As I was recently watching a brief video presentation on Medscape, “Do transgender patients feel welcome in your practice?” my mind went to the memory of my over-35-year-long relationship with Margo, who was Johnny when I first met him in 1954.
At the time I was a live-in student intern at the old North Vancouver General Hospital and Johnny was the most experienced, jovial, and kind orderly on the urology ward. He was roughly 40 years old then, with several years of experience as an orderly at the Cedars of Lebanon hospital in Los Angeles. There he met some well-known actors of the time, and he was active on the sidelines of the theatre world. He was openly gay. He taught me how to pass a catheter and I learned a lot from him about the nursing care of patients with urological problems.
A few years later, when I was married, he became friendly with my wife, who was interested in ballet. Johnny had books and articles about ballet personalities as well as stage actors, and a great deal of information about the local theatre scene. I lost track of him for close to 20 years when I left my practice for my new career at UBC in 1966, so I was surprised when she showed up in my Sexual Medicine office in the early 1980s.
She wanted a sex change operation. She said, “I discovered I am not gay, I am not Johnny, I am Margo, I am a woman.” She had just retired and had the finances to consider a sex change operation. I was not qualified in the gender-issue areas so my colleagues, Dr Bill Maurice and Dr Diane Watson, took Margo into their care.
After all the psychiatric and hormone-management procedures Margo had her sex change operation in Montreal. Upon her return I took over the recommended periodic dilatations of her now vaginal passage, and I renewed my friendship with her. She was 68 years old, she had no interest in men, preferred female company, and had no interest in sexual practices with either gender. She was bald and wore a wig, and dressed very neatly in fashionable outfits—she had the appearance of a kindly older aunt. She was involved in volunteer work in the local theatre scene, where she was fully accepted as a woman. She came to our house from time to time with theatre literature and gossip and occasionally we went to dinner with her. Her greatest joy was when she and my wife were escorted to our table and the waiter said, “This way ladies.”
Margo had many friends, but she lived alone, and one day she collapsed with a stroke. I saw her in the hospital: she seemed very small, with her bald head on the large pillow, in a coma. She died a few days later. I believe she was close to 80 years old. I lost a woman friend.
As to the Medscape video message: please check that your office staff make the transgender patient welcome, and that the staff respect the pronoun the patient prefers and address the patient by her current name, even if it is not yet her legal name.
As to the primary care
physician’s role: it is to respect gender choices, and to know who or which
organization might provide specialized services, consultation with specialists,
and referral when appropriate.
—George Szasz, CM, MD
- Drescher J. Do transgender patients feel welcome in your practice? Medscape Psychiatry, 2017. www.medscape.com/viewarticle/886895.
This posting has not been peer reviewed by the BCMJ Editorial Board.