given the cruelty and hypocrisy of some people including a portion of those who pride themselves on being a Christian (especially in areas like the South where politeness and kindness are often denied to outsiders like LGBTQ and immigrants) it’s maddening that so many groups believe only members of their own group can be decent human beings.
Ignoring your own cruelty and hypocrisy and stereotyping. The South = bad, Christian = mean. Look in the mirror. You don’t accept diversity if it diverges from your dogmatic thinking yourself. You are no better.
Thank you Jenn for your comment. Assumptions made by others about us can hurt. Thank you for continuing to be kind and helpful to your patients; we all need more kindness in the world.
Lea, seeing the thread of your comments you clearly have a chip on your shoulder. Read the comment again. Poster clearly qualified their post saying “some” and “portion” and clearly exercised judgement in not correcting a “sweet” patient. And aren’t you being willfully blind that indeed hypocrisy exists? Nowhere did I interpret the post as generalizing the south as bad and Christians as mean. That’s your spin.
Yes, I do have a chip on my shoulder regarding identity politics. It is divisive and corrosive and is invading every single area of life, including a blog focused on finances. Specifically, saving and investing. There is no different way to invest for any identity group. Black, white, Jewish, atheist, gay – all need to save and invest to obtain financial security.
If some if a fine qualification, then some gay people need to stop talking about who they have sex with. It is irrelevant. Also, there is no thing as a trans woman. Woman = adult human female. Having a nephrologist ignore basic biology is offensive and wrong.
Thanks for the unique perspective
Thanks for reading!
Loved this article!! So glad I found the link. For the record you have always been a terrific doctor and person. Now I can add that you are also a great writer. With a big smile and warm regards from Chicago ❤️
Thank you Dr. Wayne. I’m so lucky to have had kind and wonderful mentors and role models such as you.
How does this article comport to the stated vision or mission of WCI?
Hi Peter, I’m not really sure what you mean.
Part of our stated mission is “To strengthen and support The White Coat Investor community on the path to financial success by providing engaging, useful, and accurate content …”
Going by most of the positive comments you see above you, this column by Adam clearly has strengthened and supported the WCI community. Is the column engaging, useful, and accurate? Well, the traffic for this column was solid, and getting nearly 50 comments within the first two days of this being published leads me to believe that this engaged our readers pretty darn well. One commenter wrote, “Thank you for explaining to readers that coming out is an ongoing and lifelong process.” So, yes, it was also useful.
So, does this article follow our stated mission? I’d say 100% yes.
Your forgot the part about financial success. This post is all about identity politics in the doctor-patient relationship. Any “financial success” angle is non-existent.
The White Coat Investor preaches (if I may use that word) financial education and security so that doctors don’t feel bound by golden handcuffs or a toxic workplace. My concluding argument in the article is that while I am not financially independent, my financial education and security allows me not to worry about how patients perceive me or the threat of being fired by a patient and thus earning less money.
That is a very tenuous link to financial security so as to be non-existent.
Patients, such as myself, care about doctor competency. All the identity politics in the examination room are what turn off people from doctors. Having a patient not have you be their doctor is not being fired. I wonder what you would do if upon telling a patient that you are gay unprompted, he responded with a comment that he is opposed to gay marriage. Would you continue to treat this patient? Would you treat him differently?
Well, I’m the content director here at WCI, and my decision to run this column was because it does have plenty of relevance for both financial literacy and mental wellness. This is not just a blog about finances. This is also a blog about wellness. These kinds of posts are important, because as we all know, doctors come from all walks of life and have all kinds of relevant experiences that they bring to their work.
Lea, you’ve now made about eight comments on this thread today alone. We understand your opinion. All of us now know you don’t agree with the decision to run this column. That’s OK. As Jim always says, take what you find useful and leave the rest. Hopefully, there are plenty of other posts on this site that you find relevant.
Josh, you ruined WCI. This blog used to be backdoor Roth and estate planning. Now it’s just gay this and gay that.
The day before we ran this piece, you know what I published on Sunday, May 5? It was the 10 Commandments of WCI. That piece talks about saving, insurance, and taxes. Oh, and it also talks about the Backdoor Roth IRA AND about estate planning. LITERALLY the day before this piece ran, we wrote about the Backdoor Roth and estate planning. You know, the thing you said we don’t discuss anymore. The day before.
For the record, we’ve run three pieces solely focused on estate planning thus far in 2024 with another to come later this month. We’ve written specifically about the Backdoor Roth IRA three times in 2024 and once in December 2023. If you love reading about estate planning and Backdoor Roths, WCI still has got you covered.
