Book Review: Trans Medicine by Stef M. Shuster

Transgender and non-binary issues are beginning to come to the forefront of today’s world and access to medical care is one of the most important and nuanced matters for many transgender individuals. Adequate access to transitional surgery and hormones for those who want it is crucial to garnering equality and a comfortable life for gender minorities. While certain aspects of transgender care has improved and changed over the past century, there are still many complex issues that need to be addressed if transgender people are to have full bodily autonomy and access to adequate care. In their book, Trans Medicine, Stef M. Shuster discusses how transgender medical care has evolved from its beginnings in the early 1900’s to the more contemporary issues that the transgender population are dealing with today.

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Theory to Praxis: PurpLE Clinic

Background:

            Last spring, I took the class called Graphic Med: Drawing Disability with Dr. Fox. Specifically, the readings that we completed in the transgender unit really struck me because they exposed the treatment of transgender people, and LGBTQ+ people, in the medical world. This year, I am in both GSS 101 with Dr. Gonzalez and Child Psychopathology with Dr. Stutts. Both classes have highlighted the struggle that transgender people go through, specifically when it comes to being treated and understood in the medical world. Studies have shown that transgender youth as well as other LGBTQ+ people often avoid seeking medical care because they feel that doctors are not fully equipped with the knowledge and ability to help them (Thu et al., 2020.) Additionally, there is a large distrust of the medical world because of outdated practices by older physicians (Hackman et al., 2020) and a need for increase funding and inclusion for procedures and support services that directly benefit LGBTQ+ patients. Similar to what we learned about women’s representation through the creation of the Committee on the Status of Women in India (1974) and its purpose, something similar needs to occur in the medical world for transgender youth.

Goal:

            Sexual violence and assault is experienced by the majority of LGBTQ+ members, but a staggering 64% of transgender people alone (DeKeserdy et al., 2017). The stress and risk of lifestyle judgment keeps transgender people away from medical offices (Hackman et al., 2020). Combining what I have learned in these impactful classes, and acknowledging that there is so much more to learn, I have drafted this proposal for the Layendecker Grant as a way to increase social justice of transgender youth through shadowing in the PurpLE clinic in NYC.

PurpLE Clinic:

            This grant would help me partner with the PurpLE Clinic that serves to create an environment where survivors of assault in a specialized clinic. The PurpLE Clinic is an acronym for Purpose: Listen & Engage to ensure sensitive medical care. By getting involved, we could increase awareness and even eventually make more of these clinics across the country. The clinic was created in response to feedback from anti-sexual violence community based organizations that experienced challenges in connecting survivors of sexual violence with trauma-informed and stigma-sensitive medical care.

Plan:

            With the help of this grant, I would able to travel to the clinic to work alongside the most influential physicians and nurses in the world. These workers are the future of medicine, and being involved by watching their interactions with patients would be life-changing. Each day, I could take notes of interactions and how to approach certain topics in a way that is the most comfortable and helpful for the clinics’ patients. From these notes, I would put together a “manual” for healthcare regarding LGBTQ+ populations, and specifically those who suffer from any sort of sexual violence or other traumatic history due to their identity.

Future Impact:

            I could speak with Dr. Stutts specifically to integrate these ideas into her class to be taught every year, as well as for her to bring to the clinical world. Dr. Stutts is also a licensed psychologist who serves those in the Charlotte area. By working with her, I could then ask her to incorporate these ideas into future conferences with her peers. On a smaller scale, there could be seminars each semester for future medical students at Davidson. On a larger scale with more funding, a PurpLE Clinic could be established in Charlotte, equipped with doctors, nurses, PAs, NPs, Psychologists, psychiatrics, etc. who are ready and knowledgeable about the imminent needs of the LGBTQ+ community. By spreading this manual, we can start shifting the ideas in the medical world to a more inclusive and welcoming environment for all.

Works Cited:

Do, T. T., & Nguyen, A. T. V. (2020). ‘They know better than we doctors do’: Providers’ preparedness for transgender healthcare in Vietnam. Health Sociology Review, 29(1), 92–107. https://doi-org.proxy048.nclive.org/10.1080/14461242.2020.1715814

DeKeseredy, W., Hall-Sanchez, A., Nolan, J., & Schwartz, M. (2017). A campus LGBTQ community’s sexual violence and stalking experiences: the contribution of pro-abuse peer support. Journal of gender-based violence1(2), 169-185.

