Ep. 19 - Changing healthcare spaces with Delia Sosa

#19 Meet this episode’s guest, Delia Sosa – a rockstar third-year medical student, transgender and intersex advocate, and LGBTQIA2+ educator. Delia's work in creating inclusive healthcare spaces and shaping policy for gender-affirming care is nothing short of inspiring and game-changing! 🌟

From their groundbreaking work at the American Medical Association to shedding light on the intersection of being trans and intersex, Delia's insights and experiences will leave you truly informed and inspired. You don't want to miss this eye-opening episode!

You can reach Delia on Instagram @enbydelia and on YouTube at Trans Doc in Training.

Resources mentioned in this episode:
InterACT

Everyday Trans Activism is a production of Parents of Trans Youth, a social impact business providing learning, support, and community to parents and caregivers of transgender, nonbinary, and gender-diverse kids.

Host Mandy Giles (she/her) is the Texas parent of two transgender young adults and a fierce advocate for trans kids, their families, and the transgender community.

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FULL TRANSCRIPT

Mandy: Hey y'all and welcome to Everyday Trans Activism. I am your host, Mandy Giles and my pronouns are she/her, and I am the parent of two transgender young adults and the founder of Parents of Trans Youth.

Today's guest is Delia Sosa. Delia is a third-year medical student, a transgender and intersex advocate, and an LGBTQIA2+ educator. They are the Associate Executive Director of the National Medical Student Pride Alliance, a former member of the GLMA Health Professionals in Training Curricular Reform Committee, and a Point Foundation BIPOC scholar.

Delia and their peers coauthored and testified on behalf of a resolution for the American Medical Association to strengthen protection for gender-affirming care across the United States, which was passed into policy in June 2023. Delia also coauthored a policy for the Ohio State Medical Association to prevent unnecessary surgeries on intersex youth and infants. Awesome. Delia spends their free time. I don't - what free time? I don't know? Creating educational resources and social media, educational tools for healthcare providers and staff on how to care for LGBTQIA2+ patients. They have been recognized for their work by the Latino Medical Student Association, Tufts University School of Medicine, Them Magazine, NBC News, USA Today, Yahoo, and the National Center for Transgender Equality. Wow.

Delia, welcome. I am so glad that you are talking with me today.

Delia: Thank you so much for having me. It's an honor to be on the podcast and I'm really excited for our conversation.

Mandy: Yay. Fantastic. Okay. I have so many questions for you. So I'm going to start with. I follow you on Instagram, and I love all of your content. And I know that your work focuses on creating inclusive, accessible, intersectional healthcare spaces for transgender and intersex people. So I wanted to hear more about that.

What? What would that look like from a health care provider perspective? What does that look like from a parent- I mean, a patient's perspective or parent, I guess. Um, just tell me more about that work.

Delia: Yeah, so I actually got started with this in 2021 was really kind of when it ramped up. I was living in Boston. I had just come out as transgender. Didn't know at the time that I was intersex as well, but kind of knew that like transgender and intersex things go hand in hand a lot of times, so I started looking at the healthcare that I was receiving, the healthcare that so many other trans folks and intersex folks have received, and I kind of thought to myself, like, I want to change this.

I want to make this a better experience for every transgender and intersex person out there trying to access healthcare. And then I realized, well, I am one person going to medical school, trying to help as many patients as I can, but I can't see every patient in the United States for every single condition that they might have.

So what can I do? And I kind of took a two different-pronged approach to this. So one prong of that is that I do a lot of work in like the medical education space. So trying to create resources within medical schools to help train the next generation of providers on how to care for LGBTQ+ patients. Specifically trans and intersex patients, but really the whole community kind of stands together there.

The other piece of this was trying to reach people outside of medical schools. Because the reality is that there are so many healthcare providers and staff who are in professions that don't require going to medical school. And I thought, what is the best way to reach all of these people who are going to have different educational experiences, different backgrounds, who will be working in different areas of the healthcare field? And social media seemed like a really good option.