[Ad hominem attack deleted and IP address added to the list of commenters whose comments will be reviewed prior to publication in the future.
I have a very low tolerance for comments directly attacking my staff. If you can’t be polite, you don’t get the right to comment here. It’s not a public sidewalk. I’m sure you’ll go elsewhere and complain about censorship here but guess who doesn’t care? I don’t. Sock puppeting and ad hominem attacks are both forms of internet trolling and in your case it’s getting old.]
Using different names/emails but the same IP address is the definition of sock-puppeting. Pick a name and stick with it and it’ll help build a better community.
[Yet another comment from our sock puppeting troll pretending to be from a different person.]
In case people are keeping score, I love the diverse content on WCI over the past few years. Jim’s core Boglehead message is pretty darn simple and can be absorbed over a few posts or a book or two. New types of content keeps things more interesting. Furthermore, the vitriol here highlights the need for more diverse representation, so again kudos to Jim and Josh (and Adam, et al) for publishing that.
As an aside, while I remember this from the late 1990s and early 2000s, blatant homophobia today is just really shocking to me. Once I get past the revulsion, I’m almost amused in the same way I am when I see a cassette player or a Mazda Miata – like “wow, they still make you?”
The word “homophobia” gets applied way too broadly. It’s not homophobic to say “I disagree with your lifestyle choice. I think it’s sinful and unnatural.” Just like it isn’t antisemitic to say “The Jews are wrong about God”, it isn’t homophobic to say “God doesn’t want men to sleep with men.” As wikipedia says, homophobia “has been defined as contempt, prejudice, aversion, hatred or antipathy.” Tolerance goes both ways and a free society like ours requires a lot of it to function. Learning to disagree without being disagreeable is a skill that is too lacking in our society.
OK I’ll bite on your comment, but only a little.
1) This is your website and you do a great service, lots of it for free. AND you personally platform many diverse viewpoints and allow conversations around those viewpoints. Awesome; I love it all! I was not using “homophobia” to describe you or WCI or religion in general or even the vast majority of negative comments on this thread.
2) I was using “homophobia” to describe exactly one comment, now deleted, about a physician musing that they should treat homosexuality as a disease (I believe the poster used obesity as an example). A disease you say? You mean like when homosexual men were sentenced to castration to cure their disease? Tough for me to see that line of thinking as anything more than 1950s style homophobia.
3) Touchy subject here in terms of religion (“hate the sin, love the sinner”), but personally I think that if somebody called my marriage “sinful and unnatural”, the only possible assumption I could make is that that person was treating me with “contempt, prejudice, aversion, hatred or antipathy”.
Thanks for the feedback.
365 articles a year. Every one of them will not be relevant to every reader. As you follow the blog, you’ll usually be able to figure out within a paragraph or two whether an article is relevant to you.
For example, an article about solo 401(k)s. You remember, “I’m an employee and am not eligible for a solo 401(k), so I don’t need to read the rest of this article.”
An article about tithing: “I’m not Christian. I don’t pay tithing, so I’m not going to read the rest of this article.”
An article about Halal investing: “I’m not Muslim and I think this is all dumb. I guess I’ll come back tomorrow and see what gets published.”
An article about short term rentals: “Oh, I’ve been thinking about doing this. I’ll read this and see what I can learn.”
An article where a gay doc talks about an issue that he sees as very relevant to his finances and wellness: “I’m not gay and I think gay people are sinners and that this article is probably part of their agenda to teach my kids to be tolerant of sin. I won’t read it and I’ll just come back tomorrow to learn some new tax reduction techniques.”
While we appreciate the feedback when you see something you don’t like or find offensive, it’s important to remember that every article is not for every reader. Take what you find useful and leave the rest.
Dr. Safdi, thank you so much for your article. My wife is a black pediatrician with a “Jewish” last name since we got married and some folks are surprised that Mrs. Dr. Singer isn’t what they expected. Nonetheless, she’s lost very few patients because of bigotry or racism (or antisemitism). The overwhelming majority of her patients truly appreciated her care, skill, knowledge and attention. Most of the responses to your article have already voiced what I would have said. It’s too bad that your financial well being might be at risk because of intolerance. Given the workforce problems in medicine, If I needed a specialist, I’d be thrilled that you were attending my care and contemplating your home life wouldn’t cross my mind. Peace. JS
Half of the comments have been deleted. Funny how you need censorship to continue this narrative.
I follow the same policies for deleting comments on this post that I do elsewhere on the blog. Half is a bit of an exaggeration though. I think I’ve deleted 4 or 5 so far, most of which were from an IP address that has been a problem multiple times in the past on many different posts. Some people just don’t know how to disagree politely on the internet.
