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Transgender patient's journey takes a life-changing turn in Madras

Author: Ben Salmon, 6/19/2019 4:45:00 PM

Blaine Gerondale was born with female body parts, but it didn’t take him long to realize that he didn’t feel like a female on the inside.

“I grew up with two biological siblings, both brothers,” Gerondale said. “I thought that if I acted like a boy I’d be a boy. That that’s just how it worked. So I walked around without a shirt on. I climbed trees and scraped my knees. I was a boy.”

When Gerondale was about 10 years old, a family member – new to the family – started telling him to “put on a shirt and act like a lady,” he said.

That’s when he really knew something wasn’t quite right. When he told adults about it, though, they diagnosed him as depressed and prescribed him medicine and sent him to mental health specialists. By 16, still presenting as female, he was ready to come out to his mother.

“It was easier for me to come out and say that I liked women than, ‘I’m not a woman,’” Gerondale said. “So I told her that I like women and she said, ‘We’re not going to talk about that. That’s not something we do.’ So basically, I didn’t talk about it ever again.”

When he turned 18, Gerondale decided it was time to see the world outside Alaska. So he “puddle-jumped” from state to state – six in about three years – sightseeing and also visiting doctors in hopes that someone would help him medically transition from female to male.

Everywhere he went, however, he’d get similar answers: He was too young to make that decision. He was too unstable to make that decision. He needed to go to a big city. He needed a letter from a therapist before he could transition.

“After a while, I just stopped trying. I got to the point where I was exhausted from trying to get people to listen to me,” Gerondale said. “The majority of those that I talked to told me that I didn’t really know what I wanted, or that I didn’t know what I was feeling. And I got sick and tired of being told that. So I stopped going to the doctor altogether.”

In early 2017, Gerondale settled down in Madras, where his mother lives. After talking to a therapist and one more fruitless visit to a clinic, he stopped into St. Charles Family Care in Madras, where he saw Dr. Leslie McCalister. He told her he needed treatment for some problems with his gall bladder, and that he wanted to talk to someone about gender transition.

“She was like, ‘Gall bladder now, and next time we can talk about testosterone,’” Gerondale said. “After years of … trying to get any medical professionals to listen to me, to finally have a doctor be like, ‘Yeah, that’s fine. I have no issue doing that.’ I didn’t know how to react. I wanted to jump and scream, but also I was like, ‘Is this real? Where’s the contract I have to sign to say that I’m going to do this and this and this and this and this and this?’ But there was none of that. It was just … easy.”

McCalister did her due diligence, of course. She made sure Gerondale could provide informed consent by giving him some things to watch out for and detailing the risks of hormone therapy. But once that process was complete, the path forward was pretty clear, as long as Gerondale wanted to follow it.

"Particularly for an adult patient, if I'm satisfied that I've explained everything and they understand what they're getting into," she said, "then I think it's a pretty easy decision to move forward."

McCalister graduated from medical school just five years ago, but she says she learned very little about transgender issues there. Instead, she picked up most of what she knows during her residency, because a faculty member was interested in the topic. So it's not a huge surprise that Gerondale came across a number of providers who didn't want to move forward with his hormone therapy.

"There are a lot of doctors out there who just don't have any training in this area," McCalister said. "I think a lot of people see it as a specialty issue that's kind of outside their practice, and they don't want to deal with it because of that. But I think that's changing."

In the past few years, transgender care and management of hormones has shifted, McCalister said, from an older school of thought – that the patient can start transitioning after they have certain ducks in a row – to a more modern, patient-driven approach.

"The newer perspective is that the old way just doesn't work for everybody," she said. "For some people, starting that medical transition is really a key step in helping them with other issues. Helping them with social transition. Helping them with mental health issues."

For the past nine months, Gerondale has been taking testosterone. His transition isn’t happening quite as quickly as he’d like, but his voice has lowered, his jawline has changed, his shoulders have broadened and he’s starting to get facial hair. He also legally changed his name to Blaine in February.

He still plans on having “top surgery,” or a double mastectomy and male chest reconstruction, but unlike a year ago, that seems like an attainable goal.

“It’s all much easier now that I know it’s possible,” Gerondale said.

In the meantime, he’s adjusting to life presenting as male, and nowhere does he feel more at ease than the place where his life’s new path finally opened up before him – St. Charles Family Care in Madras.

“I feel like just another face here. I don’t feel like this weird creature coming in with four eyes or whatever. I don’t get stares here. Everyone just treats me like I’m a person," Gerondale said.

“When I walk in here, no one points me out,” he continued. “No one talks down to me. I’m an adult, I can make my own decisions, and people listen.”

McCalister said she is pleased but not surprised to hear about Gerondale's experience at the Madras clinic, where staff members have gone through multiple training sessions with both the health system's Sexual Orientation/Gender Identity workgroup and Allyship in Action, a collaborative of Central Oregon consultants that engages individuals, organizations and communities to promote work around diversity, equality and inclusion.

"I think that's gotten people more comfortable and on board with the fact that this is something we're going to make a point of providing care around," she said. "And I do think the people in our clinic are warm, kind people."