What doctors should know about gender identity
-
0:01 - 0:04About six months
into my career as a therapist, -
0:04 - 0:07I was working at a drug
and alcohol rehab facility. -
0:07 - 0:10I got a call from one of the nurses
down at the detox unit. -
0:11 - 0:13She asked me to come down
and assess one of the new patients -
0:13 - 0:15that had arrived earlier in the day.
-
0:15 - 0:19So I went down to the unit
and had the pleasure of meeting Anne. -
0:19 - 0:22Anne's a transgender female,
and as her and I started talking, -
0:22 - 0:25she was sharing with me
about what brought her into treatment, -
0:25 - 0:28but I could hear this fear in her voice,
-
0:28 - 0:30and I could see this worry in her eyes,
-
0:30 - 0:33and she began to tell me
that she didn't fear coming into rehab -
0:33 - 0:35and having to give up drugs and alcohol.
-
0:35 - 0:38Her fear was that the doctors
that were going to be treating her -
0:38 - 0:40would not treat her as her female self.
-
0:41 - 0:45She then told me about this ongoing pain
that she has experienced her whole life -
0:45 - 0:48of being assigned male
but knowing she's female. -
0:48 - 0:51And what she meant by that is,
when she was born, -
0:51 - 0:53the doctor held her up to her parents
-
0:53 - 0:55and based on her genitalia said,
-
0:55 - 0:57"It's a boy."
-
0:57 - 0:58She always knew she wasn't a boy.
-
1:00 - 1:03Many years passed and the feelings
that she was feeling -
1:03 - 1:05and holding all this in grew and grew,
-
1:05 - 1:07and she knew she had
to come out to her family. -
1:07 - 1:10And when she did,
it didn't go over so well. -
1:10 - 1:12Her parents said,
"Absolutely not. You're not a girl. -
1:12 - 1:15This is not how we raised you.
We don't know what you're thinking. -
1:15 - 1:17Get out."
-
1:18 - 1:21So Anne then found herself on the streets
and in and out of homeless shelters, -
1:21 - 1:24and it's here where
she started using drugs and alcohol -
1:24 - 1:26to numb this pain she felt inside.
-
1:28 - 1:31She told me about her journey of being
in and out of hospitals and rehabs -
1:31 - 1:32trying to get sober,
-
1:33 - 1:35and when she did, the health care
providers and doctors -
1:35 - 1:39wouldn't use the correct
female name or pronouns. -
1:39 - 1:40This caused her pain.
-
1:41 - 1:44You see, when I was studying
to become a therapist, -
1:44 - 1:46I wasn't taught how to work
with transgender patients. -
1:47 - 1:50I had no idea these would be
the patients I'd be working with. -
1:51 - 1:54But the more I worked with Anne
and other patients like Anne, -
1:54 - 1:56I began to see my mission evolve,
-
1:56 - 1:59and that was to make sure
that the transgender community -
2:00 - 2:01got their health care needs met.
-
2:02 - 2:06The more I looked into this,
I saw how this very real fear -
2:06 - 2:10of violence, discrimination
and this lack of acceptance -
2:10 - 2:14caused so many of these patients
to turn to alcohol and drugs. -
2:14 - 2:17And I also heard these horror stories
-
2:17 - 2:20of when these patients
were seeking medical care -
2:20 - 2:21and how they were treated,
-
2:21 - 2:24and how a lot of their
medical needs were ignored. -
2:25 - 2:28Now let me tell you about Leah.
-
2:28 - 2:31I had the pleasure
of meeting Leah a few years back. -
2:31 - 2:34She's a female and she has
a wife and a child. -
2:35 - 2:38See, Leah was also assigned male at birth
-
2:38 - 2:42and she knew since she was a young child
that she was not a male, -
2:42 - 2:43that she was a female.
-
2:44 - 2:47She hid it from herself
and from everyone she knew, -
2:47 - 2:49especially from her wife,
until the age of 50. -
2:50 - 2:51She couldn't take it anymore.
