Challenging Institutions

by | Nov 1, 2020 | 0 comments

  • Photographed by Laura Dierbeck for Our Lives magazine.
  • Photographed by Laura Dierbeck for Our Lives magazine.
  • Photographed by Laura Dierbeck for Our Lives magazine.
  • Deployment in Afghanistan.
  • With Secretary Carter after the town hall.
  • Testifying in Congress alongside transgender servicemembers.
  • Their wedding.
  • In the operating room.
  • Leading an American Medical Association national conference on health advocacy.

I admit it. I’m a geek. Growing up in a small town in Delaware, I was never the most fashionable, outgoing, or sociable kid. But I grew up in a small family surrounded by love and with constant encouragement to chart my own path. What I may have lacked in markers of popularity, I made up for in the drive to dance to my own beat. I still love to dance, and I did manage to take home first place in the Delaware State Computer fair in sixth grade.

Healthy Beginnings

I took an early interest in science and medicine. Both of my parents are health professionals—my mom is a neuropsychologist, and my father is a dentist. Each dedicated themselves to the health and well-being of their patients, including taking calls during dinner and making emergency trips into the office on weekends to help someone in need. While I knew I wanted to become a physician early in my life as a way to give back and serve those in my community, what was less clear was how that professional identity would intersect with other aspects of my life—namely being gay. I did not have many LGBTQ role models growing up, and saw few on TV or in the media. I remember coming out at Haverford College and being unsure if that would impact my chances of getting into medical school or how being gay might be relevant to my desire to become a physician. I had only met a handful of LGBTQ people in my life, and none of them were doctors. 

A Military Tradition

While I do not think of myself as having come from a military family, I do come from a long line of veterans. My father was a U.S. Army dentist, one grandfather served in the Merchant Marines and the Army, and another grandfather was also an Army man. My mom’s family came to the U.S. in the 1600s, and a direct ancestor of mine, Reverend Ebenezar David, enlisted as a chaplain under George Washington at the beginning of the Revolutionary War and died while serving as a medical officer during the infamous winter at Valley Forge. In short, our family has been serving our country in many ways for a long time. That is one of the reasons I became a physician—to serve others. Ultimately, it is also one of the reasons I decided to join the Navy after I finished medical school at the University of Chicago—to serve my country.

One of the reasons I chose the Navy was because I always figured that if I deployed, I’d rather be on a ship than in a tent in the middle of the desert. Little did I know that in 2014 I would receive orders to staff a combat trauma hospital at Kandahar Airfield in Afghanistan. The hardest part about deploying was leaving my then-partner (now husband) Judd behind. I knew that because we were not married (nor at the time could we legally be married in Tennessee where we lived), if something were to happen to me, he would have been afforded no rights or protections. But we did what thousands of military couples do each year and figured out how to minimize the stress that time, distance, war, and uncertainty brought while I was overseas.

During my deployment, I was given orders to lead the anesthesiology department at the NATO Role III Trauma Hospital—the primary receiving facility for all wounded servicemembers and enemy combatants for the southern half of the country. Established in 2005 and originally supported by the UK, Netherlands, Denmark, Australia, the U.S., and Canada in 2009, the U.S. Navy took over running the 70,000-square-foot facility. Here I spent the better part of seven months, caring for many critically ill patients who had been wounded in battle. It was a privilege to bring the lessons I had learned and taught at Harvard Medical School to our soldiers, sailors, airmen, and marines on the front frontlines.

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The Question Heard ’Round the World

During my deployment, then Secretary of Defense Ashton Carter visited for a town hall meeting with the troops less than a week into his tenure. I had never been in a room with such a high-ranking leader before. I was excited but nervous to hear and meet him. After a few opening remarks, thanking us for what we were doing, he asked if there were any questions. I could not help myself. I made my way to the microphone, in front of a hanger full of soldiers and with the traveling press corps watching I asked, “What are your thoughts on transgender service members serving in an austere environment like this, here in Kandahar?” At the time, there were an estimated 15,000 transgender people in the military, but they could not come out as transgender because of a longstanding ban. Until I asked my question, Carter had not publicly stated where he stood on the issue. “I don’t think anything but their suitability for service should preclude them [from serving],” he said.

To ask that question was uncomfortable, yet it was the right thing to do. The Secretary’s response was the most favorable from a senior U.S. military official to date. Within hours, the event was being reported by news outlets all over the world, and by the next afternoon the White House added its support. A year later, in 2016, the ban was repealed. When Secretary Carter announced the repeal of the ban on transgender service at the Pentagon, my Kandahar question was described as “the spark that led to the end of the ban on transgender service” by then Secretary of the Army, Eric Fanning.

Changing the Face of LGBTQ Health

There are notable gaps and disparities in the health of LGBTQ people all over the country. LGBTQ people are less likely to have health insurance, a regular doctor, access to preventive health screenings, or avoid harmful behaviors like smoking. While there are many factors that contribute to this, the inaccessibility of medical care is something that pains me deeply. As a result, I have dedicated a substantial portion of my life and professional portfolio to advocating for more accessible systems that are better equipped to meet the needs of LGBTQ people.

