We are born this way

Discovering what it means to be transgender
By DEIRDRE FULTON  |  February 24, 2010

COMMUNITY NETWORKING Alex Roan helps run MaineTransNet, a resource and support clearinghouse for the local transgender community.

Policy matters: a look at the legal landscape. By Deirdre Fulton.
About 10 years ago, a young man was on his way to becoming a young woman. In the midst of this transition, he came to Maine family doctor Christopher Bartlett in search of a prescription for hormone therapy. Having never treated a transgender patient — someone who identifies with the opposite gender than the one they were biologically born — Bartlett was stumped.

"I looked at him and said, 'I have no idea how to do this,'" the physician recalls. But he vowed to find someone who did. In doing so — by calling scores of local endocrinologists (specialists trained to diagnose and treat hormone issues), and being roundly (and in some cases, rudely) rebuffed — Bartlett discovered a huge knowledge gap among medical professionals. Doctors were either unaware of, disinterested in, or prejudiced against transgender issues; as a result, people who identified as transgender were not getting the care they needed.

"Frankly, I was appalled," Bartlett says. "I feel that this is a legitimate medical need that people have, and it wasn't being met."

His well-informed patient did some independent research, obtained a clinical protocol (i.e., drug-treatment guidelines and information about dosage and possible side effects) from a facility in California, and provided the information to Bartlett. With the protocol in-hand, Bartlett felt more comfortable prescribing the hormones and monitoring the patient's progress. It was a rewarding experience.

"She blossomed into the woman she was supposed to be," Bartlett says. "It was very, very gratifying."

And so Bartlett decided to become better versed in transgender care. More than just hormone prescriptions and surgery referrals, this work involves seemingly insignificant things like making sure that both medical forms and front-desk staff can accommodate non-traditional gender identities. At its peak, Bartlett's practice served approximately 50 transgender patients. (These days, at the intimate, integrative True North health care center in Falmouth, Bartlett estimates that 10 to 15 of his smaller pool of patients are transgender.) And while he acknowledges that the medical profession is populated by "more and more folks who are getting comfortable with" transgender issues, there is a long way to go.

"There's still a real dearth of trans-competent health care providers," says Mara Keisling, executive director of the National Center for Transgender Equality in Washington DC. "Fewer and fewer are hostile, but there are few who are aware of all the issues."

Especially in a rural state like Maine, it can be difficult to find appropriate resources, says Alex Roan, who about three years ago founded the Maine Transgender Network, a non-profit organization dedicated to public education and support for Maine's trans community. Fixing the problem requires practical infrastructure that isn't in place. "There's really not many opportunities for providers to have training," says Roan, who operates, through MaineTransNet, a fledgling provider database and referral system.

To say nothing of the fact that few types of transgender care are covered under health-insurance plans — or that insurance can be especially difficult to procure if you can't get a job (see sidebar).

1  |  2  |  3  |  4  |   next >
Related: Review: 8: The Mormon Proposition, That's not my name!, Visiting hours, More more >
  Topics: Lifestyle Features , Transgenderism and Transsexualism, Health and Fitness, Social Issues,  More more >
| More

Most Popular
Share this entry with Delicious
  •   ALL THE WORLD'S A STAGE  |  July 24, 2014
    When three theater companies, all within a one-hour drive of Portland, choose to present the same Shakespeare play on overlapping dates, you have to wonder what about that particular show resonates with this particular moment.
  •   NUMBER CRUNCHERS  |  July 23, 2014
    Maybe instead of devoting still-more resources to food reviews, Maine’s leading news organizations should spend money on keeping better tabs on Augusta.
    Among last year’s 100 top-grossing films, women represented just 15 percent of protagonists, and less than one-third of total characters.
    Former Mainer Shanna McNair started The New Guard, an independent, multi-genre literary review, in order to exalt the writer, no matter if that writer was well-established or just starting out.
  •   NO TAR SANDS  |  July 10, 2014
    “People’s feelings are clear...they don’t want to be known as the tar sands capitol of the United States."

 See all articles by: DEIRDRE FULTON