WEBVTT

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About six months
into my career as a therapist,

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I was working at a drug
and alcohol rehab facility.

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I got a call from one of the nurses
down at the detox unit.

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She asked me to come down
and assess one of the new patients

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that had arrived earlier in the day.

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So I went down to the unit
and had the pleasure of meeting Anne.

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Anne's a transgender female,
and as her and I started talking,

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she was sharing with me
about what brought her into treatment,

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but I could hear this fear in her voice,

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and I could see this worry in her eyes,

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and she began to tell me
that she didn't fear coming into rehab

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and having to give up drugs and alcohol.

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Her fear was that the doctors
that were going to be treating her

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would not treat her as her female self.

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She then told me about this ongoing pain
that she has experienced her whole life

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of being assigned male
but knowing she's female.

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And what she meant by that is,
when she was born,

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the doctor held her up to her parents

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and based on her genitalia said,

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"It's a boy."

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She always knew she wasn't a boy.

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Many years passed and the feelings
that she was feeling

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and holding all this in grew and grew,

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and she knew she had
to come out to her family.

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And when she did,
it didn't go over so well.

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Her parents said,
"Absolutely not. You're not a girl.

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This is not how we raised you.
We don't know what you're thinking.

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Get out."

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So Anne then found herself on the streets
and in and out of homeless shelters,

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and it's here where
she started using drugs and alcohol

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to numb this pain she felt inside.

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She told me about her journey of being
in and out of hospitals and rehabs

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trying to get sober,

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and when she did, the health care
providers and doctors

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wouldn't use the correct
female name or pronouns.

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This caused her pain.

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You see, when I was studying
to become a therapist,

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I wasn't taught how to work
with transgender patients.

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I had no idea these would be
the patients I'd be working with.

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But the more I worked with Anne
and other patients like Anne,

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I began to see my mission evolve,

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and that was to make sure
that the transgender community

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got their health care needs met.

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The more I looked into this,
I saw how this very real fear

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of violence, discrimination
and this lack of acceptance

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caused so many of these patients
to turn to alcohol and drugs.

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And I also heard these horror stories

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of when these patients
were seeking medical care

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and how they were treated,

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and how a lot of their
medical needs were ignored.

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Now let me tell you about Leah.

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I had the pleasure
of meeting Leah a few years back.

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She's a female and she has
a wife and a child.

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See, Leah was also assigned male at birth

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and she knew since she was a young child
that she was not a male,

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that she was a female.

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She hid it from herself
and from everyone she knew,

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especially from her wife,
until the age of 50.

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She couldn't take it anymore.

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She was like, I can't
keep living like this.

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I gotta get honest.

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She was extremely scared to tell her wife.

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What if her wife said,

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"This is unacceptable,
I want a divorce, get out"?

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To her surprise, her wife was accepting.

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She said, "I love you
regardless of who you are.

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I want to help you in every way I can."

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So she talked with her wife,

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and she made the decision
that she wanted to medically transition,

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and she was interested in being
assessed for hormone replacement therapy,

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otherwise known as HRT.

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So she made an appointment
with her doctor.

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She arrived on the day
of her appointment early.

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She filled out all the paperwork,

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put the name correctly down there
and waited patiently.

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A little bit of time passed and a nurse
called her back to the exam room.

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When she got back there,
she took a deep breath,

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and the doctor and the nurse walked in.

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She extended her hand to the doctor
and said, "Hi, I'm Leah."

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The doctor looked at her,
didn't shake her hand and said,

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"Why are you here?"

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She took another deep breath and said,

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"Well, I'm a transgender female.

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I've known this my whole life,
I've hid it from everyone,

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but I can't do it anymore.

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My wife's supportive,
I can financially afford it,

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I've got to make these changes.

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Please consider me,
and let's evaluate me for HRT."

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The doctor said,
"We can't do anything today.

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You need to go get an HIV test."

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She couldn't believe it.

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She was furious.

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She was angry. She was disappointed.

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If her doctor treated her this way,
how would the rest of the world treat her?

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First, he wouldn't shake her hand,

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and second, when he heard
she was transgender,

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all he cared about was getting
an HIV test and ending the appointment.

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He didn't even ask her
any other questions.

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See, I can understand
where Leah's coming from,

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because the years that I've worked
with the community,

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I hear myths every single day
that aren't true at all.

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A couple of those are:

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every transgender person wants
to transition with medication or surgery;

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transgender people are mentally ill,
this is a disorder;

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and: these people
aren't real men and women.

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These are all myths and untrue.