I think it's a little bit scary putting myself out there every day. I have to be honest. Um, but at the same time, it's very worth it knowing that there are so many healthcare providers out there and healthcare staff out there who are seeing the resources I'm making, seeing the content that I'm making, and actually learning something from it that they're able to take back to their clinic and help their patients.

I think that's that's why I do this and why I started doing it to begin with. So knowing that I'm able to help other people learn and take care of patients the way that I want to see our community taken care of is the most rewarding thing.

Mandy: That story, it sounds familiar in a way, similarly taking my story, taking my experience and wanting to help other people, but figuring out, okay, I'm just one person and yeah, I can talk to parents one on one or whatever, but how can I, you know, get a broader message out, I guess, or whatever.

 

I'm curious about med school and like the med school curricula. I was talking to somebody the other day and we were thinking like, well, wait a minute, do med students receive any training on transgender people? Or, I mean, I can only imagine how little they get about intersex people. I'm just curious, like, what is, what is the landscape of that like in the United States right now? Dismal? Or no?

Delia: So that is my, thankfully not as dismal as it might seem. This is one of my favorite things to talk about. Um, so there's actually a lot of variation and it really depends. One, where the med school is and whether there are any like anti-DEI laws, because unfortunately that is a reality that we're facing right now.

Mandy: Like in Texas.

Delia: Um, we're facing a possible bill in my own state, which is also terrifying. Um, So it partly depends on location, but it also depends on whether there are faculty at that school who are able to teach this material well and teach people about the trans community and the intersex community in a patient-centered way. At my school specifically, we are very lucky that we have a couple faculty members who work really closely with the trans community in our city. So they'll actually bring in trans folks to talk about their experiences. We have what we call gay week, which is a whole bunch of lectures on,

Mandy: One week. Yay.

Delia: Like gender diversity. I know. One week. Amazing. But it is better than some med schools get. You know, some med schools don't have this at all. One thing that I would love to see more schools doing is incorporating transgender and intersex inclusive language into every single lecture, because the reality is that, you know, we do need hormone therapy. We do need gender-affirming surgery for a lot of people, not for everyone, but for a lot of people. And if we're just talking about that care, it kind of erases the fact that trans and intersex folks also need basic health care.

You know, we are still human beings. We still have medical problems like everyone else. We still need preventive care and surgery and emergency care. And if we're not talking about that in every single possible context, it's not that you have to have, like, a section of the lecture dedicated to it. But even just throwing in an example, like, you have this patient coming in with a broken ankle who happens to be transgender. How would you handle that? And it has nothing, like, that particular situation has nothing to do with that patient being trans. But there have been lots of trans patients whose injuries, illnesses, whatever, have been blamed on the fact that they are trans. Also known as trans broken arm syndrome.

Mandy: Ah,

Delia: So I think there are a lot of schools doing a really good job of teaching about the trans community and about gender-affirming care. But there's not a lot of schools teaching about trans people outside of that context. And normalizing the trans experience or the intersex experience.

Mandy: That makes sense. And I, I think I'm glad that at least that part of the education is there. And like, here's how to, to treat and help this part of these unique needs of this unique population and existing out and be more inclusive. Exactly. I hear about it all the time and I'm, I'm like hyper-vigilant with my kids.

Like if they have a sore throat and they're going to the doctor, what did they ask you? That's great. You know, or, one of my kids went to the dermatologist and, I will say the dermatologist did not say anything about hormones or anything. And so I was like, wow. Okay. All right. All right. I like that person.

Delia: That's a win, we'll take it!

Mandy: yeah, yeah. But yeah, that I have heard like, Oh, sore throat. So why are you on this medication? or yeah. Broken arm. Gosh, it must be from the estrogen. Well that's, that makes sense. And I'm going to be thinking about that, about how, like, I don't know how I would answer that question of if someone comes in with a broken ankle, how would you treat them? Like what is the, what is the answer? Ask them their name and pronouns?

Delia: I mean the answer is Yeah, ask them their name and pronouns, treat the broken ankle, send them home. Don't talk about their hormones. Don't talk about surgery.

