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Kalter: Transgender med student signals new era

March 22, 2017 GMT

Fourth-year Boston University School of Medicine student Jamie Weinand has faced challenges far beyond the grueling clinical rotations of med school. Before his first major exam, Weinand began a different kind of bold endeavor: the physical transition from woman — his sex assigned at birth — to man.

“People forget transgender people can actually provide health care,” Weinand said. “The discussion is usually about the care we receive.”

Weinand represents Boston’s changing face of medicine, as the idea of gender fluidity slowly gains wider acceptance and insurance coverage for associated procedures expands. The upshot is an increase in the number of people — both caregivers and patients — coming out as transgender.

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“It’s never easy to transition, but in Boston we have more resources than ever before,” Weinand said. “I think a lot of LGBT rights and policies are hopefully improving, and transgender fits in with that.”

Boston-based LGBT advocacy organization Fenway Health saw a 28 percent increase in its transgender patients between 2015 to 2016, growing from 2,020 to 2,586.

And people now feel empowered to begin the process at a younger age. The transgender clinic at Boston Children’s Hospital has had its number of evaluations for children and adolescents quadruple over the past two years.

The clinic is hiring additional staff members to accommodate the spike, and doctors are still trying to figure out how best to parse gender identity issues and various psychiatric problems, said Dr. Yee-Ming Chan, a pediatric endocrinologist at Children’s.

“We’re constantly examining and thinking about and rethinking how we’re providing care,” Chan said. “It’s partly to keep up with demand, and partly to address some of these complex issues coming up in the process.”

The higher numbers can be attributed in part to the change in insurance coverage, Chang said, which has also opened doors for transgender Bay State residents. Starting in 2014, MassHealth began covering various transitional treatments. Private insurers were ordered to do the same by the Massachusetts Division of Insurance.

Medical schools have taken notice. BU’s School of Medicine recently revamped its gender curriculum to more specifically explain and define various points on the identity spectrum, an effort partly spearheaded by Weinand, said Assistant Dean of Student Affairs Karen Symes.

“There are more physicians who are actually coming out as transgender, and more education for physicians on how to talk to patients sensitively,” she said.

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“Because it’s somewhat more accepted, at least in this state, it makes it easier for them to explain things to people and bring their classmates along with them on their journey.”

But there is still plenty of work to be done, Weinand said. Seven transgender women were killed just in the first six weeks of 2017, and less violent forms of discrimination run rampant.

Weinand — who decided to pursue medicine after losing his mother to breast cancer in high school — will work to change that when he begins his residency in family medicine next year.

“I loved family medicine, because their whole mission is they’ll take care of everyone, no matter who walks through that door,” Weinand said. “They have a social justice mission. There’s no line in the sand.”