INTERVIEW: Dr. Olivia Danforth Talks Trans-Care

In early May, we ran an op ed from local trans-woman Sloane Rittner — to say it blew up would be an understatement. Granted, the story had to do with a doctor running for School Board and Rittner’s encounter with him as his patient.  

One positive outcome was that Dr. Olivia Danforth contacted us as a resource for transgender care.  

TCA: Hi I’m Sally Lehman and I’m with The Advocate. At the beginning of the latest local election, The Advocate published an op ed concerning one of the people running for the Corvallis School Board. We received several emails against our choice to run the piece, but we also received more emails in support of the young woman who wrote the story and asked us to share it. One person who approached us was Dr Olivia Danforth, a physician with Samaritan Health in Albany. And today we are speaking with Dr. Danforth. Thank you for being here.  

Danforth: Thank you so much, I really appreciate you inviting me to join and also for your willingness to run the article and to keep it up. You know, I had heard that there was some significant pushback from, you know, the person involved, as well. And it was really nice to connect with Sloane [Sloane Rittner author of the op ed], and hear, you know, a little bit more about her experience and about how it’s been to kind of write something that was impactful on a local kind of scale.  

TCA: Absolutely. I don’t think anyone expects to have something that is so incredibly personal as transitioning be out there in the world at large. And as a writer, I think that she not only nailed her story incredibly well, but she was very courageous in letting us all see it and read it.  

Danforth: And it really stands out as a physician – the way that she’s able to break down what happened and what she was going through. It really lays out [that] this is not what you would expect for your medical care, for anything.  

TCA: So why did you decide to step up about this?  

Danforth: I am trying to settle into the area, and I practice gender affirming primary care. I prescribe hormone therapy and I routinely counsel and support patients who are seeking gender affirming surgeries as part of my overall primary care practice. It’s really important to me. It’s something that I’m really invested in the community over.  

And it was also a surprise to learn that this had happened. It was something that, you know, I’ve really appreciated, this is a welcoming area. There hasn’t been a heavy current of some of the ongoing antagonism and the waves of oppressive and cruel legislation. And that hasn’t been the case here. It’s been a place where, in my experience as a doctor and as a member of the trans community – people escape other places to come here. I’ve met patients again and again where that’s been the story, that this has been a place they can come to settle in, to find services, to hope for building a future for themselves and accessing the health care that they need. So because of all of that, it really moved me to read about [Sloane’s experience]. And it was something where I just wanted to connect with someone involved and learn a bit more about what happened and how it’s affected people locally. And it’s just sort of see what I could do potentially to help keep things welcoming here.  

TCA: So how do you know if you’re facing a normal interaction with someone or facing a microaggressive interaction with them?  

Danforth: It can be tricky. I mean, the term microaggression, if you look at it without any context in and of itself, it can be hard in the moment to understand, ‘hey, that was, you know, about me’. You sort of get that sense for it. And then you have a bigger context of experience and the setting that kind of plays out. So often, if we’re talking about the concept of microaggression, a patient in that situation will feel like they’re having a conversation that is suddenly about their character, about their worthiness, about whether their needs are legitimate or normal in a way that wasn’t expected or doesn’t seem – it doesn’t seem just or –   

TCA: Appropriate? 

Danforth: Yeah. And it’s sort of hard to talk about in general terms because there’s so many different ways in which people have this experience, where there’s just that added element of judgment or of making things personal or for transgender people. There’s often this sense that suddenly instead of being a person in the room, you are embodying some deeper gender struggle or political struggle that the doctor or the other person is very nervous about, are very concerned about. You know, it can be really bewildering and intimidating when you realize that not only is this potentially a hostile interaction, but it’s one that doesn’t seem to be about you as a person.  

TCA: What would you hope the response would be from a school board member when faced with a transgender kid?  

Danforth: I think that the bottom line, [that] the thing to understand is that this is a variation of normal. These kids, these adults, us, we have always been around. The problem that these kids face is that they’re being tortured, they’re being targeted in the media. They’re being targeted by, less often peers, more often parents, because of that phenomenon of depersonalizing them, of making them out to be a ‘representative of something’ instead of a person.   

So mostly, you know, a school board member or administrator who encounters a transgender kid, the key thing is to understand that need for safety. This isn’t something that represents an experiment or a political project. It’s just a minority population that gets abused a lot. And these are kids who do really well if they’re supported.  

TCA: Do you have any tips on how to advocate for yourself at the doctor?   

Danforth: Yeah, I mean, the first thing is a lot of us really are trying our best to mean well, and that can be true even in situations where something becomes personal or uncomfortable or hostile to an extent, because there is sometimes a mismatch, an agenda between patient and doctor. You know what the doctor thinks their role is or what they imagine the patient expects of them.   

