MetroDoctors Guest Post: Austen Ott, Medical Student
The Myth of the Transgender Medical Student
Austen Ott (they/them) is a second year medical student at the University of Minnesota Medical School. They are passionate about increasing healthcare access for rural LGBTQ+ populations, farmworker and migrant worker health justice, and community-centered family medicine. They can be reached on twitter @austenott or at ottxx166@umm.edu.
Medicine’s hidden curriculum works hard to establish boundaries, ensconcing us students within an artificial bubble of separation from our patients. We learn about disease from a safe, respectful distance––it is something that happens to “that” group of people, who we observe and watch but with whom we supposedly never identify. Many claim it necessary to divide ourselves this way to preserve our objectivity. One must ensure that they do not become too close to a patient’s situation for fear of lapsing their clinical judgment. In any given lecture, a student will hear the phrase “patients with…” numerous times. Never do we hear the word “you” or see reflections of ourselves in the curricular content.
I sat with this thought frequently during my first year of medical school when my peers and I were enrolled in a compulsory course on human sexuality. We discussed topics ranging from sexual dysfunction and contraception to sexual orientation and gender identity. This course represented a fortunate anomaly for our cohort, as the 2017-2018 AAMC Curriculum Report found that half of U.S. medical schools have only three or fewer activities related to LGBTQ+ health across the entire four-year curriculum. Despite my eagerness to discuss these topics in the educational setting, I still felt disheartened when I heard that same detached language. “Transgender people often face barriers to accessing health care due to a lack of accessible and competent providers,” we were told. “They face increased social stigma when compared with their lesbian, gay, and bisexual peers.” The words were framed in such a way that implied an impossibility that “they” could be sitting in the lecture hall alongside us, the medical students. And yet, there I was. And I wasn’t even the only one.
This isn’t a problem unique to transgender people in the healthcare field––medical education takes this approach with everyone. There is this seemingly pervasive assumption that we, as physicians, will never be the patient. This position feels especially poignant as 2023 quickly becomes a year of backlash against transgender people in both a legislative and cultural sense, with state governments fast-tracking passage of aggressive, transphobic bills. From “don’t say gay” bills to outright bans on gender affirming care, the inclusive society that LGBTQ+ people have been fighting for is at risk.
It feels weird, to put it mildly, to continue to attend my lectures and rotations while transgender people have come under such heavy public scrutiny for living out daily life.
Take walking to school or work, a common daily task. I become acutely aware of my ID’s pronoun badge each time I walk into the hospital because of its potential to draw attention to my transgender identity. While wearing my badge, my attention sometimes drifts to fleeting memories of past confrontations that were sparked over something as simple as personal pronouns. But by the time I meet up with the team in the hospital, I’ve mentally moved on to focusing on the day’s patients, the dozens of antibiotics in an upcoming lecture, or when I’m going to fit in my next run. Transgender people are just like anyone else. Our very existence may anger and disquiet some, but we will continue to thrive. Though, I’d be lying if I said these bills didn’t bother me.
Yet, for all the discussion occurring in the media sphere, I rarely see folks taking up the mantle and combating transphobic hostility in person. Physicians and medical students are in a unique position of privilege. When we speak, people listen. In January 2023, I had the opportunity to testify in support of a bill banning conversion therapy with several other medical students. It was eye opening to see how receptive elected officials are when someone wearing a white coat is speaking. While I understand that many physician schedules don’t always permit such advocacy, we must do the bare minimum and support our transgender colleagues in the line at the cafeteria or during a patient presentation. Let me explain.
According to 2022 estimates, over 1.6 million people in the U.S. population are transgender. One could reasonably expect that depending on the size of a medical school’s class, at least one student per class is transgender, if not more. In any given week, a physician will see and work with numerous transgender patients and colleagues. I guarantee that even if you think you have never met a transgender person, you have––you just didn’t know it.
So maybe you don’t have time to go to the Capitol––that’s okay. But what about when someone on the team presents during rounds and uses incorrect pronouns for a patient? When a colleague expresses frustration at having to use a new name for a colleague? From orthopedics to occupational medicine, we all will encounter transgender people regardless of specialty. Speaking up, educating our peers, and defending our colleagues and patients in instances of ignorance or antagonism are vital. And if you are feeling like you aren’t equipped to take on such a challenge? Read Access to Gender Affirming Care Saves Young Lives by Dr. Angela Kade Goepfred or How to Earn the Trust of Transgender and Gender Diverse Youth by Face-to-Face Executive Director Hanna Getachew-Kreusser. Learn from transgender people online. It doesn’t take much, and your next trans patient will thank you for it.
Look at cultures across the globe and as far back as ancient history and you will find evidence of transgender people living vibrant, rich, and fulfilling lives. That isn’t going to change any time soon. What is changing is our visibility. We are patients, medical students, and physicians. The next time you teach a student or consult a colleague, know that a transgender person could be waiting to respond. When looking out at a lecture hall, think of the students in front of you not just as future physicians, but as people with identities and experiences beyond the walls of the medical school. Most importantly, know that the idea of a transgender medical student isn’t just a myth. We are already here––and we have been for a long time. But now more than ever we need you to see us, support us, and uplift our voices. Trans joy–– the exuberance of transgender people when we are able to live our true, authentic selves–– is a powerful thing, and we’re using it to make the field of medicine a brighter, more welcoming place.
Author’s Note: Being transgender is not a disease. Additionally, it does not predispose one to requiring medical treatment. Many trans people live their lives choosing not to undergo any type of medical intervention or transition. Identity groups are not homogenous. Respect all people’s bodily autonomy and choices.