Dear Doctor, WTF? An Actual Letter I Wrote to a Dermatologist

Dear Doctor WTF. The following is an actual letter I wrote to a dermatologist following an allergic reaction. Meanwhile, I never received a response.

Dear Dr.,

I am incredibly grateful that you could see my daughter so quickly. The progress of her allergic reaction has been nerve-racking. I appreciate your bedside manner, knowledge, and taking the time to explain things to my daughter. You placed her at ease, didn’t dumb things down to my 11-year-old and were solution-oriented. Thank you.

As my staff shared prior to making the appointment with you, my daughter is transgender. She shared your overwhelmingly positive response when sharing our precious truth and vulnerability. Finding affirming providers is an arduous task. One would think that the medical community would treat all people with dignity and respect, to “do no harm” and offer kindness and empathy regardless of race, religion, ability, gender identity, or sexual orientation. Unfortunately, as a parent of this beautiful little girl, I can tell you this is far from reality.

Your staff called me yesterday to schedule her appointment. When scheduling the appointment V (can’t remember the full name) asked normal intake questions. Patient name? Patient DOB, address? Having replied with “she” or “her” several times I was taken aback when I was asked what “it” is. When I asked to clarify she responded female/male? Shock. I asked if she meant “them”? In retrospect, this should not have been my answer at all. I wish I found the strength to correct her. My desire for my daughter not to be treated as “other” outweighed my ability to advocate. Today when we arrived my daughter was marked as “male” in the intake paperwork, I corrected it on the iPad and moved on.

*Sidenote and reminder to my readers: this is an actual letter I wrote to a dermatologist.

Here is my ask- do you record phone calls? If they are, will you please go back and listen to the phone call? Perhaps I am remembering the call wrong. Perhaps your system automatically defaults to male? What is your script for intake calls? Is asking what the person’s gender commonplace? If so, do you instruct them to ask what “it” is?

In our private practice, I spend quite a significant amount of time on scripting. Language engineering is essential for converting patients and controlling the scheduling/intake process. If I’m honest I would never go “there” with a receptionist. Only if necessary do I even “go there” even with a provider. Providers who purport to be my friend and colleague misgender and mistreat her. This has happened since the day she was born. Because of the nature of her rash, I was concerned that it could be related to her implant. Again, this is nothing I would have ever shared if I wasn’t worried that it was an ID reaction to something in her arm.

I thought that is where this story ended. However, when I log into the Patient Portal, I see her label is Male. I thought maybe we had found a safe space for my daughter. I thought having spent time with you this experience feels contrary to the way you practice. You were kind, affirming, and safe. Marking patients by their “sex assigned at birth” is transphobic. My daughter has a hormone blocker in her arm. What does her sex assigned at birth have anything to do with the care you render? Having this on display for all to see is a safety concern. Perhaps you attribute it to billing? Because her birth certificate, insurance information, social security card and passport all say, Female. I would hate to have your claim rejected. Do you think this is a corporate issue? Should I send my thoughts to them?

In closing, I encourage you to speak with your front desk staff about appropriate conversations when they are “on the floor.” While waiting for our appointment, the receptionist on the right (facing the desk) was talking about having gotten into a fistfight and having been banned from a bar locally. The person on the left engaged in the conversation speaking about her own experience with physical altercations. My child should not have been privy to these conversations. It is a poor reflection on the professionalism of your practice.

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Friends, this is an actual letter I wrote to a dermatologist. In sum, reach out if you or your organization has an interest in dialogue or training. I am available. Affirming care for transgender and non-binary people is almost non-existent. I do my best to shield her so that she does not develop a fear of doctors, but it is already too late. Visiting healthcare providers is agonizing, it shouldn’t be. Dear doctor, WTF?