Dr. Ashok Srihari is an endocrinologist who treats many transgender people. He said people often come to him after decades of hoping to transition.
“They hit all the boxes and they’re ready. We write the prescription and they burst into tears: What could be more rewarding, as a physician, than to be part of that?” Srihari asked an audience Monday night. “We don’t get that with heart disease.”
Dr. Kristin Dayton took the microphone as the room erupted with laughter. She said they have plenty of patients who cry when they are told they need insulin injections, but hormone therapy is different.
“This is the only clinic where people cry tears of joy when they get to take shots,” Dayton said.
Dayton and Srihari were two of the six people on a panel at the Florida Gym Tuesday night. The panel — titled “Transparency: Physiology, Wellness & Beyond in the Trans Community” — was one part of an event planned by Joslyn Ahlgren, the University of Florida’s undergraduate program coordinator in applied physiology and kinesiology.
Ahlgren’s idea for the event came when her former student was undergoing his transition last year and asked her if she knew where he could find physiological research on the effects of hormone therapy. The coordinator had no idea. She realized he was right: this was not a topic that was in textbooks.
The two brainstormed how to change this by creating a project for Ahlgren’s students.
Her students spent the second half of the spring semester split into small groups. Each group was assigned a system — such as the respiratory, digestive and reproductive — and tasked with compiling comprehensive literature reviews that showed how the transition process affected the entire system on every level, down to molecular functions.
The student groups presented their research in posters Tuesday before the panel began.
Amanda Vaughan, 21, and Claudia Stangl, 20, looked at the effects of male to female transition on the cardiovascular system. They found that hormone therapy can lead to an increase in blood clots, which can result in a higher risk of heart attacks and strokes.
“There’s a lot more research that needs to be done in order for clinicians to be able to properly attend to those individuals,” said Vaughan.
She added this is important, not only as a woman is undergoing transition, but if they ever need medical treatment, it is essential for doctors to know how the process may have affected their systems.
Ahlgren said exposure is the only way to fill the gap in research. She said she has connections at large publishing companies and plans to present her students’ findings to them in the hopes some will include them in textbooks as case studies.
“Textbooks are very classically 10 to 15 years behind the times,” the coordinator said.”Well, someone has to change that.”
The panel started at 7 p.m. It included three transgender members: Melina Farley-Barratt, a member of Gainesville NOW and the Trans Rights Action committee; Billy Huff, the UF director of LGBTQ Affairs; and Ethan Kutlu, an international Ph.D. candidate in the department of linguistics. Srihari and Dayton were joined on the physician side by Zully Rivera-Ramos, a psychiatrist with UF Counseling and Wellness Center.
Both Farley-Barratt and Huff made it clear that many transgender individuals do not choose to medically transition. However, for those who do, it is typically extremely affirming and essential.
Huff said he is currently suing the state of Florida because every trans-affirming surgery is excluded from health insurance plans offered to state employees. He said he discovered this after planning to receive top-surgery, a common breast augmentation procedure for transgender people, and finding out, after setting the surgery date, it was impossible any employee, like him, hoping to rely on their health insurance for this expensive procedure.
The LGBTQ director said this was not only heartbreaking but affects his work. He now has to wear a chest binder, which is so constrictive it is discouraged to wear for more than eight hours at a time.
On Tuesday, Huff said he got to work at 7 a.m. almost 13 hours after that he was addressing the audience. In doing his job, and not having the surgery he needs, it is not only uncomfortable for Huff, but also unhealthy.
“I had a cold a couple weeks ago and was coughing all day. I got home and all my ribs were bruised from coughing with the binder, so it is problematic,” said Huff. He added, “So I don’t see it as optional.”
Farley-Barratt said she has faced a plethora of medical difficulties while transitioning because she was diagnosed with thyroid cancer before she started the process. Every decision she makes about expressing her gender identity has to be weighed with how it will affect her cancer treatment.
“No one situation is the same, so each one has to be handled individually,” she said. “At the time, in this moment, with the available information: What’s the best move for me?”
Farley-Barratt had to discontinue her chemotherapy when she received bottom-surgery, another common procedure for transgender people that changes their reproductive organs to better reflect their identity. Still, she tears well in her eyes and she has to clear her throat when she attempts to imagine a life without medical intervention to help her express her true identity.
“There’s a lot of talk about gender dysphoria, but that’s only one side of the coin. The other side is gender euphoria, which all you cis people generally have - that’s why you’re cis,” she said to the audience. “We just get that after we transition.”
Rivera-Ramos added to Farley-Barrett’s point by stating there is a controversy within her field that there is any psychological diagnosis – like of gender dysphoria — tied to transgender people. Her personal issue is that many people see it as a way to say something is wrong with people who are transgender.
“This is important to make sure that the person is getting the medical procedures needed for their transition,” She said of the diagnosis. “So really the pathological part is society and the way it has been constructed as a binary world that only legitimizes biologically assigned men and women. There is nothing pathological about people who identify as transgender.”