The healthcare catch-up


At the invitation of my endocrinologist, last week I attended an afternoon of transgender education at a local hospital, which is part of the IU Health system. The afternoon began with a one hour lecture to more than one hundred—Trans Ed 101, if you will—and concluded with a two hour Q & A with a number of representatives of various areas of healthcare.

IU (Indiana University) Health is in network for the insurance Julie has through her job. Because IU Health has doctors in town covering you-name-it, I became a patient with them for my transition, not to mention my new primary care physician, cardiologist, and more.

When, after Wednesday’s main presentation, I had opportunity to address the auditorium, I later learned that, besides being littered with nurses and technicians and doctors, this group ran the scale of the more experienced to those who have had little or no interaction with patients who are transgender. In the Q & A with the group of eight, only two said they had ever knowingly met a transgender person.

That meant that, for seventy-five percent of them, I was the first trans person they had knowingly met.

The purpose of the larger presentation was to provide the basics regarding gender dysphoria, the differences between sex and gender, the wide variety which comprises those on the transgender spectrum, and many helpful insights so that these folks might do well for their trans patients. The presenter did a marvelous job and, as the mother of a female-to-male trans son, spoke eloquently from her experience.

The purpose of the small group session was to dig deeper. My endocrinologist, Dr. Melissa Cavaghan, led the discussion. She provided both medical information and reflections from her having cared for many trans folks. It didn’t take much from Dr. Cavaghan to launch the group into enough questions that we never had a lull during the two hours.

During the main talk, the presenter showed the progression of names for the condition which is generally behind one’s being transgender. For years, it was “gender identity disorder.” Seeking to rid this of “disorder,” a few years ago the official name was changed to “gender dysphoria.” The presenter then suggested that, in time, it might be renamed “endocrine dysphoria,” to highlight what some, perhaps most, find is the origin of the condition/malady, that a person experiences ill feelings of self because the hormone system is out of order.

This has been my thought, so I liked her idea. When in the small group, Dr. Cavaghan, who is an expert of the endocrine system, said that she does not think this is only a disordering of the hormones, and might not be at all, and that we really have no idea why some people experience gender/brain and sex/biology which do not match.

Putting into my own words what she said in conclusion, she hopes we get to the day where we simply accept it, that it is a fact of life for some people, and that we provide good care to those experiencing gender dysphoria and give these folks a fighting chance at a good life.

I certainly want the latter two of her thoughts to occur, but I am not with her on the first one. No matter how a person considers gender dysphoria—the range is from those who find transgender a completely normal way to be, to the likes of me who find it a physical malady and a terrible situation—the fact is that, in most cases, it has to be treated medically, at the very least with cross-sex hormone therapy, and with re-socializing as the other sex, and with great disruption in the lives of those transitioning, perhaps with surgeries, and at great cost.

Since when do we accept any situation in life that has so much struggle and effort and cost attached to it? We do not. We seek to find causes. Create solutions. Keep it from occurring it if it might be preventable.

At the close of my short talk to the group in the auditorium, I quickly sketched the wide range of doctors I have seen since moving to Indy in 2014—the three surgeons for my transition surgeries, a cardiologist, a podiatrist, eye surgeons in two offices, an endodontist, and a primary care physician—and remarked on the wonderful treatment I have been given in every place. I thanked everyone in the room and encouraged them to keep on doing well.

Politically, Indiana is quite conservative and very traditional. (We sacrificed our governor, Mike Pence, for the sake of the nation. You’re welcome!) Yet, let no one accuse Indiana of being in the dark, of living in the past, of being backward. Having now been here nearly four years, my experience, living outwardly as a transgender person, has far exceeded all notions and concerns I had, of everything Julie and I discussed before deciding this is the place to which we would move.

IU Health admits that it is a bit behind with transgender healthcare, hence the title I chose for this piece. Fair enough. The good news is that they recognize it, they are striving to catch up, and they have a collective heart to do so, to provide good care and a hopeful future to its transgender patients.

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