So, I think it’s sort of hard to talk about what one should do. Ideally, we’re meeting you where you’re at, but it can be helpful to take a moment to double check or question, ‘did I just hear that or is this your concern?’ My concern is this. To try and summarize things, demonstrate that, hey, something odd just happened, something’s not going well and kind of give the doctor an opportunity to get on the same page.   

Failing that? It kind of depends on the situation in some difficult medical relationships that can be helpful to bring in an advocate. In some situations, it’s necessary to try and talk to whoever the supervisor or manager of that person is. You know, a lot of this is relational, how the other person responds in the moment, what they leave open.  

TCA: What are some of the signs that it is time to change doctors?  

Danforth: I think one way or another, if you’re consistently not feeling listened to or feeling as though you wouldn’t be comfortable stopping your doctor and saying, ‘hey, I didn’t understand this [or] I have another question. This doesn’t address what I came here to make sure we address today.’   

I think it’s important. And that’s true, even in a relationship that doesn’t make you feel afraid or potentially demeaned is you’ve got to be able to have that in an ideal medical relationship. And not every person is going to be the right provider to help every unique person out there. So, I mean, one way or another, if that’s not what you’re able to say about a primary care relationship, I would say it would be a good idea to consider a change.   

The unfortunate reality is it is really hard to find a primary care provider. It’s hard to keep on in this country and in the area. It’s hard to keep one on your insurance and make sure your insurance doesn’t change network year after year. Providers come and go. So it can be really hard to know that you have the ability to just find someone else and work to get a good fit.  

TCA: You come from a medical family?  

Danforth: A few my mom’s side of the family has a few doctors, heart surgeons going back a few generations or really since they realized you could do heart surgery. And then my stepfather’s an endocrinologist.  

TCA: And you chose general practition. Why is that?  

Danforth: A lot of it is that I really like talking to people. I really enjoy working with some of the logistical hurdles, trying to problem solve. I like a role where I’m really charged with figuring out what’s the most helpful approach to a given person, not what the objective ideal that the person should conform to is. I kind of enjoy getting to know what’s going on in someone’s life and what the obstacles are to meeting their own goals. I think primary care, and in particular family medicine, epitomizes that.  

TCA: Your bio also says that you spend time volunteering. Do you have a specific place you prefer to volunteer or any place we should be aware of?  

Danforth: I’m still trying to get back into it after residency. I’ve spent a lot of time working for Trans Lifeline. They’re an organization that does direct crisis care, crisis counseling for trans and questioning individuals. They’re nationwide. They also have a micro-grants service and a few other direct services that we’ve been working on. So I’ve been with them since 2014. It’s been an unbelievably cool experience.   

I used to do more hotline operator work. I haven’t had time for that in a few years. I’ve been doing more of the leadership side of things and it’s been a really great, great kind of setting where I’m not part of the medical apparatus. I’m not kind of in that same role, and I’m able to kind of work outside of that and just talk to people  

TCA: And be a person instead of. Yeah, a doctor.   

Danforth: It’s so centered on the person you’re working with. But to have some variation. Yeah.  

TCA: Yeah. So going back to the bio, you apparently have a fondness for bad television. So what is bad television?   

Danforth: Like True Detective is a good example. I don’t know, the first season probably you could call good TV, but not any of the other ones. And they all are very formulaic, very rote. There’s a lot of disorganization, a lot of things that maybe someone was shooting for didn’t quite do. I don’t know. It doesn’t take a lot of work to watch bad TV and it’s fun. You get to see the same things done over and over again by different people.  

TCA: What are you most looking forward to with COVID finally being containable, I guess, is the best word that I could say.  

Danforth: I don’t know, it’s been one hell of a year, honestly. I would say I’m really looking forward to exercising again and to meeting people. It’s been a long few years of residency, and it’s been kind of impossible to just go outside again, you know, so I’m really excited about that.   

Like we had our first concert in four years, we’re going to go to over the summer. We had travel plans, all kinds of things. My sister had to push her wedding back and a whole lot of people aren’t with us anymore.  

TCA: So that’s true. Is there anything else that you would like to say to people in Corvallis and Albany?  

Danforth: I really like this area. I like being here. I like the people. It’s been a wonderful three years, even kind of half existing in the community as someone in training. And I’ve just found it to be a place that really matches my values. And I hope it stays that way. And I hope I can keep working here and keep doing my thing.  

TCA: I hope so, too. Thank you for your time. Have a good day.  

Danforth: I really appreciate it. Thank you.  

By Sally K Lehman