has long been a thought leader regarding the health challenges facing gay men. With a medical practice in infectious diseases and a particular interest in HIV and other sexually transmitted infections, he works with community groups, clinicians, mental health professionals and researchers to drive change.
In January, he was named , a new academic role at the uOttawa Faculty of Medicine and The Ottawa Hospital. In this trailblazing position, Dr. MacPherson and his team are working towards identifying and filling some of the biggest gaps that gay men face in the health-care system.
As we celebrate this year’s Pride Month, we had a conversation with Dr. MacPherson about the importance of 2SLGBTQIA+visibility, his research work, and other topics.
Q: June is Pride month. What does Pride mean to you as both a gay man and as a researcher examining the impact of stigma and misinformation that 2SLGBTQIA+ individuals can too often encounter in health care systems?
A: I think what Pride means has really changed over my lifetime. For gay guys, which can sometimes feel like belonging to a sort of invisible minority, there can be a feeling of loneliness, a feeling like you are ‘the only one.’ As a result, people can feel isolated. Historically, Pride has very much been about stepping out and being surrounded by people like you, which is just very comforting and reaffirming.
As time passes, Pride has also come to mean recognizing diversity. Not just sexual and gender diversity , but a broad diversity within society and also within the individual. For instance, I define myself as an academic, a physician, as a gay man, as a Maritimer, as a person of Scottish decent. Everyone has a great diversity within them and will define themselves in their own way. And I think that's important to understand. Medicine has often tended to treat gay men, for example, in ways where how we have sex is seen as our sole social determinant of health. And it tends to neglect that we are truly diverse as individuals. I think Pride helps us bring our individual diversity to the forefront.
Q: The Faculty of Medicine is always striving to enhance our inclusive learning and working environments. Can you talk a bit about the Sexual and Gender Minority mentoring group and its overarching goals?
A: Well, I'll start by telling you how it came to be. Roughly eight years ago, I sat down for a coffee with a number of Sexual and Gender Minority medical students. And one of the women said she’d like to meet a lesbian physician so she’d know she’s not the only one. And I looked at her and said, “But there are gay and lesbian individuals throughout the faculty and the hospital!” Honestly, I was a bit dumbfounded at first because those interactions were all around her. But then I realized, it all comes back to visibility. I realized these students were feeling isolated and lonely. It was clear we needed to set up some mentoring and provide the opportunity for trainees to meet others like themselves to overcome that isolation and to also allow our staff to better connect and support each other.
Over the years, the mentoring group has ebbed and flowed. We tend to have social events and monthly meetings to connect SGM learners with one other and with SGM faculty. It’s managed by the Faculty’s office of Equity, Diversity and Inclusion and we’re always welcoming to those who would like to find out more about the mentoring process and would like to get together with other colleagues and faculty members from the SGM community.
Q: In January, you were named as the Clinical Research Chair in Gay Men’s Health. It’s early days, but can you share a bit of what you’ve learned so far about the health care needs of gay men and how to address the challenges?
A: We've been trying to learn where the needs are most significant, and where we're able to best make a difference. In these early days, I think one of the things I've learned is just how entangled everything is – and the impact of mental health is a big one. When it comes to what we've learned about gay guys, depression is very high. The point prevalence of depression is higher than 13%. And anxiety is at 17%. So that's much higher than in the point prevalence in the general population, which are roughly four and 2% respectively. We're talking rates three to five times higher for gay guys. This is challenging and troubling.
The other thing that's become apparent via various surveys we’ve done is that 20% of gay men in Ontario reported a history of being sexually assaulted. Equally as troubling, 35% reported being physically abused by their family or their partner. It means that being ‘out’ comes with risks. And I think that's important to recognize because these days people are thinking it’s very easy to be ‘out.’ Certainly, it's not as hard as it used to be, but it clearly still comes with significant risks.
Q: This role is the first of its kind in Canada. Are you hopeful that this trailblazing work will inspire health-care institutions across Canada to adopt similar initiatives?
A: Absolutely. And I hope that’s the case broadly. I think a lot of minority health just needs a champion. I'm a gay guy and I’m more than happy to push towards better and more inclusive gay men's health, but other champions will come forward to advocate for other minority groups. I do hope that what we’re doing sets an example broadly for others.
Q: What advice do you have for 2SLGBTQIA+ students thinking about pursuing a life in medicine?
A: My first bit of advice would be the same for anybody pursuing a career in medicine: I hope you know what you're getting yourself into! It’s a very demanding job and you have to be prepared for that. Having passion for your work is important.
Specifically for Sexual and Gender Minority individuals pursuing a life in medicine, I’d suggest being honest, open, and visible. It's important for our patients. It's important for future trainees. And it's important to be seen to reinforce to everyone that we're people, too. We do the laundry, and make coffee in the morning just like everybody else. So yes, be honest and open and visible. It's good for you. And it's good for the people around you.
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