Implicit biases are deeply rooted, unconscious attitudes or stereotypes that can influence our judgments, actions, and decisions. When I was tasked with taking an implicit bias test focused on transgender individuals for the Gender Affirmation Elective, I found myself feeling quite nervous. Despite my conscious efforts to treat everyone equally and with respect, a tiny voice inside me questioned whether my subconscious biases might differ from my conscious beliefs.
Test your own Implicit bias on various topics by
The Project Implicit here: https://implicit.harvard.edu/implicit/selectatest.html
I distinctly recall my introduction to individuals with diverse gender expressions, sexual identities, and variations in sexual organs during my 10th-grade psychology class. A group of students representing these identities, most of whom were older than me presented to my class. Among them, one individual stood out - a person who identified as intersex. They presented themselves as outwardly feminine, but when they disclosed their intersex status, I was taken aback. It was a revelation to me that someone could be born with multiple sexual organs, allowing them to express the gender they felt most comfortable with in their own body.
Another eye-opening experience occurred when I spoke with the parent of one of my martial arts students, a five-year-old boy who had chosen to wear nail polish at the studio. I was initially concerned that other students might ridicule them. To my surprise, the parent responded by emphasizing that they couldn't control what others thought. Their primary concern was their child's happiness and the freedom to make choices that were not harmful. This encounter challenged my preconceived notions about children's agency in making decisions about their appearance, which contrasted with my own upbringing, where my parents had imposed strict rules about how I dressed. To my parent they always wanted to me to dress “feminine” which included make-up, hair, and dresses. Even though I secretly liked dresses, I was bothered that I had to wear them. None of the other children had to wear them, and they prevented me from adequately climbing the playground structure.
I vividly remember a subsequent encounter during my pre-medical training, when I shadowed a doctor who allowed their own pre-teen child to begin hormone therapy to prevent the development of breasts. This was an entirely new concept to me, and I questioned its safety. The doctor assured me that extensive research supported the therapy's safety and that the child could discontinue it if they chose to develop breasts later. More than a decade later, this individual has blossomed into their true beautiful self, a testament to how such decisions can positively impact a person's life.
These are just a few of the many experiences that have shaped my perspective before I entered medical school. These interactions with the transgender community have left an enduring mark on my heart. I believe that these encounters are a significant reason why my implicit bias tests have indicated an equal bias towards both cisgender and transgender individuals.
Common First Steps in Gender Affirmation:
Exploring Clothing Options- society has chosen which styles of clothing are more feminine/masculine
Exploring Changing their Name - society has dictated which names are associated with female/males/gender-neutral
Exploring Different Pronouns she/her/ Ellahe/him/ Elthem/them/ ellosZe/ZemMix of any of the above!
Exploring Changing Speech through pitch
Speaking to their Health Care Provider
Speaking to a Mental Health Therapist & Psychiatrist
Non-Hormonal Body Modification
Learn more about Binding:
Binding Safety Tips - DO NOT USE ACE BANDAGES or WRAPS because they limit the chest's ability to take a full breath! There are clothing (sports bras, compression clothing) made to make the chest look flatter
There are clothing (sports bras, compression clothing) made to make the chest look flatter
Learn more about Tucking:
Hair Removal - cut, shave, wax, laser, etc.
CAUTION - Dangerous & Illegal Loose Silicone Injections - NY Times Article on "Pumpers"
Trained Plastic Surgeons use silicone IN implants and NOT ALONE
Hormone Replacement Therapy (HRT)
***Not all individuals who are transgender or are exploring their gender identity use HRT**
Taking hormones allows individuals to alter or change (increase or decrease) their secondary sexual characteristics (breasts, hair, fat distribution) that usually become most prominent during puberty
Overview & Considerations by TransCareBC
Gender Affirmation Surgery
***Not all individuals who are transgender or are exploring their gender identity go through surgery***
Care of the Patient Undergoing Sex Reassignment Surgery (SRS) by Transcend: Transgender Support & Education Society and Vancouver Coastal Health’s Transgender Health Program
Phalloplasty: techniques and outcomes - surgical procedure & pictures
Transgender vaginoplasty: techniques and outcomes- surgical procedure & pictures
Legislation to be Aware of:
Movement Advancement Project Map on www.lgbtmap.org
shows the current legal landscape for queer individuals by state. It contains a lot of eye-opening information on healthcare coverage, workplace protections, education/sports laws, and more.
ACLU's Map on current US State legislation at www.aclu.org/legislative-attacks-on-lgbtq-rights
Trans Health Care Resources:
Learning to Address Implicit Bias Towards LGBTQ Patients: Case Scenarios, from the National LGBT Health Education Center
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8
UCSF's Guidelines for the Primary and Gender-Affirming Care of Transgender and Nonbinary People -Great resource to click through if you have a patient with a specific question regarding transgender and nonbinary health that you do not know the answer to
Transgender ToolKit for HealthCare Clinics
National LGBTQIA+ Health Education Center Resource Library at www.lgbtqiahealtheducation.org
Howard Brown Health Center in Chicago, IL 60613 howardbrown.org
» Services: primary care, HIV/STI prevention, support groups, drop-in hours, and youth services (Broadway Youth Center)
Resources for Families of Transgender Individuals
SUPPORTING GENDER DIVERSITY TOOLKIT by Chicago Public Schools
Families in TRANSition: A Resource Guide for Parents of Trans Youth PDF from www.ctys.org
Gender Spectrum.org - PDFs worksheets & Printable Guides
More Resources for LGBTQIA+ Individuals
More Resources for Health Care Providers
***This Blog Post is for educational purposes only and is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. This does not imply a doctor-patient relationship. All opinions are the opinions of the writer and not reflective of any institution or employer. Please follow up with your health provider and therapist for any additional questions or support.***