Vital Views

Unknown Speaker 0:20
Music.

Unknown Speaker 0:31
Hello and welcome to School of Nursing. Vital views at UNLV. My name is Rocky, and I'll be hosting the part two of a discussion for pride. 2024 welcome everyone again. My name is Rocky. I am a nursing faculty, a nurse by trade at the School of Nursing. And to my left, I'd like to introduce Calvin bird. Calvin, tell us a little bit about yourself. Hey,

Unknown Speaker 0:53
how's it going? How you doing today? I'm

Unknown Speaker 0:55
good. I'm good. Glad to have you here.

Unknown Speaker 0:57
Thank you. My name is Calvin bird. I'm a community leader, and I own a nonprofit caught on cloak. And uncloak is centered around the well being the trans man,

Unknown Speaker 1:07
excellent. And let me back up. My name is Rocky. My pronouns are he, him, his. I am a gay, cis male, happily married. Feel comfortably. Introduce your pronouns if you want. Yeah.

Unknown Speaker 1:19
Pronouns, this. Calvin pronouns, he, him.

Unknown Speaker 1:21
Thank you, Calvin. And to Calvin's left is Bree brie. Starks, tell us a little bit about yourself. Bree, sure

Unknown Speaker 1:28
my name is Bree, like the cheese, so it's just Bree. Our pronouns, are she, they and I am a social worker, a lawyer and a civil and human rights and Diversity Equity inclusion advocate,

Unknown Speaker 1:40
welcome Bree. We're glad to have you here. And to bree's Left is Samuel Hickson. Samuel, tell us a little bit about yourself. I

Unknown Speaker 1:47
don't know how I can follow Bree, but this is Dr Samuel Hickson. My pronouns are he, him, and I am a clinical trials Raider and psychotherapist. In addition to that, I like to tell people that I'm a health behaviorist, trying to understand how people's cultural ideologies intersect with their ability to engage the healthcare system.

Unknown Speaker 2:09
That's nice.

Unknown Speaker 2:11
So we have about 25 minutes, and I'd like to continue the conversation that I was having with Calvin and Bree and Samuel. Introduce you and bring you in part two, we were having a conversation about the use of pronouns, about identity versus gender expression. Gender identity, gender expression. And one thing we didn't get into talking about was sexual orientation. And see where we can go with that. Is that okay? Can we continue that conversation, of course, and I'd like to tie it back, since we are a university, since we are School of Nursing, kind of bring it back to the health focus, partly in that how the LGBT community and our medical community can support each other and understand each other and have a conversation. What do you think? Absolutely So, I think one thing I would like to do is talk a bit about medical classification and intersect in healthcare, we do have medical classifications of female, male or intersect, often classified as anatomical, chromosomal and hormonal characteristics. I know it's a little bit dry there, but includes secondary characteristics in that medical classification, so male female intersect and anatomical, chromosomal whereas intersect, a general term used for a variety variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn't seem to fit the typical definitions of male or female. So with that said, I think I'd like to maybe start off with the discussion of sexual orientation, and what I mean by that is we can identify as male or female ident I was born male. I identify as male, and my orientation is is part of who I am, and it's who I'm attracted to. I happen to be happily married and was attracted to a man, my husband, my my everything and enjoying that. But I think in our community that we also have the trans community, that are also straight, are also gay, or also bi or also pan. Anybody want to jump in and talk about that or share some thoughts or ideas,

Unknown Speaker 4:37
I don't mind kicking it off. I think it's important to stress the fact that gender and sexual orientation is two totally different things. Just because I am trans male doesn't mean that I'm automatically attracted to women or men or any one of like any stereotypical or. You know, assumption, I want to say, but yeah, I think it's very important for medical professionals to know the difference between gender identity and sexual orientation.

Unknown Speaker 5:13
I think last time we had left off on talking about how when entering an office visit for the, you know, a doctor or a healthcare professional. Sometimes no all the time. It is important to not assume who someone is being sexually active with, or even if they're being sexually active when visiting the doctor. For example, a lot of people assume that non binary folks, depending on how they look, automatically. Maybe it's a person who was born a female and now identifies as non binary, that they might also be lesbian, or maybe they don't like men, or whatever it may be. And I think that that is an assumption a lot of people making is very misleading as it relates to people in their gender identity and their sexual orientation, which

Unknown Speaker 6:01
are two separate things. I've got a couple of definitions I'd like to throw out there, actually four, sexual orientation, identity, behavior and attraction, and I'd like your thoughts about it as well. So sexual orientation, how a person experiences physical, romantic and or emotional attraction to others. Identity? Do you consider yourself? Gay, lesbian, bisexual, straight, queer or something else? Behavior, what gender or genders Do you have sex with and then attraction. What gender or genders are you attracted to? Are those okay definitions?

