By Adam Safdi, WCI Columnist

In March 2025, I saw the highly entertaining Drag: The Musical off Broadway in New York City. I hope I’m not spoiling anything by saying this: by the end of the show, one of the queer characters is revealed to have secretly amassed a fortune—and that wealth ends up resolving a major conflict of the show.

It got me thinking: Why am I accumulating wealth?

I have previously written about how my husband and I are living childless by choice. If we die with a large nest egg, there will be some very appreciative charities. So, why do I feel such a strong drive to accumulate? I believe it stems from a scarcity mindset shaped by my queer identity.

We often associate the scarcity mindset with immigrant experiences. But I believe a similar mindset can emerge from growing up queer.

Identifying as queer means existing as a minority. Even with growing acceptance, we still face risk—discrimination, job insecurity, or family rejection. Recent polling shows that more than 1 in 4 Gen Z adults identify as LGBTQ+, but the number remains about 10% across all adults. Regardless of the exact figure, queerness frequently comes with marginalization, and the fear of discrimination can fuel financial anxiety. As more adults might identify as LGBTQ+ in the future, the queer scarcity mindset could affect more people than ever before. That’s why it is crucial to examine the roots of the scarcity mindset and consider what we can do to challenge and dismantle it.

 

Growing Up Queer: The Origins of Scarcity

 

Childhood Perfectionism

I recently rediscovered a journal of mine from second grade. Every week, our teacher gave awards for “citizenship,” “academics,” or “sportsmanship,” and every week, I would write with either joy or disappointment on whether I won. That early competitiveness followed me through school.

Looking back, I realize my drive for academic excellence wasn’t just ambition—it was survival. I wanted my parents to be proud of me, even if they eventually discovered I was gay. If I couldn’t be loved unconditionally, maybe I could be loved for my academic success.

This isn’t just my story. Many queer children experience what is known as the Best Little Boy in the World syndrome—a pressure to overachieve to compensate for a concealed identity. A 2013 study found that this tendency to achieve can be a learned strategy, a way to deflect attention from stigma and assure value in a world that might not accept you.

 

Fear of Being Disowned or Disinherited

As a teenager, I stayed firmly in the closet—not because my parents were unkind, but because I feared losing everything: home, support, love. In an ironic twist of fate, my mother eventually found a pamphlet in my backpack titled How to Come Out to Your Parents, and the secret was out.

I was lucky. My parents did not kick me out of the home. But many LGBTQ+ youth are not so fortunate. A conservative estimate suggests that 320,000-400,000 LGBTQ+ youths face homelessness every year.

The fear of losing everything can stay with you, even when it doesn’t come true.

More information here:

Do I Need to Come Out of the Closet to My Patients?

 

Present-Day Scarcity

Many queer adults fear job loss or workplace discrimination. I have been fortunate to work in environments where I can be out. But not everyone is so lucky.

While this fear persists regardless of who’s in the Oval Office, the political climate can certainly worsen it. Recent headlines have highlighted concerns from LGBTQ+ federal workers under new executive orders rolling back diversity protections.

And it is not just queer physicians who may feel under threat—it is also those doing research or care for the queer or queer-adjacent community. I have a dear friend who has dedicated her life to public health and international aid, particularly in providing immunizations and HIV/AIDS care. She recently informed me that she will lose her job at the end of 2025 and will need to find new work. That breaks my heart—not only for her (a straight woman, married with two wonderful children) but for the global health community.

 

Future Scarcity: Aging Without Children

Many queer people do have children, and some hope to rely on them in old age. But others—like my husband and me—live childfree, by choice or circumstance. Without adult children to support us as we age, we might feel pressure to save more—for long-term care, private aides, or even private financial management if we become incapacitated.

I have previously written about my father’s long-term care insurance policy and how it convinced me to self-insure. But I still worry: if something happens to my husband AND me, who will manage our finances?

More information here:

The Many Different Kinds of Wealth

 

Breaking Free from the Scarcity Mindset

Scarcity is a powerful force—but it’s not an unchangeable one. Here are strategies that have helped me.

 

#1 Build Your Nest Egg Early

If you worry about your future, start saving now. As the saying goes, the best time to invest was 20 years ago; the second-best time is now.

Don’t try to time the market. Just automate your investing with every paycheck. Dr. Jim Dahle, WCI's founder, often recommends saving 20% of gross income for retirement. But if you can, save more. My husband and I aim for a 30%-40% savings rate. That gives us flexibility if our careers are cut short or if we want to retire early.

As Mr. Money Mustache famously pointed out, the higher your savings rate, the faster you can retire. Why? Because you save more and you train yourself to live on less, reducing the amount you’ll ultimately need to retire.

 

#2 Go to Therapy

My mother used to say, “Everyone needs a good shrink.” Therapy can help you:

  • Shift your perspective—financial, professional, or personal.
  • Identify the root causes of your scarcity mindset.
  • Challenge limiting beliefs.
  • Strengthen self-worth.
  • Reduce stress and anxiety.
  • Improve decision-making.
  • Foster a growth mindset.

Remote therapy is now easier than ever. You can choose from national platforms or work with local therapists offering online sessions. For example, many of my patients in Reno see licensed therapists based in Las Vegas, thanks to telehealth. My scarcity mindset shows up as ongoing perfectionism—especially in how I write clinical notes, which often take too long after clinic hours and cut into time with my family. My therapist is helping me find a balance between writing thorough, professional notes and letting go of the perfectionism that drives me to overdo them.

 

#3 Practice Radical Gratitude

Burnout can threaten our career longevity and our financial goals.

A year or two ago, I felt close to burnout. One night while taking call from home, I spoke with the ER and hung up. My husband said, “You were kind of mean on that call.” He was right—I was exhausted and irritable. I wasn’t living up to my self-proclaimed title of the “friendly neighborhood nephrologist.”

So, I changed my approach. I started every middle-of-the-night call with appreciation: “Thanks for working the night shift. How can I help you?” I thanked nurses, techs, transportation staff, everyone.

Did the work change? No. But my experience of the work changed. Gratitude transformed the work environment within my mind, and it kept burnout at bay.

 

#4 Give Money Away

Giving money away might seem counterintuitive when you are worried about not having enough. But generosity cultivates an abundance mindset.

Charitable giving also builds community. My husband and I donated to a local theater and then attended an event hosted by that theater, where we discovered a neighbor was also a donor—it strengthened our bond.

You don’t need to give millions. A named hospital room might cost $10,000, but it can build legacy, reputation, and pride.

Or give quietly. One day at a dialysis clinic, I noticed a technician eating only a granola bar for lunch. I didn’t know if it was dieting or desperation. The next day, I bought lunch for the whole clinic. Everyone was grateful. No one needed to know why I did it.

 

The Bottom Line

Life isn’t always a Broadway musical and you might not have a fairy godmother coming to rescue your finances, so it’s good to be your own hero. If a scarcity mindset has shaped how you see money, security, or success, you are not alone. Whether it stems from being queer, an immigrant, or simply a product of difficult circumstances, I hope these ideas help you move toward a more abundant, secure, and peaceful future. And if this resonates with you, feel free to leave a comment or share your story.

What do you think? Have you experienced or are you still experiencing a scarcity mindset? How have you dealt with it?