Editor’s Note: Dr. Saju Mathew is a primary care physician and a public health specialist. He is a CNN medical analyst. Follow him on X @drsajumathew and Instagram @adventureswbubba. The views expressed in this commentary are his own. Read more opinion articles at CNN.

CNN  — 

I was depressed and anxious. It was August of 1999 and getting through my shifts as a medical intern at Grady Hospital in Atlanta was a nightmare. The reason? I had just broken my one-year engagement to a very pretty doctor, a young lady introduced to me by my parents via an informal Indian arranged-marriage system, a tradition practiced by my family for generations. But I did it for the right reason. I am gay and I hid this secret for many years.

Don Stallings Photography
Saju Mathew

Now, as we observe Pride Month, I recall those days of tremendous pain and reflect how coming out set me free but also marked the beginning of a long and winding road of healing and acceptance.

You see, coming out isn’t much an act as it is a process. That process isn’t the same for all of us in the LGBTQ community. Mine started at the core of an Orthodox South Indian Christian family in Nigeria, West Africa, where I was born and raised.

I was a dark skinned, left-handed kid with curly hair, unfortunately not the most celebrated features for an Indian boy. And to make matters worse, I’m the only son to my very loving strict Christian parents. From the moment I was conceived, you could say, my future was already planned and destined.

India has a very long-standing tradition of arranged marriages which, while declining, remain common. In 2020, 68% of new marriages in India were arranged versus 44% in 2023, according to a survey.

The “system” works as follows. Family members and friends in the community make recommendations, you meet the person and if you are not interested, you move on to the next one. They match your interests, hobbies and even occupation of choice, as seen on the popular Netflix show, Indian Matchmaking

My entire family and cousins of my age have had arranged marriages for generations. I am the first one in my family to break this tradition. And I did pay a price for this truth.

In my culture, getting married is sign of stability and prestige. And the pressure of not having a child, especially a son, in the traditional way, to carry my family’s name always weighed heavily on my mind. Being gay can be perceived as very shameful and devastating to an Indian family — regardless of how incredibly accomplished you might be.

Silently, even today, most Indian parents would be thrilled if their kids became doctors —it’s estimated that India is the biggest source country for doctors in the US.  I was never forced to go into medicine but perhaps I felt that due to my sexuality I could make it up to my parents by becoming a doctor.

Courtesy Saju Mathew
Dr. Mathew at 8 months old in Kabba, Nigeria.

I knew what was expected of me, but I also knew I was different. I didn’t feel like the other boys in my class. I was never physically attracted to women, but I was always close to women, especially my mother and my sisters.

From the time I was about 11, I was pretty sure that something was not “right” about my sexuality. I thought that if I prayed and strictly focused on my goals, everything would work out.

First and foremost, I was determined to leave Africa after high school and start college in the US. This would give me a much better chance of getting into a good medical school. Then, I would find a way to postpone the wedding for as long as I could. This was my plan and it got me through the next few challenging years.

But my worst nightmare was quickly approaching. The excuses of “she’s too short”, “not tall enough” and “let me get through residency” that I had been using all throughout my adulthood were leading me to a dead-end. But while I struggled with my secret life, academically, I was thriving.

After four years of hard work in college, where I earned a fully paid merit scholarship, I finally was admitted to the prestigious Morehouse School of Medicine in Atlanta. Four more brutal years later, I was about to start my internship in family medicine at the Emory University School of Medicine, when my family made it clear to me — it was time to get married.

I met my ex-fiancée when I was just starting my first year of residency. She was finishing her last year of medical school. I was hoping she wouldn’t like me at that “first meeting,” which by the way is a very big deal in my culture. Unfortunately for me, she did.

Courtesy Saju Mathew
Dr. Mathew in 1998, during his medicine school years in Atlanta.

Our families also adored each other. Despite meeting through a very complex and detailed network of “aunties’ and “uncles,” we might as well have dated in college — that’s how wonderfully they paired us. We had so much in common.

We both were born and raised outside of India, we were overworked doctors in training and even had common tastes in music and a strong love for the game of tennis. I felt so sad that while this would have been exactly the person and family I wanted, I couldn’t have this. It wasn’t for me.

I was very sad and angry at the same time. Suddenly, the whole premise in India that “ you don’t marry the girl you love, you love the girl you marry” seemed so real. I could have loved her and her family. This could have been a marriage made in heaven.

From the moment we met until our engagement, everything happened so quickly. I couldn’t stop the train. Before I knew it and after meeting her a few times, I was putting a ring on her finger during an Indian engagement ceremony that drew over 500 people.

I knew I was making a huge mistake. I would not only ruin my life but hers and her family’s. I wanted to make this work — for me, for my family and for her. I wanted that big Bollywood wedding every Indian guy dreams of. “How could my family and the ‘system’ do such a great job with this match?,” I thought. I wanted to make my parents proud for all the sacrifices they had made to get me here. My mother had even given up her PhD studies, so she could be home with us as kids. All of these sacrifices flashed through my brain day and night.

My then-fiancée moved to Atlanta in June 2000 to start her residency. Our wedding was set to take place in a few months. But I couldn’t take it anymore. I was ridden by guilt. Then, motivated by some very close European friends who knew my truth, things cleared in my cluttered brain. I was the only person that could make this right. And yes, I forced myself to realize that sometimes even your “perfect” family may not have the right answers.

Courtesy Saju Mathew
Dr. Mathew getting ready at CNN's studios in Atlanta for a segment last May. He's been a medical analyst at the network since 2020.

After many long and painful conversations that lasted to the wee hours of the morning, my ex-fiancée finally understood what I told her. At first, she was in denial and came up with every possible solution to every potential problem that would arise in our marriage. But, finally, we decided to call everything off.

I had to tell my family the truth and try to get through my residency, all at the same time. The next many years were tough — counseling sessions, taking some time off during my training, feeling insecure and being the therapist to all my family members. You see, there is a lack of support system in my culture for this sort of and issue; it’s something no one wants to talk about. You feel very isolated and lonely.

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It took me decades to find the strength to even write this op-ed. I am hoping that sharing my story will give those in a similar situation the strength to reach out, seek professional help and live their truth. We South Asian members of the LGBTQ community need our families to find the strength to talk about their gay kids with the same pride as they speak about their straight children.

I am convinced now that God makes no mistakes. I believe we were created extra special due to the hardship we have to face. But in our families, the mold must be broken. And that starts with difficult conversations and honesty.

Now I am quite content with my life. I am so happy I had the strength to come out. Yes, I caused a lot of pain, but at least I get to wake up every morning knowing I did the right thing.

My family has come a very long way and I am proud of them. It’s not easy to fight a strong traditional ancient culture but this is how I did it. It wasn’t perfect. I am not perfect. I made mistakes along the way but it’s my story. I hope and pray some young Asian kid out there will also have the strength to stand up and do the right thing — live their truth.