Johns Hopkins Medicine will open the Center for Transgender Health by early spring of next year. The Center aims to provide transgender people with a lifelong healthcare program.
The News-Letter sat down with Paula Neira, the new director of the center and a former officer in the U.S. Navy. Neira left the military to transition from male to female, and now works as a nurse educator at Hopkins.
Healthcare services provided by the Center will include gender affirmation surgeries and other services for transgender people to receive proper medical treatment. After the new year, the Center will begin working with adult patients who have already contacted the hospital for gender affirmation surgery.
Neira spoke about the ongoing discrimination faced by the trans community in healthcare.
“The transgender population faces lots of health disparities,” she said. “One of the initiatives at Johns Hopkins Medicine is to look at health disparities and try to address them and also to provide world-class, patient-centered care.”
She stressed that trans people often face stigma, saying it only exacerbates the healthcare inequalities.
Neira spoke about the University’s role as a global leader in healthcare and what she hopes the new Center will achieve.
“We’re looking at, in some ways, recreating our history. Hopkins was a leader in providing transgender-related care back in the 1960s and early ‘70s, and in the last couple of decades we have not been involved in providing that care,” she said. “Now, in the 21st century, we’re going to go forward and do the right thing.”
Neira identified lack of education on transgender health as a problem that limits the quality of care accessible to a transgender person.
“There’s a low level of cultural confidence in providing transgender health care across the board in medicine because it has never been an issue,” she said. “Hopkins is no different than anywhere else. Most people have had limited exposure to transgender patients, and fewer people have had formal training in the health concerns of the transgender population.”
Demere Woolway, the director of the Office of LGBTQ Life at Hopkins, looks forward to the Center’s development.
“I’m really excited that the Hospital is dedicating resources and support to trans folks in terms of a variety of health care needs,” she said. “What I see in the trans health clinic is an effort to do what is considered best practices in terms of transgender health.”
Woolway further elaborated on some of the concerns that need to be considered when providing services for the transgender community.
She said that in addition to educating health care practitioners, it is important to address parts of health care that are not specifically about transitioning. This includes connecting patients with trans-affirming counselors, giving patients access to their desired hormones or allowing them to alter their medical record to respect their name and gender.
She also stressed how important it is that Neira, who identifies as transgender, will be running the Center.
“Any time you’re doing any kind of service, it’s really important to make sure that it is not some group of people trying to pretend like they know what somebody needs,” she said. “Creating something new, dealing with a lot of different facets, it is incredibly important to have a representative group of people.”
Despite Neira’s experience with her gender identity, sophomore and treasurer of the Hopkins Diverse Sexuality And Gender Alliance (DSAGA) JoJo Castellanos has concerns about whether the clinic will be effective when addressing the problems faced by minorities within the transgender community.
“I’m very happy that a place like this is opening,” he said. “I’m just a little concerned on how effective it will be when you throw in trans people of color, especially black trans women, who I think are the most marginalized group.”
Castellanos said that black trans women face many obstacles that might affect their ability to access health care, like homelessness, poverty, discrimination and police brutality. He hopes that the workers can empathize with the black trans experience on an individual basis.
He expressed doubt about the history of some medical research, both at Hopkins and worldwide. Castellanos cited that some of the University’s affiliates have marginalized the transgender community.
Neira addressed this reputation that Hopkins has developed regarding transgender health care, saying that it is important to acknowledge the hospital’s history. In 1979, former Hopkins Hospital Psychiatrist-in-Chief Paul McHugh shut down the program for gender affirmation surgery.
“There have been some individuals that have affiliation with Johns Hopkins that are anti-trans because of their personal opinions,” she said. “Yes, we have to acknowledge that our reputation in providing transgender care would lead to a lot of skepticism because of the history of the past couple of decades.”
She emphasized that this Center will move away from the University’s reputation by providing the highest standard in transgender health care.
“We do have a checkered history, and going forward, that’s not going to be how we’re interacting with this population,” she said.
Castellanos said that seeing Neira at the helm of the project was comforting.
“Having a transgender woman as the director, I feel that they’ll be better able to relate to the experience of being a trans person — what identities and what intersections they may have to deal with,” he said.
Woolway expressed confidence in Neira as the Center’s new director.
“I’m thrilled to get to work with Paula,” she said. “She’s just a standout in so many ways. You need to be able to talk to the people you are serving and follow their lead, rather than thinking you know better than the people you’re serving.”
Neira believes the new Center will be successful in meeting the needs of the transgender community.
“We’re going to do the right thing,” she said. “The proof is in the pudding. See what we do, and hold those of us that are doing this work accountable for what we do.”
Editors note: The term for the surgeries mentioned in this article has been changed to "gender affirmation surgery," also known as sex change surgery.
Correction: In the original version of this article, former Hopkins Hospital Psychiatrist-in-Chief Paul McHugh's name was misspelled.