Unknown Speaker 6:49
I think ultimately they're okay for now, I think we have to understand that gender and orientation changes all the time. As humans start to learn about themselves as we evolve, as we change. The definitions cannot be fixed, and I think that is one of the errors that medicine in general tend to make, is that we take one definition and then we run with that for many years, for decades, sometimes centuries, and we don't think about the implications of what those definitions do, not just to our practice, but to the patients that we see. Ultimately, medicine is guided by our ability to do the right thing. It is guided by our understanding of disease and how it moves, how it behaves, how it thinks. Yes, there are intersections of gender and sexual orientation, and those things are important when we are going into a medical practice, but when we as medical professionals, misunderstand those definitions, when we mislabel, when we call someone by the wrong identity type, whether you want to think of that as your gender, your orientation, all of that is a Part of how someone identifies themselves. When we incorrectly mislabel someone on any of those facets based on those definitions that we see, what we get is medical mistrust, and this is where we tend to have problems within the community. Because now I don't want to go back if you can't even understand the basic, basic tenets of those definitions rocky that you just gave to us, we don't feel safe, we don't feel comfortable, we don't feel like you understand what we are going through. So I think they're okay for now, to answer that question for you there, but I do think they need to be permeable, adaptable. They need to be able to be changed as we evolve as humans. We could

Unknown Speaker 8:41
probably wrap this up. That was good enough. Very well. Said, very well. Said,

Unknown Speaker 8:46
Yeah, I like that. You said that as far as the evolution and people learning more about themselves, because I think that exposure is huge. I think personally for me, I don't think it was until I was an adult that I was even asked in a doctor's visit if I had sex with they were like, did you have sex with a male or female? And like, even as a teenager, I would have never thought to, like, say, because I would have probably felt like I was exposing myself if I said, like, oh, I had sex with a woman, or whoever it may be. And I think that that's something that is flawed in the system is like, they're not. A lot of professionals are assuming and not asking you, right, like, what your experiences are, and just going for whatever, or just touching you or doing all kinds of things without saying anything when they don't know your experiences or what you're used to. So

Unknown Speaker 9:32
you bring up a good point, and I've got to ask, do you prefer Dr Hixson or Samuel? Okay, what's

Unknown Speaker 9:37
your preference? Sam is fine, Sam, I know I have my PhD. I don't need to be reminded.

Unknown Speaker 9:43
And congratulations on that. That is not that is not an easy task. Thank you. You bring up a good point, and I think we've talked about this a little bit in the past, is that that feeling safe, that safe environment, that feeling of safety, to be who you are, to answer. Questions, not feeling like you're being judged by the healthcare professional or you're being questioned. So let's talk a bit more about that, that creation of that, that safe space, I believe. And I'm gonna kick it back to you, Calvin for just a minute. I believe that you had mentioned on our first part about your stealth. Is that the right word? Yes, you were being stealth. You were checking out a oh,

Unknown Speaker 10:24
that's called guinea pig. Guinea guinea pig. I

Unknown Speaker 10:26
wasn't stealth at the time. Guinea pig.

Unknown Speaker 10:28
I love this story,

Unknown Speaker 10:29
so tell us a story you What were you doing? Why were you doing it, and what did you find when you found Dr Janice Eurekas in the care that she gives,

Unknown Speaker 10:41
aka Dr bestow, because she's best friends with the whole community. Well, I have a network of trans men that need sort the resources, and they need different type of resources to make sure that they're safe wherever they go. So what I'd like when

Unknown Speaker 10:58
you say resources, in this instance, you're talking about medical care, medical health care, health

Unknown Speaker 11:04
care. Thank you in this, in this very specific situation, yes, they needed a medical professional that they felt safe with me. I would like to say that I have tough skin when it comes to my identity. I already been through enough. So, I mean, nobody can be harder than I would. I already been through. So I was searching. I was head hunting for medical professionals that felt comfortable interacting with trans men in a safe manner, in a respectful manner, and so I got on my insurance line, and I found some reproductive clinics, and, you know, started making appointments. My very first stop was at Dr bestows office. I got Dr Janice, and I wanted to I wanted to see how the natural interactions were with trans men, like, how did the front desk treat me? How was How was it when I set my appointment? Did I have to answer a series of invasive questions over the phone? Were they patient when I wasn't, when I wasn't comfortable disclosing everything, or the reason that I wanted to visit the office? So I literally documented step by step what I wanted to, you know, bring back to the community, if it was safe or not, or if, even if, it was an opportunity to engage with the medical professional in a way where they will respond and be willing to learn. And so when I got to the doctor's office and encountered Dr Janice, I immediately, like fell in love with that lady. She is so nice. Her mannerism was great. She immediately was more concerned with how I felt before she even asked me any questions. And I think it's important to start the communication with making sure that the person that they're in, that the professional is interacting with, is comfortable in the setting, before even engaging. Why I'm there. So

Unknown Speaker 12:55
I'm assuming that when you encountered Dr Janice, you first call the office on the phone, yep, and it wasn't Dr Janice at the time. It was not. It was in front desk. And then when you presented yourself, when you attended the office, it wasn't Dr Janice at the front desk, right? So tell us a little bit about what those healthcare people, what you felt, what you saw, what you heard on the phone, as well as at the front desk, that that kept you exploring and said that you felt like this was the right place, and I don't want to put words in your mouth, this was a safe place. This was a comfortable

