“Please lift your left breast.”

Every time I heard it, it made me cringe. Being transgender, I could never quite get used to being topless in a sports bra or having my classmates make direct references to my breasts. In the PA program, we practice performing physical exam skills on each other so that when we go out to local community clinics, we have a muscle memory for and an understanding of how to perform certain skills and what to look for. It felt like a small sacrifice every day to put on a sports bra, take my shirt off, and hear the word “breast” in reference to my chest. But I gladly made this weekly sacrifice for the betterment of myself and my fellow classmates.

On December 26^th, I said goodbye to making that sacrifice as I said goodbye to my breasts. I had a gender-affirming double mastectomy and chest reconstruction surgery so that I never had to “lift my left breast” again. Following this surgery, I could not lift my arms over my head, sleep in any position other than on my back, or remove my chest binder for 1 month. I figured that I could probably just coast through the rest of the year playing the “I just had surgery” card and never have to take my shirt off in front of my classmates again. The reality is that all I needed to do was say that I did not feel comfortable and no one would have batted an eyelash. But that did not sit right with me for some reason. I have never been one to take the easy way out and this was no exception.

As I reflect on my first year of PA school, I think about all the ways in which I’ve grown, both as a health care provider and as a human. It is impossible to tease apart my personal growth from that which PA school has provided me thus far.  The fast pace of the program forced us to step out of our comfort zone and to lean on each other for support. We all have our own strengths and weaknesses and are stronger together than as individuals.  I do not get the highest grades on exams, sometimes my mind blanks when I get nervous, and the EMR confuses the heck out of me. But I am honest and relatable, I genuinely care about the person sitting in front of me, and I am not afraid. I am not afraid to fail, to be laughed at, to be stared at, to be wrong, to admit that I am wrong, to try new things, or to succeed.

So, on June 11^th, I had my very last physical exam performed on me by one of my classmates. I told him that I was going to bare my chest and that it was my first time ever being topless in front of anyone other than my wife. I also said that I really wanted to do this (for myself) and that I wasn’t afraid or ashamed (ok I was a little afraid). I told him that I was proud of my chest and proud of my journey and that I didn’t feel like I had anything to hide. That day, baring the scars on my chest to my classmate and our faculty grader (which happened to be the program director), felt like the end of a chapter in my life and the icing on the cake for my first year of PA school.

I am not the only one in my class who has faced adversity during this first year. Many of my classmates have had both open and private struggles – all while having to “keep it together” and keep pushing forward. And while it’s easy to get caught up in grades and scores as way to measure growth, we are constantly reminded that there is more. More than the weekly exams and metrics, it is these types of unique challenges and experiences that shape the person that we become and improve the quality of care that we are able to provide our patients.

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