According to an article by Julie Woulfe, PhD, and Melina Wald, PhD, from Columbia University’s Department of Psychiatry, the COVID pandemic has adversely affected members of the transgender and non-binary (TGNB) community. This community has “been uniquely affected by the pandemic in several ways, including risk of exposure to the virus and its adverse outcomes, delays in access to gender-affirming care, and diminished access to social support, which is crucial to protecting against the effects of stigma and discrimination.”
Woulfe and Wald explain in the report that “Individuals with gender dysphoria need to plan and prepare in advance to access medically necessary gender-affirming interventions…” However, as hospitals alternatively filled up or cancelled non-emergent surgeries, these important and “medically necessary procedures” became significantly more difficult to have.
Additionally, many TGNB people are discriminated against by education institutions, employers, and sometimes their loved ones, resulting in them experiencing economic instability, which has only been worsened by the conditions of the pandemic. Some TGNB people rely on peer networks and organizations that are accepting of them. Due to the social isolation caused by the pandemic, however, these resources have diminished, leaving many with less social support.
Barriers to gender-affirming medical care have also worsened as a result of COVID, leaving many TGNB people’s surgeries and other forms of care to be postponed. Annaliese McDermond, senior development operations engineer for FlexRadio Systems and a resident of Lebanon, has experienced these delays to gender-affirming care firsthand.
The Journey for Confirmation
McDermond began the surgical part of her transition with top sugery — according to the Mayo Clinic, this is “a procedure transgender women might use to increase their breast size and improve the shape of their chests.” McDermond had top surgery, as a means of feeling more feminine, at the beginning of the pandemic. This meant she moved to the front of the line for bottom surgery — performed on the genitalia as part of gender-affirming care and quite intensive.
The wait for bottom surgery is a long one, particularly in the Pacific Northwest. Only two surgeons in the entire region perform bottom surgery, both of whom are at the Oregon Health and Science University.
As a result of the pandemic, McDermond’s initial consultation with her surgeon was moved to Zoom. This made the process more complicated, considering how difficult it is to do a physical exam virtually. It wasn’t until July of 2020 that McDermond could see her surgeon in person.
Her surgery was scheduled fairly quickly after that appointment, for August. McDermond and her wife, Cathy, made preparations for the procedure, even renting a hotel room for the night before. However, McDermond got a call postponing the surgery about 12 hours before she was scheduled to come in. The hospital didn’t know if they would have an available bed for her after surgery because of the number of COVID patients.
The procedure was postponed to the Saturday of Labor Day weekend — not usually a day that surgeries are scheduled. Thankfully, McDermond’s surgery was not postponed again, and she was able to have the procedure done.
“I would think that surgeons are doing a whole lot less bottom [surgeries] right now,” McDermond said. “That’s been a challenging thing in going through transition, is just getting in to see medical professionals that I need to see and things like that.”
The Effect of Delays
Before she was able to receive her second surgery, McDermond was very distraught when she heard the news of it being postponed. And though it was scheduled for not long after the original date, she had been waiting a long time for the procedure, and a delay felt detrimental.
Many TGNB people experienced gender-affirming care being postponed nationwide when the pandemic began. The problem, as noted by AMA Chief Experience Officer Todd Unger in a COVID update on June 15, 2020, is that “gender affirming surgeries are technically labeled as elective or nonessential.” In Oregon, elective surgeries were shut down from the end of March until May 1 of 2020. Several major hospitals postponed elective surgeries in November of 2020 as well.
“You can look back on it and say, ‘oh a week and a half wasn’t very big,’ [but] when you’re waiting for it and have been waiting for it for that long, it’s a huge, huge deal for people,” McDermond said.
COVID also affected who could be in the hospital room with her.
“It was very difficult not to have my family around me when I had my surgery in September,” McDermond said. “The hospital restricted visitors to a single person who could be in my room. We were actually afraid beforehand that even Cathy wouldn’t be let in because that was the policy at the time. Because of the circumstances, exceptions were made in my unit in the hospital.”
Generally, the pandemic also added more stress to McDermond’s transition experience.
“COVID has been stressful, and transitioning adds more stress on to that,” she said.
It’s More Than Surgical
McDermond also feels adversely affected by the pandemic in another way. Because she is spending a lot of time at home, she feels frustrated that she cannot present her femininity in public, which she has waited a long time to do.
“Appearance is very important to me,” she said. “I always want to present very feminine, and it makes a huge difference in me and my quality of life when I can do that.”
Additionally, COVID moving most conversations to the phone has negatively affected McDermond’s life as a transgender woman.
“The move during the COVID era to phone calls for a lot of things is also distressing for a trans woman,” she said. “My voice doesn’t necessarily match my body as perceived by others, so I get ‘sir’-ed a lot on the phone.”
When asked if she had experienced any decline in social support, McDermond said she is not actually a part of any trans community in Lebanon. This is partially because Lebanon doesn’t seem to have a big one, according to McDermond. And though she was born and raised in Corvallis, McDermond is also not tied to the trans community here.
Though Lebanon doesn’t seem to have an active trans community, McDermond said she has not experienced a lot of overt transphobia either. “The vibe I get in Lebanon and going around town,” she said, “I feel like a lot of places are like ‘we don’t necessarily like trans people, but you’re our trans girl, so we like you.’”
She also explained that she has experienced many cisgender women covertly showing their support, often by complimenting the way she is dressed or how she presents herself.
McDermond is also not part of a trans community for another reason.
“While I would like to talk to people that have my experience, my quest isn’t to be a trans person – if I had my choice…I’d be a cis girl,” she said. “In seeking out, for me, the trans community, it’s acknowledging that I’m different and that I’m not what I really want to be.”
Besides seeing the negative effects of COVID in delays for gender-affirming care, McDermond and her wife noted that they have also seen a positive benefit: more people seem to have the time and freedom to experiment with different gender expressions, which they may have not been able to do without the pandemic.
Trans Legislature
Some things that have been especially hurtful to McDermond throughout the pandemic, however, are the bathroom bills. In 2017, one particular case was brought by a group of Oregon parents, challenging a school district’s trans-inclusive bathroom policy. In December of 2020 however, the Supreme Court declined to hear the case.
In 2021, CNN has called the year “record-breaking” in terms of anti-trans legislation — 37 states have presented more than 100 bills which specifically target the trans community and their rights.
McDermond’s main issue with the bathroom debate in particular is that others view her as a threat, simply because she is being who she is.
“For me, that’s confusing and hurtful…It rests on a fundamental assumption that I’m not a woman,” she said. “[Trans women are] women like everybody else.”
McDermond has a lot of advice for those going through transition, but the most important in her opinion is to not be fearful.
“I think the most important thing that I would have to tell people that are transitioning is to not be afraid to be out and themselves,” she said. “You will be surprised the places where you will find acceptance in this world. You’ve come too far to live your life in fear of what others are going to think of you or [how others] react to you. People largely pick up on your attitude to decide how they’re going to react. If you act confident and like nothing’s wrong, people will tend to act like nothing’s wrong in return.”
By Cara Nixon
Do you have a story for The Advocate? Email editor@corvallisadvocate.com