Just Read: Dr. Sara Hurley’s Dissertation on the It Gets Better Project, and my story within

Sara Hurley, PhD (@saralovesyou) is a newly minted doctor with a degree in education. Her dissertation is entitled “Public Pedagogy and the Experience of Video Creators in the It Gets Better Project” (Direct link to PDF).

I am honored to have my story included in it.

With Sara’s permission, I’m republishing it below. It accurately captures the drive that many humans have to live in their true identity, and to use the resources that society provides to help others who come after them. I love the juxtaposition of my story with the story of Alexis:

a white 23-year old first year medical student, the kind of person Ted thought of when he recorded his video.

It’s true, I did, and if anyone wants to know why I am an ally for people who are transgender in 2015, this is good background reading.

It’s the broken places in health care where a generation of physician leaders were born, and now we’re going to change everything 🙂 .

The original post from 2010 is here: Doctors know : It Gets Better | Ted Eytan, MD. 34,000 views, 57 comments, mostly supportive (the others justify why a video was necessary in the first place – love always wins).


The Dissertation

The formal title of my dissertation is Public Pedagogy and the Experience of Video Creators in the It Gets Better Project (publicly accessible).

What’s in it?

  • A synthesis of the unacceptable situation our LGBTQQ young people still find themselves in due to their school environments (despite the significant gains that have been made).
  • A history of the It Gets Better Project, including parts of an interview with Dan Savage.
  • Based on my research, a process that most video creators went through that had radiating effects in their own lives.
  • Finally, it details two major themes that made the It Gets Better Project novel and important: the freedom for video creators to “speak to the gaps” in dominant representations of LGBTQ people and the personal transformation that some experienced by participating in something they saw as positively affecting others.

Speaking to Create Visibility in a Profession: Ted & Alexis

One of my participants was a medical doctor and two were in medical school. Ted is in his mid-40s, and went to medical school in an era marked by the HIV/AIDS crisis. His experience as a gay medical student during that time affected his perspective on his responsibility to future doctors and what kind of support they need. Alexis is a white 23-year old first year medical student, the kind of person Ted thought of when he recorded his video. Laurel is a non-traditional medical student in her late 30s who has a different experience and history than Alexis, and I will focus on her story in the next chapter. I pair Ted and Alexis because the reasons Ted had for how he framed his video were in many ways validated by Alexis’s experience and concerns as she worked towards admission to medical school.

The profession of teaching is not the only one that has a tradition of conservatism that affects the ability of LGBTQ people to live openly. Laurel recounted the difficulty of finding out doctors in her medical school in our interview and Alexis thought that she was the only LB woman of the 100 women in her entering class. It is unlikely that the actual number of LGBTQ people in either of these cases is so low. When I emphasize the theme of video creators as identifying and speaking to a gap in the educations and experiences of LGBTQ kids, this takes many forms. One of those is breaking open professions in which people are often closeted or there is a lingering history of feeling pressure to be closeted.

Ted’s video had a great deal of positive response, but people also questioned why he and his friends made the decision to focus only on their professional affiliations in the video. He is white and professionally successful in an elite field, as are the friends he made the video with, and this was critiqued. However, he had audience-specific reasons for the construction of his message and it is important to remember that the IGBP is a collection of voices that embody the range of possibilities for LGBTQQ youth.

When I was in high school, I really believed—and I think it was almost true, there’s data to support this—that if I was out I would actually not get a career. I might be killed, actually. There really was that fear. And in the medical world,there is some data around the time I matched for residence that around 25% of residency directors would actively blacklist a gay or lesbian candidate to their residency, which is your whole life. And so, I just sort of—so the goal was to say, look, there are doctors, lawyers, people in these positions that have not been held back by who they are. And that’s the goal. So anyone thinking about—you know, there’s many occupations you can be, but you’re not limited. And you know, in my era and when I trained, people felt limited. They thought “I can be in the service industry,” which is great, but I couldn’t be a doctor.