Mandy: Like.

Delia: Like.

Mandy: like everybody else. Yeah.

Delia: Exactly. Like, I think there are some contexts where hormone therapy specifically can be relevant. Like for example, if you're concerned about a patient who is on estrogen, who has been flying and might have a pulmonary embolus, that is one time where hormone therapy might actually come into play, because having increased estrogen can slightly increase the risk of developing a blood clot, but that doesn't necessarily mean that that's all you should focus on.

Because it might not be a pulmonary embolus, it could be something completely different. It could be pulmonary fibrosis. It could be acute respiratory distress syndrome. So, hyper-focusing on someone being trans doesn't do that patient any good.

Mandy: I mean, I think that oh frankly just for any - not to minimize this situation - but wouldn't it be wonderful if all of our healthcare providers looked at us as a whole and did not reduce us to one or two or even three things that are like wrong with you? Oh, I could do a whole other podcast on a doctor's appointment I went to yesterday, but I won't. So now I'd say

Delia: Oh, geez.

Mandy: just,

Delia: Oh, I hope you're okay.

Mandy: you know, Oh no, no, no, no. I'm good. I'm good. Um, but just thinking about, just think about our, our healthcare system and what is the focus and how, like you said, a patient-centered approach. And so I'm glad that you are doing what you're doing and making those changes. And so I think that's really super important in the world.  

So I wanted to hear more, a little bit more specifically, I, and you touched on this a little bit about the relationship between a transgender identity and being intersex. And I know that you've made some videos about it. There was one recently in particular where you had suggested a new definition of what being transgender means. And that was fascinating to me. And I wanted to hear more about that.

Delia: Yeah, absolutely. So take this with a grain of salt because this is from my own experience as a trans and intersex person. I'm just going to start off with that. But I think the biggest thing to start off with is understanding that there is a difference between gender and sex, because a lot of folks don't know that there is a difference.

So, you know, understanding that gender is something that is internal to our sense of self. It is not something that is related to our biology or our anatomy or anything like that. There is some research being done that is connecting gender identity to genetics and epigenetics, which is the way that genes are expressed in the body.

Um, but there's still work being done on that. We don't have like any definitive conclusions on how that works. But being intersex is a little bit different in that being intersex has to do with the specific combinations of hormones and chromosomes, the genes within those chromosomes, our internal anatomy, our external anatomy, and the way that our genes are expressed.

So there's kind of, historically people have thought of sex as two separate buckets. They've thought of it as a male bucket and a female bucket, and you fall into one of those two. Intersex people fall into a third bucket somewhere in the middle. So we have combinations of hormones, chromosomes, genes, anatomy, et cetera, that doesn't neatly fall into the male bucket or the female bucket.

And there's over 40 known intersex variations. So there's a whole bunch of different combinations. There's probably intersex variations that we don't know about yet because science just hasn't advanced to that at this point. So it's, it's kind of interesting being someone who is both trans and intersex, especially someone who found out that I'm intersex later in life.

The definition that most people think of for the word transgender is being a gender identity that is different from your designated sex at birth. And for a lot of transgender people, that is an accurate definition.

But for some trans people, it's not. Especially trans people who are intersex. Or have some sort of variation in sex characteristics. Some of us were designated either male or female at birth. And some of us weren't. Some people have an X on their birth certificate.

Mandy: Really?

Delia: So, it's not common because a lot of times, when intersex babies are born, they'll kind of be forced either into the male bucket or the female bucket, even if that's not how their body is born.

That's a big can of worms that we can definitely

Mandy: Yeah. No, but I didn't even know because I was going to ask you if there even was. Okay. That's, that's good to know that there's that. Okay. That option. Okay.

Delia: Yeah, yeah, um, it's yeah, it's a little complicated.

Mandy: Mm.

Delia: but, um,

Mandy: Mm.

Delia: When you have someone who is intersex from the time they're born, if we're using that definition of transgender, of being a different gender identity than your designated sex at birth, if someone is born intersex, then what does that mean? Does that mean that they can't be nonbinary and still be trans?

