Fertilizing Dreams

Readers, if you bother finishing this piece, you owe me one for having slogged through this article for you:  “We need more transgender and gender nonbinary doctors.”

Yep, that’s exactly the thing we were missing in medical school.  This New York City (oh great) MD/PHD candidate told a friend’s story:  “Years of distress from gender dysphoria and constant bullying for being “effeminate” led Krystal — now in their mid-20s and working as a retail clerk — to come to the clinic to explore the gender transition process.”  “Their”?  So Krystal was also suffering from multiple personality disorder?  Nothing psychiatric there…

“So, when Krystal reached out … In my mind, I hurriedly combed through a list of all the attending physicians who had given lectures: No one was TGNB-identifying that I knew of.”  Oh no, what to do?!

“In a 2018 matriculating student survey by the Association of American Medical Colleges, just 0.7% of respondents identified as TGNB…”  It would have seemed pretty disconcerting to me if I had been asked about my cis/mono-binary/LGBTQWTF-status during my med school interviews. 

The author asserts that there are approximately 1.4 million transgender/non-binary in the U.S. and “The need for that care is growing exponentially.”  What care, specifically different than what one would receive from a physician NOT suffering from severe mind-body disconnect, or subsequent hormonal, psychologic, and even surgical mutilation?

The author gives skepticism the day off when he/his states that being TGNB “translated into high rates of depression, self-harm, homelessness, disordered substance use, and HIV and other sexually transmitted infections,” not wondering whether mental illness leads to these secondary problems.  And then this line:  “…and nearly half have had to teach their clinicians about the care they need.”  To keep it topical and fashionable, we also learn that “transgender women with HIV” have been more likely to contract COVID-19.  There was no follow-up as to whether the virus was targeting transgenders, or whether it was going after the immunosuppressed the way it does in the non-trans population.

This silliness concludes that medical schools need to print brochures and actively recruit TGNB students to fulfill the same old diversity and inclusivity goals the worth of which no one can ever really define.  Also recommended are outreach efforts to colleges, high schools…and middle schools “to vocalize acceptance of any gender identity.” 

Aaaand there we have the real goal.  The entire TGNB-recruitment movement is based on mental illness elevated to the level of a civil rights plea, and coopting medicine to validate it.  Are physicians trained to say to the 90 lb. anorexic who actually sees a 300-pounder in the mirror, “that’s good, that’s healthy, go with your feelings”?  Do we tell the addict that our recognition of their unique health problems means their behavior choices don’t contribute to their discomforts?  The author is a “diversity representative” at his medical school, clearly more interested in sexual politics than the subject he purports to pursue.  Like the patients who have to “teach their clinicians”, this student somehow needs to teach his school about what he should be taught.  That is an impressive degree of hubris even in a know-it-all med student (and we’ve all known ‘em).  That a medical student is pushing to recruit more students who will ignore objective reality and encourage patients to do likewise, is the real rub.  This is not a push for better care, but for acceptance, and then embrace and celebration of a psychiatric condition.  This is the opposite of compassion, and the opposite of authentic medicine. 

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Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at AuthenticMedicine.com . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption. 

  7 comments for “Fertilizing Dreams

  1. PW
    September 7, 2020 at 6:43 pm

    Just never write a supposedly scholarly article on the lack of white male students- heresy!

  2. Rick
    September 7, 2020 at 11:53 am

    Lance, more on Pat’s piece later, but Lance, I saw a t-shirt I’d love, and so might you: I Drink Coffee
    It’s What I Do
    I Hate People
    I Know Things

  3. Sir Lance-a-lot
    September 7, 2020 at 11:30 am

    Well, I never thought the calculus prerequisite for med school made much sense, but I may have to admit I was wrong.

    Our good friend Mr. (or Ms., or Mx.) Google says there are 331 million people in the US.
    1.4 million TG/Whatever people would therefore be 0.42% of the US population.

    So, if 0.7% of the med school population believes themselves (theirselves? hisherselves?) to be TG/W, but only 0.4% of the US is, that demographic is over-represented in med school already, by nearly 50%.

    And that means that some other group must be underrepresented by a similar amount, and therefore cruelly disadvantaged.

    Perhaps the author of that article might rework his/her thesis after a remedial math course or two.

    … And isn’t Krystal another word for methamphetamine?

    More and more, my goal is just to avoid people. All of them. Al the time.

    • HM
      September 7, 2020 at 11:49 am

      Thank you for leaving the best response…like your solution also!

    • Pat
      September 7, 2020 at 11:52 am

      Ever the brilliant take, bravo!

      • Sir Lance-a-lot
        September 7, 2020 at 3:12 pm

        Thanks, Pat.

        I mean, if you can’t do simple arithmetic, it’s probably best not to include numbers in your histrionic article, y’know?

  4. HM
    September 7, 2020 at 10:51 am

    The author has insured their elevation to professorship…thanks for saving me from the read…science is dead and truth is subjective…appreciate that you had the integrity to write what many think and what most are bullied into silence over

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