‘That’s My Sister!’ Taking a Twin’s Gender Fluidity in Stride

This post was originally published on January 18, 2015 in the New York Times, Motherlode blog. It was written by Dr. Winifred Curran, my friend and colleague from DePaul University. This is a beautiful piece, well worth the 3 minutes it’ll take you to read it.

Credit KJ Dell’Antonia

Do you have a sister? This is the “question of the day” that greets us as we enter my twins’ preschool class. My heart sinks. Question like these can be difficult to navigate in my family. Can we just say sibling?

One of my twins was born a boy but, for the moment at least, identifies as a girl. This has evolved from insisting on wearing dresses by the age of 2, to wanting to go to the bathroom with the girls at 3, to firmly identifying as a girl, crying if referred to as a boy, by the age of 4. And so, the debates on what exactly constitutes woman and sisterhood are personal and immediate. But as it turns out, everything I need to know about sisterhood, I learned from a 4-year-old.

I am in no rush to define my child as anything; who knows how she will identify years from now? But the world does insist on forcing the issue. The ambiguity of my child’s gender makes people decidedly uncomfortable, and it often seems that conformity is more important than what is best for my child. Complete strangers feel free to tell me that I should force my child to wear “boy” clothes. My sister believed it was simply a matter of providing more “boy” toys. The pediatrician said we had to get her out of wearing dresses because she was too pretty. People seem to feel that they deserve an explanation when they ask for the twins’ names and one of those names is a typically male one.

My child’s evolving gender identity has been part of a learning curve for me, our extended family, her teachers and classmates. Though I am an academic well trained in feminist theory and the idea that gender is a social construction, having a child who presents as transgender has made me far more sensitive to how gender is defined and policed.

All of this has made me an ambassador of sorts for transgender issues with my children’s teachers, other parents and school officials. I have explained to other preschoolers that people can be whatever they want to be and that there are lots of ways to be a girl. I am always and everywhere an advocate for my child. But even I sometimes revert to male pronouns.

Only one person has taken every transition in stride, often, in fact, explaining them to everyone else. That is her twin sister. It was she who explained to me that the reason her twin didn’t want to go to school was because she no longer wanted to go to the bathroom with the boys. Once we knew this and the school agreed, the problem was solved. It is she who corrects me, and other people, if they refer to her twin as he. She generously shares dresses and princess toys and fire trucks and doctor sets. She accepts her twin as she is, even as this changes and evolves, because she loves her. She knows her as she is and has no conception of how she is “supposed” to be.

For her, the definition of gender, the politics of it, and the way some people may look askance don’t matter. When someone recently referred to her twin as her brother, she quite forcefully yelled, “That’s my sister!” Her twin is who she says she is. They are a source of strength for each other, a team (except, of course, when they are bickering the way 4-year-olds do).

So, do you have a sister? I read the question to my twins and the joy of recognition lights up their faces. They both, without hesitation, answer yes. In light of the recent suicide of Leelah Alcorn, who killed herself because, “The life I would’ve lived isn’t worth living in … because I’m transgender,” can’t we agree that our common assumptions are not more important than people’s lives? One report among many shows that transgender people face pervasive discrimination, are more likely to live in extreme poverty, and over 40 percent attempt suicide.

As parents and sisters and friends, our response must be, as Jennifer Finney Boylan argues, to read, write and scream against the injustice of it all. We can choose to accept our children for who they are, in all their wonderful complexity, and liberate ourselves from the narrow conceptions that gender places on all of us.

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Caring for Transgender Patients

An article by GLMA nursing colleagues Laura Hein and Nathan Leavitt  appears in the November/December 2014 issue of  Nursing Made Incredibly Easy. The article is free, and Caring_for___Transgender_patients___Nursing_made_Incredibly_Easyyou can earn Continuing Education based on the article! Another article in this same issue addresses the spiritual needs of LGBT patients, authored by Rabbi H. Rafael Goldstein.

It is worth noting that this issue focuses on diversity, but unlike most discussions of diversity that only address race, ethnicity or culture, only one of the articles in this issue addresses “different cultures.” In addition to the two articles focusing on LGBT issues, other articles focus on caring for nontraditional families, patients with disabilities, patients with tattoos and body piercings, incarcerated patients, and patients of different religions.

Check out this very significant issue in the nursing literature!  It is ground-breaking!

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LGBTQ Scientists


If you work in a science related field, you have undoubtedly heard of the push for “stem.” STEM is an acronym for “science, technology, engineering, and mathematics.” Higher education institutions across the United States are trying to bolster their STEM programs and attract more students to these programs. This commentary is not about STEM though… it is about the LGBTQ people who work in STEM professions.

I am an emerging scientist in the nursing discipline. As an out gay man, I have not experienced much discrimination from colleagues, administration, or students. This can probably be chalked up to the fact that gay men are universally accepted in the nursing profession. However, this is not the case for many other STEM professions, such as chemistry, physics, engineering, computer technology, and mathematics.

