Interview Topic Log

0:28 Growing up, impact of family, decision to become doctor, mother’s negative impression of doctors 1:31 Early advocacy sentiment 1:53 College education at Georgia Tech, engineering and molecular biology background, Medical College of Georgia, residency in North Carolina 3:06 Interest in preventative healthcare, influence of older sister 4:04 Interest in endocrinology, diabetes in family 5:47 First referrals of transgender patients 7:09 Realizing similarities between gender affirming care and general endocrinology 7:44 Decision to permanently train in gender affirming care 8:01 Connection to patients 8:13 Experience with multidisciplinary medical teams, gender clinic founding in 2015 8:37 Interdisciplinary recruits and volunteers, social worker Chris Russell, religious care 11:25 Other interdisciplinary teams in Duke Medical pediatrics 12:30 Pure chance or “fate” of original involvement in transgender care 12:59 Rewarding nature of gender affirming care, excitement from patients 14:37 Relationship with patients’ parents, use of medical data and information to ease concerns 16:58 Effect of North Carolina House Bill 808, pain of turning away prospective patients 19:23 Power of being advocate and speaking up 20:12 Support from Duke, benefits of working in a private institution 21:02 Involvement in legal system, anxiety, support from legal experts, learning about legal system 24:06 Support from Duke Communications, vetting of media outlets and organizations to talk to, Human Rights Campaign 25:55 Challenges of advocating for transgender youth as a ciswoman, empowering transgender youth voices 27:17 Advocacy to make hospital system and staff more accepting to transgender people, pronoun training and sharing 29:41 Work with Epic medical records system 30:31 LGBT+ advocacy at Duke School of Medicine, Sex and Gender Diversity Inclusion Council, inclusivity training 32:32 Sex and Gender Wellness Clinic, LGBTQ+ unity, LGBTQ+ organizing with entire Duke community 32:24 Clinic growth, importance of recruiting from within own medical trainees 35:34 Need for more administrative support, pressure on social worker 36:06 Interest from medical students, Cultural Health and Health Disparities Course 37:10 North Carolina “Bathroom Bill,” protective feeling towards patients 38:24 Increased awareness of gender clinic from “Bathroom Bill” 39:23 Policy vs advocacy work, learning how to be an advocate 41:22 Learning from others, American Academy of Pediatrics advocacy course 42:10 Learning how to convince with data and stories 43:08 First legal cases, Lambda Legal, ACLU, being an expert witness and care provider, Adams v. The School Board of St. John’s County, Florida 44:37 Positive relationship with legal experts, Pauli Murray Award 46:26 Effect of wide geography region of care, effect of legislative attacks on other clinics 48:39 Future of gender affirming care at Duke. adult gender-affirming care, hope 50:16 Talking to patients about having to wait to access care 51:40 Recognition for work, learning to accept recognition 53:22 Learning from other disciplines, reliance on other providers, limitations of subspecialties 55:17 Continued work in inpatient services and general endocrinology, division of clinical time 56:09 Effect on advocacy of being from the South 57:22 Involvement with Equality NC, talking to state legislators, counteracting misinformation 59:38 Learning from patients, importance of staying informed on gender affirming care 1:01:15 Learning from parents, empathy for parents, education sessions for parents in the right setting 1:03:18 Importance of understanding patients’ self-identification and terminology, separation of gender identity and sexual orientation 1:05:25 New research, long history of affirmative care data, limitations of data, combatting skepticism of gender affirming care research 1:08:09 Overwhelming volume of work, extremely rapid growth in involvement in affirmative care 1:09:29 Setting boundaries, small size of department, setting limits on advocacy work 1:11:45 Patient voices, involving patients in medical school education, patient feedback, community advisory board 1:12:57 Registries to track long-term outcomes, tracking geriatric and adult outcomes 1:13:29 UNC Master of Social Work study for patient feedback, electronic health records (EHR) training, training modules for staff 1:15:15 Expansion of training modules over time, requirements to display ally symbol 1:16:40 Learning from early patients, designing treatment plans to meet patients goals 1:17:44 Learning about everyday struggles for transgender youth, training exercise for medical students to understand struggles of daily life 1:20:35 Joy of successfully helping patients transition, life changing effect of gender affirming care, patients becoming advocates 1:23:08 Empathy for reluctant parents, overcoming parent fear with education, fear for children who do not access clinic at all