Patient: ‘Whole body wellness includes the mind and body’

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Justin Michel

Kathryn Bowser, MD, a member of the Society for Vascular Surgery (SVS) Diversity, Equity and Inclusion (DEI) Committee, talks to Justin Michel, 29, who identifies as a non-binary trans masculine person, about the patient experience navigating medical care as an individual of minority sexual identity.

Q: Can you explain your story, what your identity and acceptance of your identity by others mean to you? How does your identity, if at all, come up in clinical encounters?

A: I started socially transitioning 10 years ago and started my medical transition a little over five years ago. At the beginning of my transition, I simply identified as a trans man, but in the last year or so I found myself not fully batting for either team, though I prefer to have male pronouns. Acceptance has always been something I fight for, but it’s a complicated battle on many different fronts. I just want to be seen as who I am, and not what’s in my pants or how people perceive me.

Q: Have you been targeted or marginalized in any way by physicians or healthcare providers for your identity, and how so?

A: I don’t believe that I have been directly targeted, though I feel like a lack of knowledge knocked them off kilter. Whenever I would see a doctor, they always assumed that whatever ailment I had was because of my hormone replacement injections [HRT], even though I had been stable on my meds for more than three years. Another way that left a bad flavor in my mouth was when I was having my gender confirming surgery. Everyone at the hospital kept referring to me by my birth name and legal pronouns. Plus, whenever they saw I was having a double mastectomy, their first assumption was that I was a cancer patient. The only people at the hospital who called me by my chosen name and correct pronouns was the surgeon and his assistant.

Q: What does it mean to be a LGBTQIA+ friendly physician in your eyes?

A: An LGBTQIA+ friendly physician is someone who takes into account what your body is doing but still respects how you wish to be seen. When I see a doctor about my uterus, I don’t want to be smothered in she/her and femme language. I’m still a man and I wish to be respected as such.

Q: How important is it for you to see a doctor who is LGBTQIA+ friendly?

A: At this point in my life, I no longer will go to a practice that is not LGBTQIA+ friendly. I no longer want to have to tiptoe around who I am. If their office doesn’t say anything about LGBT on their website, I’m not interested.

Q: How important is it for you to be comfortable with your doctor, and what is one message you would want our readership to know?

A: It’s literally life and death when it comes to medical treatment, so I want to be comfortable enough to speak plainly. If my doctor is to take care of me they need to know all aspects of me. Whole body wellness includes the mind and body, so all things must work together. If the patient is uncomfortable and disrespected, then the mind isn’t well and you are doing your patient a disservice.

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