His intent was grounded in his life experiences and, to a large extent, his professional identity as a doctor and what that entails in terms of how you present yourself and how you frame your opinions. Alexis is a new generation, just graduated from college, with a different message in her video. Like many younger video creators, she wanted to relate to people as a peer, or at least someone closer to the age of her envisioned audience.

I wanted teenagers to see someone that looked young and I know sometimes that I look a little young for my age and I wanted them to see somebody who looked kind of a lot like they did. You know, not like 40 or something. Like it gets better by the time you’re 40, but it gets better by the time you’re an undergrad, and I wanted them to know that, for me, just the change between high school and college made all the difference. And just the environment was completely different. I went from feeling completely not okay to at the end of college completely okay and I just want them to know that if they just hang on a little more, things can get better fairly soon.

The It Gets Better Project is powerful because it is a creation of the collective: a multiplicity of examples and role models and messages of hope across populations. In this, participants were consistently aware of how they portrayed themselves; the performative aspect is always present. Video allows you to craft an image and story in unique ways, and people adapt that as a hook for others to resonate with. The appearance of “peer” is not Alexis’s sole hook: she is a high achiever in school, and has the posture and slender physique that show the years of her ballet training. There are girls who would see themselves in Alexis, and see her life as a possible future they could have.

As she is about 20 years younger than Ted, one might assume that she was not affected by concerns of discrimination in her medical school applications, but Alexis’s experiences show the similarities and differences that linger across generations. As I noted, one of the shared experiences between Ted and Alexis is a lack of out physicians that medical students can look to as examples of what their futures could be like. Ted is an exception to this, and he feels strongly about this responsibility. Though he has sometimes been critical about Dan’s work and tone:

I really looked at it [the It Gets Better Project] and I realized, you know, he really does at this level really promote what he’s talking about and he’s put himself on the line a lot. In my own medical training, I’ve always felt it really important to be that model for the next generation because there weren’t models for me and it was kind of consistent with that thing of “I’m gonna do a video, I’m gonna put it on my blog, it’s got my name on it, and I’m gonna say I’m a doctor and that it’s okay to be me.”

This is still an important message for future doctors. While Alexis was moved by the It Gets Better Project early on and wanted to make a video, she held off because she was applying to medical school and worried about someone on the admissions committee seeing the video and being biased against her as a result. While her concerns were not at the level of what Ted experienced when he started, they were still there and the lack of people like her who were out was a problem. This was the case in her time in high school as well, “I lacked role models when I was younger and, like I said, in high school pretty much if you were an out gay person, people classified you automatically as a shadow kid.” The concept of “shadow kids” was extremely troubling, especially considering Alexis’s age. These were marginalized youth in school, and while they were not all LGBTQ, almost all of the out LGBTQ youth fell into that grouping. She described them as being unhappy, with their grades affected by their status. Entering college, she assumed that if she came out, she would have to find new friends—that the studious, “nerdy” people she spent time with wouldn’t like her anymore. This was not the case and she was able to engage more in social justice, come out more, and wanted to help teenagers who might have thought like she did, that “I have no idea how I’m going to just live a life on the track that I’m going to” if they were out.

What Alexis wanted to see when she was younger was someone who could be a role model.

I’m glad they got a lot of videos because I think a lot of the problems I had when I was younger was trying to find a role model, and I didn’t find anyone I could look up to until I was about 21 years old and then one of my teachers—she had her life together and she reminded me a lot of myself—she was 16 years older than me. It just takes really one person to be able to look up to and say “oh, they have their life together, they have a child”—I’ve always been interested in having children.
The importance of multiple videos is illustrated across these stories. Someone like Alexis could watch a video like Ted’s and see an out doctor, but she could also seek out one of lesbian parents who lived the kind of life she might aspire to personally.

Ted’s experience was embedded in the context of the AIDS crisis and a larger cultural environment in which homophobia was more acceptable and overt. He searched the videos in the It Gets Better Project for others of physicians and did not find any. The impetus to do the video synced with his philosophy of how to live openly as a gay man and physician because he did not see that modeled for him and the level of shame closeted doctors exhibited was difficult to witness from his perspective as a student at the time.

