As early as I can remember, there was tension, which I did not understand, between my eldest sister and parents: a silence of the unspoken. My sister rarely visited, and I usually saw her only at holiday gatherings. I remember visiting her at college once and having a wonderful time. I could not understand why I did not see her more often. As I got older, I learned the secret: she was lesbian. My parents—Catholic Puerto Ricans with traditional beliefs—found it challenging to accept her fully.
We navigated these trepidatious waters for four decades until, finally, my sister’s daughter was born. Her daughter, Hope (name changed for her protection, but reflection of what she brought to our family), brought my family together. The tension diminished as my parents only saw love and hope. We had more gatherings, more laughter, more of everything.
Reflecting on this, I wished it happened sooner. There were so much unnecessary emotional, mental, and physical (of being slapped/hit) traumas due to conflicts of complex belief systems that encompass from generational trauma and expectations from family due to their cultural beliefs and expectations. Not only for my sister, my parents, but also mi familia. She tried to be the exemplary daughter—attaining her educational degrees, becoming professional, and trying to be “perfect,” even though my parents’ religion and culture were not in line with who she was as a person. My sister persevered. She has accomplished many goals and helped my family navigate the loss of both of my parents. She opened the door for me to live with my Black boyfriend for years until we finally decided to tie the knot because we wanted to not because society said we had to and for our nieces and nephews to be who they wanted to be and love who they wanted to love. Before my parents passed, they accepted her, me, their daughter, my nieces, and nephews for who they were and who they loved. There was no longer a secret or tension but love and hope.
These experiences helped me on many occasions in the clinical setting. One day, my LatinX patient came in for a follow up. She was in tears because her daughter had told her she was lesbian. Although she loved her daughter, who was so accomplished, this conflicted with her beliefs. She felt so distressed that she couldn’t speak to anyone about this in her family or community. She couldn’t sleep. I thought my family situation, given our similar backgrounds, would provide healing and reduce stigma for her. Since it was personal and not medical, I asked permission to discuss what happened with my family.
“Is it ok if I share with you something personal, something that happened to my family?” She accepted. We discussed what happened, the aspect of rigid culture and religious beliefs that were similar and how they caused separation and pain. In the end, the beautiful outcome of acceptance and love, when one could find what was most significant about that relationship. That she didn’t have to wait for four decades to re-connect. In the end, she came to her own conclusion that her faith asked her to love all. So, she should love her daughter for who she was. She felt the weight lifted. In sharing the experience and allowing for the moment of compassionate presence, my patient was able to have a new understanding and appreciation of her daughter and who she was. She was no longer in conflict or distressed with her cultural and spiritual beliefs.
When there’s so much discord in the world, from media to state legislation, it’s important we recognize the human experience as unique, meet individuals where they are at, educate, and advocate for those who are considered “different.” There is a high prevalence of distress, violence, and suicidality among individuals who identify as LGTBQIA+. I’m thankful for Mi Familia and our experience. To my nieces, nephews, children and LGTBQIA+ community, I stand with you, next to you, behind you, in front of you, whatever is needed on your journey to be who you want to be and love who you want to love. Thank you for making this world brighter by being entirely you!
I call on governmental bodies, professional organizations, and healthcare systems to do the same. As there are threats to LGTBQIA+ rights from local to national levels, specialties, healthcare organizations, professional societies, and governmental bodies must join forces to advocate for protection of LGTBQIA+ rights and ally with LGTBQIA+ organizations when those rights are in jeopardy.
Advocacy, Clinical Practice, Medical Ethics, SGIM, Social Justice, Wellness
Dr. Torres-Deas (firstname.lastname@example.org) is an assistant clinical professor in the department of medicine, director of the Community and Population Health, and co-chair of the Diversity, Equity, and Inclusion Committee in division of Internal Medicine at the Allen Hospital at Columbia University Vagelos College of Physicians and Surgeons.
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