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As this community expands and grows older,

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it is imperative that all
health care providers be trained

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on how to take care
of their health care needs.

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Back in 2015, a survey was done

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and found that 72 percent
of health care providers

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did not feel well-informed

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on the health care needs
of the LGBT community.

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There's a huge gap
in the education and training.

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Today, in this talk,

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I want to offer a new way of thinking
for three groups of people:

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doctors, the transgender community
and, well, the rest of us.

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But before we do, I want to cover
a couple of definitions

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that's going to help you wrap your head
around gender identity a little bit more.

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So I hope you've got your paper and pen.
Get ready to take some notes.

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So let's start out
with this idea of a binary system.

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And what this means is,

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before, we always thought
there was only two, male and female.

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Get it? Binary? Right?

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So we've come to find out
that this isn't true.

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Gender identity is a spectrum

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with maleness on one side

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and femaleness over here
on the other side.

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This spectrum of identities

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include identities such as
gender-nonconforming,

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gender-affirming,

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gender-nonbinary,

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two-spirited, three-spirited,

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as well as people that are intersex.

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The term transgender is this umbrella term

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that encompasses all these
different types of identities.

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But for today's talk, I want you
to think about transgender

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as someone who is assigned
a sex at birth that doesn't match

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with who they are as a person
and their sense of self.

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Now, this is very different
than biological sex.

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So gender identity is sense of self.

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So think of it as
what's between your ears:

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sense of self, who you are.

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This is very different
than biological sex, right?

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Hormones, genitalia, chromosomes:

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that's what's between our legs.

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Now, you may be thinking, "Dr. Kristie,
I have never questioned who I am.

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I know I'm a man, or I know I'm a woman."

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I get it. You know who you are.

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This is how many
transgender individuals feel.

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They just know who they are

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with that same conviction.

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It's important to know that there
are many different types of identities,

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and I identify as a cisgender female.

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Now, for all y'all out there
that like to know how to spell things,

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cis is spelled "c-i-s."

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It's the Latin term
for "on the same side of."

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When I was born,

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the doctor held me up
to my parents and said,

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"It's a girl."

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All this, based on my genitalia.

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Even though I grew up
in a small farm town in Georgia,

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very much a tomboy,

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I never questioned that I was a female.

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I've always known I was a girl,

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regardless of how I was as a kid.

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Now, this is very different
than someone who's transgender.

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Now, trans is a Latin term
for "on the other side of" --

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think about transcontinental airlines,

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across, on the other side of --

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someone that's assigned a sex at birth

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and they identify
on the other side of the spectrum.

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A transgender male is someone
who was assigned female at birth,

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but their sense of self,
who they are, how they live their life,

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is as a male.

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And the opposite is, as we talked earlier,

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a transgender female,
someone that's assigned male at birth

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but lives their live
and sense of self as a female.

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It's also important to point out here

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that not everyone
that has a nonbinary identity

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identifies with the term "transgender."

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Just so nobody gets confused,
I want to point out sexual identity,

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or orientation.

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That is simply who we're attracted to,

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physically, emotionally,
sexually, spiritually.

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It's got nothing to do
with gender identity.

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So just for a quick recap,
before we continue on:

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gender identity between the ears,

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biological sex, just think
of it between your legs,

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and then sexual identity,
well, sometimes we use our heart,

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but it's here.

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Three very different identity spectrums.

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Now, the average medical student

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spends about five hours learning
about the LGBT health-related needs

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while they're in medical school.

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Now, this is despite us knowing
that there are unique health risks

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to this community.

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And there's an estimated
10 million American adults

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that identify as LGBT.

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Most doctors that work
with transgender patients,

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they learn trial by fire.

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That means they figure it out
as they go along,

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or the patient ends up spending their time

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trying to teach the doctor
how to take care of them.

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Many doctors don't feel comfortable
asking about gender identities.

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Some don't feel like it's relevant at all
to their medical care

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and others just don't want
to say the wrong thing.

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Many doctors who say
something inappropriate

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or they say something negative,

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they may not be coming
from a malicious or mean place,

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they may have never been trained
on how to care for these individuals.

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But this can't be accepted
as a norm anymore either.

NOTE Paragraph

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So what happens to a transgender male --

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for a quick recap, that's someone
who is assigned female at birth

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but lives their life as a male --

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what happens when this transgender male
goes for their yearly gynecological visit?

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How that doctor treats that patient

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will set the whole tone for the office.

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If that doctor treats that male
with the correct pronouns, correct name,

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gives dignity and respect,

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it's highly likely
that the rest of the staff will too.

