More Questions Than Answers

What do you do when people look to you for answers, but you don’t know what to say? When they want you to represent an entire community, but you’re only one person?

I live and work in Kansas City. Despite being in the middle of the country, it is a border town: one large metropolitan area comprised mostly of Kansas City, Missouri, and Kansas City, Kansas. Like a lot of folks, I live in Missouri and commute to Kansas for work. Unlike a lot of folks, I am transgender.

Recently the attorney general in Missouri issued an order that would severely restrict access to gender-affirming care for all trans people—minors and adults. On the day the order was announced, I was not working at my job as an academic family doctor and medical director of our Gender Diversity Clinic. I was not at work because I was on medical leave after my own gender-affirming surgery. The irony is not lost on me.

There was seemingly no end to the questions I was being asked about the impact of the attorney general’s order. I am confident that if my answer was, “Sorry I’m on medical leave,” that would have been respected. But as the only openly trans physician and trans faculty member at my institution, I wasn’t sure who else would be able to answer.

There were questions from patients. Will I still be able to get my hormones? What about the surgery I have planned? Will you still be my doctor?

There were questions from colleagues and students. How do we fight this? How can we find time to see patients before this order takes effect? What do we do for patients who can’t come to Kansas for care?

The most challenging questions were those I asked myself. Should I be typing this email even though I’m not supposed to be moving my arms as I recover? How do we respond with speed, but not toxic urgency or haste? How do we make doing work that is constantly under attack sustainable? What do you do when draconian policies threaten not only your job, but your existence?

I think so much about our queer ancestors. The secrecy needed to protect themselves. The bar raids. The violence. The refusal to bend or break in the face of unrelenting hostility. How scared were they? Where did they find comfort and joy? Did they hope we would be freer? Did they know that the pendulum of our basic human rights would swing back and forth, making us dizzy with confusion?

Ultimately, I look to the future for solace and answers. While I spent some of my recovery in meetings with other providers and lawyers, where I found the most healing was at a rally organized by a few trans medical students and trans community organizers. I’m so often in awe of the trans and nonbinary medical students I’ve had the honor of getting to know. They are a constant source of inspiration. Their speeches at the rally were filled with calls for trans survival, trans existence, trans beauty, and trans resilience.

They helped me remember that I became a doctor to heal, but I became a teacher for them. It is such an honor to watch medical students learn an unlearnable amount of medical information and physical exam skills, but it is something entirely different to watch them come into themselves and their own power.

It’s easy to forget that we have as much to learn from our students as they learn from us. I imagine being the only one of anything is isolating and exhausting. Being the only trans doctor certainly is. In watching these trans students refuse to acquiesce and assimilate, they are teaching me what to say, how to advocate, and how to refuse to remain stagnant and silent. Trans and nonbinary medical students are the future of our profession. I won’t be the only trans doctor out here for long. Together we will build collaborative answers for a more just and restorative future. Answers that center community, evidence-based medicine, and our collective ability to heal and thrive.