Why Are Many Doctors Scared of Transgender Patients? By Kristie Overstreet (Transcript)

Kristie Overstreet PhD at TEDxLivoniaCCLibrary

Here is the full text of transgender care expert Kristie Overstreet’s talk titled “Why Are Many Doctors Scared of Transgender Patients?” at TEDxLivoniaCCLibrary conference.

Kristie Overstreet – Transgender care expert

About six months into my career as a therapist, I was working at a drug and alcohol rehab facility. I got a call from one of the nurses down at the detox unit. She asked me to come down and assess one of the new patients that had arrived earlier that day.

So I went down to the unit and had the pleasure of meeting Anne. Anne’s a transgender female. And as her and I started talking, she was sharing with me about what brought her into treatment. But I could hear this fear in her voice, and I could see this worry in her eyes.

And she began to tell me that she didn’t fear coming into rehab and having to give up drugs and alcohol. Her fear was that the doctors that were going to be treating her would not treat her as her female self.

She then told me about this ongoing pain that she has experienced her whole life of being assigned male but knowing she’s female.

And what she meant by that is when she was born, the doctor held her up to her parents and based on her genitalia said, “It’s a boy.” She always knew she wasn’t a boy.

Many years passed and the feelings that she was feeling and holding all this in grew and grew, and she knew she had to come out to her family. And when she did, it didn’t go over so well.

Her parents said, “Absolutely not. You’re not a girl. This is not how we raised you. We don’t know what you’re thinking. Get out.”

So Anne then found herself on the streets and in and out of homeless shelters, and it’s here where she started using drugs and alcohol to numb this pain she felt inside.

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She told me about her journey of being in and out of hospitals and rehabs trying to get sober. And when she did, the health care providers and doctors wouldn’t use the correct female name or pronouns. This caused her pain.

You see, when I was studying to become a therapist, I wasn’t taught how to work with transgender patients. I had no idea these would be the patients I’d be working with.

But the more I worked with Anne and other patients like Anne, I began to see my mission evolve. And that was to make sure that the transgender community got their health care needs met.

The more I looked into this, I saw how this very real fear of violence, discrimination and this lack of acceptance caused so many of these patients to turn to alcohol and drugs.

And I also heard these horror stories of when these patients were seeking medical care and how they were treated, and how a lot of their medical needs were ignored.

Now let me tell you about Leah. I had the pleasure of meeting Leah a few years back. She’s a female and she has a wife and a child.

See, Leah was also assigned male at birth, and she knew since she was a young child that she was not a male, that she was a female. She hid it from herself and from everyone she knew, especially from her wife, until the age of 50.

She couldn’t take it anymore. She was like, “I can’t keep living like this. I’ve got to get honest.”

She was extremely scared to tell her wife. What if her wife said, “This is unacceptable. I want a divorce. Get out”?

To her surprise, her wife was accepting. She said, “I love you regardless of who you are. I want to help you in every way I can.”

So she talked with her wife, and she made the decision that she wanted to medically transition. And she was interested in being assessed for hormone replacement therapy, otherwise known as HRT.

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So she made an appointment with her doctor. She arrived on the day of her appointment, early. She filled out all the paperwork, put the name correctly down there and waited patiently.

A little bit of time passed and a nurse called her back to the exam room. When she got back there, she took a deep breath, and the doctor and the nurse walked in. She extended her hand to the doctor and said, “Hi, I’m Leah.”

The doctor looked at her, didn’t shake her hand and said, “Why are you here?”

She took another deep breath and said, “Well, I’m a transgender female; I’ve known this my whole life. I’ve hid it from everyone, but I can’t do it anymore. My wife’s supportive, I can financially afford it, I’ve got to make these changes. Please consider me, and let’s evaluate me for HRT.”

The doctor said, “We can’t do anything today. You need to go get an HIV test.”

She couldn’t believe it. She was furious. She was angry. She was disappointed. If her doctor treated her this way, how would the rest of the world treat her?

First, he wouldn’t shake her hand, and second, when he heard she was transgender, all he cared about was getting an HIV test and ending the appointment. He didn’t even ask her any other questions.

See, I can understand where Leah’s coming from because the years that I’ve worked with the community, I hear myths every single day that aren’t true at all.

A couple of those are “Every transgender person wants to transition with medication or surgery”; “Transgender people are mentally ill, this is a disorder”; and “These people aren’t real men and women.”

These are all myths and untrue. As this community expands and grows older, it is imperative that all health care providers be trained on how to take care of their health care needs.

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Back in 2015, a survey was done and found that 72% of health care providers did not feel well-informed on the health care needs of the LGBT community. There’s a huge gap in the education and training.

Today, in this talk, I want to offer a new way of thinking for three groups of people: doctors, the transgender community and, well, the rest of us.

But before we do, I want to cover a couple of definitions that’s going to help you wrap your head around gender identity a little bit more. So I hope you’ve got your paper and pen. Get ready to take some notes.

So let’s start out with this idea of a binary system. And what this means is, before, we always thought there was only two: male and female. Get it? Binary? Right?

So we’ve come to find out that this isn’t true. Gender identity is a spectrum with maleness on one side and femaleness over here on the other side. This spectrum of identities include identities such as gender-nonconforming, gender-affirming, gender-nonbinary, two-spirited, three-spirited, as well as people that are intersex.

The term transgender is this umbrella term that encompasses all these different types of identities. But for today’s talk, I want you to think about transgender as someone who is assigned a sex at birth that doesn’t match with who they are as a person and their sense of self.

Now, this is very different than biological sex. So gender identity is sense of self. So think of it as what is between your ears: sense of self, who you are. This is very different than biological sex, right? Hormones, genitalia, chromosomes: that’s what’s between our legs.

Now, you may be thinking, “Dr. Kristie, I have never questioned who I am. I know I’m a man, or I know I’m a woman.”

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