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Growth--and Growing Pains--for Association of Gay Doctors : Health: The American Assn. of Physicians for Human Rights is getting involved in policy and research. But it faces an identity crisis over a name change.


As Dr. Katherine O'Hanlan listened to her colleagues at a national meeting on breast cancer, she wasn't surprised that no one mentioned lesbians.

The meeting, held by Health and Human Services Secretary Donna Shalala, was focusing on minority women's low access to cancer screening.

"Everyone kept talking about minority women's access to mammography screening," recalled O'Hanlan, a gynecological cancer surgeon at Stanford. African Americans, Latinos--each had poor mammography rates. But no one was mentioning gay women.

Then O'Hanlan took the floor. Lesbians, she pointed out, were the least likely to go for mammograms but, for reasons that are unclear, have among the highest rates of breast cancer.

"Because Shalala had invited me to that meeting, we were able to ask that all future research on breast cancer (include) sexual orientation," O'Hanlan recalled. Several large upcoming studies, including the sweeping Women's Health Initiative, will stratify data by sexual orientation.

The story illustrates one of many recent inroads that can be claimed by the nation's predominant group of gay doctors--the American Assn. of Physicians for Human Rights--of which O'Hanlan is president.

As gay rights takes on greater importance under the Clinton Administration and with increasing social tolerance, this 13-year-old medical society is seizing the opportunity to make its mark, its leaders say.

"This organization has always had enormous potential. But I think we're tapping into it more than ever before," said Benjamin Schatz, who took over as executive director of the San Francisco-based group in 1992.

For example, Schatz said, when the American Medical Assn. recently convened a select group of members to discuss the future of medicine, AAPHR was asked to send a representative.

"That would never have happened even a few years ago," Schatz said. "We're finally getting somewhere."

The group's burgeoning presence is reflected in numbers; membership has almost tripled since 1993 to 1,200 members, and that number is expected to reach 2,000 by year's end.

But the expansion has had a price. Growing pains are obvious as the organization struggles to define its identity. It's thorniest problem is whether to change the cumbersome and euphemistic name to one that would clearly denote a homosexual orientation.

Members have until Friday to return ballots on the proposed name change, and Schatz, who is overseeing the vote, said he has no idea what the outcome will be.

The group's dilemma reflects the same struggle facing gay doctors all over the country: whether to divulge their sexual identities to patients and colleagues.

The anguish of this decision was apparent in the group's recent newsletter. Said O'Hanlan, who suggests a name such as Gay and Lesbian American Medical Assn.: "As agents of change, our most powerful tool is our visibility."

But, said another member, writing from a small rural town: "I cannot risk being associated with anything that would identify me as being gay . . . (it) would destroy my practice and throw me into bankruptcy."

Schatz sighed when asked about the turmoil accompanying the name change.

"We're turning 13. This is our bar mitzvah year," he said. "We are becoming an adult organization. And we are trying to find our identity and figure out what we'll be doing the rest of our lives. You can't change this much without conflicts. But that's good. It means people care about the organization."


Members give different reasons for why, after 13 years, both membership and outside acceptance have suddenly soared.

"I don't think it's a coincidence that our membership increased during the Clinton presidency," Schatz said, noting that membership in other gay doctors groups--such as medical students, lesbian doctors and medical specialty groups--has also risen. "I think the gay and lesbian community, as a whole, was exhausted (during the Reagan and Bush eras) by being seen as second-class citizens."

O'Hanlan said the rising number of openly gay doctors is similar to what is occurring in other professions.

"Gay and lesbian doctors have become fed up with homophobia. I think we have less patience for it now. More of us are saying, 'We ought not to hide.' "

But the debate over a possible name change shows that it is not that easy to put one's beliefs before practical considerations. Many doctors within the organization say they fear a name change would jeopardize their practices.

Belonging to an openly gay group, they say, would put them one step closer to being "outed" in communities that are not ready for them. About half of AAPHR members have practices that treat mostly heterosexuals.

"Most gay and lesbian physicians feel very isolated," Schatz said. "Seventy percent of our members are outside New York and California. Chances are they are in a center in which they are the only one."

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