Because technically nonbinary could be seen as a parallel to intersex. And that's how a lot of people see it. If they are a woman, would they still be seen as trans if their intersex variation makes them more feminine? So that definition doesn't really fit, which is where the definition that I kind of proposed came up with.

 And that definition is being a different gender identity than the gender that you were socialized as, which for some trans people is true and some trans people is not. This was a conversation that came up after I made that video.

Mandy: Mm.

Delia: there are some trans people who other people will socialize them as a gender identity that aligns with their designated birth sex, but they don't see themselves that way.

So they do not socialize themselves that way, even if other people do. But for people who are intersex or for people who might have figured out their trans later on in life, being socialized as the gender identity that aligns with their designated birth sex, mean that that new definition of transgender could fit better for them.

Mandy: Okay. That's a lot to think about, but, but I could definitely

Delia: It is.

Mandy: and I think that makes perfect sense that, well, frankly, that there would be multiple definitions of being transgender because, and as someone who is not transgender, this is something I'll have to say that this is what I've learned from talking to transgender adults, youth, that there are so many infinite number of experiences. And so maybe there's an infinite number of definitions and ways to define yourself. And so, so that makes sense.

And now I can kind of see how that definite, the, the more common definition of being transgender as, as related to kind of tied to sex assigned at birth, how that would be a little … not problematic, but like, Hmm, if it's like, again, like remembering, Oh, intersex people, where, where do we fit in, um, with that? So I could see

Delia: Exactly.

Mandy: how that may not fit for everybody. Okay. Well, that's cool. And thank you for explaining that cause that will give me even more to think about now, definitely. Okay.

Listeners, I want you to know that I cleared this question with Delia before, before we got started. So because it's gotten a lot of airtime in various media. So there's been a lot of discourse recently during the Olympics about Lin Yu Ting and Imane Khelif, the women boxers. And there's so much wrapped up in, I don't even know what's in the discourse, I should say. On all sides, transphobia, interphobia, white supremacy, misogyny. And, I don't think I have anything new to say about it, and I don't think it's honestly, I was thinking about like, Oh, maybe I should make a reel about this or something, but I'm not, I don't think it's my place.

And I think other people have said things so much better than, than I ever could. And I do want to look at just what happened in a broader way about variations of bodies and I think, I think, I think maybe why people get so hung up on variations of people's bodies is that, I don't know if that's what the direction we want to go and like, why, why it bothers people so much.

And like, I, when I try to explain, not even thinking about like sports or anything, but just like people come in all shapes and sizes and abilities and variations. And it's incredible, miraculous variations in, in nature and in our universe. So where does that come from that someone who is and can pack a hell of a punch is now like, She, she must not be real, you know, and so, ah, it makes me, if I think about it too much, it makes me mad. And so I wondered

Delia: me too.

Mandy: your take is kind of in that way, or if there's another way you want to talk about it. Yeah, well help me out, help me make sense of it.

Delia: Yeah. Yeah. Before I answer that question, I also just want to apologize to Lin Yu Ting and to Imane Khelif because this whole discourse around their bodies is so public. For anyone to have to go through that, no matter who they are is I can only imagine so frustrating and angering and hurtful, and it's not fair to these two women who have worked their whole lives to get to the Olympics that so many people have said so many hateful things about them, have made assumptions about their bodies, and

Mandy: Mm hmm.

Delia: I do want to apologize to them as well, because I don't think it's fair that this is the spotlight that they've been put in.

Mandy: and I think that's kind of the point. Like what? Yeah. Okay. Go ahead.

Delia: exactly. No, no, you're okay. it's so frustrating because I think there's this deep-rooted fear of trans people that, to be honest, I don't know the whole history of where this fear came from. That's some learning I need to do myself as well. But there's this whole idea that trans people are trying to harm women, which is not what is happening at all. I want to say it was maybe a year ago or a year and a half ago. I was testifying at my state house on a bathroom bill actually. And the whole point of the bathroom bill was to try and keep trans people out of public restrooms, but like force them into a restroom that they're not safe using and it was a mess and there was one politician

Mandy: Mm hmm.

