Tuesday, August 15, 2006

I shouldn't have been surprised... but I was

I shouldn’t have been surprised… but I was.

The first sign of what was to come was a speaker’s topic. The keynote speaker at a retreat to be hosted by my school will speak on "Adventures in Gender: The Emergence of Transgender Medicine."

Then, yesterday, I saw a flier in a computer lab offering a great credit card offer. If I signed up to join a group called “AMSA,” I could apply for a credit card and receive a free copy of a “Netter Anatomy Atlas.” I thought – sure, I’ll do that! It was when I went to the AMSA website to sign up for the credit card this afternoon that I started seeing the face of AMSA. For one thing, they offer discounts on "Straight but Not Narrow" pins, which feature a pink equilateral triangle. I decided not to order the credit card, after all.

The AMSA website also listed “Health Concerns of the LGBT Community.” Various disorders are listed. For HIV, the authors explain:
“while no longer the primary population effected[sic] by HIV, HIV/AIDS continues to have a profound effect both physically and psychologically on this community. HIV transmission up to 3-5 times higher when other STDs are present. CDC identified Youth (ages 13-24) as the most likely group to contract an STD, with 30% of new HIV infections reported as MSM.”

Instead of asking the question, “Might these unnatural behaviors be increasing our risk of contracting these diseases,” those who prepared the list point their finger at physicians who are uncomfortable with LGBT patients. The following list is from the AMSA website:

Homophobia is a Health Hazard.
Quality of care is affected.
Education and training regarding LGBT health needs is inadequate.
Communication and disclosure of sexual orientation are significant issues.
Never assume Sexual Behavior based on Sexual Orientation.
Never assume Sexual Orientation based on Sexual Behavior.
Physician discomfort around issues of sexuality is evidenced by the fact that studies indicate that only 11% to 37% of primary care physicians routinely take a sexual history from new adult patients.
Stigma is compounded for the LGBT Community as studies indicate only 18% to 49% of LGBT patients disclose their Sexual Orientation to their physician.
Be aware of these issues so that you can provide the best care possible to your patients regardless of Sexual Orientation!

The website showed that homosexual men have an increased chance of becoming infected with Hepatitis A or B, and/or developing an eating disorder; that transgendered patients can still have health issues associated with their original gender; and that other members of the LGBT “community” are confronted with increased chances of developing other health problems.
After all of this, these “alternative lifestyles” are not questioned: their medical health care providers are questioned. Obviously, a spike in health disorders in only one portion of the population must result from inadequate medical attention – unless that population consists of smokers.

Again, yesterday I saw two entire pages in the orientation handbook devoted to "Queer Medical Students." I’ve included footnotes in the form of asterisks (*) that show my response to what I was reading:

Queer Medical Students (QMS) is a group of gay, lesbian, bisexual, transgender, queer, and allied students, faculty and staff at the College of Medicine, School of Nursing and Medical Scholars program.

This organization was started several ears ago by two activist medical students. Our name reflects this origin, reclaiming a term once considered derogatory. However, despite our expressed mission of education and activism, it is out high priority to maintain the privacy of those who contact us. We often provide confidential referral to gay community resources... for those who are questioning or coming out as medical students. It is our goal to improve the medical field for LGBT physicians and other care providers as well as for LGBT patients.

Some of our recent activities and member projects include: attendance at statewide and national gay and lesbian medical conferences, brining in speakers for lunch time talks, and the usual cookouts, road trips, discussions, pot lucks and happy hours.*

For more information about upcoming events, or to be added to our email list, please contact… Your confidentiality will be protected form the rest of the list if you so request.

The second page has a list of FAQ’s. I’ve included a few of these here:

What is AMSA?
The American Medical Student Association is the largest, independent medical student organization in the country. Currently, AMSA is focusing our energy on three key areas: increasing diversity in medicine, promoting medical student well-being and working toward providing health care for everyone.