-
2:51 - 2:53She was like, I can't
keep living like this. -
2:53 - 2:54I gotta get honest.
-
2:54 - 2:57She was extremely scared to tell her wife.
-
2:57 - 2:58What if her wife said,
-
2:58 - 3:01"This is unacceptable,
I want a divorce, get out"? -
3:02 - 3:05To her surprise, her wife was accepting.
-
3:05 - 3:08She said, "I love you
regardless of who you are. -
3:08 - 3:10I want to help you in every way I can."
-
3:11 - 3:12So she talked with her wife,
-
3:12 - 3:16and she made the decision
that she wanted to medically transition, -
3:17 - 3:20and she was interested in being
assessed for hormone replacement therapy, -
3:20 - 3:21otherwise known as HRT.
-
3:22 - 3:24So she made an appointment
with her doctor. -
3:26 - 3:28She arrived on the day
of her appointment early. -
3:28 - 3:30She filled out all the paperwork,
-
3:30 - 3:32put the name correctly down there
and waited patiently. -
3:34 - 3:38A little bit of time passed and a nurse
called her back to the exam room. -
3:38 - 3:41When she got back there,
she took a deep breath, -
3:41 - 3:43and the doctor and the nurse walked in.
-
3:44 - 3:47She extended her hand to the doctor
and said, "Hi, I'm Leah." -
3:48 - 3:51The doctor looked at her,
didn't shake her hand and said, -
3:51 - 3:52"Why are you here?"
-
3:54 - 3:56She took another deep breath and said,
-
3:57 - 3:59"Well, I'm a transgender female.
-
3:59 - 4:02I've known this my whole life,
I've hid it from everyone, -
4:02 - 4:03but I can't do it anymore.
-
4:03 - 4:06My wife's supportive,
I can financially afford it, -
4:06 - 4:07I've got to make these changes.
-
4:07 - 4:11Please consider me,
and let's evaluate me for HRT." -
4:12 - 4:14The doctor said,
"We can't do anything today. -
4:14 - 4:15You need to go get an HIV test."
-
4:17 - 4:18She couldn't believe it.
-
4:19 - 4:20She was furious.
-
4:20 - 4:22She was angry. She was disappointed.
-
4:23 - 4:27If her doctor treated her this way,
how would the rest of the world treat her? -
4:27 - 4:29First, he wouldn't shake her hand,
-
4:29 - 4:32and second, when he heard
she was transgender, -
4:32 - 4:36all he cared about was getting
an HIV test and ending the appointment. -
4:36 - 4:38He didn't even ask her
any other questions. -
4:39 - 4:41See, I can understand
where Leah's coming from, -
4:41 - 4:44because the years that I've worked
with the community, -
4:44 - 4:47I hear myths every single day
that aren't true at all. -
4:47 - 4:49A couple of those are:
-
4:49 - 4:54every transgender person wants
to transition with medication or surgery; -
4:54 - 4:57transgender people are mentally ill,
this is a disorder; -
4:57 - 4:59and: these people
aren't real men and women. -
5:00 - 5:02These are all myths and untrue.
-
5:03 - 5:06As this community expands and grows older,
-
5:06 - 5:09it is imperative that all
health care providers be trained -
5:09 - 5:12on how to take care
of their health care needs. -
5:12 - 5:15Back in 2015, a survey was done
-
5:15 - 5:18and found that 72 percent
of health care providers -
5:18 - 5:21did not feel well-informed
-
5:21 - 5:23on the health care needs
of the LGBT community. -
5:25 - 5:28There's a huge gap
in the education and training. -
5:29 - 5:30Today, in this talk,
-
5:30 - 5:34I want to offer a new way of thinking
for three groups of people: -
5:34 - 5:38doctors, the transgender community
and, well, the rest of us. -
5:38 - 5:41But before we do, I want to cover
a couple of definitions -
5:41 - 5:44that's going to help you wrap your head
around gender identity a little bit more. -
5:45 - 5:48So I hope you've got your paper and pen.