Delia: in this hearing who kept reiterating Well, if we let trans people go into women's bathrooms, it's not going to be safe for women. And just over and over, it's not going to be safe for women, it's not going to be safe for women.

And we all kept making the point, or everyone who was testifying kept making the point of, well, if there's someone who's going to harm a woman, they're going to do it no matter if trans people are allowed into the bathroom or not. Like, it's not it's very much become a matter of policing bodies under the guise of trying to protect women. I do think there is something to be said for the history of feminism in the U. S. and how many people have actively harmed cisgender women over the course of history. But we see similar things happening to transgender people that have happened to cis women. And when we try to police

Mandy: Sure.

Delia: trans people's bodies, it's ultimately, we end up policing cis people's bodies as well. Because if someone doesn't seem feminine enough or womanly enough, like what happened to Imane Khelif and Lin Yu Ting, their bodies are called into question, their sex is called into question, their gender is called into question. These are all very personal things that no one should have to talk about publicly if they're not comfortable with that. And it's so frustrating to me

Mandy: it's nobody's business.

Delia: Exactly. Thank you. It is nobody's business,

Mandy: Like

how I keep thinking like Oh,

Delia: Go ahead. Go ahead. No,

Mandy: I am not on the committee that gives people whatever stupid gender test there is, which is also just dumb whatever, whatever. That's a whole other thing. And so I don't have those results. So, like, who, whose business is it, what results or what chromosomes or, like, that's really personal.

That's, that's in your body and, oh, like you said, like reducing these incredible athletes to their, I was about to say to their bodies and it is kind of, I mean, cause they're athletes, it's more their skill, not being an athlete myself, I guess. Um, I, I don't know, I was going to make a joke about, I would like to be reduced to my body if I were an athlete, but that's probably, that's probably in poor taste, sorry.

Um, but anyway, that like their skill and, and their training and their expertise and the work that they put in. And then now it's like, what chromosomes do they have? And, okay, I could just, I could go on. Okay. I'll let you talk. How about.

Delia: I appreciate this because, you know, the reality is even if they did have XY chromosomes. It doesn't matter because chromosomes don't always dictate what your body will look like, how your body will behave. There are people with XY chromosomes who have no male features whatsoever. And it's so frustrating to me that there are so many people out there who believe it is their right to make determinations about other people's bodies, make decisions about other people's bodies and what other people are and are not allowed to do because of the body that they were born in. That is so aggravating to me.

Mandy: Uh, and, oh, there's so much we could say about that too, about policing bodies. I did, the one good thing that came out of my doctor's appointment yesterday was that, we were talking about the work that I do. And, in a good way, she kind of went off about like, gender-affirming care for, for trans kids, like that is between no one, but the patient and their doctor and the family and whoever else needs to be in there. Like the government does not to be talking about this. And then if you,

Delia: Amen.

Mandy: there's that with, with gender-affirming care. And then if you look at like a more regulating body for Olympics or a swimming association or whatever it is, Or, you know, that's how, abortion access can be tied in all of this autonomy of people's bodies.

And it just, it makes me, it's a little, it's a little heavy. So, so what's the, do we have a solution, Delia?

Besides the work that you are doing, what, I guess what would your answer have been to everything that happened, like just to say like, go about your business, people, or what changes would you want to see in that kind of regulatory body?

Delia: Yeah, I mean, I would love to see more education for the regulatory bodies about the difference between sex and gender, because I do think that is a really critical education topic that, because it has been so lacking in the past, has not only excluded transgender people, but has also excluded a lot of intersex people.

That's one big thing. I would love to see more engagement with transgender and intersex athletes, because as you mentioned before, every single person who is transgender and who is intersex, and really every person in general, it's not just limited to trans and intersex people, is going to have a different experience

in their bodies and in the way that their bodies move. And if we're not getting a broad perspective from as many athletes as possible, from as many trans people as possible, from as many intersex people as possible. It is not possible to capture all of those experiences in policies that are being made.

