Interview with a Transgender Adolescent for Case Development

Interview with a Transgender Adolescent for Case Development
By: Dan Brown, Emory School of Medicine

Along with Stephanie Holt, M.D., I recently developed a case featuring a transgender adolescent. To ensure a fair, accurate, honest portrayal, we wanted to base the character on a specific person. I interviewed Lane Brown, my brother, and his answers were so helpful and eye-opening that I thought they would be beneficial to share with the ASPE community, for anyone else who has interest in developing a transgender case. These are some excerpts from that interview.

Dan Brown: What are some of the things that made you realize that you were transgender?

Lane: This is both the easiest and the hardest question to answer. People normally try to answer this with a list of masculine/feminine things they said or did or liked, because this question makes people feel like they need to “prove” their gender. Gender stereotypes aren’t reliable proof of gender at all, but it is also sometimes literally what medical professionals look for, so after a while it comes to feel like the safest approach. But the real answer is, “I realized I was transgender because of a persistent feeling that being assigned a female identity was wrong, and a male identity was more correct.” I’m aware that just repeating the literal definition of trans is probably not helpful…

I say “more correct” because, for me, some days my sense of my gender seems to take a vacation. When it’s around, it always feels male, and “female” feels very uncomfortable. On the other hand, when it’s not around, “male in a kinda androgynous way” doesn’t feel uncomfortable in the same way. If I feel male, being called male feels awesome, and if I feel genderless being called male feels okay. This isn’t actually that uncommon. Some people who feel that way like the word “demi-boy” or “demi-guy.” I think the word is accurate for me, but I don’t feel the need to claim that label or make everybody understand it. I can accept that for most people, getting the idea of trans male is complicated enough.

This is a big disconnect between the trans community and the medical community, although it’s getting better. We see gender as a complicated, messy spectrum, and they’ve spent years conceptualizing it as a distinct binary. I don’t think even cis people tend to have simple genders. It’s just that a cis man who wants to sing and dance on Broadway or be a stay at home dad, well, to be perfectly blunt, he doesn’t have to go see a doctor and explain why he wants to do all that and still keep his penis. Because trans people are so intensely analyzed, they have to analyze themselves.

DB: What was your experience as a young transgender patient during any doctor’s visits? (before or after coming out)

Lane: Before coming out, stripping down for any kind of examination was awful. Nobody likes it, so I assumed it was just what everybody deals with. Now I can just think, "yeah, this is a doctor's examination, they're used to it and I've got nothing to be ashamed of.” I think it was an attention thing… any kind of obvious scrutiny from somebody else gave me that feeling, whether it was from trying on clothes or just being eyed on the street.

Since transitioning, I've been lucky enough to have mostly positive experiences, as my regular check-ups tend to be through very trans positive clinics. I don't stress about questions; I've even had some cool conversations with doctors about my scars. There was one time, though, when I was pre-chest surgery and I got an awful case of bronchitis. I had to go to the urgent care clinic and when the doctor took my vitals I was so afraid the binder would cause questions. It was a scary few minutes as I imagined everything he might say. He didn't mention anything though; I'm not sure if he didn't notice, or knew what it was, or just was being polite.

DB: What were some coping mechanisms that worked?

Lane: The internet was helpful. It let me keep in touch with some people I was especially close to after we moved. It wasn't as good as in-person contact, but before I could drive it was better than nothing. I also really liked spending time around kids and animals. I've noticed this is a recurring theme in gender variant people. Kids are more open-minded about gender, and animals don't care, so a lot of us have memories of a time when we felt like we didn't fit in with our peers, so we let kids and animals be our social outlets.

Publications Committee Mission: “To bring high quality reporting of current research, trends, techniques and information regarding SP methodology and other relevant industry articles to the attention of the membership through the web-based ASPE eNews blog.”

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Valerie Fulmer - Thursday, November 09, 2017

Thanks for sharing this , Dan. We are building a new mini- elective on this topic and this information is quite helpful. Yours, Val Fulmer

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