All of the 15+ deleted comments were polite- they just had legitimate feedback you didn’t want to hear and the only way to control your narrative is with censorship.
At the risk of angering the locals, Adam’s article fits in just fine with WCI’s mission of financial security and physician wellness. I’m a straight, white, conservative Christian in the Southeast (lordy!), and this blog is no more mine than Adam’s or anyone else’s. I’ve alluded to my faith in my articles because it’s important to me and guides how I live my life. I don’t have to agree with all of Adam’s values to understand that his are also important to his wellness and how he lives his life. There are some readers who identify with Adam’s experiences and some more so with mine, and it’s great that Jim and Josh let us both write from different points of view. Adam, hey man, welcome to WCI!
Daniel, I second this, not the part about being a southern Christian (I am neither), but that this blog fits well into the WCI mission. As a group, we are all the better for Adam writing for WCI and for Jim and Josh for platforming Adam for the WCI community. Welcome, Adam, and kudos to all three of you!
Adam,
Thank for this thoughtful inaugural post, and welcome to the WCI columnist family.
While I am a lucky winner of the 21st century privilege lottery as a tall, white, straight, wealthy, land owning, centrist-Independent, Christian, male doctor and thus am largely immune from the travails of personal or professional bigotry, I nonetheless found your story engaging and relatable. Despite not having a paralleled experience to yours, I can yet relate to the notion of leaving a patient interaction feeling hurt, unseen, or otherwise diminished.
The skill to find connectivity to another’s humanity that is beyond my own lived experience is one that did not come easily to me and thus I have empathy for those whose fragility is on display in some of the comments above. My own brittle disposition still too gets the best of me in my most nervous and scared moments. I likewise find myself occasionally unable to take what serves me and leave the rest, so I am not surprised to see that underdeveloped skill manifest here amongst my peers who find a perverse solace in going out of their way to be pointedly and uselessly cruel.
I find myself believing that you and Josh have in fact ruined WCI for them. At my most hurt and unhealed, 5-10 posts out of 365 in a year that did not align with my rigid worldview would have been enough to derail the 355 that do. I will miss them in our ranks but am assuaged that posts such as these add seventy times seven to our fold. You and Josh both have my thanks for broadening our beloved community with articles such as these.
It is notable to me that Jim’s posts about tithing as a Latter-Day Saint or Christian Healthcare Ministries are free from accusations of identify politics and conservative pandering (as they should be, such assertions are ludicrous). To levy such claims here is a hypocrisy that, ironically, the Bible speaks about in plain terms alongside its charge that what we should do unto others as we wish for others to do unto us, and its descriptions that love is patient, kind, that is does not behave itself unseemingly, that it is not easily provoked, and that it render nothing evil. In short, I am impressed that you can so consistently turn the other check as these detractors are yet unable to do. A skill that is, unfortunately, mandatory for those that generously offer up their vulnerable truths in the world of modern digital forums such as these.
Finally, I hope that you, like me, can enjoy a moment of levity when commentors offer up their omniscience so generously yet with such limitations. I can’t help but chuckle when someone above spoke so knowingly that “gay people don’t want to be equal, they want to be special”. After letting the smallness and overt ugliness of that digest, I enjoy a chaser of mirth at what else they must know about other unknowable categories of our world. If only their omniscience spread to whether small value or small growth would perform better in the next 20 years! That would be so useful to know and share, but sadly they choose to limit their vast and unassailable knowing to what a group of people to which they don’t belong universally want. I guess we will just have to stick with a diversified portfolio and leave all the winning stocks to others more fortunately omniscient than we.
Thank you again for you offering. I receive it in gratitude and am better for it. I look forward to your future contributions and hope to be the beneficiary of your future insights.
“While I am a lucky winner of the 21st century privilege lottery as a tall, white, straight, wealthy, land owning, centrist-Independent, Christian, male doctor and thus am largely immune from the travails of personal or professional bigotry“
What planet are you on? White men are actively discriminated against in college and med school admissions.
Actually, the data is pretty clear that currently the most discriminated against group in higher education is Asians. I’m not sure it’s ever been white folks.
Average MCAT scores for matriculants to U.S. medical schools by race/ethnicity based on data from the 2023-2024 application cycle:
Asian: 514.3
White: 512.4
Hispanic or Latino: 506.4
Black or African American: 505.7
American Indian or Alaska Native: 502.2
My recollection is GPAs by race look similar.
Thank you Tyler for your comment and for reading the article.