Hackman, C. L., Bettergarcia, J. N., Wedell, E., & Simmons, A. (2020). Qualitative exploration of perceptions of sexual assault and associated consequences among LGBTQ+ college students. Psychology of Sexual Orientation and Gender Diversity. https://doi-org.proxy048.nclive.org/10.1037/sgd0000457.supp

India. Committee on the Status of Women in India, & Guha, P. (1975). Towards equality : report of the committee on the status of women in india. Govt. of India, Ministry of Education & Social Welfare, Dept. of Social Welfare.

Theory to Praxis: Ending Child Abuse and Building Resilient Families

Written by Anna Newman

Overview:

I will be implementing my knowledge of gender and sexuality studies, specifically on women’s rights, feminism, and rape culture, to plan a civic engagement experience over the summer. Through a collaboration with SAFEchild in Raleigh, North Carolina and Strong Girls United, the goal of the project will be to educate children on noticing and responding to child abuse appropriately before it escalates, while also learning more about the implications that domestic violence has on parenting.  

About the Partners: 

SAFEchild is a non-profit advocacy center that ensures children have a safe living environment, free from abuse. SAFEchild empowers the children and their families by providing counseling services and childcare. One important aspect of SAFEchild is a program they run called “Funny Tummy Feelings” which is a program that educates first-graders about noticing and appropriately handling child abuse when they see it or are subject to it. Funny Tummy Feelings has been implemented in the Wake County public school curriculum for first graders; however, the goal of this project is to expand Funny Tummy Feelings to the Strong Girls United program. 

Strong Girls United is a mentorship program for young girls which pairs collegiate athletes with elementary school girls and the groups meet to discuss confidence building, mental health, and new sports skills. I believe that Funny Tummy Feelings could also be a beneficial addition to the Strong Girls United curriculum. Unfortunately, rape and sexual abuse are pervasive parts of society, but one way to combat this is to educate about rape culture and the ways you can stand up to it and notice it before it escalates.

Connections to GSS:

This project will be focusing on providing children and mothers the skills needed to build confidence in response to child abuse and domestic violence. Confidence and mental resiliency begin at a young age, and if we can empower elementary school girls, we can empower an entire generation to put an end to domestic violence and child abuse. My research would overlap with several articles that we studied in class about feminism. In the article titled Committee on the Status of Women in India, the author discusses how marriage can become a “hindrance for women seeking career advancement” which demonstrates that a marriage with power imbalances is the basis for domestic violence and abuse of power. Betty Friedan talks in the Feminine Mystique that in the 1970’s, rape was not considered a penalty. Friedan also discusses the topic of women not being fulfilled simply by staying in the house, making beds, washing dishes, and cooking for the family, which relates to the lack of liberties that the woman has within a marriage. These hindrances that married women face are the basis for domestic violence and patriarchy. One notable quote from the Feminine Mystique is “when she stopped conforming to the conventional picture of femininity, she finally began to enjoy being a woman” (279). When women stop allowing their husbands to control and abuse them, they enjoyed being women. Additionally, bell hooks’ work called Feminism is for Everybody encourages the notion that equality is the goal of feminism, and the goal is not to subvert men. In relation to my book review on the book titled Medical Bondage, white male physicians were abusing enslaved women’s bodies by taking advantage of their position of power and conducting unsolicited gynecological research and painful experiments. The consequences of these experiments were destructive, both physically and mentally, for these women. The enslaved women’s experiences with the gynecological experiments parallel the domestic violence that women today face in abusive relationships. Abuse within a relationship affects the way a mother can parent a child, which demonstrates the vicious cycle of domestic violence at a young age starting with a lack of self-confidence, then getting wrapped up in abusive relationships, and to then raise kids in an environment filled with abuse and neglect. So, my goal for this project is to confront and help children notice domestic violence at a young age so that they can grow up to be confident people in healthy relationships. After doing an analysis on the film Moonlight in my writing class, it was brought to my attention that some abusive family dynamics are avoidable, while others are out of one’s control. In Moonlight, a young boy by the name of Chiron was being raised in an abusive and neglectful household because his mother was involved with dangerous drugs and did not have time for her child; however, the opportunities available for the mother to parent her child were lacking. While I’m doing my research, l will be sure to look at the context of the situation (what resources are available to the family?) versus judging the situation and the parenting choices. 

