Transition and Growth: A Reflection on my First Year in PA School

“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 26th, 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 11th, 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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7 responses to “Transition and Growth: A Reflection on my First Year in PA School

  1. Dorian, I appreciate your candor and courage in sharing this reflection on this element of your experience in PA school with all of us. Thank you for offering me a window into how your gender-affirming surgery intersected with your experience practicing physical exams with your PA student and faculty colleagues. I have a strong sense that your gift for writing may be connected to your gifts as a clinician!

    1. Thank you Niki. I make a concerted effort to be open and honest about my identity and my experiences because I feel fortunate enough to be in a position where I can effect change. Trans visibility is important for a number of reasons that I could talk to no end about.

  2. Thank you for sharing your experiences, Dorian. Your transparency and visibility are part of what help create a safe and supportive environment for patients and colleagues alike. I appreciate hearing about your journey and am heartened you are one of our future health care providers.

  3. Thank you for this generous teaching moment. Your patients, and all of us, will benefit from your experience, perspective, and compassion. Good luck this year!

  4. Thank you for your article! As a homosexual male applying to the program this year, it was so helpful to hear your experience. Wonderfully written 🙂

  5. Dorian,
    Thank you for sharing your experience of top surgery! We all bare more of ourselves to our peers than we knew we would when we started PA school. You have the courage to discuss it. It made me smile to read about your pride and being unafraid.
    Good luck in clinical year!

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