Bodies in Confidence

The podcast discusses the history and ongoing fight for transgender healthcare. It highlights the discrimination and lack of access to healthcare faced by non-binary, gender non-conforming, LGBTQ+, and transgender individuals. The episode mentions the book "Bodies in Doubt" by Elisabeth Reeves, which explores the oppression faced by intersex individuals. It also discusses the evolution of transgender healthcare, including the establishment of the first gender-affirming care clinic in the US in 1966 and the changing perspectives on transgender identity. The progress made in transgender healthcare is acknowledged, but the fight for equality continues. The episode concludes with an interview with Elaine Chuang, who discusses the importance of trans healthcare and her advocacy efforts. Welcome to Trans Care, where gender meets medicine. The podcast that's here to prove that navigating the labyrinth of trans healthcare does not have to be as confusing as Drake and Kendrick Lamar's current silly beef. My name is Dyrene, a current nursing student and gender warrior at the University of San Francisco, and today we tackle the history and ongoing fight towards trans healthcare. To all the listeners who are with us today who have ever been othered, dismissed, or just outright plainly discriminated against in a healthcare setting, we see you and uplift you to demand the healthcare that you so rightfully deserve. It's about damn time healthcare got its shit together. If you have ever been to a doctor's office, you are probably familiar with a phenomenon known as white coat syndrome. White coat syndrome is a term coined to describe the anxiety that a majority of patients have when they see a doctor in a white coat, with some patients even showing symptoms of an inaccurate high blood pressure. Although this is a widely popular phenomenon due to the, let's be honest, scary-ass nature of seeing a figure in an unfamiliar uniform from Grey's Anatomy, this fear and anxiety is elevated in individuals who belong to the non-binary, gender non-conforming, LGBTQ+, and or transgender community. Our current healthcare system, plagued by its discriminatory past, continues the oppression of these individuals, and as a result, lessens their access to health and negatively contributes to their health outcomes. A major source of inspiration for this episode came from a reading from our Gender Warriors class. Bodies in Doubt by Elisabeth Reeves is a novel that encourages us to consider the physical bodies of those outside the binary. Filled with medical jargon that is surprisingly and impressively digestible, considering that many medical texts are not as easily comprehensible, she outlines the history of oppression that intersex individuals have faced and continue to face. Reeves analyzes the ways in which the medical perspective of intersex people changes based on the gender view society has at various times in history, and as a queer nursing student, it really is fascinating to learn about the intersection of medicine and history. Want a break from the ads? If you tap now to watch a short video, you'll receive 30 minutes of ad-free music. Yes, really. If you tap now to watch a short video, you'll receive 30 minutes of ad-free music. Someone doesn't have Spotify Premium. How embarrassing. Anyways, I also wanted to highlight the evolution of transgender health care, a published research article by the American Journal of Managed Care in which they emphasize some vital moments that shaped trans health care, starting in the early 1900s and making its way to our current era. The first being the establishment and opening of the first gender-affirming care clinic in the United States in 1966 by Johns Hopkins Hospital. This clinic was really the first of its kind, but after a short 13-year run, Johns Hopkins actually closed down the clinic because of a study from Johns Hopkins themselves that suggested that gender reassignment procedures, and I quote, did not provide substantial psychosocial benefits to those who received it and that these individuals were not better off in this regard compared with those who went without the procedure. Yikes. Talk about cisgender bias. Am I right? On the bright side, this created a surge of academic interest in transgender care, which led to the opening of other gender-affirming care clinics outside of Johns Hopkins and put even more of a spotlight on trans health care and scientific research regarding the topic. Are y'all still following? So basically after that in the 1980s, the American Psychiatric Association listed a new term, gender identity disorder, to their DSM in order to categorize transgender individuals as having a disorder, which is plainly wrong and so, so dehumanizing. But because the transgender community prevails amidst adversity, this new diagnosis actually allowed a good amount of transgender individuals to gain some access to health care. Categorizing the transgender identity as disorder did not disappear surprisingly until 2013 when it was renamed gender dysphoria and opened the doors for Medicare to include gender transition procedures under their coverage in 