Get ready to take some notes. -
5:48 - 5:51So let's start out
with this idea of a binary system. -
5:52 - 5:53And what this means is,
-
5:53 - 5:56before, we always thought
there was only two, male and female. -
5:56 - 5:57Get it? Binary? Right?
-
5:57 - 6:00So we've come to find out
that this isn't true. -
6:01 - 6:03Gender identity is a spectrum
-
6:03 - 6:05with maleness on one side
-
6:05 - 6:08and femaleness over here
on the other side. -
6:08 - 6:10This spectrum of identities
-
6:10 - 6:14include identities such as
gender-nonconforming, -
6:14 - 6:15gender-affirming,
-
6:15 - 6:16gender-nonbinary,
-
6:16 - 6:19two-spirited, three-spirited,
-
6:19 - 6:20as well as people that are intersex.
-
6:21 - 6:24The term transgender is this umbrella term
-
6:24 - 6:27that encompasses all these
different types of identities. -
6:28 - 6:31But for today's talk, I want you
to think about transgender -
6:31 - 6:34as someone who is assigned
a sex at birth that doesn't match -
6:34 - 6:37with who they are as a person
and their sense of self. -
6:37 - 6:39Now, this is very different
than biological sex. -
6:39 - 6:42So gender identity is sense of self.
-
6:42 - 6:45So think of it as
what's between your ears: -
6:45 - 6:47sense of self, who you are.
-
6:47 - 6:50This is very different
than biological sex, right? -
6:50 - 6:52Hormones, genitalia, chromosomes:
-
6:52 - 6:53that's what's between our legs.
-
6:55 - 6:59Now, you may be thinking, "Dr. Kristie,
I have never questioned who I am. -
6:59 - 7:01I know I'm a man, or I know I'm a woman."
-
7:02 - 7:03I get it. You know who you are.
-
7:04 - 7:07This is how many
transgender individuals feel. -
7:07 - 7:08They just know who they are
-
7:08 - 7:10with that same conviction.
-
7:12 - 7:16It's important to know that there
are many different types of identities, -
7:16 - 7:19and I identify as a cisgender female.
-
7:19 - 7:22Now, for all y'all out there
that like to know how to spell things, -
7:22 - 7:25cis is spelled "c-i-s."
-
7:25 - 7:28It's the Latin term
for "on the same side of." -
7:28 - 7:29When I was born,
-
7:29 - 7:31the doctor held me up
to my parents and said, -
7:31 - 7:33"It's a girl."
-
7:33 - 7:35All this, based on my genitalia.
-
7:35 - 7:37Even though I grew up
in a small farm town in Georgia, -
7:37 - 7:41very much a tomboy,
-
7:41 - 7:43I never questioned that I was a female.
-
7:43 - 7:44I've always known I was a girl,
-
7:44 - 7:47regardless of how I was as a kid.
-
7:47 - 7:50Now, this is very different
than someone who's transgender. -
7:50 - 7:54Now, trans is a Latin term
for "on the other side of" -- -
7:54 - 7:56think about transcontinental airlines,
-
7:56 - 7:57across, on the other side of --
-
7:58 - 8:01someone that's assigned a sex at birth
-
8:01 - 8:03and they identify
on the other side of the spectrum. -
8:04 - 8:08A transgender male is someone
who was assigned female at birth, -
8:08 - 8:11but their sense of self,
who they are, how they live their life, -
8:11 - 8:13is as a male.
-
8:13 - 8:15And the opposite is, as we talked earlier,
-
8:15 - 8:18a transgender female,
someone that's assigned male at birth -
8:18 - 8:21but lives their live
and sense of self as a female. -
8:21 - 8:22It's also important to point out here
-
8:22 - 8:25that not everyone
that has a nonbinary identity -
8:26 - 8:27identifies with the term "transgender."
-
8:29 - 8:32Just so nobody gets confused,
I want to point out sexual identity, -
8:32 - 8:34or orientation.