What does AMSA do?
AMSA leads initiatives both locally and nationally in medical education, public health, student and patient advocacy, health policy and global health. We have a long history of political activism in Washington as well as at the local level. Here at our chapter, we have projects ranging from bringing in speakers to participating in a candle light vigil for the uninsured.**

What do I get if I join?
Lots of benefits! We have a brand new online career development program, a credit card (no annual fee, $15 credit and HIV disability insurance option), a free Netter Anatomy Atlas*** (believe me, this is one of the most important books you’ll use your M1 year!) a great magazine called The New Physician, a student loan program and lots more.

Why should I be a national member if I can just participate locally?
…Our National Convention, in Washington DC in March, will be the most fun you’ll have in medical school. Past speakers have included numerous Surgeon Generals, Marion Wright Edelman and Patch Adams.

What is the difference between the AMA and AMSA?
AMSA actually started as the student branch of the AMA but split off in the late 1960’s went the AMA opposed the creation of Medicare**** and failed to provide support to the civil rights movement and the community health movement. Students have a much stronger voice in AMSA and we are the largest, completely student-led,***** medical student organization n the country.

What is AMSA’s policy on Residency Work Hours?
AMSA supports the reduction in hours as long as patient care is not compromised. We have other very exciting policies regarding issues such as physician-assisted suicide, sexuality, complementary and alternative medicine, and Reproductive rights. If you want to change or add a policy, you can write a resolution to be voted upon at he national convention in the House of Delegates.

*I believe “happy hour” means “drinking hour.”

**So this group has a candle light vigil for the uninsured. How does that actually help the uninsured in this country, let alone those in another country without access to such luxuries as CVS or the ER?

***If I’d known the credit card came with an HIV disability insurance option, I wouldn’t have been so quick to sign up for it!

****Wow! I didn’t know the AMA opposed the creation of Medicare!

*****And look where their leadership is carrying them.

The AMSA (American Medical Student Association) website can be accessed here.

What do you think… maybe next year, once I’m a part of the CMDA or Grad IV group, I could ask to have 2 pages devoted to one or both of those groups inserted into the student orientation manual. Hmmm…

Finally, even if I was fully supportive of the AMSA, I would be confused by their message. For example, do the terms “sexual orientation” and “sexual behavior” have any definite meaning? Also, isn’t the point of atransgender operation to actually switch someone from male to female, or vice versa? Then wouldn’t it be the height of rudeness to mention prostrate cancer to a person made “female” surgically?

The other day a good friend of mine, a nurse, came up to me and started talking about transgender medicine. She had heard about the speaker who was coming to speak on campus, and she knew I didn’t want to attend the lecture. She mentioned that some people are born “half” female and half male – one of her patients had been. I think she wanted me to be a little bit more sensitive in my view of transgender medicine.

So if I stopped and asked the question – Why am I not in sympathy with transgender medicine? – I have to answer by saying that when people reject God’s plan for their lives, there’s always consequences to live with.

Today we talk about “a match made in Heaven.” The first match that was made in Heaven was between Adam and Eve, the only people who ever knew what it was like to be perfect on earth. As I was reading this morning, “God created man in His own image… male and female He created them.” (Genesis 1:27)

God gave them an identity: male or female. If God gave them this, then why should be in sympathy with those who would 1) deny the existence of a God, 2) reject the importance of such an identity given by God, 3) try to reverse their God-given identity?

At this point in our history, we are outside Eden. Because we are outside Eden, because our sin has deformed our world, birth defects do occur. Some people are physically and/or genetically neither female or male. Yet seeing the confusion that occurs in such a case, why open yourself up to that kind of questioning on purpose?

Even though the world is no longer perfect, we can choose to look for and preserve the many remnants of God’s perfect plan. One of those remnants which is still overwhelming evident is male or female identity. Instead of joining those who would destroy this identity, I will remember God’s gift and remind others of what God has given them.

The other option is what George Gilder terms “Sexual Suicide.”

Picture reference: 1

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