musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

Conceal me what I am, and be my aid for such disguise as haply shall become the form of my intent.


I realize that someone in his autumn leaf like me should be able to zero in on his identity fairly easily; there has been ample time to consider the question. But the trouble is there are still a few leaves left clinging to my branches as if their lives depended on it. So which to choose? And on whose authority can I confirm who I really am?

Age is such a muddle sometimes: so many choices made; so little time to decide on more. I sometimes feel I need to shout the defiant words of Macbeth near the end of Shakespeare’s play: ‘Damned be him who first cries hold enough’!

But it really is a dilemma to decide which of all the identities I inhabit is the most representative of who I am. That there may still be choices available is confusing to say the least. Perhaps I read too much -or at least did before my voice was broken, my wind shortened, my chin doubled, my wit singled, and every part about me was blasted with antiquity (with apologies to the damage done to Shakespeare’s Falstaff in his Henry IV, part 2).

Fortunately, there are at least two main choices from which my identities can be skimmed: a metaphysical identity, or an existential one -oh, and even more fraught with risk, both[i]: Sartre’s ‘existence precedes essence’ -which, I assume is my existential choice; or the preferred opinion of many feminist philosophers: the metaphysical choice. There is a fair divergence I have to say but in many respects they are both compatible.

Let’s start with Sartre’s existentialism. ‘We do not have an essence until we give ourselves an essence.’ In other words, ‘man first exists: he materializes in the world, encounters himself, and only afterward defines himself.’

Okay, I agree with that, but I’m also enamoured of the metaphysical view that identity is determined by social forces – how others identify me, not necessarily how I identify myself. It is, in other words, a necessarily intersubjective activity. What matters, in the end, is whether I meet the socially determined success conditions for the category in question.

But these are two different, but compatible forms of identity, aren’t they? ‘Metaphysical identity has to do with who you are, as a frank and straightforward matter of fact.’ That type of identity doesn’t require much soul-searching. I am a doctor (or at least was until I retired). Simply wanting to be a doctor, or feeling like a doctor, doesn’t actually make me a doctor.

‘Existential identity, by contrast, has to do with deeper truths about a person’s self, their cares and values. This kind of identity is private and intimate. In order to find out who you are existentially, I would have to get to know you, or you would have to trust me enough to tell me…  it might mean that you have to undergo a journey of self-discovery in order to get a better understanding of your deeper, existential self.’ This kind of identity doesn’t require outside approval from anyone; when it comes to existential identity, I define myself.

‘Existential identity feels both like something we discover and like something we choose because it is something we avow. When I discover who I am, deep down, I am not a passive observer. I am an active participant in the process.’ This is the self that I choose to be, that arises from self-creation and self-discovery.

Therein, of course, lies the rub: what if what you feel about yourself conflicts with what society judges about you? What if you are trans? Is gender something that other people have to give you? ‘How much should we, collectively, change the success conditions for metaphysical identity such that they allow a person’s metaphysical and existential identity to align? There is a real value to allowing people to be seen for who they are.’ That’s really what metaphysical identity is about, at some level: societal recognition… isn’t it? But shouldn’t we value the possession of a unified self?

Identity matters less to an elder like me than perhaps it might to a younger man, or even more so if I were trans gendered and trying to make my way through a skeptical world. I recently wrote and published an essay that touched on that.[ii]

It’s difficult to put myself in the position of the woman I met on a trail in the woods, and although at the time, I had no difficulty in accepting her as a fellow traveller, I wondered whether I might have tried too hard not to notice her chosen gender, tried too obviously, too embarrassingly -but not for her so much as for myself… I didn’t even ask her name, or introduce myself…

I saw her in sitting alone at a table in a local coffee shop the other day; the same multicoloured dress and hair with quite pronounced pink highlights. I asked her if I could share the table with her. She seemed startled at first, but then smiled and nodded her head.

“I don’t know if you remember, but I saw you on the trail a while ago, and confessed my friendship with a particular boysenberry plant beside the path.”

She smiled warmly at me. “Of course I remember you and your friend the plant… Who could forget that?” she added with a little wink. “My name’s Martha,” she said and extended her hand.

“I’m called G,” I responded as we shook.

“I’m new to the area,” she said somewhat hesitantly. “I just moved here from Toronto.”

“I went to a university in Hamilton a century or so ago,” I countered. “We were almost neighbours, eh?”

She blushed at that, and then tried to cover it by reaching for her coffee. “I… had a friend there once.” She thought better of trying to disguise it and put her cup back on the table. ‘He… well, he changed his mind…”

“I’m sorry,” I said. “Friends are important…”

She shook her head. “That’s what I thought… but I’m not so sure anymore.”

I sighed and sent my eyes to rest on her cheek. “I am. Everybody goes through rough times; you just have to show them you still care, give them some space, and then…”

Her smile lightened up the table. “And then keep in contact… like you and your Boysenberry bush friend?”

I nodded. “I mean look how easy it was to befriend me, eh?”

Her eyes immediately twinkled. “And I had to come all the way across Canada, to learn to trust myself…” She reached over and took my hand. “All the way across the country to learn how special friends can be.”

I nodded as she squeezed my hand and stood to leave. “Thank you,” she said and warmed the room once again with her smile.

[i] https://psyche.co/ideas/who-do-you-think-you-are-there-are-two-answers

[ii] https://musingsonwomenshealth.com/2026/04/29/intimacy-should-not-faint-like-a-pale-faced-coward/

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