Over the past 8 months I’ve gradually taken over responsibility for our Ground & Control segment here at Spaceflight Industries, making sure we’re on-track to support our upcoming launch. Apparently I worked myself into a new role. Today I was promoted to Software Development Manager over Ground & Control.
It’s been insanely exciting watching our next-generation ground systems come online. The team is doing some highly innovative and industry-leading work on automated satellite commanding, whole-constellation planning, ultra-low-latency telemetry propagation, distributed system monitoring & alerting, and more. We learned a ton from our first iteration that is operating Pathfinder-1 and we have significantly improved on it now that we better understand the problem space1.
I’m stoked to be a part of this team as we prepare for Global-1 and beyond!
1 Ba dum bum.
I have a hard time finding common ground with you, and common ground is essential in establishing a fruitful conversation about anything.
Can we at least agree that Nazis are bad?
The Nazis that came bearing swastikas.
The Nazis with their goal of an Aryan-only (ie: white-only) world.
The Nazis that hated and killed Jews, gays, the disabled, and anyone else who wasn’t like them.
The Nazis that killed over 11 million people in World War II.
The Nazis that my grandfather fought on the beaches of Normandy on D-Day.
Can we at least agree that Nazis are bad?
Because President Trump can’t:
“I’m not putting anybody on a moral plane. What I’m saying is this — you had a group on one side, and you had a group on the other, and they came at each other with clubs and it was vicious and it was horrible and it was a horrible thing to watch,” Trump said. “But there is another side. There was a group on this side, you can call them the left, you’ve just called them the left, that came, violently attacking the other group. So you can say what you want, but that’s the way it is.”
Trump is claiming a moral equivalency between people who showed up with guns and swastikas chanting “Jews will not replace us” and the protesters who showed up to oppose them.
So I ask you again: can we at least agree that Nazis are bad?
Last year my very good friend Dr. Monica Tschirhart was giving a lecture to some medical students in Oklahoma about LGBTQ+ health. She reached out and asked if I had anything to share. After giving it some thought, this was the feedback I gave her based on my own personal experience and stories from friends.
- LGBTQ+ people, particularly those in conservative areas, can be afraid of coming out, even to their healthcare provider. The most important thing you can do for them is make them feel comfortable talking about all aspects of their health, including their sex life. This may mean putting aside your personal beliefs or judgments — doing so will make you a better physician.
- Don’t assume the person you are interacting with is straight. Doing so by asking about their girlfriend/wife (if they present as male) or boyfriend/husband (if they present as female) already forces them to correct you, making the already stressful “coming out to the doctor” worse.
- Don’t assume that just because they are married they are straight, regardless if it’s from the intake form or a wedding band.
- If discussing their sexual practices, don’t use euphemisms – be direct. Like straight folks, “sex” means many things, oral sex, anal sex, etc. If they say they are having “safe sex” it could be they use condoms when having anal sex but are having unprotected oral sex. Also don’t cringe. If you can’t say “do you practice safe anal sex” without cringing, practice in the mirror until you do.
- Never, ever ask “are you the girl” or “are you the boy” regarding sex. If you’re comfortable with the terms, ask “do you bottom” or “do you top”. If you aren’t comfortable with those terms ask “are you on the receiving end or giving end of anal sex”. Again, practice in the mirror until you can say it without cringing.
- If asking about their sexual practices, don’t assume they are monogamous if they have a partner. LGBTQ+ folks are often non-monogamous and just because they have a partner/boyfriend/girlfriend/husband/wife doesn’t mean they’re only having sex with that person. And yes, most of the time their significant other is fully aware and OK with it.
- Don’t inadvertently out your patient. Unless they tell you differently, you should treat how they identify as confidential. LGBTQ+ folks can be fired for being gay, ostracized from their communities of faith, and worse. It’s sad, but there are good reasons why some people are still in the closet — particularly in conservative areas of the country. The moment you out them you’ve violated their trust and potentially their safety.
Daniel added these two very important points to the conversation:
- Treat your patients as individuals, not stereotypes. If you want to talk about sexual health, start by asking them about their sexual practices (or lack thereof) instead of assuming you know what “people like them” do based on their age, race, sexual orientation, gender identity, or whatever.
- Give your patients an opportunity to tell you what name and pronoun they want to be addressed by — and always use it, both in conversation with them and in conversation or notes about them.
This doesn’t even touch on PrEP, knowing the risk factors of STI transmission of different types of sex, etc which are all important but I think is somewhat secondary if the LGBTQ+ person won’t open up to begin with.
Dr. Tschirhart said that the students appreciated some of my comments and that it made it more real to them than some general statistics. And that’s just it — we’re people, not statistics or stereotypes.
The above is decidedly cis-gay-male centric based on my own experience. LGBTQ+ folks, what other things would you like doctors to know to provide great care for our community?
PS: The American Medical Association’s LGBTQ physicians resources page is a great springboard for doctors too.
Recently I was discussing with a friend how much better medical care I received as a gay man when I started going to a gay primary care physician. It occurred to me that it might not be obvious to other LGBTQ+ individuals how important it is to have a medical provider you can fully trust and open up to so I thought I’d share my experience.
When I first came out in 2000, I was suffering from depression attempting to reconcile my fundamentalist Southern Baptist faith with being gay. During a visit to my doctor I brought up my depression and ultimately came out to him in tears there in the exam room. I got the deer in the headlights look. Instead of compassion, reassurance, or suggestion to talk with a counselor I got a prescription for anti-depressants and told I should be tested for HIV immediately. I changed doctors after that.
I came out to my next doctor in the first meeting wanting to make sure I had found someone who wouldn’t flinch. This doctor was straight but treated me being gay as a total non-issue. As part of the physical he asked about my mental health, any depression, if I was seeing anyone, was I having sex, etc. We discussed safe sex practices and had a discussion about regular STI testing based on my sex practices and risk profile. After I started dating Benjamin, he asked about Benjamin at every visit. He treated me like a human being — that made all the difference.
Fast forward to when I moved to Seattle in 2010. I intentionally sought out not just a gay-friendly doctor but a doctor who was himself gay. Asking around I discovered Dr. Chu and the good folks at Capitol Hill Medical. Hands down this is the best medical care I’ve ever received. I feel totally comfortable chatting about all aspects of my health and sex life with a fellow gay man who understands the LGTBQ+ community. The front desk doesn’t bat an eye when I call in and schedule a regular STI screening and I’ve experienced zero judgement.
Just because you’re gay doesn’t mean you have to have a gay doctor, but I believe it is vitally important that you have a primary care physician that you feel comfortable having open and frank conversations with. If you can’t talk to your doctor about any and all aspects of your health you aren’t getting the best medical care possible. If you’re looking for an LGBT+ health provider, check out the Gay and Lesbian Medical Association’s provider finder.
Regardless of your sexual orientation, race, or gender I strongly encourage you to find a primary care physician you trust. We all deserve the best medical care possible.