-
8:34 - 8:37That is simply who we're attracted to,
-
8:37 - 8:39physically, emotionally,
sexually, spiritually. -
8:41 - 8:43It's got nothing to do
with gender identity. -
8:43 - 8:45So just for a quick recap,
before we continue on: -
8:45 - 8:47gender identity between the ears,
-
8:47 - 8:50biological sex, just think
of it between your legs, -
8:50 - 8:53and then sexual identity,
well, sometimes we use our heart, -
8:53 - 8:54but it's here.
-
8:54 - 8:57Three very different identity spectrums.
-
8:59 - 9:01Now, the average medical student
-
9:01 - 9:07spends about five hours learning
about the LGBT health-related needs -
9:07 - 9:08while they're in medical school.
-
9:08 - 9:12Now, this is despite us knowing
that there are unique health risks -
9:12 - 9:14to this community.
-
9:15 - 9:19And there's an estimated
10 million American adults -
9:19 - 9:21that identify as LGBT.
-
9:22 - 9:24Most doctors that work
with transgender patients, -
9:24 - 9:26they learn trial by fire.
-
9:27 - 9:29That means they figure it out
as they go along, -
9:30 - 9:32or the patient ends up spending their time
-
9:32 - 9:34trying to teach the doctor
how to take care of them. -
9:35 - 9:39Many doctors don't feel comfortable
asking about gender identities. -
9:39 - 9:42Some don't feel like it's relevant at all
to their medical care -
9:42 - 9:45and others just don't want
to say the wrong thing. -
9:46 - 9:49Many doctors who say
something inappropriate -
9:49 - 9:50or they say something negative,
-
9:50 - 9:54they may not be coming
from a malicious or mean place, -
9:54 - 9:58they may have never been trained
on how to care for these individuals. -
9:58 - 10:01But this can't be accepted
as a norm anymore either. -
10:02 - 10:05So what happens to a transgender male --
-
10:06 - 10:09for a quick recap, that's someone
who is assigned female at birth -
10:09 - 10:10but lives their life as a male --
-
10:10 - 10:15what happens when this transgender male
goes for their yearly gynecological visit? -
10:16 - 10:19How that doctor treats that patient
-
10:19 - 10:21will set the whole tone for the office.
-
10:22 - 10:26If that doctor treats that male
with the correct pronouns, correct name, -
10:26 - 10:28gives dignity and respect,
-
10:28 - 10:31it's highly likely
that the rest of the staff will too. -
10:32 - 10:35So that's a little bit
about my thoughts on doctors, -
10:35 - 10:37and now let's move on
to the transgender community. -
10:37 - 10:40I'm here talking about fear,
-
10:40 - 10:43but y'all know who
is really fearful, right? -
10:43 - 10:45It's the transgender community.
-
10:45 - 10:47Earlier I shared the story about Anne
-
10:47 - 10:49and how she was so worried
about going into treatment -
10:49 - 10:52and not being respected
as her female self, -
10:52 - 10:54and then Leah who was scared
about how her doctor would react, -
10:54 - 10:57and the second
that he didn't shake her hand -
10:57 - 10:59and ordered that HIV test,
her fears came true. -
11:01 - 11:03The transgender community
needs to be empowered -
11:03 - 11:06to speak up for their health care needs.
-
11:06 - 11:10The days of remaining silent and taking
whatever treatment you can get are over. -
11:11 - 11:14If you don't speak up
for your health care needs, -
11:14 - 11:15no one's going to do it for you.
-
11:17 - 11:18So what about the rest of us?
-
11:20 - 11:23A lot of y'all, maybe in the next week
or a couple of months, -
11:23 - 11:25are going to have
a doctor's appointment, right? -
11:25 - 11:28So let's say you go
to your doctor's appointment -
11:28 - 11:29and when it's over,
-
11:29 - 11:32you feel worse than you did
when you got there. -
11:33 - 11:35What if you felt dismissed by the doctor,
-
11:35 - 11:37that they ignored your needs,
-
11:37 - 11:39or you even felt judged?
-
11:40 - 11:45That's what happens for many
of the 1.4 million transgender adults -
11:45 - 11:46here in the US
-
11:46 - 11:48if they're lucky enough
to get an appointment. -
11:50 - 11:53Now, you may be thinking,
"Why is this important to me? -
11:53 - 11:56I'm not transgender.