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So that's a little bit
about my thoughts on doctors,

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and now let's move on
to the transgender community.

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I'm here talking about fear,

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but y'all know who
is really fearful, right?

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It's the transgender community.

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Earlier I shared the story about Anne

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and how she was so worried
about going into treatment

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and not being respected
as her female self,

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and then Leah who was scared
about how her doctor would react,

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and the second
that he didn't shake her hand

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and ordered that HIV test,
her fears came true.

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The transgender community
needs to be empowered

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to speak up for their health care needs.

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The days of remaining silent and taking
whatever treatment you can get are over.

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If you don't speak up
for your health care needs,

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no one's going to do it for you.

NOTE Paragraph

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So what about the rest of us?

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A lot of y'all, maybe in the next week
or a couple of months,

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are going to have
a doctor's appointment, right?

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So let's say you go
to your doctor's appointment

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and when it's over,

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you feel worse than you did
when you got there.

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What if you felt dismissed by the doctor,

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that they ignored your needs,

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or you even felt judged?

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That's what happens for many
of the 1.4 million transgender adults

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here in the US

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if they're lucky enough
to get an appointment.

NOTE Paragraph

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Now, you may be thinking,
"Why is this important to me?

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I'm not transgender.
I don't know anybody that's transgender.

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Why should I even care?"

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Think of it this way.

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A transgender individual is human,

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just like you and me.

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They deserve competent
and trained health care providers,

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just like you and me.

NOTE Paragraph

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So let me ask, if you don't
mind raising your hand:

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Do you know or have you met
anyone who is transgender,

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gender-nonconforming, agender, intersex,
two-spirited, three-spirited?

NOTE Paragraph

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Thank y'all so much. Lovely. Thank y'all.

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Every one of y'all
who did not raise your hand,

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in the very near future

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you will get the opportunity to meet

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someone that falls into one
of these identities, I guarantee it.

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The number of this
community is increasing.

00:12:37.480 --> 00:12:40.280
That's not because it's a fad
or the new thing to do.

00:12:41.120 --> 00:12:43.000
It's safer to come out.

00:12:43.680 --> 00:12:46.656
There's more awareness.
There's more visibility.

00:12:46.680 --> 00:12:49.896
There's more safety, so people
are speaking up about their true self

00:12:49.920 --> 00:12:51.160
like never before.

00:12:52.160 --> 00:12:56.136
That's why it's so important
that our health care system get on board

00:12:56.160 --> 00:12:59.976
and make sure that our doctors
and health care providers are trained

00:13:00.000 --> 00:13:03.256
to approach these patients
with dignity and respect,

00:13:03.280 --> 00:13:05.200
just like we expect.

NOTE Paragraph

00:13:06.640 --> 00:13:09.056
I remember being
in my 11th grade literature class,

00:13:09.080 --> 00:13:11.256
with one of my favorite
teachers, Mr. McClain,

00:13:11.280 --> 00:13:14.896
and he shared this quote by Heraclitus
that sticks with me to this day.

00:13:14.920 --> 00:13:16.576
Y'all may have even heard it.

00:13:16.600 --> 00:13:20.600
It's, "The only thing that is constant
is that things will change."

00:13:22.600 --> 00:13:23.800
Familiar, right?

00:13:24.640 --> 00:13:27.776
Every single one of us
face changes in our lives,

00:13:27.800 --> 00:13:30.136
and often when we're faced
with these changes,

00:13:30.160 --> 00:13:32.200
we've got some difficult
decisions to make.

00:13:33.320 --> 00:13:36.936
Will we remain in fear, stay stuck

00:13:36.960 --> 00:13:38.616
and not grow?

00:13:38.640 --> 00:13:43.016
Or, will we face fear with bravery,

00:13:43.040 --> 00:13:45.600
evolve, take the opportunity to grow?

00:13:47.000 --> 00:13:49.856
Every one of us face new things.

00:13:49.880 --> 00:13:51.080
What will you do?

00:13:51.920 --> 00:13:54.176
Will you remain in fear,

00:13:54.200 --> 00:13:56.080
or will you grow?

00:13:57.040 --> 00:14:00.696
I invite each of you, doctors,
the transgender community

00:14:00.720 --> 00:14:02.056
and you and I,

00:14:02.080 --> 00:14:03.776
to face fear together

00:14:03.800 --> 00:14:06.536
as we walk into this brave new world.

NOTE Paragraph

00:14:06.560 --> 00:14:07.776
Thank you.

NOTE Paragraph

00:14:07.800 --> 00:14:12.200
(Applause)