QUEER HEALTHCARE: ALEXIS CHAVEZ OF THE TREVOR PROJECT
Photo courtesy of Alexis Chavez
As the Medical Director of The Trevor Project, Alexis Chavez’s main job is to serve LGBTQ+ youth. Although this is no easy task, Alexis is fueled by their potential and perseverance. Moreover, Alexis’ own battle against transphobia allows her to empathize and better support LGBTQ+ youth through their explorations of sexual orientation and gender identity. Her insight on the healthcare system’s neglect of transgender Americans is a necessary eye-opener to a suppressed injustice.
LTA: Could you introduce yourself and explain what you do?
I’m Alexis Chavez, the medical director of the Trevor Project. I make sure that all of our services and programs are evidence-based and up to date with the latest research; I’m constantly working with all of our departments to ensure that we are innovative in our care methods for LGBTQ youth. This allows me to work with amazing and intelligent people every day—including the over 1.8 million youth that we care for.
LTA: Why do you do what you do? What impact do you ultimately hope to have?
I do what I do is because it is so necessary. To me, it’s really sad to see young lives lost because there is such a great, unrealized potential that they have. The deaths are particularly disheartening when they are a product of bullying; when they are the result of a President and a society that won’t accept people the way they are. So part of the reason why I do what I do is because I can. With the Trevor Project, I would love to change the world; I would love for LGBTQ youth to live their fullest lives every day while being accepted for who they are. When some people say that they want to change the world, they’re speaking metaphorically. But I think The Trevor Project has a better chance of making that a reality than any other organization that I’ve seen.
LTA: Could you tell us about what your personal journey with your LGBTQ identity has been like?
It has been really hard at times. Like many people in the community, I’ve lost friends and family; I’ve experienced discrimination, violence, and difficult access to healthcare. It’s certainly been very intense at times. But I just remind myself that I’m not done yet; I still have a lot of things I want to do.
LTA: How has your journey influenced your career goals and motivations?
As a teenager, it can feel isolating to try and explore your sexual orientation and/or gender identity if no one you know is like you in that regard. It can be very nerve-racking to try and think about what it will be like to come out to your family or friends and you worry that you might lose everything. So I think that if I would have known even one person that was out of the closet, it would have been really different for me. And I wish that I would have known about the Trevor Project: having someone that anyone can reach out to is exactly what we do 24 hours a day, 7 days a week. It’s really amazing that I’m here—and that is how it has shaped me.
LTA: That is amazing. And as a person in the medical field, do you believe that the American healthcare system has often neglected care for transgender Americans?
Absolutely. I think that the medical system, unfortunately, was on the forefronts of discrimination against transgender Americans for a long time. I think that there is an amount of blame that we have to take... For example, psychiatry—which is my specific background—stigmatized transgender individuals by saying that being transgender is a “mental health disorder”. We’ve been doing that for decades and it’s still not entirely out of the DSM (Diagnostic and Statistical Manual of Mental Health Disorders). We’ve made people feel like, by definition, anyone that has a variation in gender identity or sexual orientation—which was also in the DSM for a long time—is “other” or “crazy.”
LTA: What would successful integration of transgender Americans into this healthcare system look like to you?
In an overly simplistic way, I think that it means that transgender people would be treated just like any other American. Often times, people will ask me why we need things like specialty clinics. They’ll say: “Well, why can’t everyone be treated with competence and with respect anywhere they go?” And I’ll reply saying, “I’d love that!”
That seems like a best-case scenario. But we know that the reality is that many people experience discrimination even with their healthcare providers: they are either denied care, harassed, or feeling like they have to educate their doctors. We know that people are more likely to receive delayed care because of that. Therefore, successful integration means that every provider has the competence to treat LGBTQ individuals and understand, in addition to all the other things that all people experience, the development and exploration of sexual orientation and gender identity.
LTA: How are the clinics you mentioned specialized in assisting LGBTQ youth in the way you just described?
First and foremost, we want providers to feel like they have a broad competence when working with LGBTQ individuals. It’s the same message I give when I give training for providers: everyone wants to do their best and we just have to help them learn how to. If we can help teach providers about normal exploration of sexual orientation, gender development, how that might progress over time, how people might understand that, and what variations might look like, then they can better understand if someone comes in and says, for example, that they’re feeling depressed for various reasons. Then, we could apply the minority stress model and understand how that might be contributing to their depression. But something like how they broke up with their significant other, for example, might contribute to what they are feeling. And also how they’re having trouble coming out to some of their friends might be contributing to it as well. It’s not one thing or another; it’s not one simple answer: it’s how everything works together.
LTA: Do you have any advice for transitioning transgender youth as they navigate the healthcare system?
I would say a few things: first, I would say that, if possible, find a provider who is competent and has experience working with transgender youth. They will have the most complete and nuanced ways of helping you. The second thing I would say is, if you can’t find that provider, to find someone who is open to learning and understands what they may not know; the youth—if willing—may have to teach them. Although it can be frustrating to have to teach your doctor, because that shouldn’t have to be the case, every time you do, it makes the healthcare system a little better. Lastly, I would say that it is important to remember that you are never alone. That, at the very least, we see you. Here at the Trevor Project, we are always here at any time that you need us. And I am sure that there are people in their lives that care about them quite a bit. Although I know that sometimes it can be hard to see.
Written by Adelaide Graham
Edited by Serene De Sisso
September 2019