Dr. Maja Castillo on discrimination, navigating second parent adoption paperwork, and finding the right pediatrician for your family.
My pediatrician search was a cinch. When I found out that there was a lesbian mom pediatrician one block from my house, I knew in an instant that she would be my daughter’s doctor. I know not all gay parents have it that easy, though. Finding a doctor who is comfortable with gay families and with whom you feel comfortable is one of the top priorities gay parents-to-be face. This week I had the opportunity to ask my doc some questions that just might help other parents in their search.
IC: There are a ton of “questions to ask when interviewing a pediatrician” checklists out there. What do you think are the key aspects a parent should look for when choosing a pediatrician?
Dr. Maja Castillo: I think it should be very simple. Choose someone who will give advice without being authoritative. Choose someone who will recognize what is important to you and not make you feel judged for your personal decisions or choices. And most importantly, choose someone you feel comfortable with.
IC: Is there anything additional you would add for gay parents?
MC: For gay parents, I think that it is pretty much the same. The only thing I would add is make sure the person feels comfortable interacting with both parents equally and does not feel that one person is more of a “parent” than the other.
IC: Many people reading this interview are still in the process of conceiving or adopting a child. When do you suggest is a good time to start looking for a pediatrician?
MC: I think that it is a good idea to start exploring pediatric practices a few months before the baby arrives – most practices have group information sessions, websites or will discuss the practice over the phone. That way you are ready should baby arrive earlier than expected!
IC: Tribeca Pediatrics is a very large practice, however you work in a small branch of it where you are the only pediatrician. Because of this, I feel like you would have a good insight into both large and small practices. Can you describe for parents the advantages/disadvantages of a large practice versus a small one?
MC: The advantages of a large practice are that they typically have more accessibility and better hours, which can prevent long and scary ER visits. The disadvantage is that you can feel like your child isn’t really “known” well by anyone. Most large practices try to control for that by having you always see the same doctor and having a good communication system between doctors. The advantage of the small practices is you can really develop a personal relationship with your doctor. The disadvantage is they may be overworked – they can’t return your calls as quickly or accommodate visits anytime. And they still need to have their own lives – go on vacation, have sick days, etc. You may be sent to another practice or an ER in those situations.
IC: In general, do you think gay parents are now pretty much accepted by pediatricians? In other words, when two men or two women walk in with a child, do you think they might still face discrimination or do most pediatricians not really blink an eye these days?
MC: I would say it depends where you are. In Manhattan I think most doctors are very used to non-traditional families. However, in small town Alabama it may be more of a challenge. Unfortunately, discrimination can happen anywhere. When my partner was in labor with our eldest child, the first labor and delivery nurse (who was very young) pretty much ignored me as if I wasn’t an important person in the room! Maybe she would act that way to a father as well, I don’t know. As gay parents it is important to find ways to calmly set the record straight with these people we encounter.
IC: What should a parent do if their doctor seems ignorant about gay parents (for example not treating both parents equally, etc.?)
MC: I would say in general it’s best to assume that the person has the best intentions and is just not aware of the way they are coming across. This is an opportunity to educate someone about how gay parents are just like everyone else. I would tell the person that I want to discuss something with them and tell them how they are coming across to us and how we would like to be treated. If they respond negatively, it’s time to find a new pediatrician.
IC: Have you ever felt discriminated against in your profession (such as if a patient’s parents found out about your sexual orientation and treated you differently)?
MC: I’ve only had one unfortunate comment made by the father of a patient. He thought he was being funny.
IC: Do you talk openly about your sexual orientation to your patients’ parents? (or only if it comes up, if they ask, etc.?)
MC: In general, I talk about it openly if it comes up.
IC: I love the line in Modern Family when the pediatrician told Cameron and Mitchell, “Babies are designed to withstand new parents.” As a first-time parent, I know that I made a few calls to your office in between visits when Ava was a newborn. What is the most common “new parent” question/concern leading to an off hours/in-between visit call?
MC: Crying. Most new parents are completely thrown by the “bewitching hour” crying between the second and sixth week of life. I try to “warn” new parents about this phase but it still causes a lot of understandable worry for new parents!
IC: Can you explain to potential parents out there what happens when someone calls with questions off hours? Do most pediatricians also respond to email questions from parents?
MC: Most practices take turns being on call for urgent matters after hours, meaning you will talk to someone in the practice. Other practices have a nursing service or call service that will give advice and only contact your pediatrician if there is a problem. Most pediatricians do not respond to emails due to the legal issues it raises.
IC: Would you say that you notice any difference between your patients with gay parents and those with straight parents?
MC: It’s a HUGE generalization and not true in all cases, but in general I find that gay daddies tend to worry less and ask fewer questions while two gay mommies often leads to twice the questions. I think it’s a condition of being a mom…we feel it’s our job to worry!
IC: I was very impressed with your article about second parent adoption. I know that personally that was one of the reasons we chose to have you as Ava’s doctor. It was wonderful to not have to explain the whole crazy process in order to get the necessary forms filled out and “letter of good health.” You just knew exactly what was needed and what to write. Do you think that most pediatricians know about this process by now? How do you suggest patients go about getting this information from their pediatricians who may have never heard of the process before?
MC: I think most pediatricians don’t know about the process – especially how long it takes or how hard it is on families, having to have a home study and getting fingerprinted and all of the legal stuff…However, we ARE used to filling out forms. Lots and lots of forms. So just ask for exactly what you need. Many lawyers will actually write out a form letter that the pediatrician just so to sign and stamp. If your lawyer doesn’t, take the initiative and just write up a letter stating the child is in good health and attends all their scheduled visits and leave a place for the doctor to sign!
IC: As a gay parent yourself, do you have recommendations about family groups or resources in NYC?
MC: The LGBT Center. They also have a family friendly gay pride celebration.
IC: Do you have any other recommendations for gay friendly pediatricians 1) in your practice, 2) in other practices in the area and 3) outside of New York City?
My practice is 100% gay friendly – there are several gay doctors and nurse practitioners and everyone is familiar with the issues gay families face. Unfortunately there is no “list” of gay friendly pediatricians*, but I think it is definitely a question you should ask when considering any pediatrician before taking your child!
IC: Thank you so much for taking the time to answer these questions! Is there anything else that you’d like to add to help guide our readers through the adventures of parenting?
MC: Let me think about that…there is so much to say. The main thing is just don’t read too much and ENJOY!
*Although IC has put a list of gay-parent-recommended pediatricians in the NYC area. Check it out!
Dr. Maja Castillo, a board-certified pediatrician practicing at Tribeca Pediatrics in Manhattan, earned her undergraduate degree from the University of Chicago and her doctorate from Columbia University College of Physicians and Surgeons. In 2008, she completed her residency in pediatrics at Columbia’s Children’s Hospital of New York. Maja has a particular interest in complementary and alternative medicine and is an active member of the Integrative Pediatrics Council. Of Puerto Rican heritage, she is fluent in Spanish. Maja currently resides in Manhattan with her partner, Steph, their daughter, Marcella and their twins, Isadora and Gaetano.