I’ve had a long history—I mean I had this thing where when I came out in residency, and I actually remembered just today getting ready for this, thinking about this, I remembered a story of when I was an intern, like my first year, and I was in Seattle, I went out to the Neighbors, which was a gay bar, and there was a nurse there from the hospital I was working at. I remember this because I decided once I had arrived, once I had got my MD, they weren’t gonna take it away, and so forever more I was never gonna lie about it. And so the next day the nurse comes up to me in the hallway and he said ‘I just want you to know I won’t tell anyone that I saw you there last night.’ And I still remember to this day saying ‘you can tell whoever you want, I don’t care.’ And so from that moment on, it’s always been like—I’m never going to be that doctor that everyone knows is in the closet that is afraid of who they are.

It tracks back, like actually in medical school there was this—the other thing that I did was in medical school we had that one lecture on being gay and it was taught by a faculty member who was clearly uncomfortable with himself—and this is Arizona and it was really awful because my classmates were attacking him. I actually became that faculty member for the University of Washington and taught that same class, except I was who I was and so it was a much different experience because I walked in saying there’s nothing abnormal about this, so let’s talk about how you actually take care of these people who are just as valuable as anyone else. And so in the video is that reflection of: I am a doctor, I am gay, it’s part of who I am, they’re not separable, you’re not gonna take my MD away from me or who I am and if you choose to be this way, no one will do that to you either….I did it as a professional video, basically. To say a professional person who actually works and is this person all day long—I don’t go home and then become gay.

I noted that embedded in the process that people collectively went through, there were iterations of the message of “it gets better” as it was defined and redefined based on individual video creators’ messages and concerns and experiences, and that there were collateral benefits to participants. This includes Ted and Alexis. Alexis’s engagement with the It Gets Better Project didn’t end with her video. She noted that there were criticisms of the IGBP and that people would say we should make it better now, so at her medical school, she and some others made an It Gets Better video where “people who were there wanted to talk about how we’re making it better as health care professionals” and that it could be more than just waiting for college, even though that was how she managed things. In this, you can see Alexis at an early stage in her career, in much the same way as Ted did, figuring out what her responsibilities are as a future doctor who is also a lesbian and cares about the LGBTQ population.

All participants navigated identity in different ways and valued different ways of presenting themselves, Ted talked about a kind of evolution of control in terms of the project: “We own this piece of media, right? We can delete the comments, we can write back. It’s our little space so I think that’s kind of huge.” That sense of having a say in how we’re represented and what the tone is, is extremely important when you consider the lack of empowerment that many, including people who are doctors, have endured. Ted and I talked about what it was like during the AIDS crisis, and it is almost unfathomable what was done to patients:

During that time, if you had HIV, if you had AIDS, you would be put in a hospital room and no one would talk to you. And actually, I was on a rotation with a resident and he was the gay resident in the hospital and he’s the only one that would round on that patient. You can’t even imagine that today, that there would be a patient that no one would talk to, not even the nurses or the doctors. And they would just be left to die is what would happen.

It is important to have people like Ted and Alexis making videos, because we need more out physicians. The culture of a discipline cannot change without people who are part of that culture being a part of changing it. They identified the ways to use their skills and positions to figure out how to make things better in that field, which looks different than it would for people in a different field or with a different life experience. Ted sums it up in how he can create change in the context of his role as a physician.

It’s easy to be a health activist. And so that’s what I can be. And my employer is totally supportive of health, so no one is gonna come and say ‘oh my goodness, I can’t believe you wanted to support gay marriage.’ I’m like—the data is clear. This study last year showed that people in Massachusetts that are gay are much healthier now than before the marriage law passed.

What was implicit in how participants spoke about who their audiences were was how they contextualized their role in relation to the imagined audience. They either understood or had an increasing understanding of how to communicate their messages in a way that would fit their perceptions of themselves, but also the contexts in which they lived.

Ted Eytan, MD