Creating Safety in Small Symbols

John Grab, DO (he/him)

I learned early on what it means to read a room. Growing up gay in the South taught me to scan for signs, both literal and emotional, that I was safe. Now, as an obstetrics and gynecology resident in a place where open support is rare, those signs still matter. Only now, I get to choose which ones I put up.

Sometimes inclusivity begins with something as subtle as a badge pin, a pronoun sticker, or a rainbow watch band. These small details may seem minor, but they convey a clear message: you are welcome here. For patients who regularly feel judged, ignored, or misunderstood in health care, even a quiet gesture can create a sense of safety and belonging. Often, that is all it takes for someone to finally exhale, to feel like they can speak honestly and be seen for who they are. Visibility itself can be a powerful form of advocacy. In environments where visible support is lacking, even unspoken cues can help a patient feel less alone. I have cared for patients who tear up not because of what I say, but because they realize they do not have to explain or defend who they are. That kind of connection stays with me. But truly being affirming takes more than a shared identity: it requires real intention. This is why I continue to bring Pride flags into our spaces, wear inclusive accessories daily, and create opportunities for conversation among colleagues. I answer the questions people are hesitant to ask, help bridge gaps in understanding, and remain open even when it is uncomfortable. The effort matters.

Still, it is not always embraced. Pride symbols have been removed from clinical spaces after being labeled “not inclusive” or accused of being “pushed in everyone’s face,” as if visibility itself is an act of aggression. Even now, as a physician, I continue to feel the weight of quiet judgment, the awkward silences, the subtle shift in tone that makes it clear I am being seen differently, and not always kindly, once someone realizes who I am.

That is exactly why we need to continue, because every symbol, every gesture, and every conversation can make a difference. For each moment of pushback, there is a patient too scared to come out and unsure where to start, a gender-diverse patient worried whether their identity will be respected, or a couple nervous about how they will be treated. One moment of safety can quickly change everything.

Pride is not just about celebration. It is about creating a space, both visibly and vocally, for those who continue to be pushed to the margins. If a flag, a sticker, or a single conversation can help someone feel seen, safe, or respected, then it is worth it.

We are all threads in this fabric of freedom. And while I may be just one, I hope the spaces I help weave feel warmer, more welcoming, and more whole for those who come next.

John Grab, DO, is an obstetrics and gynecology resident in Oklahoma and the incoming Junior Fellow vice chair for ACOG’s Oklahoma Section. He is passionate about inclusive care, with a particular interest in reproductive endocrinology and infertility for LGBTQIA+ patients.

This June, ACOG wants to hear from members about what the WorldPride theme of Fabric of Freedom means to them in 2025. Email [email protected] to share your thoughts.

Disclaimer: Published submissions reflect the experiences of individual ACOG members and may not represent official organizational opinions of ACOG.