In the this installment of the Trans Physician & Trans Scientist Project, anonymous, a recently-graduated doctor in Oslo, Norway, discusses their experiences questioning their gender, transphobia in medicine, and the hurtles that transgender Norwegians face in medically affirming their gender.

Name and pronouns?

Anonymous. In my heart I prefer they/them pronouns, but I officially use she/her pronouns in public for a number of reasons – one of which being a phase where I tried (and still somewhat try) to convince myself that I’m cis, because everything would be easier that way.

How do you identify, in terms of gender and sexuality?

I am bisexual, although it took me some time to admit that to myself, as if it’s an obscene word. In terms of gender, I would describe myself as nonbinary/genderfluid– neither fully male nor female, but fluctuating in between.

What is your current job or position?

I am a doctor – I recently graduated from the University of Oslo, and I am currently looking for a new job.

When did you start questioning your gender?

I started to question my gender after I started my studies at the university. It was a slow process.

When did you first come out to yourself?

It’s hard to answer when I first came out to myself, because it was coloured by heavy self-denial. I used to think to myself: “I’m not trans*, and even if I was, I wouldn’t be trans* enough to really be trans*.”

Are you “out” at school/work? What was it like for you to come out at work at first?

I once came out collectively to my university class, as part of my reaction to our OB/GYN semester, which at the time triggered massive gender dysphoria in me. I received only positive reactions from my class, but suffered a negative reaction from someone close to me which turned it into a painful memory.

Do you think the medical community as a whole is accepting to transgender physicians?

It’s hard to say, I have very rarely heard about and rarer still had the pleasure of meeting a fellow physician on the trans spectrum. I’m under the impression there is a general acceptance.

Do you ever feel like your gender and/or sexuality conflict with your role as a physician/scientist?

Neither has caused conflict with my professional role, but gender dysphoria made it tougher to learn certain skills and topics. I would see myself in a patient’s place, and be confronted with similarities I did not particularly like. I have learned to deal with it, and it no longer bothers me the same way. A medical education teaches us to deal with many challenging things.

Do you consider yourself to be a member of the broader transgender community? The LGBTQIA+ community? Why or why not?

I did once consider myself part of the broader transgender community and the LGBTQIA+ community. Now I view myself more as a passive bystander. I told myself that I needed to create a distance between myself and the community, back when I was convinced I ought to denounce my queer identity for religious reasons.

Are you involved in advocacy for the trans or LGBTQIA+ community? If so, what kind of advocacy do you engage in?

I am not involved in any advocacy – I am quite simply too frightened for what it would cost me socially. Also I lack confidence in my own voice as one to be listened to.

Do you feel that your identity can help you empathize with and treat sexual/gender minority patients?

Yes, absolutely. I have a concrete example in mind. I observed a consultation between a psychiatrist and a trans patient. The patient was tasked with describing their gender dysphoria. I could relate to a phrase used by the patient, which the psychiatrist didn’t fully understand.

What are your views on gender dysphoria as a medical diagnosis?

I believe it is useful to have the opportunity to diagnose gender dysphoria. It most certainly is a real condition which can cause distress and negative consequences for the health of those who experience it. I am in agreement with the changes presented in ICD-11, where all trans-related categories have been moved from the mental health chapter to the chapter of sexual health. Mental health conditions are unfortunately stigmatized (which they shouldn’t be), but that’s another story. The point of the matter is that being trans is not a mental illness, and should not be viewed as such.

What are your views on the informed consent model of gender affirming treatments?

The informed consent model for gender affirming treatments does not have much hold in my country. There’s only one national centre which holds the authority to officially diagnose “transsexualism”, which gives the right to have treatment expenses covered and not pay everything out of pocket. There’s a “narrow window” to get through to get diagnosed, and those who seek help there are eventually turned away when they don’t qualify for the strict criteria of the diagnosis. Non-binary patients are disqualified from coverage of treatment costs. The reasoning behind this restrictive attitude is to make sure nobody wrongfully receives gender affirming treatments. Within this system, many who need help do not receive it. An informed consent model would make gender affirming treatments more accessible, which I believe is needed over here.

What is the biggest challenge you’ve faced as a transgender health care provider?

We had a seminar on sexual reassignment surgery, held by a leading plastic surgeon in the field. He expressed concerning views on transgender people. They were especially concerning given his position. This was no one-time occurrence either; said surgeon has co-authored a newspaper article describing gender affirming treatment of young trans men as “providing hair growth and a darker voice to the daughters of the nation.” It’s disheartening to keep one’s head held high as a gender non-conforming doctor and carry on, when you know someone responsible at the top holds view like these.

What is your message to upcoming generations of transgender or gender non-conforming physicians?

Your visibility is valuable to others – both for patients, and for those who wish to pursue medicine. Role models are needed.

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Previous Trans Physician/Scientist Articles:

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