The White/Straight/Cis world of Psychiatry

I went to a conference last weekend. It was a psychopharmacology conference in New York City. I hadn’t been to a conference overnight since I was seven weeks pregnant. I have done my continuing education credits online or as one day trainings. I was excited to get away, excited to stay in Manhattan kidless and wifeless, and excited to be going to a conference. Because I can totally geek out on psychopharmacology and neurobiology.

During the introductions I looked around. It was a beautiful snooty hotel and the grand ballroom was full. There were a lot of white people. A lot of middle age and older white people. I counted. There were four people of Color out of probably four hundred. There was one person wearing a hijab.

I also distinctly felt out of place as a Queer. I didn’t get the sense there were many of me hanging out there.

I have a love/hate relationship with where I trained. It was with several middle age white  straight men. They made ignorant statements about transgender individuals and they made statements like “she just has ‘Hispanic-itis'”. Yeah. That happened. More than once. However, they were and still are, considered leaders in our field. In fact at this very conference there were at least three papers presented by the team of physicians I trained with.

I learned so much from them but I also learned about sexism hardcore in the workplace. I learned about misogyny and racism and transphobia in healthcare. I learned that these were all things that these physicians would never say they are (sexist and racist and transphobic) yet their actions spoke louder. It was just all overlooked because they were brilliant.

Well apparently that’s universal in psychiatry. Because here I was, in a room full of leaders in our field. None of the presentations mentioned minorities. In the presentation on “Treating the Medically complex with Psychiatric Medications” not once was it broken down to say that maybe treating African Americans with Lithium would be bad as they have a higher risk of kidney disease. Nor was it mentioned about treating transgender individuals and let me tell you, they are some of the most medically complex patients I treat, due to the hormonal and surgical interventions they face. Also they have the highest suicide rates and substance abuse/use of all the minorities I treat.

But yeah, it seemed like every one in the room, the leaders in my field, were focused on treating white straight cisgender middle aged individuals.

I’m not knocking white straight cisgender individuals, I mean, some one has to treat them, and it sure as hell isn’t me.

But they tend to have access to better medical treatment, to more preventative measures, and lower suicide rates and lower substance abuse percentages. Which sort of keeps them off my radar as high risk.

Anyway. So I’m at this conference. Not learning anything about the populations I treat the most. Thinking about all my clients who are people in minorities who have been put down by other psychiatrists. Told they aren’t depressed that they are “transgender which just makes you depressed” or that they weren’t necessarily raped, because “you were bigger than the person who raped you,” that they aren’t starving because “don’t you have a mother who can buy you food?”

And it just hurt me. That my field is so disgustingly and ignorantly privileged. That we as a field put off the minorities and individuals who are most vulnerable to mental illness because of our own privilege and biases.

That conference sent a survey for feedback. I politely stated that I would likely not go back due to a lack of diversity among the presenters (who were all white) and among the topics presented.

I realized that all the trainings I’ve done in the last six years have been targeted toward the Queer population or another minority. Apparently that’s how I roll. And unfortunately the world of psychiatry in general doesn’t.

The world of psychiatry needs to expand it’s boundaries and invest in educating themselves and others about minorities. Because good lord if my work experiences and this weekend with the “leaders” in my field was any indication, we have a long, long way to go.

In the meantime I’m going to keep treating my Queer folk.

I’m grateful for all the therapists I work with who also treat minorities and excel at it. And I’m grateful for my clients. Many of whom have been marginalized by other mental health providers and medical professionals and who have continued to fight and persevere and continued to engage in treatment for their own mental health.

You are the bravest people I know.

For the record individuals can be transgender and depressed- as in separate issues. Sexual assault is sexual assault. And some people have parents who have abused them, so no they can’t call them for grocery money. Ignorance is not bliss. Ignorance is ignorance. Educate yourself.