In their daily work with transgender patients, Deborah Dunn and Elyse Pine see too much isolation, fear and tragedy.
So the difficulties presented by COVID-19 have, in many ways, felt like familiar enemies. Pine and Dunn have made it their mission to prevent these stresses and traumas from growing exponentially for the young people they serve.
“This is completely essential care. People’s lives depend on this,” said Pine, a pediatric endocrinologist at Chase Brexton Health Care. “So we had to find a way to continue doing it.”
Pine and Dunn, a veteran physician assistant, have worked together to keep operations humming at Chase Brexton’s Gender JOY program, which serves about 1,800 transgender, non-binary gender and gender-diverse youths in the Baltimore area and beyond. The program offers medical aid in the form of puberty blockers and hormone treatments but also goes into communities to help patients gain comfort in their homes, schools and places of worship.
Dunn and Pine know their patients’ medical, social and emotional needs have not lessened simply because large sectors of daily life have been put on hold in the pandemic. In some cases, those needs might be greater because young patients are isolated with family members who do not understand or tolerate their identities.
“I’ve definitely seen patients who really get a lot of support and strength from their friendships and connections in school and from seeing people in real life,” Pine said. “So the isolation has been taking a large toll.”
She and Dunn have shifted much of their work to telemedicine while finding creative ways to make sure patients receive the medication needed to continue with transitions or puberty blocking. Before the pandemic, for example, many patients went to Chase Brexton’s offices to receive testosterone shots. But in homes where family members are unable to give those shots, Pine has switched patients to patches or gels.
Dunn, meanwhile, said she’s seen powerful benefits from practicing telemedicine. She’s reached some people who might have been uncomfortable traveling to in-person appointments. As she spoke about her work on a recent morning, she had just finished an appointment with a college student in Denver.
“There are so many areas, even in Maryland, that have poor access to trans care,” she said.
Dunn had worked as a physician assistant in emergency rooms and family practice settings for almost 30 years before she began specializing in transgender medicine in 2009. The 63-year-old Laurel resident said she’s part of the LGBTQ community but knew little about trans issues. She now considers the work a calling and the “the most gratifying job I’ve had in my life.”
“My patients teach me resilience,” she said. “How to live authentically as myself.”
Dunn and Pine share an office but more importantly, a similar passion for the work that has bound them.
“When I meet kids, I really find that they’re experiencing distress,” said Pine, a 41-year-old Howard County resident, who began working at Chase Brexton in 2015. “And then, people are so much more comfortable in their own skin as they go through their transition. So for me, to get to see them go from suffering at the beginning to blossoming, I love it.”
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