I know of a few “closeted” scientists in academia who are afraid to disclose their sexual orientation to their colleagues. Although I have never questioned their fears, I imagine they fear the progression of their career. Much of a scientist’s career depends on the judgment of their peers (publications, grants, and promotions). If a scientist works in a climate that is not accepting of LGBTQ people, they may risk promotions and career progression if they are open.

My claim that LGBTQ scientists may be afraid to be open is more than anecdotal. Dr. Erin Cech, assistant professor of sociology at Rice University, authored a paper titled, “Navigating the heteronormativity of engineering: The experiences of lesbian, gay, and bisexual students.” She interviewed 17 engineering students and found that engineering is a heteronormative climate, requiring students to “cover” their sexual orientation. This requires tremendous emotional work on the part of the student, resulting in isolation, lying, and hiding. Although the interviews were conducted with students, it gives insight into the environment for the working scientists as well.

The issue of unwelcoming STEM environments is so pervasive that there is an actual guide on how to support LGBT physicists and astronomers in academia. The issue has even garnered the attention of Nature. They recently published an edition on diversity in science and the highlight news feature was specific to LGBT scientists. Other commentaries on this issue can be found here, here, and here.

Thankfully, a few great organizations are bringing awareness of LGBT people to the STEM professions. Two of the prominent organizations are oSTEM (Out in Science, Technology, Engineering, and Mathematics, Inc.) and NOGLSTP (National Organization of Gay and Lesbian Scientists and Technical Professions, Inc.). I think it is especially important to make STEM students aware of these organizations.

The purpose of this blog was to bring more attention to this issue. I urge you to click on the links that I provided and read up on this topic. Also, if you work for an academic institution that offers STEM degrees, please urge your institution to consider creating an oSTEM or NOGLSTP chapter (or at least advertise the organizations to students and faculty members).

I end with a video of a lecture by Professor David K. Smith about LGBT scientists, “Not all scientists wear white coats (some wear purple shoes).”

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HIV/AIDS 30 Years On: MSM Ignorant, In Denial

For more than three decades we have lived with HIV/AIDS. The earliest years of the epidemic were characterized by both dread and hope, anxiety and action. Community-based peer education and activism emerged among sexual minority collectives. When public officials failed and fell short, the HIV infected and affected marshaled energy and intelligence, learning about treatments, teaching each other risk-reduction strategies, and forcing changes in medical research, public policy, and law through direct action like ACT UP.

With the development and introduction of anti-retroviral treatments in 1996, the AIDS epidemic turned a corner. From a nearly guaranteed death sentence, HIV infection became a manageable chronic condition. Over the past two decades HIV has become a nuisance rather than a nemesis.

Men who have sex with men (MSM) have largely become complacent, careless, and in denial.

A new study conducted by the Henry J. Kaiser Family Foundation, HIV/AIDS In The Lives Of Gay And Bisexual Men In The United States, has found:

  • Half of MSM respondents said that HIV/AIDS is somewhat or very significant to them, but only one-third were concerned about becoming HIV infected and over half said that they were not concerned.
  • Most are ignorant of infection trends — that new infections among MSM are rising — thinking that infection rates have stayed the same or declined.
  • Most MSM are unaware of current treatment recommendations, including early intervention after HIV infection and even PrEP prevention to reduce infections among those who are engaging in risky behavior.
  • Most report that they have not discussed HIV/AIDS with friends or even sexual partners.
  • One-third have never been tested for HIV, while only one-third have been tested in the past year.
  • More than half have never had a primary care provider recommend HIV testing, and almost two-thirds reported that their primary care providers did not initiate a conversation about sexual behavior.

These disturbing findings constitute a wake-up call for MSM (many of whom do not identify as “gay” and who may not be connected to gay social networks).

They remind us how essential it is the initiate a conversation with primary care providers about our sexual practices and relationships.

They remind us how essential is our taking ownership of our health, disease prevention, and self-management of chronic conditions.

As journalist and chronicler of the AIDS epidemic, John-Manuel Andriote, has written of this Kaiser report: “The most powerful gay liberation movement we could ever launch would be to liberate ourselves from the many harms that ignorance can inflict on us. The movement’s success starts with each one of us making healthful choices. The first step forward is to know your own HIV status.”

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Nurses changing healthcare practice

This article popped up on my news feed today and thought I’d share it. Nurses changing healthcare experiences for lesbians and bisexual women

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LGBT Healthcare Bill of Rights

Healthcare is not an easy subject for many who identify as sexual and/or gender minorities.  Many have had negative experiences with healthcare encounters, have heard horror stories from their friends, or, fearing the worst, simply avoid risking any encounter with the system.  This is not the way it should be, and there are many individuals and BORwallet-2_pdfgroups who are working to change the system for the better, and to assist LGBT people and families know how to navigate in these waters that are all too often troubled.