Limitations:

The limitation of this project is that Strong Girls United does not mention anything about transgender children, non-binary children, or gender-nonconforming children. This is a research question that l will be asking the SGU executive board in hopes that something is done to make the organization more inclusive of children of all gender identities. Part of feminism is creating equity across the genders, so this feminist project is aimed at creating equity for boys, girls, and gender non-conforming children. Overall, the goal of this project is to provide a form of mentorship for children seeking assistance with confidence, mental health training, and skills needed to confront abuse if they ever need to use them. 

Implementation of Plan: 

A few summers ago, my mom and l volunteered at SAFEchild and we babysat the children while their mothers were in a counseling meeting. I am hoping to resume my volunteering with SAFEchild by babysitting the children and then shadowing one of the leaders during the counseling meetings. I feel like I would gain another dimension of appreciation for the struggles that these families deal with by listening to the mothers speak. Also, it would be impactful to listen to the women’s stories of domestic abuse within their marriages and how this abuse impacts their ability to mother their children. 

After shadowing a counselor, l would ask one of the leaders/counselors at SAFEchild to be a guest speaker at one of the meetings with Strong Girls United. The counselor can focus on teaching a Funny Tummy Feelings course for the SGU children. The plan is to empower young girls by giving them to skills to notice and respond to child abuse in a confident way. One possibility of furthering my research experience would be to shadow a pediatric physiatrist to learn about the impacts of child abuse, neglect, and domestic violence on youth’s mental health.  

From Theory to Praxis: Medical Care of LGBT Individuals

Over this semester, I have been exposed to a broad spectrum of concepts, issues, and questions through our readings and discussions. GSS has given me a new lens through which I see the world and a deeper understanding of the structures and institutions in place that govern our lives. As a senior, I will soon be entering the job market and am really looking forward to taking my newly acquired GSS knowledge to my future endeavors. I am looking for a job in the medical field, a field in which LGBT individuals are underserved and often reluctant to pursue care. In this context, lesbian, gay, bisexual, and transgender individuals are often grouped together in a way that implies homogeneity, which is not the case. These individuals are distinct in terms of race, socioeconomic status, age, and ethnicity in addition to their gender and sexual identities. What groups these people together is the underlying discrimination and stigma that they face in society as a result of living at the intersection of multiple different groups. The intersectionality of marginalized groups is a topic that came up frequently in our class discussion and has really opened my eyes as to how a person’s identity is not defined by just one element or trait, it is the combination of these interlinked traits that make up one’s identity.

There has been a long history of discrimination stemming from a lack of understanding of LGBT individuals in the medical field (i.e. the listing of homosexuality as a mental disorder in the DSM). However, as understanding has improved, the treatment of LGBT individuals in the medical setting has gotten somewhat better. There are certain diseases that disproportionately affect the LGBT community such as HIV and other STDs, and these disparities stem from structural and legal factors, social discrimination, access and availability of medical care, and the lack of culturally informed health care.

There are many things that those in the medical field can do to encourage an inclusive and welcoming medical environment. Below are some suggestions to be implemented in different medical environments, which I hope to bring with me to my future occupation:

  1. Allow patients to privately self-input information about gender identity and sexual orientation (ensure that there are a wide range of options on the questionnaire).
  2. Allow patients to specify the pronouns that they prefer.
  3. Be open and non-judgmental when collecting sexual histories of patients.
  4. Refrain from making assumptions about individuals based on appearance.
  5. Do not assume heterosexuality (i.e. Ask “Do you have a
    partner?” rather than “Do you have a boy/girlfriend?” when conducting sexual
    history).
  6. Make sure all staff are trained to interact respectfully
    with LGBT patients (i.e. ensuring use of their preferred pronouns).
  7. Make sure that the medical environment has a non-discrimination policy that includes discrimination based on gender identity and sexual orientation and publicly display this policy.
  8. The use of brochures and medical information that include images of LGBT people as well as medical information that specifically addresses concerns that
    these individuals face.

All of these suggestions are important, as a clinician may be one of the first people whom an individual discloses non-heterosexual behavior to, and for this to happen, individuals need to be in a space where they feel comfortable. The goals of medicine include providing quality and effective care, and through these suggestions and the scope of my GSS knowledge, I plan to do my best to create an inclusive and welcoming environment for all patients.

Works Cited

http://www.lgbthealtheducation.org/wp-content/uploads/Improving-the-Health-of-LGBT-People.pdf

http://www.aafp.org/dam/AAFP/documents/medical_education_residency/program_directors/Reprint289D_LGBT.pdf