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Loving ignorance, how acceptance of a lack of knowledge led to a whole new model of care

In 2019, we contributed our first hand experiences to a study being conducted by a team at the University of Oxford. The research sought to understand the role of bias in trans healthcare and the barriers that this put in place for gender diverse individuals. Dr Magdalena Mikulak was a qualitative researcher on the study and she recently published an article based on her work.

Given the lack of training available to healthcare professionals on trans healthcare and the subsequent lack of knowledge of trans health, bodies, and identities, the study explores the function of ignorance in the trans patient/health professional relationship.

 

Dr Helen Webberley was one of the 18 professionals interviewed as part of the study and her experiences were mirrored by other participants quoted in the piece. One such participant shared their experiences of encountering their first trans patient who was struggling to find a GP willing to prescribe hormones:

That was my first experience of trying to navigate this area in terms of prescribing … It certainly piqued my interest and made me think well … if this patient is struggling, I wonder how many others are? And it really made me think, this isn’t good enough. When I realized that there is no other option for patients … if the GP is unable to prescribe and there is no endocrine support then actually that is the end of the road for trans people in terms of accessing hormone therapies … I was absolutely horrified. I thought this is … a really terrible situation and it’s a dire situation, this puts people at risk … and okay, as a GP what can I do? I can teach myself and I can navigate this for myself in terms of my own practice, but I wanted to do something more. I wanted to know whether I could make a contribution to improving access to treatment.

 

The GP in question went from this position of wanting to improve access to treatment to doing something about it. Dr Mikulak describes this as: “loving ignorance, an acknowledgement of one’s own ignorance, of the unequal playing field and its harms and one’s own privileged epistemic position in affecting change can be catalysts for transformation. Importantly, loving ignorance is the ‘opposite of willful ignorance’ (Tuana, 2006, p. 15), operating from a sense of humility towards difference

The article goes on to explain:In the context of trans health, to be lovingly ignorant is a point of realization and departure, rather than a destination, for to be lovingly ignorant pushes one to not only acknowledge one’s own dead angles, but also to actively work to overcome them in ways that support rather than burden the trans community. For the GP quoted above, this meant learning about the current processes and becoming involved in improving them also through getting to know their local trans community, taking the time to listen to their grievances and eventually becoming their ally and advocate.

Dr Webberley is often quoted as saying she learned everything she knows about trans individuals and their needs from the individuals themselves. The healthcare was simply an adaptation of expertise and medical learning she gained from her many years working as a GP, supported by insights and teachings coming out of WPATH and the Endocrine Society and other international centres of excellence. This pathway created the foundation for the GenderGP model of care, which has since been refined and perfected and which supports thousands of individuals all over the world with affirmative care to help them to live their lives more easily.

 

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