How a Private Conversation about Gender Got Me Fired from My Dream Job

I assumed that treating sexually transmitted infections would be reality- based. I was wrong.

A few years ago, I landed a job as a field epidemiologist in sexual health, having worked previously in HIV prevention. The job was in a mid-sized city in the Northeast (think New Haven or Burlington).

Field epidemiologists (“field epis,” as we are sometimes called) in sexual health try to persuade people and their partners who are infected with sexually transmitted diseases to come in and get treated. They go over educational materials with patients and follow up with them to ensure treatment is successful. They’re often embedded in sexually transmitted infection (STI) clinics, working on a multidisciplinary team of physicians and nurses.

Field epi work is essential to public health; I’ll recount one example. A pregnant woman had been infected with syphilis by her boyfriend, who was not the father of her baby. Treating syphilis during pregnancy is time-sensitive, as the infection can cause serious harm to the baby. The team and I were able to get the mother and boyfriend into the clinic to get them treated. Later follow-up included retesting post-treatment and testing again after the baby was born. Syphilis is rare in the U.S., especially in pregnancy. It is also known as the “great imitator,” as it can have variable clinical presentations. As a result, syphilis is often missed by physicians who don’t work with infectious diseases and don’t know treatment protocols. Without prompt treatment, the mother could suffer a stillbirth, or both mother and child could endure lifelong complications. (Thankfully, both came out OK.)

I know this job is not for everyone. Sexual health is a sensitive topic, to say the least. But it was my dream job. It was also my very first job after completing my Master of Public Health. Little did I know that after only three months on the job, I would leave my field entirely.

Extreme Peaking

I peaked during the final year of my master’s program, but the road to peaking was a long one. The straw that broke the camel’s back came during service on my local LGBTQ+ Pride board. In spite of my being in the process of helping to finalize the organization’s 501(c)(3) status, they voted me off for being a “cisgender” white gay man. The board held yearly elections, and I was up for a one-year term as president of the board. There were two candidates on the ballot: myself and a disabled, nonbinary Black woman.

I had a long history of work with the organization. Besides the 501(c)(3) process, I updated administrative documents, used my network for community relations, and operated as one of the main public faces of the organization. My opponent, on the other hand, not only had no prior involvement in the organization, she didn’t show up in person on election day. She did send an email to the board members accusing the organization of being racist, sexist, and transphobic, and ended by admonishing us to “do better.” By “do better,” she meant electing her.

She won by a landslide. I was devastated. I spoke to one of the few board members who had supported me and found out that another board member, a white lesbian, had organized a bloc to vote me out, citing my race and sex—not ability or character—as the primary reason. Some crimes, like being white and male, can never be forgiven.

Most of my fellow board members had colorful “hobby identities,” a term I use to describe the messy mix of neo-pronouns, reality-defying self-ID, progressive politics, and questionable hairstyles. It wasn’t just the organization’s leadership. My STI testing booth at the Pride festival was overrun by obviously autistic women on testosterone, so-called “trans children,” their very proud parents, all manner of Queers for Palestine, and, of course, Furries. This parade of mentally confused kids, oblivious parents, and—Furries—was just too strange to ignore. I often say that gender ideology is a mile wide but paper thin. Once you see it for what it is, you can’t unsee it. And I had seen too much.

Reality-Challenged Healthcare

What’s past is prologue.

A reality-challenged LGBTQ+ whatever org was one thing, but I expected the public health professionals at my new job to be more, as the kids say, based. My advisor, a child-maternal health expert with a PhD in epidemiology, was censored by journal editors when she submitted papers using “controversial” words such as “mother” or “woman.” If she refused to use preferred terms such as “birthing person,” “uterus haver,” or my least favorite, “chest feeder,” her reputation and employment would be endangered. In secret, we vented our disgust at these dehumanizing, dystopian terms that the public health sector had so rapidly embraced.

