A Journey to Self-Acceptance and Surgical Residency

30 Jun 2024

Alexis L. Woods, MD

 

Being comfortable with my queerness is not something that always came easy to me. I grew up in a Southern household where homophobic comments were common. As a result, I had a lot of internalized homophobia as a teenager and I struggled to come to terms with being gay – leading down a winding road out of the South and to medicine. I was in denial for a few years, lacking positive queer role models. It was the 90s, and there were only a few queer women openly out and I didn’t identify with them. Emancipated at 16-years-old, I left my parents’ home, began working, and finished high school through a community college completion program. During this time, I could no longer deny I was queer, but I was closeted and spent a lot of time wishing I wasn’t gay. In my early 20s, I found seasonal adventure jobs that took me to Bavaria in Germany, Alaska, and Baja California Sur in Mexico. It was an incredible gift to get to travel and explore nature. I landed in the Pacific Northwest in my mid-20s, coming into my “gay awakening,” where I finally felt comfortable being out and was surrounded by other queer people, easing the transition. To witness queer joy in others, who were living full and happy lives was transformative. My journey of self-exploration and love for being gay evolved over time, and my desire to live out and proud in life and at work became non-negotiable. 

I pursued medicine later than some, and when I was applying to medical school at 33-years-old, it was the summer of 2014, and marriage equality was not yet legal in all states. The Defense of Marriage Act was still in effect and there was debate among people who I asked if I should be openly queer on my application. Being part of the LGBTQ+ community was such a huge part of my journey to that point, and I knew I didn’t want to be somewhere that didn’t celebrate that aspect of me. As a result, I only applied to schools in states with marriage equality and was openly gay on my personal statement. I also knew I deserved equal rights and wasn’t prepared to settle for less, even to pursue my dream of being a surgeon. Luckily, I ended up in Los Angeles for medical school and didn’t have to compromise those goals. DOMA was overturned just before I started medical school in 2015 and it seemed like LGBTQ+ issues weren’t such a hot button issue anymore. We were finally making progress nationwide, which was an especially good thing, because I met my wife at the end of my second year and we were married in my fourth year. We matched at our top choice for general surgery residency at University of California, Davis in Northern California, a place where I have been lucky to feel valued as an LGBTQ+ voice in the room and have not experienced homophobia. I know not all are lucky enough to have the same experience in training and I am forever grateful. 

My home state continues to have LGBTQ+ supportive laws, but I have watched in horror over the last few years as LGBTQ+ rights have been taken away across the country, particularly for the transgender/gender diverse (TGD) community. I’m a cisgendered queer woman, but I’ve seen that TGD people face multiple health disparities and barriers to healthcare access. Despite awareness of these disparities, education for surgeons is lacking and the training that is in practice is often focused on medical students, leaving a large portion of practicing surgeons without TGD-inclusive training. 

Our surgery department’s mission is creating an inclusive environment and culture in which everyone feels respected and valued. Equity and social justice are essential to the health of our patients. I felt it was important to ensure our mission aligned with the care we were providing to our TGD patients. To address that need in my health system, I created the TransCare Initiative: A Knowledge-to-Action Project. We first wanted to assess the department-wide understanding, awareness, and comfort in treating TGD patients with a survey covering 4 domains (personal perceptions, prior healthcare training/experience, comfort providing care, and barriers to access for TGD patients). This was sent to all faculty and residents in the surgery department. With a response rate of nearly 48%, split evenly among faculty and residents, most of our respondents were aware of the unique health needs and barriers to access, but lack of experience and training created gaps in their comfort and ability to provide ideal care, particularly when it came to obtaining comprehensive histories and physical exams. In fact, 38% had no prior training on the topic and another 10% weren’t sure if they had. To address those needs, we curated a grand rounds lectures on TGD healthcare, barriers to care, and clinical encounter training. We also wrote a practical guide to TGD healthcare, which included definitions, language for clinical encounters, tips for physical exams, gender affirming care, and healthcare disparities that TGD patients experience. This guide and pronoun pins were provided to the surgery department. 

To provide further training to our residents, we partnered with Rutgers Surgery to help pilot a general surgery resident curriculum on equitable and inclusive surgical care for TGD patients. The response was overwhelmingly positive from our trainees, and I hope to find additional opportunities to improve training on this important topic, especially when TGD people everywhere are under attack. I love my LGBTQ+ community, and I am grateful that I have had institutional support at UC Davis to carry out this project. This month I am celebrating my queerness in all its incarnations. As I go forward through training and begin my career, I hope to keep expanding better access and surgical care to all my LGBTQ+ community. Happy Pride!

 

Alexis L. Woods, MD received her undergraduate degree from University of California, Berkeley, graduating with highest honors in molecular and cell biology with an emphasis in neurobiology and attended medical school at David Geffen School of Medicine at University of California, Los Angeles. She is a PGY-6 in general surgery at University of California, Davis, with research interests in clinical outcomes and health equity and plans to pursue a colorectal surgery fellowship.

Leave a Reply

Your email address will not be published. Required fields are marked *