I think so often what happens, especially around trans and intersex bodies is people will hear one perspective or hear a couple of perspectives and use those one or two perspectives to drive whatever point they're trying to make or whatever policy they're trying to create. But the reality is that if you're not talking to people with a whole bunch of different perspectives from these communities, it's impossible to create policies that include all of us.

Mandy: Yes. Which is why, oh, I can think of in so many ways, thinking about having a seat at the table, the proverbial table of whatever that table is. Like what you're doing in, in healthcare and healthcare policy and, and medical school’s curricula. And then if we, transfer that over to something like the Olympics or whatever, like, do you think there's any transgender or intersex people on those bodies? I don't know. Maybe they don't know, but my guess is maybe not so much.

And I would think because it sounds like under the current whatever rules and stuff, if they are measuring things like hormone levels, then because so much of that is intertwined with or can be, I guess, with, with being intersex and, and can get conflated or whatever that it seems like you might want an expert in, uh, like a medical expert on that.

That could be, if you're ever interested in that, you would be awesome. It'd be like, all right, look here, y'all, this is the way we need to do things.

Delia: I actually never thought of that, but that would be a pretty good gig. I wouldn't mind doing that. With the other thing too, with hormone levels specifically, is that there are medical conditions that cisgender women have that can increase their level of testosterone. So are we going to exclude these cisgender women as well?

This is what, this is a perfect example of what we say, what we mean when we say that regulating trans and intersex bodies also harms cis women. We're not only policing trans and intersex bodies, we're policing women's bodies. Which is what the people who are policing trans and intersex bodies claim they're trying to prevent.

It's kind of ironic, if you look at it.

Mandy: It really is. It really is. There's a lot, I don't know, I wish we could solve it into our conversation.

Delia: Me too, but you know what, we're contributing to the solution by talking about it.

Mandy: Exactly talking about it and learning more. And I think, well, no, I know this is one of my blind spots of learning more about being intersex. And so I appreciate you being so open and vulnerable about your lived experience and about what you go through and have gone through.

And so, so I appreciate that. That's really important for people to learn about. So thank you for that.

So I want to hear more about your activism work on a policy level. How did you get started in that? How did you get to do all these wonderful things like with the American Medical Association?

Delia: Yeah, so that was, I have to credit my spouse for that. I actually did not have much of an interest in policy until I got to med school. And it was my spouse who got involved with the AMA and a couple of other organizations who really taught me about what medical policy writing looks like. I choose not to call it advocacy because I think there's a lot of different forms of advocacy and just calling policy writing advocacy does not really encompass everything.

Yeah, so it was through my, it was through my spouse initially. And then I met a couple of other trans folks, one at my med school and one who's at a different med school who were really passionate about health policies, specifically around gender-affirming care. And the three of us kind of became a little group, and it was the friend from my medical school who spearheaded the resolution that ended up going through the AMA and passing as policy last year.

I sort of realized that as much as I do want to see national change, there is a little bit less room for it because There are so many people doing work at the national level who have already written some fantastic policies on transgender care specifically. There's still more work to be done on intersex care, but there's a lot that's already been done on trans care and there are a lot of people coming together from around the country in these national policy spaces who are doing this work.

So, over the last year, I've shifted more towards state-level policy, especially because I'm living in a state that is trying to ban gender-affirming care and has done some pretty awful things to intersex people. And I think there's a lot more room for growth, at least to catch up to where we are nationally.

So, I've sort of shifted to more of the like state and local level type of things, but really there's policy opportunity at every level. It just kind of depends how much into the weeds you want to get and how much work has already been done in the area that you are passionate about.

Mandy: That is a really good point. And it kind of segues a little bit because I was going to ask you about if someone wanted to get started in, policy writing work, or any other kind of taking action. I think that's that's something I'd never thought of, of what's already being done. I do think about that, or I have, I should say, I've learned to think about that more from an ally perspective of like, am I really needed here? Where should I be standing in this space?

