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With or Without Children: In All Honesty, It's None of Your Business

Narjust Duma, MD · Florez Lab

Disclosures

April 12, 2022

"Do you need to go and pick up the kids?" I am asked by one of my colleagues as I leave the elevator. This particular circumstance allowed me to walk away without needing to answer, but this is not always the case. As a woman in my 30s who has completed training and is now a junior faculty, I often need to explain or justify why I don't have children, and often do it in a way so that the person asking does not feel offended, when in fact it is none of their business.

Society has set "goals" for all, but some are strictly enforced for women, such as parenting and the decision to mother/father/care for other humans. If a man decides to delay parenthood, it is seen as a career choice; but for women, particularly for those in medicine, the story is very different. Women without children are often seen as more masculine (the assumption that not having children was a career choice), less empathic, or somehow "broken."

I have faced all of the questions.

"When are you having children?!"

"Time is ticking — when are we going to see a Duma baby?"

"I thought you were having a baby this year. Didn't you?"

My answers to those questions vary by the level of energy I have, if I have had my morning coffee, or if I know the person well. Sometimes, though, I blandly ignore them, because in all honesty — it is not their business.

A journey full of fertility treatments and changes in my relationship status have appeared in my route to motherhood, but it is often assumed that "I made the decision for my career" and am judged based on that assumption, though it is far from the truth. Time after time, I am portrayed as the "aggressive" woman that "doesn't want children," even before someone dares to ask me why.

I admire the work and dedication of mothers who also cope with the many pressures of academic medicine. As the daughter of a surgeon, I grew up hearing the horror stories of my mother needing to put in a Foley catheter when she was a pregnant resident, or her attending physician would not let her be part of a case or scrub for a surgery. That story, sadly, is only the tip of the iceberg.

Women continue to be punished for breastfeeding and pumping, through reports of their decreased productivity (RVUs) and changes in priorities, and often are left out of meetings because "they must attend to their children."

So ask yourself: How are these conditions appropriate? How is it fair to judge a woman for not having children, knowing the horror and backlash that she will experience, particularly in medicine? Would you jump from a bench knowing you will break your leg? I don't think so.

In medicine, women without children are often given call during the holidays, service during spring break, and are asked to meet later during the day because "they don't have children, they can do it." The goal of this post is not to request that women without children be treated in such ways, but rather, I (we) ask not to be punished for not checking yet another box that society has set up for us.

And my final answer is: "It is none of your business."

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About Dr Narjust Duma
Narjust Duma, MD, is originally from Venezuela, born of a Colombian mother and Dominican father. She completed her internal medicine residency in Rutgers New Jersey Medical School and fellowship at the Mayo Clinic in Rochester, Minnesota.

Her clinical interests include the care of women with lung cancer, including their unique aspects of cancer survivorship. She is the principal investigator of the Sexual Health Assessment in Women with Lung Cancer (SHAWL) Study, the largest study to date evaluating sexual dysfunction in women with lung cancer. She also has opened the first clinic in the Midwest dedicated to women with lung cancer only.

Dr Duma is a leading researcher in gender and racial discrimination in medical education and medicine. She is the recipient of the 2018 Resident of the Year Award by the National Hispanic Medical Association, the Mayo Brothers Distinguished Fellowship award, and the 2020 Rising Star award by the LEAD national conference for women in hematology and oncology. Connect with her:
Twitter: @NarjustDumaMD
Instagram: narjustdumamd

The Florez Lab, formerly known as the Duma Lab and the Social Justice League, was founded in August 2019 and focuses on social justice issues in medicine, including discrimination and gender bias in academic and clinical medicine, cancer health disparities, and medical education.

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