Dr. Karin Selva, a pediatric endocrinologist at Legacy Emanuel’s Randall Children’s Hospital, saw her first transgendered patient in 2010. A 15-year-old who was born male, the patient suffered from Type 1 diabetes and depression. After seeing a counselor, the patient revealed she identified as female.
“When I first met her she was sullen, reclusive, depressed, wouldn’t make eye contact, and had dropped out of school. She was a very sad individual,” says Selva. But after counseling, hormone therapy, and finally, “bottom” surgery, this now-22-year-old woman has blossomed. “It was remarkable to watch her transform. Now she’s smiling, cracking jokes, and is back at school.” She also has a tight group of friends and is on the hunt for a job, says Selva.
Selva, who opened the T Clinic at Randall Children's Diabetes and Endocrine Center last June, has worked with 50 patients and their families over the past four years and says the clinic gets 3-4 new referrals each month. Selva’s name has become well known in the city’s trans community, but she also credits the uptick in families who seek out her services to increased media coverage of transgendered people, from Laverne Cox (who plays Sophia Burset on “Orange is the New Black”) to Brad and Angelina’s first-born, who now goes by John to Olympic icon Caitlyn Jenner.
“That does a lot, you know. And the more parents who accept it, the more kids get care,” says Selva.
It’s never easy to wrestle with “gender dysphoria”—the formal term for someone who feels distress with the gender he or she was assigned at birth. But Portland is, by many accounts, a supportive place to do it. This January, the Oregon Health Plan changed its policy and now covers puberty suppression, hormone therapy, and sex-reassignment surgery (for adults). Portland is also home to TransActive, a unique nonprofit that offers counseling and support groups for transgendered youth as well as educational programming for educators, doctors, family law judges, and anyone else who works with children and families.
And though there’s still a dearth of mental health professionals who focus on transgender care in Portland, roughly 25 doctors on the Oregon Health Plan—surgeons, primary care doctors, nurse practioners and naturopaths—focus on transgender care. One of these is Dr. Megan Bird at Legacy Medical Group, a gynecologist who administers hormone therapy to transgendered adults and provides hysterectomies to trans-men. Like Selva, Bird had to learn on the job—there's very little training on transgender care in medical school. (Though Selva has done a series of lectures to each department at Legacy Emmanuel.) She loves her job because she can see direct results of her care. “Over 3-6 months you really see a big change in people: They are less depressed, less anxious, and they start to take better care of themselves. It’s amazing to see them turn around so quickly.”
Comments