Students sat at long tables in the classroom, dressed in their best clothes for one of the most important days of their lives, medical school graduation.
In 2014, I was invited to be a Commencement Speaker at Wayne State University School of Medicine, one of the largest medical schools in the United States. As part of the commencement activities, I was asked to meet with the student leaders and discuss my career in medicine before the official ceremony. I expected them to answer questions about choice and success. But their first question was about what medical decision I regretted the most.
The proverb of learning from mistakes was literally at the heart of this discussion. So we often block unpleasant situations from our memory. But images of events in my clinic when I was training as a young fellow in endocrinology quickly came back to my mind. It was a teaching moment that I knew you would remember.
A boy came into the clinic with his father.What caught me off guard was that he had been complaining of pelvic pain since early puberty. congenital adrenal hyperplasia, a genetic disorder that affects the adrenal glands, which make hormones, including androgens, hormones that masculinize the body. Girls with this disorder may have obscure external genitalia that resemble male genitalia, but still have a uterus, fallopian tubes, and ovaries. Puberty may begin earlier, the voice may become lower, acne may develop, facial and body hair may thicken, and menstrual irregularities may occur. You may also have gender dysphoria. This patient was identified as a boy and was raised as a boy.
I knew he needed a pelvic examination, but my clinic was not prepared for this type of examination. They told me to send him upstairs to the clinic. At that moment, I didn’t realize that I was about to sit a boy with her father in a clinic full of women. No one around me — from my fellow endocrine clinic overseeing physicians, our nurses, or gynecologists — told me not to do this. In fact, I was relieved.
Years later, as an older female patient, sitting in an OB/Gyn clinic surrounded by young pregnant women, I felt out of place, as if I didn’t belong. Then I remembered what my patient, the boy who was with her father, must have felt. My heart was filled with grief and I hoped that the traumatic experience would not cause any serious emotional damage to either of them. I should have requested the gynecologist to examine my patient in my office.
We make decisions that can harm others, both in medicine and in life. We must stop and ask whether these actions are the result of benign negligence or malice. What are the reasons behind these decisions?
In the case of my patient decades ago, decisions were made out of a lack of knowledge and experience in providing not only competent but compassionate care to this individual and his family. In addition, many advances in medicine have revolutionized the way patients are diagnosed and treated.
For example, since 2001, the National Academy of Sciences has pointing to sex As a biological construct based on physiological and anatomical characteristics and gender as a social identity. These overlapping structures are widespread.
programs such as National Center of Excellence in Women’s Healthwas founded from 1996 to 2007 by the Department of Health and Human Services’ Office for Women’s Health and was supported by and transformed the healthcare landscape by advocating a “one-stop-shopping approach” to interdisciplinary services. Services were defined by intersectionality and interprofessional care, and the importance of gender and gender-based differences in medical research, health education, and clinical practice. It’s time to build on these advances towards a National Center for Gender and Health Equity. suggestion Designed by me to promote equitable and personalized care for patients of all genders and gender identities.
One community that has faced significant discrimination and harm is the transgender community.Attacks by elected officials and others have escalated over the years to the point that some have vowed to punish educator People who discuss gender-related issues, and even doctors and hospitals who provide gender-affirming care to transgender minors. Why is this community getting attention?
I am the daughter of a Holocaust survivor who was tortured in concentration camps and lost generations of relatives. Including all his parents and siblings, as he was Jewish. The Nazis categorized people by race and used the term “Aryan” for the idea of a purely German race who thought they were superior to all. It was a way of uniting people against people.In addition to Jews, Romans and blacks, disabled and gay people were also persecuted and killed.
I often asked my father how he could love a human being after he endured, but I always said that it was my father who tried to destroy him and our family. They taught him to learn how not to treat others, how to offer compassion rather than punishment, and how to share empathy rather than indifference or hatred. I believed I could teach others not to ignore or hurt.
Saralyn Mark, MD is the founder of SolaMed Solutions, LLC, host of the “Always Searching” podcast, and founder of iGIANT (The Impact of Gender/Sex on Innovation and New Technologies). She is her COVID-19 leader for the American Medical Women’s Association, the White House, the Department of Health and Human Services, and she is a former senior medical and policy adviser to NASA.
