At a recent LGBT healthcare conference, I was somewhat surprised to discover that many LGBT nurses in attendance (and other healthcare providers and allies) were not aware of the disparate ways that gay male and lesbian nurses have experienced the discipline of nursing. In some fields, LGB and T people may be lumped together because of similar experiences of stigma and resultant discrimination, but nursing has a unique history that differs significantly from other health professions. I’m going to simplify the discussion in this first blog to gay men and lesbians. Bisexual and transgender individuals have unique experiences, but were largely invisible in the history that I outline here. I hope someone else will take up the cause and write about those experiences in the near future.
History of Nursing
Nursing was and still is a female-dominated profession. From its origins, women made up the bulk of the profession, because the tasks/responsibilities of a nurse fit firmly within gendered stereotypes of nurturance, care-giving, and self-sacrifice. In the early days of nursing, women were in servitude to men’s needs and nurses in servitude to doctors. Prior to the 1970s, and the second wave of feminism, most women were in the workforce only temporarily, until marriage or childbirth, leaving the only women who could be career nurses the “spinsters” or nuns. Both groups contained disproportionate numbers of lesbians. They became the head nurses, the directors of nursing, the deans and directors of nursing schools, and the faculty in nursing schools. They were deeply closeted, out of necessity. Around the same time (1970s), when nursing was striving to be viewed as an autonomous discipline from medicine, with its own theories, interventions, and outcomes, there was even more pressure for lesbian nurses to remain closeted. As in the feminist movement, the presence of lesbians was thought to “taint” the efforts to be a legitimate force in health care and in society. Lesbian-baiting was a way to discount the entire movement or the entire discipline of nursing. So while the LGBT movement was emphasizing coming out as a political strategy, lesbian nurses remained in the closet. We were kept there by other closeted lesbian nurses who feared what would happen if some of us were out (they might be outed), we were kept there by faculty mentors who told us as students or junior faculty that we dare not do research on LGBT topics or we would not get grants, get published, get jobs, or get tenure, and sometimes we closeted ourselves to keep our jobs, or in a misguided belief that we were helping the profession. Lesbian witch hunts in nursing schools continued well into the 1990s, confirming that we could be fired for being out.
Gay men, on the other hand, have had a very different experience. Because nursing was and continues to be considered a “feminine” profession, men who choose nursing are automatically considered to be gay. Gay men in nursing fit stereotypes about “effeminancy” equating them with women (lesbian stereotypes proclaim as not fully women). It’s not as difficult to come out as gay if everyone already assumes you are gay. In fact, heterosexual men may find it challenging to be out as heterosexual without sounding homophobic. Women in nursing leadership roles who do not have a feminist consciousness (way too many of the leaders) tend to glorify men who choose nursing, and we know that men often move up the ranks faster than women in nursing. Nursing may be the only profession where men are actively recruited as a minority group. I’m not implying that gay men have it easy in nursing, but I think it’s easier to come out as gay than come out as lesbian. And once out, there is less hostility, suspicion, and imposed silence on gay men than there is on lesbian nurses. In the many years of working as a hospital nurse, and then as a nursing educator, all the gay male nurses I knew were out and fairly well-accepted. But most of the lesbian nurses I knew were not out. When I took my faculty position in 1987, I would estimate that 30% of the faculty were closeted lesbians and another 20% were an “open secret.” That is, they lived together, but never called themselves lesbians or talked about their relationships.
Where’s the Evidence?
I am writing this from my own experiences and observations from 20 years as a lesbian nursing educator and 15 or so years in clinical nursing settings. I have not seen this written up anywhere, so I may be biased by my own experience. I’m not a historian of nursing history. So please, weigh in on my comments and let’s build a theory about how sexual and gender identities, feminist orientations, and other factors differentially shape the experience of men and women in nursing, as well as lesbian, gay, bisexual, and transgender experiences. It’s time to shed some light on these experiences, so that we can better support the next generation of LGBTQ nurses and our heterosexual allies.
Thank you for this very thoughtful and informative post, Mickey!
This is an interesting topic, and something I have not given much thought to in the past. I think your assertions about people assuming men in nursing are gay is correct. As a gay male, I sometimes assume the male students I teach, or the male nurses I encounter, are gay. However, most of the males I know in nursing are not gay. I have never given my “coming out” in the nursing profession much thought. I have always been mostly open about my sexual orientation since the age of 16, and I don’t recall if it was “easier” for me to open up after becoming a nurse.
When I practiced in the clinical setting, I knew of two female nurses who were lesbians. However, neither of them were open about their sexual orientation. I am not sure if them not being open had to do with their nursing profession though.
Because I am a young nurse, I was unaware of the history of homophobia in the nursing profession. You alluded that this homophobia was mostly present before 1990. Do you think the homophobia was unique to nursing, or do you think this was common in other professions? I’ve spoken to LGBT faculty members at my work institution, and there are some professions where faculty members still keep silent about being LGBT because they fear not getting tenure or promotions.
Great topic of discussion!
I think the homophobia in nursing still exists, but still much more so for lesbian nurses than gay men. I think there has been an increase since about 2000 of articles in the nursing literature, but the 1990s was still pretty bad for us. Other professions have homophobia as well, and LGBTQ people might stay closeted to avoid losing jobs, but lesbian nurses often stay closeted to protect the profession as well. Kind of like the experience of lesbians in feminism in the past.
Hi Mikey and Michael: As an older lesbian nurse, I believe your comments are right on. It has also been my experience that gay men are more welcome into nursing. I suppose it is because they are not sexually threatening to the female staff and female staff that are friendly to “out” lesbians would feel guilt by association. Here is my question… since more men leave nursing than women (almost 2 to 1), is it possible that the retention rate of gay men in the profession is better? Does anyone have any reliable statistics on this?
Thanks for your comment and question! I was not aware of the statistic that more men leave nursing than women. Does “leave nursing” refer to leaving the clinical setting or changing professions? Mickey is much more familiar with the literature on this topic than I am, and she might know of such an article. I am not familiar with such literature off the top of my head.
From my own experiences, I have not known of any men who left the profession. I know of many men who left the clinical setting (including myself who went into academia), but it seems to have been an equal mix between gay and straight men. I think all men, regardless of sexual orientation, are readily accepted in the nursing profession. So, I would hazard to say that there is probably no difference. Rhonda, what have your personal observations been with men who left nursing?
I have no idea about this. Would make an interesting study to find out whether LGBT nurses in general have higher or lower retention rates than heterosexual nurses. In my personal experience, it seems like heterosexual men in nursing advanced faster than women or gay men, but I have no actual data on this.
Do you know any lesbian nurses form history? I need to do a historical research paper on famous nurses and I wanted to do it about a lesbian.
Rachel, how far back in history do you want to go? You could always start with the speculations about Florence Nightengale. Or message Peggy Chinn on this site to get ideas from more recent history, or interview Peggy (who is now in her 70s and experienced a long career as a lesbian nurse).