Organic chemistry, doctors, and transgender people–one of these topics seems as if it is not like the others. However, all of these topics are deeply related and introductory organic chemistry courses could help doctors become more sensitive about trans issues before they are even through medical school.
information for figure gathered from: http://www.glaad.org/reference/transgender
Pre-medical students may not think about their future interactions with trans patients when they are practicing doctors, but there is a very high chance that at least one of their patients at some point of their career will be transgender. These patients deserve access to the same basic medical treatments as their cisgender counterparts, as well as affordable and non-judgemental access to certain treatments they may need as a trans person. Most of the medical treatments that a transgender person might need, related to their identity, are not covered by medical insurance plans, and especially not without a diagnosis of gender dysphoria by a mental health professional–even though not all people with trans identities experience gender dysphoria. However, the cost factor is not the only limiting factor for members of the trans community in regards to their health care–doctors may refuse treatment or make a patient uncomfortable by not respecting or understanding their identity. A specific case of this was reported by the Huffington Post, and is sadly more of a common experience than a rarity for transgender people when they seek medical help or consultation, even when their visits are completely unrelated to their gender identity.
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“When Brandon James walked into an ER trauma center suffering from elevated
blood pressure and severe anxiety in 2011, he needed medical attention. Instead,
he was humiliated by hospital staff who were unfamiliar with treating transgender
patients.
James…recounted his experience in an article published this month in the Journal
of Emergency Nursing. He described hospital personnel who pointed at him and
said things like: “No, that’s really a girl.”
“It wasn’t business-like at all,” he wrote. “I was a spectacle. I was a freak show at the
circus. It was definitely to draw attention to the fact that my outward appearance didn’t
match [my identification].””
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These attitudes may be able to be fixed early in the science career of a student on a pre-medical track because of a concept in organic chemistry which utilizes the prefixes “cis” and “trans.” Though taking a course in sociology or queer studies is not necessary for a pre-medical students, organic chemistry is as it is needed to pass the Medical College Admission Test–which is commonly know as the MCAT. Passing that test is crucial to acceptance into a medical school, and since medical school is a necessary step on the path to becoming a doctor, every doctor will have encountered an organic chemistry class and learned the concept of isomers, likely in the first years of their undergraduate career.
Isomers are molecules that have the same chemical formulas but have some difference between them in the exact placement of its atoms. Stereoisomers are specific kinds of isomers that also have the same connectivity–they have the same atoms connected to each other. When there are configuration differences between these stereoisomers, they can be defined as cis or trans. Cis isomers have their substituents on the same side of the bond being analyzed, whereas trans isomers have their substituents on different sides of the bond, as can be seen in the picture below.
made with Google Drawing       Â
The concept of cis and trans isomers is a concept that must be understood and memorized for pre-medical students taking the MCATs so they can earn a top score on the test to help them ultimately get into medical school and become a doctor. Many of these students would likely use a mnemonic to memorize this concept, in the form of a relation between the concept of cis and trans isomers and the usage of the “cis” and “trans” prefixes that have to do with gender identities because that’s what they would already be familiar with. This comparison would make these chemistry concepts easier to remember because the prefixes are used in a similar ways for organic chemistry and gender identity terms. Cisgender means that someone’s gender identity is the same as their assigned birth sex, whereas transgender means that someone’s gender identity differs from their assigned birth sex–in both cases cis denotes “same” and trans denotes “different.” What is most important in relating the concept of cis and trans isomers to gender identity is to keep in mind that these isomers are equal but different–they are made of the same atoms but are arranged differently and have differing properties. Cisgender and transgender people should also be viewed the same way–as equal; we’re all human–but different in the alignment between the gender they identify and express as, and their assigned birth sex.
Sadly, there is probably not enough time in an introductory organic chemistry course to discuss the connection between cis and trans isomers and gender identity-however, it is likely students will make this connection on their own, especially with the increase in media coverage of the trans community as of late. Also, the metaphor for the relationships among cis and trans isomers and gender identities is not perfect, and is based off of an introductory understanding of organic chemistry. It is true that cis and trans isomers are equal but different, but it is also likely more complicated than that simple generalization, just as gender identity is. At the very least, studying cis and trans isomers should cause those who hope to become doctors to think about people who are transgender more than they may have otherwise, which could help lead future doctors to be more sensitive to the needs of transgender individuals.
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Sources used for this article:
Organic Chemistry: Principles and Mechanisms by Joel Karty
Molecular Visions Model Kit
http://www.transstudent.org/graphics
https://www2.chemistry.msu.edu/faculty/reusch/VirtTxtJml/sterisom.htm
http://www.usnews.com/news/articles/2015/09/03/obamacare-expands-rights-for-transgender-patients
http://www.huffingtonpost.com/2015/04/08/obama-lgbt-conversion-therapy_n_7029648.html
http://www.apa.org/monitor/2013/04/transgender.aspx
http://www.glaad.org/reference/covering-trans-community
http://everydayfeminism.com/2015/08/not-all-trans-folks-dysphoria/
http://magazine.good.is/articles/new-app-helps-trans-people-find-trans-friendly-doctors
http://www.thedailybeast.com/articles/2015/09/19/transgender-a-doctor-won-t-see-you-now.html