But not necessarily like where, you know, Yeah, like national, like everybody's doing stuff. But, but like you said, there, there's some good people at the top, the top levels or top, but national levels doing cool things and, oh, I'm, I'm guessing we both know about state-level stuff that it's, there's still a lot of work to be done, and even further down in local policies as well. So how would someone get started in that? What if someone wanted to start kind of on, on a more local level, what would you recommend for that?

Delia: Yeah. So it really depends how local you want to get. If you want to focus on your town or city specifically, go to a town hall meeting, see what they're talking about, see what legislation or policy is being proposed in your town or city, and if there's anything that you feel you can contribute to, whether it's through policy writing or through testifying, there's a whole bunch of different ways to get involved and to make your voice heard as a citizen of that town, or if you are more knowledgeable about policy, like as a policy writer.

On the state level, I've been more involved with like the state medical association. So, there's a lot of policy writing opportunities there. There's policy opportunities, not so much in state governments, because a lot of times, like it's the Congress that will write the policies and propose those themselves.

But testifying at hearings is a fantastic way to make your voice heard. You don't even have to go in person in a lot of states. Some states will allow you to just submit written testimony, and then you can watch from home and hear everyone else testify and share their stories and cheer them on if, if you're not one of the people who wants to do that publicly.

There's,

Mandy: it's hard,

Delia: to think

Mandy: hard work, heavy, heavy lift.

Delia: Oh, it is very hard, especially, so many of the people who have shared their stories, in testimony are sharing very deeply personal things to them. Brief content warning for suicide and self-harm, but my state, unfortunately, is one of the states that passed a ban on gender-affirming care.

And, um, the classmate I mentioned earlier and I went to the state house to testify against this bill as it was going through the Senate and, um, I always get emotional talking about this, but, uh, during the hearing, there was a transgender teenager who got up with her parent and testified and she shared that if she did not have access to gender-affirming care, she did not feel she could continue living and she would unalive herself.

And it's so difficult already knowing that that is a reality that so many trans people are facing, both youth and adults. It's even harder to hear it directly from someone who is living that, and especially from a young person who is living that. But I think those are ultimately the stories that provide the most power and help the most because you know, we can provide all the data we want, we can provide all of the evidence that we want, that gender-affirming care works, but hearing it directly from someone that these policies are affecting is what really holds a lot of weight.

Mandy: Sure. And, the more people I talk to about this kind of thing, especially working with, shall we say uncooperative state governments, that maybe you think your voice doesn't matter, even if you have this incredible story and you just lay your heart out on the table in front of these legislators, and then they still pass these bills.

But what I'm also learning, that the part of the power of that is not only empowering for that person to find their voice and to, uh, to, to be able to say that in front of people in person, in public, but also all the people watching. The other trans teens who are watching and saying, you know, gosh, that, that's me too. And, and thank you for, for going and standing up for, for, for me. It's it's still hard. For sure.

But that's a good point too, in saying that it's still, it's a place to get involved. And if you don't want to go or not able to go in person and lay your heart out, then written testimony is also a really good thing where I know people who have, especially in situations where you need to be anonymous, then you could have somebody else read your testimony or submit your testimony and then that way, if you didn't want to disclose your identity, whatever part of your, your name or address or your, you know, your, your, whatever your identity is, then, and then that can be another way to, to get your voice heard. So, oh yeah, there's a lot of ways.

So one last question, where do you see allies in the work that you do? This can be a touchy question because I know there are some allies out there who are like, I know everything there is to know about being intersex. And you're like, well, no, not really.

Um, or transgender or whatever it is. How, how do you see allies in working toward equality and, and opportunities and, and rights?

Delia: Yeah. I really see allies as having a critical role in this work, especially in healthcare, because, you know, the majority of people who are working in healthcare, whether it's as a provider or as a staff member, are not going to be trans or intersex, that they know of. And it can't just be up to those of us who are trans and intersex to do all of the educating and to take care of every single trans and intersex person.

