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.