Nadie está Excluide: Delia Sosa's Perspective as an Incoming Medical Student and Transgender Latine
I was in elementary school when it became apparent that my dad and I were different. He was born in Puerto Rico and was visibly not white. My mom’s family was entirely white, and so was the community we lived in. He was the brown in-law, and I was the brown baby cousin. The older I got, the easier it became to recognize the ways people treated us differently because we’re Latine. For example, my dad was afraid to drive at night during a trip to the southern part of the U.S. because he worried his darker skin and thick, dark beard would make him an easy target for state troopers. A white family member used to berate my dad because he wasn’t able to teach me Spanish despite his upbringing in a Puerto Rican family. People have asked my dad whether he is an American citizen, even though Puerto Rico is a United States territory. In coffee shops, employees have assumed our ethnicities and told us we didn’t know what our heritage was when we corrected them. I have been asked if I am an American citizen because of my last name. And, on more occasions than I can remember, I have been followed around stores by white employees, and even threatened by one when I was thirteen.
And yet, every time our heritage was questioned or we were harassed because of it, my dad told me that I deserve to be proud of who I am, that I deserve to be proud of where our family comes from. He doesn’t remember Puerto Rico because he came to the United States as a baby, but he made every effort to teach me what he could. He brought me to visit his parents and grandparents so I could meet them and learn about their lives. He introduced me to his favorite foods - his abuela’s budin, pasteles, and bacalitos - so I could learn about our heritage through food. He always gave me space to be proud to be Puerto Rican, even when the world we were living in didn’t want us to.
When I came out as transgender, my dad, who didn’t fully understand what that meant, told me that to him, it didn’t matter what language I used to describe myself. I would still be his child, and he was still proud to be my dad. He has made a really meaningful effort to use the correct pronouns for me, and when I told him about getting top surgery, he was one of the people in my corner the most. When I was outed as queer to my entire middle school by one of my classmates, I yet again felt like I lived in a world that neither understood nor wanted me. But having a dad who wanted me to be my fullest self, even if he didn’t always understand what that meant, allowed me to find safety and solitude in belonging, not just for myself, but in creating spaces for others to belong.
My parents both encouraged me to pursue a career in medicine from the time I was little. It wasn’t because they had that expectation for me, but because they knew how much I loved medicine as both a science and an art. They saw the way my face light up when I could take out library books about visiting the doctor, understood how much I enjoyed being a lifeguard in high school because it was ever-so-slightly related to healthcare, and shuttled me around to science fairs so that I could join the science honor society by the time I was a sophomore. I knew I loved medicine and wanted to become a physician, and they knew it too. But, when it came to figuring out why exactly I wanted to be a physician and where I saw my path leading me, it took coming out as transgender to fully understand.
It took about five years from the time I began questioning my gender identity to the time I was able to come out publicly. The Catholic community I grew up in, the same predominantly white one that my dad and I never fit into, was not able to offer enough space or grace for me to come out or be out safely. I had no place to fit into. Once I left that community and began to understand my gender better, I found spaces where it was safe to be myself and figure out the nuances of gender I had recognized in myself but never understood. With that understanding came a new recognition of my position as a queer and transgender patient.
The first time I saw my primary care physician (PCP) after I started dating my first non-cis male partner, the question of romantic and sexual partners came up. She asked if I was dating men, women, or both. I earnestly answered “neither”. My partner was a transgender nonbinary person who was neither a man nor a woman. She spent the rest of the visit asking me questions about what transgender means and how to use they/them pronouns. Although I knew she was just trying to learn in order to better treat her transgender patients, I left that appointment feeling defeated. I had so many questions about accessing gender-affirming care myself that I never had the opportunity or space to ask them. It would be over two and a half years before I was finally able to access gender-affirming healthcare and over four years until I was able to access what ultimately was a life-saving gender-affirming surgery.
I started using the term “Latinx” instead of “Latina” to describe myself and the Latin American community to others because it was a more gender-neutral option than “Latina”. Not long after this personal shift in language, I became aware of conversations that were happening among people in Hispanic and Latin American communities around this shift. My initial reaction was one of shock and frustration. I couldn’t help but wonder why people would be opposed to inclusion of more folks in the community who do not fit into the gender binary, especially when so many of us, like my dad and I, had been excluded from communities and spaces for being Hispanic and Latin American. But the more I read, the more I saw that for some, the use of “Latinx” felt like a form of erasure. The history of Latin American and Hispanic communities is rich and rooted in both oppression and resilience, and the use of “Latinx” as opposed to “Latina and Latino”, for some, seemed like a way of erasing and neglecting our history by neglecting the language. From that moment on, I started using the phrase “Latine” as a middle ground to include as many Latin American folks as possible. It still follows the basic rules of Spanish but leaves room for gender and sex diversity.
This one shift in language, and the acknowledgement of the impact of such a shift, put into perspective the kind of physician I hope to be. Our patients deserve to receive their healthcare in a space where they will be safe to be themselves, where they do not have to fear judgement or a lower quality of care because of the identities and experiences they bring into the exam room. They deserve to be met where they are and guided through the healthcare decisions that work best for them. I use the word “Latine” because it includes everyone. No one deserves to be left out the way my dad, my queer and trans siblings, my Latine family, and I were left out.