It's just not possible. There aren't enough of us. And even though, like, there are more of us now than there used to be you can't cover every specialty in the hospital It's not like we can be a gastroenterologist and an emergency medicine doctor and a surgeon. It's just it's not possible, so we really rely on allies to do the learning by hearing from and talking to transgender and intersex people personally, or you know, listening to our stories online, like through your podcast.

We rely on that learning, and we rely on applying that learning in practical situations. For many of us, if we see an ally standing up for a trans person or an intersex person doing the learning, trying their best, even if they don't always get it right. That means more than someone being too afraid to try in the first place.

And that shows us that we can trust our provider. We can trust our staff member because they are willing to try, and they see us and want to understand us better. That's really the biggest thing.

Mandy: Hmm. I think. That's such a good point that there are a lot of allies, and even I, I hear this from parents of trans kids who are so afraid of making a mistake that they don't even try whether that's in, in taking action or even, I know some, some I've worked with some parents who just, who have a hard time even talking to their kids because they, they don't want to make the mistake of a, of a name or a pronoun or the wrong kind of vocabulary, whatever it is. So, I think that's a really good point of doing your best and being uncomfortable and taking the leap and that's better than not doing anything at all. So that's a good lesson for, well, for anybody really wanting to, to speak up and take action, but for sure for allies as well. So thanks for that point.

Okay. I know you are super, super busy. I mean, hello, med student. So, I want to give you back your time, and thank you so much for talking with me. This has been, oh, so wonderful. And you are so wise and smart. And I love hearing, oh, so much of the way you want to change healthcare and changing the world.

And, what an amazing role model. Thank you for being you and thank you for putting yourself out there and letting us know who you are and what the work you're doing. So thank you.

Delia: Well, thank you for all of the work that you are doing for all of everything that you are doing to teach people and to show the world what our community looks like. And to show people how to support trans folks in real life and in real time, especially trans kids. You know, I think being a med student and seeing how the world affects trans people and especially trans kids, it's, it's hard to watch every day.

And seeing parents like you who are doing so much to support, not just your kids, but kids across the world, it's incredible. And I can't thank you enough for everything that you have done and continue to do, and for inviting me to this conversation, I'm really grateful that we got to be at the same table today and really dive into things that both of us are so passionate about.

Mandy: well, thank you. Thank you so much. Okay. So where can people find you? Where do you want them to go? Are you promoting anything right now?

Delia: not promoting anything right now. Thank you. Hopefully will be at some point soon, but

Mandy: Oh,

Delia: yet. Um,

Mandy: Okay.

Delia: Keep the antennas on. In the meantime, you can find me on Instagram at enbydelia, and you can find me on YouTube, the name of my channel is Trans Doc in Training.

Mandy: so just for those who may not be in the know, the Instagram, can you spell that please? “Enby.”

Delia: Yes. I gotcha. It is E, N as in Nancy, B as in boy, Y, and then D as in dog, E L I A.

Mandy: I'll have all that in the show notes. And then, at the end of all of my episodes, I ask people that if they want to show gratitude for my guest and their work to make a donation to a cause that might be important to you. So what is important to you right now that we can send people to?

Delia: Oh my gosh, this is beautiful. Um, one organization that I am very passionate about is an organization called Interact. They provide a lot of resources, education, and support, created by the intersex community and for intersex folks and allies. They're an incredible organization. They went through a leadership change recently, so I think a little bit is changing on their end, but they do incredible work. They do advocacy policy, things, education. I cannot say enough good things about Interact. Please go check them out.

Mandy: yes. I've been to their website. It's just a good for those who maybe are just learning about intersex issues, what it means, how just all the things, then it's a really, really incredible source of information. So, listener, if you would like to show gratitude for Delia and their time today, and, and all of their work, then please go check out, Interact and make a donation.

So thanks again. And, thanks for your time. I thank you for your work and I hope that maybe we get to meet in person someday.

Delia: I hope so too. That would be so much fun. Oh, I would love that.

Mandy: All right. Well, thank you so much.

Delia: Thank you.

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Ep. 20 - Gender-affirming fitness with Syd Young

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Ep. 18 - College and advocacy with Mars and Indigo Giles