'They die there in the hospital. ... They were transgender and took their life. They were 10 years old.'
The phone rings. Another admission. The pediatric ICU has only one bed ― our “crash” bed, saved for only those in the most critical condition.
I wish I could say this story is an exaggeration. While details have been altered, this scenario is real and, sadly, not uncommon. More than 50% of transgender and gender diverse individuals have seriously considered suicide. The exact number is difficult to determine since we do not include gender identity on death certificates ― many of which I’ve filled out.To me, the “specialized” care I do is just another component of my primary care practice.
I went to high school in a Texas suburb. I never thought much about the LGBTQ+ community. My junior year of high school, a new girl moved from Austin who identified as bisexual. The thought of being anything other than “straight” had never crossed my mind. After this, I started exploring my sexuality and quickly realized I was a lesbian.Unfortunately, this realization was not met with as much ease by my peers.
On day one of the training ― “LGBTQ+ 101” ― I was discussing gender and sexuality as a spectrum rather than binary concepts. Out of the corner of the tunnel vision I had because I was so nervous, I saw a hand raise in the crowd. I recognized the face ― a provider known for being anti-LGBTQ+ and for openly refusing to prescribe pre-exposure prophylaxis for HIV prevention, something that was well documented to significantly reduce the rates of HIV transmission.
Now, as a practicing physician in Los Angeles, I am a part of a specialized gender health program, a wonderful cohort of people who provide multifaceted care to transgender and gender diverse individuals of all ages. Yet, even here, the physicians who are “LGBTQ+ specialized” are responsible for educating medical students, residents, faculty and entire health systems, in addition to providing care for these communities.
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