Field epis go through extensive training in diseases and demographics. We must be able to talk to anyone, from Muslim women whose husbands cheat to gay men who… let’s just say have very busy sex lives. The Centers for Disease Control (CDC) train field epis to work with a wide range of people. Unfortunately, this training, while well intentioned, was subverted into struggle sessions and social justice indoctrination. The one training that will always stand out to me was called “Cultural Humility With Men Who Have Sex With Men.”

As a gay man, I didn’t need this course, but all field epis were required to complete it. This is pretty standard practice in government public health jobs and was implemented for good reason. Those outside the field of public health probably do not realize that public health is an overwhelmingly female profession. You see men at the very top, mostly physicians, but your average public health worker is going to be female; this includes field epis. For example, in my graduating class, there was one other male. There were possibly half a dozen men in my entire program. Men in public health are an exception, not the norm, so trainings of this sort could serve as useful introductions to the unique needs of gay and bisexual men (known in the field as “men who have sex with men,” abbreviated MSM).

I was surprised, however, when the trainer (also a gay man) redefined MSM as “anyone who identifies as a man who has sex with anyone else who identifies as a man.” Confused? Me too. It gets worse.

After the pronoun ritual was observed, the training consisted of a mishmash of sexual health promotion materials about MSM aimed at women, but the entire topic was muddled by content for women who believe they are gay men (aka “gay trans men”). As it ended, I politely pointed out that “trans men” have different concerns than men do. Women who believe they are gay men are still women with all of the same sexual and reproductive concerns women have (pregnancy, cervical health). Furthermore, sex matters when it comes to infectious disease.

The syphilis example I gave earlier is a good one, but chlamydia can have far worse complications in females if left untreated. Let’s also add in the fact that these women may or may not be taking testosterone, which increases their risk of infection due to vaginal dryness, and that they may be more likely to be sexually assaulted than gay men are. All of this is because they are female.

Lastly, to work with women who believe they are men requires education in a confusing and complicated system of jargon (pronouns, various “trans masc” identities, alternative anatomical terms like “front hole”), which must be carefully used so as not to offend the patient. While I disagree with gender ideology and medical transition, I believe that trans-identified people deserve accurate sexual health education and care that meets their unique needs. Women who say they are gay men are not, in fact, gay men. They have sexual health needs that are robust enough and significantly different from that of men’s to necessitate a separate training.

Put simply, talking about female sexual health in a training ostensibly about same-sex-attracted adult males helps exactly no one. Gay men’s concerns are material and embodied. Alternative pronouns and made-up anatomical jargon are not priorities. Avoiding HIV and clearing up that gonorrhea you picked up on the last Gay Men’s Fantasy Cruise are.

When I carefully, painstakingly pointed this out—like walking on eggshells—the pushback was swift and severe. Hell hath no fury like a woke woman mildly disagreed with by a “cis white man.” The women in the training absolutely piled on me. One Black woman from South Carolina told me that my anger was “blinding” me and that I needed to “listen” more. I’m fairly certain that she meant “listen” to her, because, as a woman of color—or better yet, a “Black femme”—she is in possession of a kind of wisdom, a gnosis if you will, or at least a vantage point atop the woke hierarchy that I, a “white cis gay,” will never fathom.

Needless to say, I got angry. Like full-on gay rage mad, and I shot my mouth off.

You might be wondering why this training in particular enraged me. It was partly the timing. The training took place when the world was coming to grips with the monkeypox epidemic, which overwhelmingly affected men who have sex with men. Public health professionals refused to acknowledge this, acting as if monkeypox affected everyone equally and performing “what aboutism” wokeness. I attended meetings with state-level CDC officials who were well-versed in trans health and women’s health, but woefully unprepared when it came to understanding the unique needs of gay men. I even had to fight with other gay men, who would look at the epidemiological findings showing overwhelming rates of monkeypox infections among gay men and ask, “But what about trans and nonbinary people?”

The state-level CDC leadership was at first unaware that the patient population of the clinic I worked in (the largest PrEP prescriber in the state) was at least two-thirds men who had sex with men. Despite having this fact explained to them, they were extremely reluctant to let us offer the vaccine at our clinic. Nor would they let me organize clinics at the gay bars, sex club, or even the LGBT center. They later relented, but a gay nurse practitioner and I had to run clinics out in the field on our own—unpaid. Meanwhile, at the CDC-funded pop-up clinics we hosted—strangely located at high schools—young women saying they were gay men kept showing up to receive a gender-affirming dose of the monkeypox vaccine.

It got worse. In weekly meetings, the HIV epidemiologist at the state-level CDC regularly presented her findings with the sex markers “male,” “female,” and “other genders.” Whenever I asked the program managers and the epidemiologist (both female, by the way) what “other genders” meant, they scowled at me.

Meanwhile, in the clinic itself, I saw a patient I will never forget. A young white woman, no more than 25, who identified as “trans masc/non-binary.” She was five feet tall, slim, unhealthy, and just starting to grow facial hair due to testosterone use. When I administered our standard sexual health intake (which includes the sex of the patient’s partners), this young woman told me that she had sex with both males and females. The jargon of gender made it extremely cumbersome to communicate, but she eventually divulged that she had an open relationship with a man who believed himself to be a woman. With delight dancing in her eyes, she told me, “It’s like… heterosexual, but not. We are, like… queering heterosexual sex, you know?” When I asked her if she had a contraception plan, she professed to have no idea why she would need it—because she was having “queer sex.” She was a women and gender studies major at an expensive private college nearby.

Inevitably, Cancellation

Like a film noir detective, my doom would come in the form of a femme fatale. She came into my office crying. Her name was Ayden.

Ayden (not her real name) was a woman working in a different department who believed she was a man. She professed to be on the autistic spectrum as well as bipolar. Nevertheless, gender medicine being what it is, she had been given cross-sex hormones and a radical mastectomy, which had left her chest disfigured. I knew this from seeing her fully nude in the men’s locker room at the gym we shared. Huge scars, “pepperoni” nipples. Ayden was also obese. In other words, she had exactly none of the qualities gay men are known to prefer in partners. I was single at the time. Ayden liked to message me on Grindr saying, “You have the kindest eyes.” I would ignore the messages and block her. Not only was I not interested (because, you know, I’m gay), but she was a co-worker.

The reason Ayden was crying in my office that day was because, she said, she was sexually assaulted by a man she met on Grindr the night before. I immediately went into public health mode. I gave her an HIV test, listened to her story, and offered comforting words. I also walked her through the post-exposure prophylaxis (PEP) protocol, connecting her with providers who could get her on PrEP. I even gave her the number of a therapist, another trans-identified female, who I felt could help her.

I did this all while using he/him pronouns. Why? I don’t care if you are the devil himself. If anyone needed HIV prevention services, they’d get them whether I liked them or not. In my career, I had given HIV tests to people who said offensive things to me about gay men. A good public health professional is driven by the mission—population health—not ideology. In healthcare, you put your personal beliefs aside to first get the patient what they need. Unlike my colleagues who pushed their gender ideology wherever they went, I refused to impose my beliefs on this fragile, trans-identified woman.

A few days later, Ayden walked into my office. I asked her how she was doing and if she had contacted the therapist I had referred her to. She acted as if our earlier meeting had never happened. Surprised, I questioned her more persistently, mentioning that I had noticed her profile had reappeared on Grindr earlier that day. Keep in mind her profile was offering something like, “Looking to host cum dumps at my house. I’ll blindfold you while men come over and feed you their loads.” I suggested that, considering what had happened to her a week ago, she might want to take a break from Grindr. She denied it all, including the four hours I had spent counseling her. She backed out of my office, and I never saw her again.

My experience with Ayden is essential to understanding the doctrinaire cruelty of my final cancellation. Later that same day, I was doing some training with another field epi. We weren’t having much luck connecting with our cases because it was the middle of the day, right before Christmas. She was a lesbian, and the conversation casually turned to current LGBT issues. We mostly agreed on everything. The tone was convivial, and never once did she indicate to me that she was uncomfortable in any way. I mentioned that, in my personal life, I refused to use “they/them” pronouns and that I had concerns about “pediatric gender medicine.”