I don't know anybody that's transgender. -
11:56 - 11:57Why should I even care?"
-
11:58 - 12:00Think of it this way.
-
12:00 - 12:02A transgender individual is human,
-
12:02 - 12:04just like you and me.
-
12:04 - 12:07They deserve competent
and trained health care providers, -
12:07 - 12:09just like you and me.
-
12:10 - 12:13So let me ask, if you don't
mind raising your hand: -
12:13 - 12:16Do you know or have you met
anyone who is transgender, -
12:16 - 12:21gender-nonconforming, agender, intersex,
two-spirited, three-spirited? -
12:21 - 12:23Thank y'all so much. Lovely. Thank y'all.
-
12:24 - 12:26Every one of y'all
who did not raise your hand, -
12:26 - 12:29in the very near future
-
12:29 - 12:30you will get the opportunity to meet
-
12:30 - 12:34someone that falls into one
of these identities, I guarantee it. -
12:34 - 12:37The number of this
community is increasing. -
12:37 - 12:40That's not because it's a fad
or the new thing to do. -
12:41 - 12:43It's safer to come out.
-
12:44 - 12:47There's more awareness.
There's more visibility. -
12:47 - 12:50There's more safety, so people
are speaking up about their true self -
12:50 - 12:51like never before.
-
12:52 - 12:56That's why it's so important
that our health care system get on board -
12:56 - 13:00and make sure that our doctors
and health care providers are trained -
13:00 - 13:03to approach these patients
with dignity and respect, -
13:03 - 13:05just like we expect.
-
13:07 - 13:09I remember being
in my 11th grade literature class, -
13:09 - 13:11with one of my favorite
teachers, Mr. McClain, -
13:11 - 13:15and he shared this quote by Heraclitus
that sticks with me to this day. -
13:15 - 13:17Y'all may have even heard it.
-
13:17 - 13:21It's, "The only thing that is constant
is that things will change." -
13:23 - 13:24Familiar, right?
-
13:25 - 13:28Every single one of us
face changes in our lives, -
13:28 - 13:30and often when we're faced
with these changes, -
13:30 - 13:32we've got some difficult
decisions to make. -
13:33 - 13:37Will we remain in fear, stay stuck
-
13:37 - 13:39and not grow?
-
13:39 - 13:43Or, will we face fear with bravery,
-
13:43 - 13:46evolve, take the opportunity to grow?
-
13:47 - 13:50Every one of us face new things.
-
13:50 - 13:51What will you do?
-
13:52 - 13:54Will you remain in fear,
-
13:54 - 13:56or will you grow?
-
13:57 - 14:01I invite each of you, doctors,
the transgender community -
14:01 - 14:02and you and I,
-
14:02 - 14:04to face fear together
-
14:04 - 14:07as we walk into this brave new world.
-
14:07 - 14:08Thank you.
-
14:08 - 14:12(Applause)
- Title:
- What doctors should know about gender identity
- Speaker:
- Kristie Overstreet
- Description:
-
Kristie Overstreet is on a mission to ensure that the transgender community gets their health care needs met. In this informative, myth-busting talk, she provides a primer for understanding gender identity and invites us to shift how we view transgender health care -- so that everyone gets the respect and dignity they deserve when they go to a doctor.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 14:25
Brian Greene edited English subtitles for What doctors should know about gender identity | ||
Brian Greene approved English subtitles for What doctors should know about gender identity | ||
Brian Greene edited English subtitles for What doctors should know about gender identity | ||
Joanna Pietrulewicz accepted English subtitles for What doctors should know about gender identity | ||
Joanna Pietrulewicz edited English subtitles for What doctors should know about gender identity | ||
Joanna Pietrulewicz edited English subtitles for What doctors should know about gender identity | ||
Joseph Geni edited English subtitles for What doctors should know about gender identity | ||
Joseph Geni edited English subtitles for What doctors should know about gender identity |