As I was growing up, my father often repeated this quote: “We are coming into troublous times, but let not one of the people of God, by his individual course of action, create a time of trouble beforehand.”[1]
As a physician facing various controversial issues, I have tried to “fly under the radar” to avoid creating a self-inflicted “time of trouble!” But recently, I stumbled into a “troublous time” where I had no recourse but to stand firm for principle at the potential cost of my reputation and career.
The names in this story have been changed, but the details are accurate. I hope my experience gives courage to those facing similar challenging issues.
Interacting with Lawmakers
Every year, medical residents across the United States take a day to lobby at their state capitals. This is a required part of residency. It is important for physicians to learn how to interact with lawmakers and advocate for reforms that better the lives of citizens.
Somehow, I missed this during my residency. I think I was always post-call or on a rotation that did not allow a day off in the middle of the week. This bled into my faculty position. Because I had never done it as a resident, I wasn’t qualified to lead it as a faculty member. And since it wasn’t a particular interest of mine, I had never bothered to go through the steps necessary to lead.
Could I Go?
It was Monday, the start of a very busy week covering the floor service. I had just finished rounding when my residency program director called and asked me to lead a group of residents to advocate at the state capital that Wednesday. The physician who typically takes them was out of town and his backup couldn’t do it. No one else was available. Could I go?
I didn’t really want to go. It would mean being at the hospital by 5:45am, driving three hours one way, and being gone all day. I had a reasonable excuse: I’m not a member of the organizing academy (membership is expensive), I had never done this before (required to lead), and I was leading the inpatient team (difficult to cover).
The program director agreed, but given those reasons, I definitely couldn’t go. I put the idea out of my mind and went ahead with my busy Monday. Then, on Tuesday evening, the program director called again.
“I have found someone to cover the inpatient team. I have already called the Academy, and you don’t have to be a member nor have prior experience. They will send a representative to show you the ropes. Please go, I cannot find anyone else.”
Reluctantly I agreed. I resigned myself to a boring day lobbying the state congress for better seat belt laws, tighter narcotic control, and healthier school lunches.
I was supplied with a packet of materials before leaving work. I didn’t have time to look at any of it. My priority Tuesday night was to be sure my patients were all stable and ready for my colleague who would cover for me.
“I Don’t Agree”
The next morning, at precisely 5:45am, five tired residents piled into my car to drive to the capital. I thought they would probably sleep most of the way. But we had barely pulled onto the freeway when Dr. Appleton, sitting in the front seat, abruptly stated, “I don’t agree with the positions the academy wants us to advocate for on two bills; I’d like to discuss it with you.”
Dr. Appleton is not a Christian. He is open about his dislike of fundamental Christian beliefs. He knows I am a Seventh-day Adventist, and we have had several very cordial discussions about politics and religion in which we found little common ground. Considering this, I was very surprised with what he said next.
“One bill would prohibit gender altering procedures and hormone therapy in minors and another bill would prohibit those procedures to be done without parental consent. The AAP (American Academy of Pediatrics) is advocating against both bills and I strongly disagree with the AAP.”
We had never talked about gender issues, but clearly, he was confident that I would agree with him. He then proceeded to tell me his personal story.
He had a troubled background as a child. His parents divorced when he was young. He was very smart, artistic, and sensitive. This made him a target for bullying, which happened frequently. Over time, He grew restless with his identity as a male. He felt he was a female trapped in a male body. Eventually, in college, he started counseling. He was able to process his feelings and realized that he really wasn’t a woman trapped in a man’s body. He was actually just very depressed. Once his depression was treated, his gender dysphoria disappeared. He fell in love, got married, and now is the proud father of several beautiful children.
“As a child,” he said passionately, “I didn’t have the maturity to know the ramifications of gender-altering surgery. As an adult, I was able to process my feelings and discovered that I really did not have gender dysphoria— I had severe depression. I would have been misdiagnosed and mistreated.”
Soon all six of us were in a vigorous but respectful discussion. Two residents agreed with the Academy’s position, one resident didn’t care, and two residents strongly disagreed. It was a courteous, three-hour discussion! In the end, all five residents agreed that as a group we should not support the academy’s official position on those two policies, but we would support the three other policies dealing with different topics.
Into A Lion’s Den
As we neared the capital, my heart turned to ice. I hate conflict. I do my best to remain inconspicuous and fly under the radar, but I couldn’t fly under the radar here. I had asked for an Academy representative to be with our group. Had I not invited her, we could quietly do our own thing, but not now. I knew our position would be a slap in the face to that representative. I could lose my job, license, and reputation. I felt like I was voluntarily walking into a lion’s den!
