The first time I had my primary care appointment at the transgender clinic, I left feeling more at ease than I ever had before in health care. When the nurse called my name from the waiting room, it was without gendered honorifics. When she brought me to be weighed, the first question asked was, “What name do you prefer? What pronouns can I use for you?” When I met the doctor, she had no hesitation in welcoming my gender and sexuality, understanding without my instruction how to care for a nonbinary, queer person like me. At the time, I did not have the clarity I have now as to how I would utilize gender affirming care, but I knew that I was transgender and was hoping to find a doctor who understood me in the fullness of who I am. I wanted to be understood, and I was. Since that day, my doctor, the nurses, and the front desk staff of the transgender clinic continue to provide me with so much healing and possibility that for the first time in my life I feel in control of my health and at home in my body.
Years after that initial experience, it is now my privilege to serve as the chaplain for this clinic and for all LGBTQIA+ services of Vanderbilt University Medical Center. Because I have lived it too, I easily join the expressed gratitude of the patients I serve in this clinic. Many of them sought gender affirming care longer ago than I did, and they share of the difficulty of living without access to care. I have heard stories of how patients used to get their hormones from a veterinarian or from the internet. They share this memory in awe of what it is to receive safe care at a clinic where your whole self is honored and understood.
As the chaplain in this space, I get to bear witness and celebrate the joy when someone signs a consent form to begin hormone replacement therapy. I get to come alongside the everyday life experiences of loss, grief, depression, and family conflict that may be complicated by our transgender identities. More than once I have had a conversion with a transgender person full of regret. Their regret stems not from regret of transitioning but rather regret that it took them so many years of their life to accept themselves. My work with this person is sharing the knowledge that has been passed along to me that there are no missteps on this path. I cannot undo the past for this person, but I can claim with them that this present moment holds so much potential and possibility. Together we welcome the new. For another patient, they may be struggling with the religious teachings they held deeply for much of their life. Their faith tells them that being transgender is wrong, but every feeling in their body when they dress as themself and when they are taking hormone replacement therapy tells them that being transgender is deeply right for them. Here, my job as the supportive person is to affirm the knowledge within, in one’s very own body, and to claim with them the goodness of self-acceptance.
Every part of the transgender journey is sacred to me because it is sacred to listen within and to discover what part of yourself needs to be made known. As a chaplain, I feel that it is my greatest honor to journey with someone to that inner space and to affirm with someone that truest form of self.
I deeply love my job, and I hope that more medical centers, hospitals, and clinics will hire chaplains like me trained in LGBTQIA+ spiritual and emotional support. But I am even more grateful that such an affirmation does not require a chaplain. Each of you, by committing to the work of understanding and affirming LGBTQIA+ people are planting seeds or watering what is already there for the transgender person to spiritually thrive.
When you advocate for us to receive fair and safe health care, you are tending to a spiritual need. When you correct yourselves and others when misidentifying a patient in name or in pronoun, you are enacting a justice, a right to a wrong. When you tend to the seasons of life transgender people face just like anyone else—grief, loss, new life, new opportunity—you are embodying spiritual healing. You and I both may not be able to heal in one interaction the religious or spiritual trauma someone may have already experienced, but together we can write a new story of possibility for spiritual and emotional health. Together, we can promote wholeness.
My heart’s intention for this article is to offer my deepest gratitude and thank you to every provider striving to make healthcare more accessible and welcoming to LGBTQIA+ people. It may feel small sometimes, it may feel impossible other times, but what you do in caring for our whole selves saves lives and enriches what it is to be alive and transgender. It is sacred work that you do—healing not just the body but the soul—making it possible for us to welcome ourselves home.
Every one of us has this opportunity to change a life. Transgender people deserve just as much care, devotion, and thoughtfulness as every other patient who walks through our doors. Will we meet them with joy? Because when we do, what we offer is the truest form of blessing: to be known.
Advocacy, Medical Ethics, SGIM, Social Determinants of Health, Vulnerable Populations, Wellness
Rev. Meredith Cox (email@example.com) is a staff chaplain at Vanderbilt University Medical Center, offering spiritual companionship to LGBTQIA+ patients and families seeking gender-affirming interventions and primary care.
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