Four hours later, an email arrived from my boss’s boss, the clinical program’s manager. She informed me that I was to be suspended with pay. (This was a woman with whom I’d had a long, very TERFy conversation only a week before, about her daughter having to play against boys on her high school soccer team.)

The investigation by management produced no evidence, only hearsay. Essentially, someone at the clinic — who knows who, maybe Ayden, maybe my colleague, maybe even a woman from my graduate school who was working at the state CDC — had claimed I was promoting “anti-trans and anti-non-binary rhetoric.” This person recommended that my contract be terminated.

The STI clinic staff subjected me to a struggle session in which they all pretended to be pro-trans — even my boss, whom I know was not. They grilled me with a bunch of questions about what had happened, my beliefs, and so forth. Stupidly, I was honest with them, thinking that this would save me. But just before Christmas, I was fired, and essentially blackballed from working in public health in my state.

Soon after, a former colleague (another gay man) told me that Ayden had been stalking him for months. Using an anonymous account, she would send him sexually explicit text messages or just threaten to get him fired. I later learned that Ayden was a heavy drinker and cocaine user, and that she’d get on Grindr for hook-ups while intoxicated or high. After she sobered up, she would regret what she had done, and claim she had been assaulted. While my colleague had never hooked up with her, she harassed him constantly. HR wouldn’t do anything about it for a long time, essentially because Ayden self-identified as trans. Eventually she was fired. I still saw her occasionally in the gym locker room. She continued to get completely naked in front of the men. She pretended not to know me. But on occasion, she would take the time to create an anonymous profile on Grindr, just to call me a TERF and then block me.

Truth Continues To Be True, If Inconvenient

In the years since, I have been forced to accept a truth I never imagined when I first began my public health career: The institutions that preach “evidence-based practice” will abandon evidence if it inconveniences gender ideology.

I entered this field because, as a Gen X gay man who lived through the AIDS crisis, I wanted to help others in a way the generation before me had helped me. AIDS reminded us that disease spreads because of behavior and biology, not identity and ideology. We care for others because they are human, not because they agree with us. I believed, and still do, that healthcare professionals must meet people where they are—literally, physically—not where activist vocabulary insists they must be.

Yet the moment I questioned the dogma, even privately, I was pushed out of the field I had dedicated almost a decade of my life to. That’s right. An experienced, highly qualified, and passionate public health professional was blacklisted from his field—for a private conversation.

I did attempt to take legal action for what I believe was an illegal firing. I contacted six law firms, and none would take my case. I think it was a combination of my state having “at-will” employer laws and not wanting to be on the “wrong side” of the trans issue. My colleague and friend, Cori Cohn, wisely advised me that pursuing the matter could limit future employment options due to media exposure that the case could attract. Sadly, I let it go.

Part of me regrets speaking so freely at that job. I sometimes wish I had lied in the struggle session or stayed quiet during the indoctrination. They had no evidence, just the hearsay of zealots. On the other hand, another part of me doesn’t regret speaking honestly. I don’t know how much longer I could have tolerated working under such bizarre conditions in the field. I have seen firsthand how public health collapses when it prioritizes identity over outcomes, slogans over data, affirmation over quality. My cancellation did not change what was true; it only revealed who was unwilling to admit it.

I don’t know if I will ever find my way back into the profession I once loved. But I do know that silence will not fix the problem, and compliance with the lies has never protected anyone—not clinicians, not researchers, and certainly not patients. Especially not disturbed trans-identified people, like Ayden. If anything improves, it will only be because enough of us refuse to pretend anymore.

Until then, I am rebuilding my life outside the system that cast me out. I am grateful for my colleagues and friends at LGB Courage Coalition. Perhaps someday the public health field will remember what it is supposed to serve: not ideology, not activism, but the health of human beings.