In Massachusetts in 2007, I led an effort to create the Massachusetts Committee on LGBT Health which continues to this day to work to advocate for policy change. When I relocated to Nashville and joined the faculty at Vanderbilt University, I co-founded and led the Vanderbilt Program for LGBTQ Health—a multidisciplinary effort that ultimately launched four regional transgender health clinics and a comprehensive gender confirmation surgery program. We also created a first-in-the-nation, free, on-demand transgender patient navigator program to provide advice and support using trained transgender peer advocates called “Transbuddy.” This work had the effect of changing the face of care for LGBTQ—and particularly transgender—people across the Southeast and has become a model nationwide. I led numerous research studies about the health of LGBTQ people, illustrating among other issues the gaps in medical training curricula around LGBTQ health and the policy impacts of insurance access on LGBTQ care. Given that the field of LGBTQ health is still emerging, one of my proudest moments came when I received the inaugural Sex and Gender Minority Research Award from Dr. Francis Collins, Director of the National Institutes of Health in 2018.

Leading the American Medical Association

In 2014, I was elected to the Board of the American Medical Association (AMA). Founded in 1847, the AMA is the largest association of physicians and medical students in the United States. My election to its board as an openly gay physician was a milestone—as was my subsequent election to lead the AMA as its Chair in June, 2018. Remarkable to think that just 25 years earlier, I could not have even been a member of the AMA as it wasn’t until 1993 when the AMA amended its bylaws to include sexual orientation in its nondiscrimination clause. During my time on the AMA Board, I have had many opportunities to advance the cause of health equity. I have met with senior government officials, testified in Congress, and participated in countless meetings at the White House about LGBTQ health and ways to better meet the health needs of our community. But I have also tried hard to serve as a role model for others who might be asking themselves “so what does becoming a doctor have to do with my identity as an LGBTQ person?” I may not have known the answer to that when I was just starting out, but I do now: Everything.

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Welcome to Wisconsin

Quite honestly, I had never considered that Wisconsin would become part of my journey. Today, I can’t see myself anywhere else.

In September 2019, I joined the faculty at the Medical College of Wisconsin’s Milwaukee campus as senior associate dean and director of MCW’s statewide philanthropy called the Advancing a Healthier Wisconsin Endowment (AHW). It’s an organization unlike any other I’ve come across. But in many ways, it is perfectly aligned with my desire to advocate for positive change in the world around me.

While AHW is housed within the nation’s third largest private medical school, we have a public mission and statewide mandate to improve the health of Wisconsin. It’s a thrill to sit at the intersection of the power of philanthropy to create change and the power of academic medicine to find groundbreaking new solutions to critical health problems.

The legacy that was left for me was deep. Since 2004, AHW has invested more than $279 million in more than 477 projects across the state. These projects are leading to new research discoveries, developing the health workforce of the future, and creating positive impacts in Wisconsin communities. And, importantly, these projects are challenging and changing the status quo around health in our state—including several funded efforts to improve LGBTQ health across Wisconsin.

The opportunity to advance equity in health drew me to the position.

As I’ve spent the last 12 months leading the organization, I’ve begun to lean on both my career in service and advocacy and my personal experiences to do just that.

Centering Equity

Today, the data is clear. America is not healthy. Wisconsin is not healthy. And this is especially true among Black, brown, LGBTQ, and other racial and minority groups who continue to live sicker and die younger. This is true nationally, and it is especially true in Wisconsin. 

These disparities should be unacceptable to all of us, and I am deeply committed to solving these challenges.

In my work leading AHW, I’m focused on building a healthier future for all marginalized populations, including LGBTQ individuals.

As Chair of the AMA, I championed the call for LGBTQ equity. I advanced a call to ban conversion therapy nationwide. I stood up to amplify physician voices in a nationwide call to end police brutality and racial injustice. And now, in Wisconsin, I look forward to adding my voice to those who know our world can, and must, be a better and more just place.

This past year has been a truly challenging one for all of us. We have all experienced stress and uncertainty during the COVID-19 pandemic. I continue to struggle personally with trying to make the best decisions I can to keep my family safe as we navigate an ever-changing landscape. I also grapple with the ongoing daily challenges posed by the inequities and injustice that continue to bubble up around us. Recently, I cared for a patient from Kenosha who described to me the unfathomable sight of watching armed men roam around her neighborhood with machine guns. We can, and must, do better.

Physician. Veteran. Husband. Dad.

As you can imagine, there are many words that people ascribe to me and my career—mostly related to my advocacy or professional identity. But in closing, the two words that I am most proud of represent my most important accomplishment, my family. Those words are “husband” and “dad.” I could not be more grateful to have a beautiful son, Ethan, and a loving husband, Judd. Their support is what makes all my achievements possible and meaningful.

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