During the early days of the COVID-19 pandemic, nonemergency surgeries were suspended, delaying gender affirming procedures for months. Paula M. Neira and other nurses were redeployed to respond to the pandemic, and the Johns Hopkins Center for Transgender Health had to put a moratorium on new patient intakes.
“Paula is a clinical kind of leader in health care, because I really saw that in COVID,” said Dr. Deborah Baker, the Senior Vice President for Nursing for the Johns Hopkins Health System.
“Paula became a very integral part in the Department of Nursing and then for the hospital in manning the emergency command center and using all her skills to help us plan for these surges in staffing and resources,” Baker continued.
Since opening in 2017, the Center for Transgender Health has about 50 clinicians involved in comprehensive transgender health care and has interacted with over 2,800 patients. They offer gender affirmation surgery and nonsurgical services across such fields as dermatology, fertility, and voice therapy. What drives Neira, the center’s inaugural clinical program director, is the oath she took as a U.S. Navy officer.
“I swore that I would support and defend the Constitution and that I bear true faith and allegiance to it,” said Neira. The Desert Storm veteran served primarily as a surface warfare officer until 1991.
“When people are denied access to medically necessary care simply because of other people’s prejudice, that offends the notion that we’re all equal and that we’re all free and that we all deserve dignity and respect,” she said. “That’s why I do the work to try to remove those barriers, to try to allow people to live their most holistically, healthy and authentic lives.”
Neira, was the first transgender Navy veteran to have her name corrected on her discharge paperwork by order of the Navy. Neira began a new career as a nurse and lawyer.
Neira started working for Johns Hopkins Medicine as a travel nurse and became a nurse educator in the Department of Emergency Medicine in 2008. With the Modern Military Association of America, she helped lead the repeal of Don’t Ask, Don’t Tell and change the military regulations that had previously barred transgender people from serving in 2016.
“Getting large institutions to change, to evolve is a long process,” said Neira. “One of the hardest things to accept is that [for] people that suffer injustice, justice will never come fast enough. The pace is always too slow, but the motto of our center is ‘ever forward,’ semper porro in Latin, because that’s the only direction you can move in.”
Neira is a member of the LGBT Bar Association and a core team member at the Hopkins Medicine Office of Diversity, Inclusion and Health Equity. Neira currently serves as the Secretary on the Board of Directors for GLMA: Health Professionals Advancing LGBTQ+ Equality.
Preexisting health disparities for LGBTQ+ people has been exacerbated by the pandemic, noted Neira.
“Within the LGBTQ+ community, there’s a higher risk for violence or suicidality,” she said. “We know that there’s a higher risk for anxiety, depression, that there’s a higher risk for substance abuse, and all of that is really grounded in stigma and discrimination.”
Stigma and discrimination impacts the social determinants of health, such as the ability to get a job, have stable housing, and interact in society as an equal citizen.
Neira says a challenge for the center is also true across the American health care system: ”the patient volume outstrips our resources.”
“I would like to have more surgeons and to have more primary care providers who have the cultural and clinical competence to provide really good care to the community so that we can lower some of those barriers. I would like the insurance system to be changed so that people can access coverage.”
Baker says Neria is a consummate educator, who has been called upon by the community, professional organizations and by the Navy to give lectures around her experiences and advocacy.
“Paula has an intuitive sensitivity to people who have had challenges in the health care system, and I think that insight is just helpful for all of us because health care is complicated,” said Baker. “It’s one person at a time and it’s also a community at the same time.”
Decades after leaving the military, Neira became a co-sponsor of the USNS HARVEY MILK. Sponsors are charged by the Secretary of the Navy to imbue a ship with their spirit, personality, and character. They support the crews’ morale throughout the ship’s operational life.
USNS HARVEY MILK is named for the first openly gay person elected in California. Milk was dishonorably discharged from the U.S. Navy after being forced to describe his sexual relationships. It is the first ship in the Navy named for an openly LGBTQ+ person.
This article is part of our Newsmaker series that profiles notable people in the Baltimore region who are having an impact in our diverse communities. If you’d like to suggest someone who should be profiled, please send their name and a short description of what they are doing to make a difference to: Diversity, Equity, and Inclusion Editor Kamau High at firstname.lastname@example.org.
Stephanie Garcia is a 2020-21 corps member for Report for America, an initiative of the GroundTruth Project, a national service program that places emerging journalists in local newsrooms. She covers issues relevant to Latino communities. Follow her at @HagiaStephia.