by Jay Samson
Smiling as he looked into the camera, head slightly tilted in thought, Dr. Jeff Day, an assistant clinical professor at New York University Rory Meyers College of Nursing, said, “I went to San Francisco. I remember very clearly walking down the street and seeing a trans woman ahead of me, and I remember thinking,
that’s the next frontier.”
He was discussing his upcoming course at NYU — a series of lectures focused on LGBTQ health — and we had begun to chat about his inspiration and why he felt the course was important. The course dives into the deeper waters of queer health, focusing not only on the “big picture” but on individual communities and issues. The conversation was filled with moments like these; moments in which we could truly see the engagement and care Dr. Day had for the subject he would begin to teach this upcoming semester.
Dr. Day is a nurse practitioner with the Center for Transgender Medicine and Surgery at New York Eye and Ear Infirmary of Mount Sinai, board-certified by the American Nurses Credentialing Center as an adult-gerontology primary care nurse practitioner and certified by the National League for Nursing as an academic clinical nurse educator, and is an active member and chair-elect of the Nursing Section of the Gay and Lesbian Medical Association, dedicated to ensuring equality for LGBTQ individuals and healthcare professionals. Dr. Day’s current pursuit is a course at NYU focused on LGBTQ+ health. This course has one clear goal — to educate the next generation of healthcare professionals and to “take care of LGBT individuals.”
Interestingly enough, the course came to fruition both out of Dr. Day’s belief that the topic went under-teached and out of the request of students. It wasn’t simply one or two students who would come to Dr. Day about feeling underprepared for helping queer patients; several students came to him with questions on queer health and a interest in learning much more than he was able to share in the moment.
“I identify as gay, and I have had my fair share of poor treatment in healthcare… I had a friend who was trans and had an abysmal treatment in healthcare and ended up taking her own life,” Dr. Day told us, somber, and then added, “I needed something that was my own.” That opportunity came in the form of this course: the issue was clearly prevalent and on the minds of students, and Dr. Day knew he had to step in.
The course, which begins this upcoming fall semester, caters to students with little to no experience in LGBTQ+ healthcare, although those already informed on the topic are also able to participate. Curriculum is divided into week-long chunks, with, for example, one week dedicated to HIV/AIDs care and chronic conditions, one week dedicated to intersex care, and two weeks dedicated to general transgender care. Although Dr. Day created the course for those already interested in LGBTQ+ healthcare, he shared with us his ultimate hope for the future of education: “Ideally, LGBTQ+ content would be weaved into curriculum… Ideally, we would make space in each of those classes, such as Pharmacology or those medical-surgical courses, dedicated to LGBTQ care,” and while he “felt it was important to open up an elective for those who have a passion for it,” he believes that expanding LGBTQ+ care to be part of general study is important.
When asked why he thinks LGBTQ+ healthcare hasn’t become a general topic found in all courses yet, Dr. Day, with a sigh, shared he believes it is because professors lack understanding of queer health. In fact, a study conducted in 2011 concluded some disappointing facts: many medical students only received, at the time, around five total hours of education relating to queer health — and many of these rising physicians felt as if they were inadequately trained for working with queer patients. Although this study concluded a decade ago, these numbers have hardly changed. Many students still feel uncomfortable working with queer, especially transgender and intersex, patients, with many reporting that they feel as though they are uninformed on the subject of transgender/intersex care, according to this 2017 study.
Ideally, LGBTQ+ content would be weaved into curriculum.
The amount of students who came to Dr. Day asking for more clarity on LGBTQ+ health only proves this lack of education.
How can medical schools improve? According to Dr. Day, “We need trans, gender nonbinary, gender nonconforming, gay, bisexual, we need all of this literature provided to students before they get to the classroom. It will make students more sensitive that way. In a way, they’ll understand what they’re getting into… I also think we need to tackle it from a faculty perspective. We need better training.” The problem goes beyond what students are being taught now; the issue began decades ago. If professors received improper training in their education and proceeded to avoid queer healthcare, never properly learning themselves, how could they teach the next generation any better?
Still, it’s no excuse, and Dr. Day agrees. Professors have a duty to not only their students, but to their students’ future patients. Even the smallest changes, such as introducing oneself with one’s identities present and explaining that one has a different viewpoint and experience than those one is working with, can go a long way. As we continued to chat, Dr. Day offered advice for professors struggling with feeling inadequate, or as if they might make their students uncomfortable, explaining that in his course, “My ultimate goal is to bring in some guest speakers. I frame my lectures by saying, ‘I am not a person of trans experience,’ ‘I am not a person of color experience.’” These disclaimers mixed with the real-world experience of those impacted directly can do quite a bit for students who might, in many ways, also feel as though they could never understand queer health or would always be walking on eggshells with queer patients.
I frame my lectures by saying, ‘I am not a person of trans experience,’ ‘I am not a person of color experience.’
Disclaimers can encourage acceptance and growth, according to Dr. Day.
This ability to recognize one’s identities and experiences contrasted with the identities and experiences of others allows one to accept their own drawbacks, and even accept their own possible failures. That acceptance is an early step in moving forward. Optimistically, Dr. Day added, “I do anecdotally hear that there is some improvement in nursing schools… I am getting word that it seems to be helping. I do hope to one day have students come back and tell me about their experiences.”
This care is not only rewarding to the patient, but to the physician as well. “I had a patient who tied balloons to their bed, because they had gotten gender affirmation surgery and was celebrating their first birthday, and you hear me get choked up about that now… There’s something super special about working in that area,” Dr. Day shared with us, his excitement obvious.
It’s clear: there’s nothing Dr. Day wants more than to bring these experiences to both his students and their future patients who might otherwise never receive such care. The Rory Meyers College, where Dr. Day is leading this course, works with future nurses, a field in which the relationship between oneself and the patient is of utmost importance. The impact of a nurse on a patient can influence a variety of things, including, but not limited to, the patient’s decision to receive treatment, the patient’s comfort with said treatment, and the patient’s willingness to continue to seek the aforementioned treatment.
To see a patient thrive under one’s treatment — that is what inclusivity is for. Dr. Day shared with us an experience he had working with a transgender patient who had received surgery to raise her voice, and it is impossible to say that she did not thrive. “(T)he sheer joy she experienced coming in and preparing for this was just infectious,” he said, “We talked about her past surgeries… I just see people sail as a result of these procedures that I don’t often see in other individuals.”
Hundreds of patients await experiences such as these, but due to a lack of education and a lack of access catered to queer patients, many are unable to proceed with the care they deserve. That is also part of why Dr. Day is so adamant about his course, and courses like it: they are not simply taught for fun, but for the betterment of millions of people.