“Thank you so much for being nice to me.”
That was the last thing he said to me at the end of our first visit. My patient and I had talked about a lot of things during his visit. We had made big plans for surgery (a hysterectomy) as a congruence measure. We had reviewed the risks of surgery, and also the benefits that would come to him from having his hysterectomy. But what he was thankful for, above and beyond medical expertise or surgical technique, was kindness.
“Thank you so much for being nice to me.” He said it again each time we met.
The first time he ended our visit that way — it was a heartbreaking moment of clarity. As a trans man, he had endured intolerance so many times, including in the medical setting. Imagine if for the majority of your life, you felt uncomfortable in your skin. You were told you need to “be” something you feel with every fiber of your being that you are not. When you get the courage to be your true self, you are told you are wrong. Then you go to the doctor, a place where you are all more vulnerable, more scared, more anxious. In the past, my patient had received judgement and prejudice, and he came away frustrated and uncared for. While it’s hard for me to stomach the idea of a physician being cruel to a patient simply because of gender identity, I know that it very much happens even today.
My goal of caring for any individual is that they feel my office is a safe space to talk. It could be about an ingrown hair, a new breast lump, concern about pregnancy, or concern about getting pregnant or not getting pregnant. My goal is for my patients to know they can come to me with all of their concerns and worries, and that together we can find a solution. The simple act of treating this man the way I treat every patient — with respect, dignity, and kindness — was a novel experience for him.
In this era when there is a perceived increase in acceptance, the LGBTQ community still experiences this kind of discrimination in all settings. Family, schools, and communities need to be safe spaces for all of our members, regardless of gender identity. So how can we be a better community for everyone?
At my practice, we take extra efforts to ensure we are open in our questioning with regards to gender identity and sexual orientations. I try not to make assumptions that we all exist as a cisgender individual with an opposite sexual preference from our gender identity. I made the mistake of asking a patient and her wife what they plan to use for pregnancy prevention after the birth of their child (major facepalm moment). They were gracious enough to laugh with me when I did that actual face palm during our conversation. So as much as I fancy myself an educated and woke individual on the subject of LGBTQ care, I still make errors of habit myself.
So how do we do better? Let’s start with the facts, and get some terms defined.
Gender identity. A person’s gender identity is his or her innermost core concept of self, which can include boy/man, girl/woman, a blend of both, neither, and many more. Gender identity is how individual people perceive themselves and what they call themselves. One’s gender identity can be consistent with, or different than, the sex assigned at birth.
Cisgender/transgender. The term cisgender refers to people whose gender identity aligns with their assigned sex at birth, whereas the term transgender can be used broadly to describe those whose gender identity differs from their assigned birth sex.
FtM vs. MtF terms. Transboy/Transman or FtM refers to a person who was assigned a female sex at birth but whose gender identity is boy/man. Transgirl/Transwoman or MtF refers to a person who was assigned a male sex at birth but whose gender identity is girl/woman.
Other. Gender fluid, gender queer or gender non-conforming are identities and descriptors to explain someone who does no identify as strictly male or female but rather presents and identifies as a person in between the gender spectrum.
What can we do as as parents if we have a child, adolescent, or grown child who identifies as transgendered? As parents, it starts with getting your kids in the proper medical setting. Seek care in a center where mental health and overall wellbeing is a top priority. You’ll want to educate yourself and your child about the transitioning process. You will learn about and discuss over the years all the possible treatments that can support gender congruence.
While I always consider myself a safe space for my patients, hormonal care and mental health care with transitioning individuals is best done at a center with expertise in this process. Your OBGYN, family doctor, or pediatrician can help get you in contact with the true experts in the field. At the end of the day, it’s about getting the medical and psychosocial support for your child and for yourself, arming yourself with information to tackle the biases that still exist in a world that struggles to create space for people who don’t fit into confined norms. Find local and Internet-based support groups to meet other families in your situation. You are not alone.
One term not outlined above that we do need to hear is transphobia: fear of, dislike of, and/or prejudice against transgender people. In a world without “phobias” in general, this topic wouldn’t be a hot one. That is not the world we live in today, but one that we can strive for tomorrow. The information above is just the tip of the iceberg when it comes to gender identity. There are so many great resources out there. For parents who may need a place to turn, the Family Acceptance Project is a really wonderful place to start. Its research shows that the most important and strong protective factor for a trans individual against poor mental health outcomes is “acceptance from family.” What we can all do as a community to support those who may be trans: Practice kindness; extend grace, love, and acceptance.
Isn’t that what we all want for ourselves, no matter who we are?
Originally published at Thank You for Being Nice :: On Honoring Gender Identity: