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.