Healthlink, a network of LGBT community centers and other partners, has recently posted a Healthcare Bill of Rights to affirm exactly what we can expect from the system, and establishes a foundation for challenging the system when it fails.  These fundamental rights are:

  • The right to be treated with equality and respect
  • The right to affirmation of your true gender identity
  • The right to designate who will make decisions for you if you cannot do so for yourself
  • The right to visitation by anyone you choose
  • The right to your privacy
  • The right to protections if you are discharged due to discrimination

You can read the details of the Bill of Rights here.  You can download the bill in several formats, including a wallet-sized summary.  Spread the word – make sure your LGBT friends and acquaintances know this Bill – inevitably someone you know will need it, probably someday soon!

Note: the links above sometimes do not connect – so I am making the detailed Bill of rights available to download here.  But the link is a good link .. be patient and try again to visit the site!

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Laverne Cox of “Orange is the New Black” tells her story!

As the holiday season shifts into full gear, it is time to be mindful of the struggles that many sexual and gender diverse youth and adults experience – including depression, loneliness, suicidal thoughts and even action.  The pain and struggle of everyday life is amplified in contexts where others are connecting with family and friends and joyfully indulging in celebrations that dull our sensitivity to the pain of others.

On the Netflix miniseries “Orange is the New Black” Laverne plays the part of Sophia Burset, who is a transgender woman who went to prison for credit-card fraud. Originally a firefighter named Marcus, Sophia was unhappy with living as a man and transitioned with the support of her wife Crystal. Sophia committed fraud to finance her operation and hormone therapy. She has a young son named Michael, who had difficulty with her transition.

Watch this wonderful video that Laverne Cox posted for the “It Gets Better” Project, telling her own story of how it got better for her.

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2015 LGBT Health Workforce Conference Building a Caring Community in the Electronic Age

Registration and abstract submission is now open for the 2015 LGBT Health Workforce Conference!  The conference will be held in New York City, May 1-3, 2015, at Hunter College City University of New York, Main Campus, West Building, Southwest conferenceCorner of 68th Street and Lexington Avenue, New York, NY 10065

This conference provides an overview of up-to-date practices (climate and educational) in preparing the health care workforce to address the health concerns of lesbian, gay, bisexual, and transgender (LGBT) communities.  This conference is designed for health professionals (M.D., D.O., P.A.-C., nurses, dentists, podiatrists, social workers, psychologists, etc.), educators, and students (pre-health professions, professional schools, and graduate), but all interested are invited to attend. CME credit will be available.

A summary of the first conference, held in 2013, is published in LGBT Health titled First Annual LGBT Health Workforce Conference: Empowering Our Health Workforce to Better Serve LGBT Communities.  This is an exciting opportunity for LavenderHealth.org followers!  Let us know if you are able to attend!

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Report on LGBT health Priorities for 2015

Earlier this month, the U.S. Department of Health and Human Services (DHHS) released a report titled “Advancing LGBT Health & Well-being.”  This is the 4th annual report that is the outcome of the President’s directive to identify steps that the DHHS can take to improve the health of LGBT Americans.  Before the Affordable Care Act, one in three lower income LGBT Americans did not have medical insurance.  Recognizing that insurance alone will not improve the health of our communities, the reports provide specific recommendations for steps that still need to be taken to address this need.

The new recommendations for 2015 are:

1. Prohibiting Discrimination Based on Sexual Orientation or Gender IdentityLGBT_Health_and_Well-being___HHS_gov

2. Funding Research on LGBT Health Inequities

3. Improving Health Data on LGBT Populations

4. Research on the Blood Donation Deferral Policy for Men Who Have Sex with Other Men

5. Improving Cultural Competency with Respect to the Two Spirit Community

6. Further Addressing the Human Services Needs of LGBT Populations

7. Re-Launching the HHS LGBT Issues Webpage

For more about what the Affordable Care Act means for LGBT Americans and their families, visit the HHS web pages dedicated focusing on LGBT health!  And  remember to spread the word — enrollment is open until Feburary 2015!  Be sure everyone you know has the information they need to get coverage!

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Promoting a research study

Can you help my colleague spread the word about her important research?  See below.

Participate in a Study on Fertility Treatment Experiences

(With a Chance to Win $100)


Are you currently trying to get pregnant using donor sperm? If so, you are invited to participate in a study being conducted by researchers at San Francisco State University and the University of California, San Francisco. The study aims to investigate various aspects of fertility treatment experiences for heterosexual and lesbian women.

To participate, you MUST be:  

•      Currently pursuing pregnancy using donor sperm

•      18 years of age or older

•      Fluent in English

Participating involves completing an online survey. If you are currently in a romantic relationship, your partner will be invited to participate as well. The survey takes approximately 30 minutes to complete. After you complete the survey, you will be entered into a raffle for $100. Drawings will be held at the end of each month. The odds of winning the prize will depend on the number of entries received each month.

Participation is voluntary and all information will be kept anonymous and confidential. You are free to decline to participate at any time even after the survey has begun.

If you are willing to participate, please click the link below to register. You will then be sent a Study ID number and a link to the survey. Please feel free to contact the lead researcher, Sarah Holley, Ph.D., with any questions via e-mail (sholley@sfsu.edu) or via phone (415-747-9990). This study is IRB approved by San Francisco State University and the University of California, San Francisco.        


Thank you for your time and interest!

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