2014. Although the fight for trans health care has been long and still continues to this day, it is important to note the progress that has been made, especially with the hard work of transgender and non-gender conforming individuals of color who are rarely highlighted in history books. I hope that gave a small glimpse into the evolution of transgender health care and as always, I encourage you to do your damn research about topics like this. Next up, I want to introduce Elaine Chuang for a trans table talk regarding trans, non-binary, and gender non-conforming care. Okay, and now Elaine is going to introduce herself. All right. Hi, my name is Elaine. I use she, they pronouns. I identify as non-binary and I'm currently a resident advisor for one of the gender inclusive floors at the University of San Francisco. Yeah, so why do you think trans health care is so important? Hey trans. Sorry. Both as a patient yourself, someone who's like not, does not fit the usual binary, but also as a health care professional taking care of other patients. Yeah, I think it's important first off, like as a patient, because being trans is a part of a lot of people's identities. Transgender falls under a whole umbrella term of different identities. For example, like I'm non-binary. Some people do go through gender affirming care and some people don't. And just knowing about that is very important for patients because that'll influence the way that you kind of interact with them and just know how to, what procedures they may have done or what medications they may be on. Especially as a health care provider, you need to be knowledgeable of this. Because it's like, it's a part of health care. Like it's not just like trans health care and cis health care in a way. It's just overall health care, but you do need to be informed about it. And lastly, do you want to speak about your experience with AACN and what you did over in D.C.? Oh, yeah. So this past March, I was one of five nursing students that went to the AACN, which stands for the American Association of Colleges of Nursing Student Policy Summit. And basically what that meant is I traveled to Washington, D.C. with the intent to advocate for trans health care, especially since all of my residents are transgender or fall into that umbrella term. Some of the things that were really nice was I got to meet a lot of like-minded students and get to talk to them about why I'm passionate about trans health care, both from my identity and from my experience helping the trans community on campus. Like, unfortunately, on campus, we don't have that many trans resources. So I have been referring my residents to off-campus resources and doing a lot of education on my part and their part. So at the AACN, it was a similar experience. So I got to meet a lot of students from different universities. But on the legislative level, it was a little harder because the purpose of the policy summit was more to further the AACN schools, which is more directed towards nursing schools as a whole. And while I did kind of transition my advocacy from like, OK, trans health care as a very broad thing, like we need more trans health care, I kind of had to pivot towards we need to educate more nursing schools about trans health care so we can produce providers that are more competent about it. So it was a little difficult because like one of the congresswomen said up there, the best time to talk about things is when there's a lot of high interest and low like opposition. And trans health care is, of course, like a topic that has a lot of high interest, but there's a lot of opposition to it or like a lot of debate. So it was a bit difficult to advocate for it up there. But I'm hoping that in the future, and at least locally, there will be better changes so we can further escalate. Well, thank you for speaking on this podcast. Do you have any final words that you want to say? I am presenting this to my gender warriors class where throughout the semester we have learned about individuals in history or throughout history that were gender nonconforming, that just didn't fit the binary. Maybe they were trans, maybe they weren't. But what do you have to say for our class or for students that are themselves either trans or want to be advocates like you? Um, I think it takes a lot of education and kind of just admitting that this may not be a topic that you know about. Because for me, I'm non-binary. But so I have not gone through any of like the gender affirmative care like my residents have, like some of them are currently transitioning. So for me, that took a lot of education on my part. And asking people that did go through those experiences, how that went for them, and then relaying that information. It's like, I think it's very, it's really good to advocate for the trans community, but you also need to uplift the actual trans voices so they can tell their actual story. Because I think there's a lot of subjectivity to this and a lot of emotion. So it's good to bring your own opinions, but also make sure that you're speaking for and with the people who are actually experiencing these transitions. Okay, thank you.