Unknown Speaker 13:33
place. Well, interacting with the person on the phone, I knew it was a safe place because when I mentioned I was trans, there was no awe, there was no pause, and there wasn't intrusive questions that might have not been relevant, but maybe for the person's own curiosity. That has happened a ton of time. They gave me the option to sign in over the phone so I can pull up to the parking lot and tell them there. And they also gave me an option to go through a back door so it didn't look like I was sitting in a waiting room for reproductive services, which, that's the biggest thing there. They didn't call my name out loud, and they told me this over the phone, and I was able to reconfirm with them, once I got there, that these steps was hap would happen. And the biggest, one of the biggest things that I immediately loved was that I only interacted with a very limited amount of people. I didn't have to see the front desk, the nurse, the person taking my blood pressure, and then another person, and then a doctor I seen. I checked in with the person that said I can stay outside, which I which I was really happy to do. And then one person walked me back, walked me to the room, asked me all the questions, and the minute I said I wasn't comfortable asking questions, they stopped and said, Okay, you're more than welcome to talk to the doctor. And I saw one doctor, that's it. So it's those little steps that they made before I even got there that showed that they were willing to make it. Safe place for my guys, Cool

Unknown Speaker 15:02
beans, and I'm sitting here catching myself nodding my head in agreement with you, and no one can see that, but I think that's pretty cool. I think that's really cool, and that really makes a difference in your experience in receiving healthcare.

Unknown Speaker 15:15
Yeah, absolutely, absolutely.

Unknown Speaker 15:19
I also have here. So what can we do in healthcare, in the community, to help make healthcare establishments a safe space for a lack of words, you know, a welcoming environment that feels safe, it's positive and it's inclusive, with images and symbols and different things. I thought I'd go into that and maybe get your thoughts and ideas and help me understand rocky you're you're on it, or you're veering off. Yeah, let's, let's talk about something else. So it should be a space that people feel they can find themselves represented and reflected where they are, and understand that all people are treated with respect and dignity. So that's the artwork that you might find in the waiting area, that may be some pamphlets or books that are in there as well, that should be inclusive on all areas, not just the LGBT community, but gender, age, social, religion, different things as well. Am I? Am I close?

Unknown Speaker 16:18
Yeah, I think you do pretty good

Unknown Speaker 16:21
that. So that we all can be treated and feel that we being treated with respect and dignity. And I have a feeling that you felt that at the office, the feel gender identities and expressions are acknowledged by staff, affirmed and respected, as you had mentioned. It wasn't pointed out. It was just affirmed, respected, and the minute that you said you didn't want to answer a question, it was respected and moved you forward. Excellent, excellent. And

Unknown Speaker 16:50
can I just point out there Rocky, that it's also important that you ask how that person wants to be addressed and how they want to be identified? Part of that is because, again, understanding the bandwidth of human communication. Most people, even if they understand what their gender expression is going to be, or their sexual orientation, some of them are very seasoned. We know right off the bat what they want, how they want to communicate, how they want to be addressed. But there are some people who don't understand the feelings. They know something is, as my patients like to say, off. They just know it's off, or they give me a little hand signal that says it's off, because we don't teach people how to communicate their expression, their feeling, their emotion. So I think beyond just making sure that the way we interact with our patients, from the front desk to everything, we have to create that safe space from the moment they fill out a form, from the moment they enter a room, from the moment they Turn the doorknob to our office, they have to know that at every step of the way the person will be seen first, not their expression of self, and that's fundamentally vital. And I have to say, Calvin, I love that story, because I know Dr Janice very well. That just makes me very happy. And I'm going to try not to cry on here, but I want to just point out that we as a medical professional have to start with meeting that person where they are, and sometimes that is understanding that they don't know. They don't know. And even if we put in culturally appropriate signage and postings and all of those things, we still have to ask, because remember the moment you print something, it becomes outdated. So we want to make sure that we are communicating in a way that says, I see you as the person. Now I need to know you as the person, so I just wanted to point that out for you. Okay,

Unknown Speaker 18:46
thank you, Sam. All right. So I guess one thing I would like to wrap this up with is discussing, what do you do when you make a mistake? And what I mean is I don't want to assume that I know that how a person wants to be described themselves and or their partners. I shouldn't assume that they are heterosexual or cisgender or what have you. And I found this thing called the repair process. I don't know if you've heard about this, but it talks about when I do misgender someone or use the wrong pronouns, acknowledge the mistake. First thing I should do is to acknowledge that mistake. I should apologize for any harm that I did. I should own it. I should continue the conversation. And when I apologize, I'm not going to make it about me and about my mistake, but about the potential harm and discomfort that I caused, and then and then, I think what's more important to me is that I take personal time and reflect on that experience and the potential areas that I need to grow to prevent that from happening again. So I think, as you had mentioned, Sam, and I think we all talked about it, is it's important that we all, all staff, doctors, nurses, all of us. I. Allow every individual to use their chosen name and their pronouns, and don't assume how do you want to be addressed? What's your name? So I just want to thank each and every one of you for spending some time with us today and and sharing a little bit about yourselves. And I wish you all a Happy Pride 2024 Thank you very much.

Unknown Speaker 20:21
Thank you. Thank you.

Transcribed by https://otter.ai