Daniel Summers is a paediatrician and regular contributor to Slate. He lives in Maine with his husband and their children, and has worked in private pediatric practice in the Northern Boston suburbs since 2010. Here, he shares with Men’s Health how being an openly gay doctor helps him to create a safe space for all of his LGBTQ+ patients, and the ways in which trans children in particular are being failed by the current system.

IT’S EXTREMELY IMPORTANT TO ME to be out in my professional life. During the pandemic, as we didn’t have a regular Pride season per se, I ordered a pair of purple scrubs that I could work into my rotation, and I started wearing the rainbow pin. Then I just kept wearing the pin for the entire year, because there’s no reason to stop wearing it.

It hasn’t meant that much to every patient, but I know there have been patients where it has clearly been meaningful to them to see that I am representing that part of myself, so they can then feel comfortable sharing whatever identity they have during their appointments. I don’t make a point of mentioning it, but I am also very intentional about not not mentioning it: I will mention my husband and my own children when speaking with parents when it’s relevant, because I think it’s important to have it be as unremarkable and a normal part of conversation as possible.

As a pediatrician, I am often the first line of contact for young trans patients, sometimes even the very first person they feel they can share that with, and it is a responsibility that I take very seriously. For patients who are not able to be safely out to their families, I am one of the few people they know who will ask them “what name do you actually want to be called” and “what are your pronouns.” In fact, I ask anybody who is about 12 or up, just as a matter of course, about their gender identity. No matter how clearly cis-presenting they may be, I just ask. Thus far, I haven’t had a single patient react negatively to it. If anything, I think it’s just becoming a new social norm for many people.

I have some patients who are trans where the parents have had a really difficult time accepting that. I have one in particular who was not out, and is still not out to their parents, but their parents are aware that they are exploring that aspect, and it’s really challenging because you want to support that patient but you also know they’re not going to be getting the care they need in that household. So for me, it’s just a question of getting them through this period of time before they can then access that care on their own terms.

I only learned a relatively small amount about trans healthcare when I was in medical school, and have since made a point to do as much independent research into this as possible in order to be best equipped to help my patients. From my perspective, there should be no dispute that medical schools should be doing more to educate future doctors on this. Even if you don’t go into obstetrics, you should learn how the birthing process goes. Even if you don’t go into psychiatry, you should have a basic idea of what depression and anxiety look like. There shouldn’t be an “opt out” for any kind of medical care; there is nothing more or less valid about trans medical care than any other area. So even if it’s not a part of your practice later on, learning how trans youth can be appropriately cared for, and what gender-affirming care looks like, is something that should be included in every medical school’s curriculum in general.

One of the most troubling things I’ve seen in the United States is this wave of legislation in state after state denying trans youth access to healthcare that is gussied up in this narrative of “it’s for the children’s own good,” and the idea that it’s protecting them from making an ill-advised choice which will irrevocably alter their lives, which is just simply not true. If you’re in any way familiar with care for trans kids, you know that it’s done in a very thoughtful, considered, gradual way, so that kids who decide over time that they don’t want to continue with any kind of medical transition can go back to whatever their innate physiology would be doing with their body. Putting it in terms of “protecting” kids is the total opposite of what’s happening. What these politicians are doing is, once again, taking a vulnerable social population and making it a wedge issue to distract from their otherwise questionable-at-best record in whatever state it is they happen to be running. But while this is all going on, this marginalized population of kids isn’t going to get the care that it needs, and it’s going to be catastrophically bad for them.

If there’s one thing that has become evident over the last year, it is that the American medical system is profoundly broken. We have seen, on a national scale, how very much where and who you happen to be, whether that’s your sexuality, gender identity, ethnicity or socioeconomic background, matter in terms of the quality of care you get. The healthcare system leaves so many people vulnerable for so many reasons, and it’s one of the greatest indictments of this country.

To any LGBTQ+ child who is not being supported by their family or healthcare provider, I want to say: please, just hold on. I know that it’s incredibly painful to have to endure this painful time where you’re not going to get the affirming care you need, and there’s not a lot that will mitigate that pain in the short term. But if you can just hold on long enough to be able to make your own healthcare decisions and choose your own provider, they are out there. It’s just a question of being able to make it through the now, so you can finally arrive at that destination and be free to live as your truest self.

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