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Several years earlier, she had come in for a routine operation. The doctor had evaluated her before the operation, learned that she was a homemaker and met her husband. But on the morning of her operation, as he pulled down the sheets to begin inserting the urinary catheter into his now sleeping patient, he was startled to discover that the patient was not exactly who he had assumed she was. She was transgender, and where he had been expecting to find female genitalia, he found male genitals instead. The patient had obviously not felt comfortable disclosing her transgender identify, and the doctor had clearly not asked the right questions.

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We knew that any one of us could have made the same mistake. While we had been trained well in treating cancer with the best chemotherapy regimen, curing flesh-eating infections with the most powerful antibiotics or transplanting organs with the greatest of ease, when it came to caring for patients who were transgender, we were lost.

For of us, the same could be said for lesbian, and bisexual patients as well.

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