Since November 6, 2024, nothing has been routine for health care providers like me who proudly provide gender-affirming health care to trans and gender-diverse people. Now, every medical visit is marked with a pregnant pause after I enter the exam room, say hello, and ask how the patient is today . . . after which each patient expresses their profound fears and anxieties about whether they will be able to continue to get the care they need to be healthy and safe. My clinical sessions are packed with patients, and discussions such as these need time and attention, so now I run more behind than ever.
The number of patient calls and messages is also increasing exponentially. Requests for gender-affirming surgery referrals, long-acting medications, and assistance with name change and gender marker paperwork have skyrocketed. People living in red states are making plans to get their needs met in blue states, placing further demands on blue state organizations. Patients feel the clock is ticking down to Inauguration Day. Everything is urgent. Any illusions of stability and predictability have been snuffed out.
A scared imagination knows no bounds. We humans are evolutionarily trained to focus on threats. Now, threats are abundant, and the unknown is terrifying. No one has a crystal ball. I try to offer equal parts realism, hope, empathy, resilience, and strength when reassuring my patients. But here is the rub—I am afraid, too. Our patients are also our coworkers, our families, our friends. The well-being of some of the people whom I love most is in danger.
The most gut-wrenching and heartbreaking conversations occur with the parents of trans and gender-diverse children and the children themselves. These children and families are petrified. Families love their children deeply and desperately and have lived through the darkness of gender dysphoria. Gender-affirming care is a lifeline that we must maintain.
I made a deliberate and thoughtful decision to provide gender-affirming care because I steadfastly believe that trans and gender-diverse people must have the same rights and privileges as cis people. And health care is one of those rights and privileges. I know countless others who feel as I do and are devoting their careers and lives to these ideals. I plan to make as many accommodations as I can to care for my patients in an attempt to keep recovering from the politics of fear.
Pamela Adelstein
Newton, Massachusetts
4 thoughts on “Rapid Mobilization”
Thank you from my heart and soul for what you are doing. I have a trans grandson. I’ve been a part of his journey for years, and know the importance of supportive healthcare providers. I love at the same time that I loathe the necessity of your phrase, ” the politics of fear.”
Thank you, Nina. I know as a parent and a physician how much a loving and supportive grandparent can make to a trans child. I still believe love does trump hate. And we will continue to spread love
Truly God’s work. Thank you for all that you do.
Thank you Judy!