We arrived. The capital was filled with residents. We were all ushered into a lecture room, where we sat for the next hour listening to a political harangue on childhood gender dysphoria. Anyone who did not agree with the Academy was labeled uninformed and ignorant. There was no respect or room given to divergent opinions.
One of the two residents who had been mildly supportive of the Academy’s position on gender identity was horrified and angered. “We had a respectful discussion in the car,” she fumed. “They are biased, unfair, and name calling.”
At the end of the session, we were provided scripts of what to say, a list of legislators to visit and a genuinely friendly representative to help us. I excused myself to use the restroom.
The residents were unaware of the heat we would face, but I knew. The academy would hold me personally responsible for our position since I was the supervising physician.
I knelt on the bathroom floor and asked God to help me be brave yet not foolish or obnoxious. These people, though they have an agenda, genuinely care about others. They do not realize that what they are doing is wrong. I needed to approach the issue with respect and grace. I pleaded with God to help me address it with our representative as kindly and tactfully as possible.
When I returned from the bathroom, Dr. Appleton was already having a full-blown argument with the representative.
“God,” I thought, “You answered one of my prayer requests. I don’t have to bring up the topic–it’s already been brought up!”
“Your resident,” the representative said to me tersely, “Does not want to advocate for the official Academy position, but he HAS TO! He is part of the Academy and so he must support our positions.”
I opened my mouth to respond, but my resident didn’t give me a chance.
“No,” he said. “I did not have a choice on my Academy membership; it was provided by the residency program. I did not have a choice about coming on this rotation, it was required. But I do have a choice on what I support, and I cannot advocate for the Academy’s position on gender dysphoria.”
The representative looked at me in shock. Her face was ashen.
“Help me, God!”
“Help me, God,” I pleaded. God heard my cry for help and suddenly, I knew what to say.
“I personally cannot support the Academy’s position, either,” I responded with surprising calmness. “However, there are three of the five bills we can heartily support. How about we advocate for those three bills.”
Relief washed over her face. “That’s a great idea,” she agreed. “Why don’t you demonstrate and talk with the first legislator.”
Oh, no. I sent up another plea to God for help. I had never done this before, and I had only a vague idea about the remaining three bills.
When introduced to the first legislator, I was so nervous I literally forgot my own name. But God came through again! For the next ten minutes words flowed out of my mouth about three bills I knew nothing about!
As we left the room, the representative remarked, “Wow, you really did do your homework, you knew so much about those bills!” Oh, if she only knew! It was not I who knew a lot about those bills…
The rest of the day flowed smoothly–with only some minor near misses! Like when we got on the elevator with a transgender enthusiast who tried to start a discussion with our group about the gender bill. Thankfully, he called the bill by its numerical number name.
“Which bill are you talking about?” I asked, trying to sound innocent, “I don’t know them by their numbers.”
“Oh, the bill on the table trying to prohibit gender-altering procedures,” the transgender enthusiast said. “I’m so glad the Academy is opposed to that bill. Thanks for coming out to help us fight that bill.”
My resident was about to open his mouth when the elevator door opened, and the individual stepped out. I was thankful the elevator door closed quickly!
Lessons Learned
I praised God all the way home. I felt like I had been delivered from the lion’s den. However, I was not surprised when my program director and the chair of the department got an email the next day recommending that I have remedial training on gender dysphoria. My chair, a Christian, stated that he allowed his faculty to think for themselves and that he did not feel the need to dictate how I think. I heard nothing further about the incident.
I learned four very important lessons through this experience.
There are good people on both sides of the political spectrum who recognize the dangers of gender-altering drugs and procedures for minors. As Seventh-day Adventists, we should not be afraid to stand firm on this issue. 1 Corinthians 6:9-11.
We must have a consistent prayer and devotional life to face life’s crises without needing last-minute spiritual reinforcement. Daniel 6:10.
We must stand firmly for our beliefs with kindness and tact. Daniel did not force his views on others but still stood firmly and without compromise. Daniel 1:9.
I must rely on God to provide the right words when faced with an unexpected, challenging situation. Luke 12:12.
Seventh-day Adventists look to the creation story for our model of worship and family. When this conflicts with the culture around us, we must be willing to stand firm in upholding the biblical ideal no matter the cost.
Dr. Stephen Brown is a pseudonym. Story is true but names have been changed.
[1] Ellen G. White, 20LtMs, Lt 117, 1905, par. 9.
