A Christian medical student who is semi-closeted (as a Christian) in her med school writes to respond to the post earlier today about Transgender Babies. I have deleted her name, and taken out or obscured identifying information to protect her from retribution:

I found your post about Transgender Babies: The New Civil Rights Frontier very true about the modern societal — and particularly medical — worldview held by many people today. I guess my reason to send this is in my opinion your posting underestimates the effect of the idea of being “Transgender” as a civil right, and its impact on the future. My point is, the future you talk about is already here.

This week in my medical school we began the ethics portion of my medical school’s curriculum.  This week, the main learning points were on Human Sexuality, Emotional Intelligence (Empathy), and Memory and Learning (How to deal with patients with dementia, learning disabilities, autism etc.). You might be interested to know that the only required classes were on Human Sexuality, with one of them being a Transgender panel. All the other classes were optional attendance; they covered topics such as Cognitive Behavioral Therapy (CBT) and how to empathize with your patients. CBT is a very common helpful tool that can be used to treat everything from depression and anxiety to bipolar disorder. However, despite the importance of emotional intelligence and memory and learning, over half of the material was about human sexuality — and over half of the human sexuality content was about how to treat LGBT patients.

We had to read the Swedish study that you or one of your quotations cited about the suicide rate in the transgender population. My understanding from the article and what we were taught is that it is not showing that those who have reassignment surgery are more likely to have suicidal ideation than those who do not receive surgery, but that Transgender individuals have a suicide rate of ~45% vs. the ~1.2% rate in the general population. This was stated as one of the primary reasons that gender reassignment surgery was such a wonderful thing for these patients. Also, hormonal therapy for children with gender dysphoria was taught to us a promising treatment option that saved these children from a life of harassment, depression, anxiety, and suicide.

The way it works is that you suppress puberty at 10 years of age (this is reversible if the child later changes their mind), at 15-16 after going through psychological testing if they have passed the testing and still want to proceed they will be given the hormones to begin and complete puberty of the gender that they affirm (this part is not reversible this action is permanent), at 18 they undergo gender reassignment surgery (this surgery will leave children sterile). We were also taught that gender identity (what gender someone feels they are) is determined by the age of 3. That a boy might play with dolls at 5 and 80% of children grow out of this, but if a 5 year old boy says “I’m a girl” when asked “Are you a boy or girl” then this child is likely transgender. That a child after the age of 3 doesn’t often change their answer to the question “are you a boy or girl?” and that by the age of 13 it is extremely rare that they will change their answer to this question. This was stated as fact, but we were not given a source for this information, so I don’t know if they are correct.

For me, what was so shocking about what we were taught are as follows:

–          No one discussed the side effects of hormone therapy on a 16 year old.

–          No one questioned that a 16 year old was old enough to make this kind of decision. (I personally wouldn’t want anything I did at 16 to be permanent).

–          No one  brought up the effects of a complete hysterectomy might have on a 18 year old. (Osteoperosis, thyroid problems etc.)

During the transgender panel, when asked how they knew they were transgender, these are the responses we received:

–          Female to Male patient – I knew because I never liked playing with dolls. I never wanted long hair and when my mom put me in a dress for family pictures I cried and cried. It was just torture.

–          Male to female patient – The doctors missed a lot of signs. I would dress up in my sisters close and play with her dolls.

When asked how they had been discriminated against in healthcare settings:

–          One of them said they were discriminated against because they went to the ER with chest pain. The first question the physician asked when assessing the patient was what medications are you on. The drug combination of hormones alerted him that the patient was transgender, so he asked what sex the patient was. The patient then explained that they were transgender and they were (Male to female) female. The doctor then asked “Do you have a penis or a vagina?” (This was apparently a very offensive question to ask.) The doctor then left the room  for the EKG to be done.

It seemed to me that this was a little quick to claim discrimination. I mean, depending on how the patient looked (were they cold and clammy with a BP of 90/70, or were they alert, pink, normal breathing, and a BP of 120/80) just coming in with chest pain might not put you at the top of the ER list. Also the EMRs that I’ve seen have a check box for M or F. If the doctor was uncertain about the gender of the patient, it seems natural that a way to have a definitive answer would be to ask what the patient’s genitals are. If the doctor hadn’t filled out the form correctly or didn’t do everything he could to fill it out correctly, that would be fraud. However, in this case as presented to us as a clear case of discrimination, and that ER doc was a horrible human being.

As a future physician, hearing that these transgender patients were often refused routine care (check ups, stuffy nose, checks about hypertension or diabetes medications) made me sad. In my opinion, regardless of someone’s sins you have to still treat them as people. I have no problem treating people with views vastly different than my own, or who are guilty of sin. I mean, if you had to be sinless for people to receive medical care, then only Jesus Christ could ever get treated by a doctor. So I don’t agree that a doctor can reject treating a patient just because they think something they have done is wrong. In many cases, in the adult setting, the damage is already done. I guess in some ways I see these individuals as the victims of depraved society. I mean in essence these people are told that feeling suicidal because they have the wrong genitalia is normal, and that with invasive surgery we can cut off the part that distresses you it will all be better. Instead of treating these poor people for their delusion, modern medicine mutilates them, and calls it a positive outcome.

I think the part of this week that scared me the most was about dealing with pediatric transgender patients. We were told that we will know they might be transgender because the parent will say something like, “Joe dresses up in his sisters dresses sometimes but that’s normal, right?” or “Little Jessica hates wearing dresses and wants to be a quarterback when she grows up. Will she grow out of this?” When we hear these kind of statements, the standard of care we are taught is to refer them to a child psychiatrist who works with the LGBT community so they can undergo psychological testing and gender reassignment if appropriate.

Consider that I was a little girl who wanted to grow up to be a doctor (a traditionally male profession), hated to shop or wear dresses, wished I could play football, and disliked ballet. I remember once telling my father that I wish I was a boy, so I could play soccer and football on the boys’ teams. I technically would have fallen under the criteria for being referred to a child psychiatrist, even though I’m a perfectly normal heterosexual woman medical student who now enjoys cooking, getting her nails done, and wearing dresses.  It seems a little insane to me that because I liked some stereotypical male activities at the age of ten that I should have been (if it had happened in 2014, and not 1995) referred for psychoanalysis and possible gender reassignment.

Medicine is a hard place for Christians these days. In my study group last night, others in the group discussed how the transgender panel must have made the conservative Christians in our class squirm, and how bigoted those Christians are. (I’m not even sure why I don’t fit into this category in my classmates’ eyes. Maybe it is because I don’t say much about my religious beliefs, and when asked about touchy subject, my answer typically is that it’s just a sad situation.) A classmate of mine who questioned the status quo of abortion as morally right was shunned by many in my class after that. I have also been personally told that on residency interviews two years from now that wearing my cross around my neck is a bad idea. That people won’t hire me if they think I’m Christian. No one thought this advice was odd, and when I asked, “Wouldn’t that be discrimination?”, I got a blank stare and  an “it’s just the way it is” response.

I apologize that this email is so long. I just saw that article today and felt very sad because I agree with you, but it seems to me that the battle is already lost. In the generation I am part of (I’m in my late 20s), I’m very much the minority, especially in my field. The indoctrination they’ve put university-educated people through, and the discrimination against Christians and other social conservatives, both make my world feel very toxic at times. All discussion ends at “You bigot!”

The Law Of Merited Impossibility: It will not happen, and when it does, you bigots will deserve it.