By Dr. Bobbi Glass, Louisville KY
(Trigger Warning: This article includes topics related to toxic mental health, conversion therapy and suicidal ideation).
When I was driving to my new job and home in Kentucky in the Winter of 1974, “Transgender Wellness” was not even a phrase in anyone’s vocabulary. I had graduated from Duke University the year before and gone to work for a radio broadcasting company in Chapel Hill, North Carolina. They purchased two dying radio stations from WLEX-TV in Lexington, KY and asked if I’d be interested in moving there and working with a small team to get them re-licensed with new call letters, re-branded, on the air 24/7…and dominating the market within Year 1.
Rock ‘n Roll was my strong suit—and even though I was still very much “in the closet”—everything I needed to resume living a double-life in Lexington completely fit into my Volkswagen Bug. So off I went to the Bluegrass to continue living in the closet, only now with a bigger paycheck and the confidence that our new stations, WBLG-AM and WKQQ-FM, would soon make me a celebrity in Lexington radio.
During my drive to Kentucky in the Winter of 1974, it had not even been one full-year since the American Psychological Association (APA) and the American Medical Association (AMA) had decided to no longer classify “homosexuality” as a mental illness and to recognize it as just another aspect of the human condition. “Transsexualism” and “Transvestism,” on the other hand, were overlooked and going to remain a mental disorder with the APA and AMA for another 38 years…until the Winter of 2012 when those two organization finally decided that being transgender was also just another naturally-occurring aspect of the human condition. Whoopee. Progress. Finally.
So for someone born in the Appalachian coalfields of Virginia in 1950…who knew from her earliest memories around age 3 or 4 that she was a girl…it wasn’t until I was 62 years old in 2012 that the mental and medical healthcare professionals of America decided I was no longer a mentally disturbed, sexual deviant in their book. Keep moving, please. Nothing abnormal, perverse or deviant to see here any more…
Can you even begin to imagine the psychological and physical toll that kind of entrenched professional, cultural and toxic ignorance inflicted on so many millions of us over our lifetimes? Can you even begin to imagine the numbers of people who lived a shadow life and went to an early grave from all the physical damage to their health caused by internalized, nonstop terror, anxiety, depression, anger, abuse, bitterness, rage and resentment?
In all of this tragically damaging and toxic mental health environment, though, there was something surprising and amazingly beautiful about Louisville, Lexington and Northern Kentucky in the 70’s. Hundreds, if not thousands, of people in those three urban areas knew better. They openly accepted and celebrated their LGBTQ+ friends, families and neighbors. All the state’s major cities already had thriving LGBTQ+ communities. Not everyone hated and feared us! Bunches of people even wanted to be our friends! So very many Kentuckians completely got us!. So many loved us. So many wanted us to be happy. So very many understood our dreams and frustrations.
And that’s why I’m still alive today.
Would anyone really be surprised to learn that most of my life can be characterized by persistent self-loathing, self-destructive habits, risky behaviors, and suicidal ideation that led to dozens of attempts?
Fortunately, my employee healthcare benefits included generous support for mental health counseling and treatment. Fortunately, I was smart enough to know I was going to die young without treatment. Fortunately, I knew I had no excuse to not get help. I surrendered in 1982.
Only one big problem, though. I didn’t realize I was part of a religious cult, and their idea of the kind of professional help I needed is now known as Conversion Therapy…more accurately described as Conversion Torture. After nearly two decades in Conversion Therapy, I lost count of the number of times I tried to kill myself.
It wasn’t until my last attempt that I came to the conclusion that I no longer had anything to lose by coming out to the whole world as transgender. What was the worst that could happen? If it killed me, if I lost everything I had, so what! With the trajectory I was on, that was my obvious ending point anyway.
So I came clean and announced to the world my intention to medically transition and…I did lose nearly everything including a 35-year marriage…and I started all over again.
By this time, though, I had found a wonderfully, trans-competent therapist. Honestly, I don’t know how anyone can successfully transition without competent counseling, if—like me—they come from completely non-supportive families of origin. Within the transgender world we each must cross our own unique minefields where a misstep in any direction can have disastrous, long-term consequences. This is the single, most important reason I never presume to tell another trans person what they should do, other than to obtain the best professional help they can afford.
So, as I began working with my therapist, Carrie Hunter, and became more involved in the trans community. I was fascinated by her directory of all types of providers for things like hormone replacement therapy (HRT), electrolysis and speech therapy,for example. As I discovered new resources, I’d share them with her and together we compiled a growing directory of trans-related providers and small businesses. We were clueless at that time that our directory was the start of what would soon become known as the KTSG Transgender Wellness Resource Guide. Carrie is still editing it and contributing to it to this day.
One session several years ago—around late 2014/early 2015, Carrie told me she was notified that the University of Louisville School of Medicine had just received a huge grant to develop the nation’s first 4-year med school curriculum for LGBTQ+ healthcare, and that they had asked her for names of people to serve on their advisory group to develop that curriculum. She recommended that I contact them immediately…and I did. They brought me on board right away, I’d like to think…because my passion for access to healthcare is obvious. Access to healthcare for LGBTQ+ residents is complex and problematic on so many levels for most people in our community. I can’t tell you how ecstatic I was to be a part of this initiative!
At that time, Carrie and I only knew of two endocrinologist who would prescribe HRT, and they were both extremely conservative in their approach, using low doses of oral estrogen and refusing to consider injections or to include progesterone. We only knew of one plastic and reconstructive surgery practice that offered breast augmentation and some milder facial feminization surgery (FFS), but they didn’t advertise their services because they didn’t want their more lucrative cisgender clients knowing they also served transgender women. There were about four primary care physician comfortable with trans patients for routine healthcare. The Speech Therapy Department at the University of Kentucky Chandler Medical Center was the only group actively working with transgender clients on their voices. We knew of five trans-competent mental health providers. So from our perspective our starting point in Louisville was, at best, humble.
The catalytic power of the UofL School of Medicine to assemble a diverse assortment of interested providers, however, was immense. I always believed the right hearts and talent already lived here, it’s just that no one had ever been able to figure out a way to bring them together and to get them talking about our healthcare needs…until the UofL Med School decided to start inviting large numbers of practitioners to events at the school and feeding them lunch—And teaching me one of life’s most important lessons along the way: “Build it and they will come. Feed them and they will stay.” It was a dream come true to see over a hundred local medical providers all in the same large lecture hall glued to presentations focused exclusively on our LGBTQ+ healthcare issues.
I will never forget one of the first such events where we were teaching about HRT and the treatment protocols of the World Professional Association for Transgender Health (WPATH) for a regiment of estrogen and progesterone injections to treat transgender women…and how—at this time—there was only one endocrinologist left practicing in Louisville…and he steadfastly refused to prescribe injections or any regimen that included progesterone.
A young Primary Care Physician with Norton Community Medical Associates asked from her seat in the audience, “Why can’t Primary Care Physicians and Nurse Practitioners prescribe and administer HRT? Why does it have to be something only an endocrinologist can do?”
There were a few seconds of silence, then murmurs, then almost an immediate response of consensus—There was absolutely no reason at all why only endocrinologist could do this! Any Primary Care Physician and Nurse Practitioner who wanted to embrace the WPATH protocols and monitor bloodwork could start providing this treatment right now if they wanted. The physician who originally asked the question was Dr. Lori Caloia, and I could have kissed her right there in front of the whole crowd!!! Instead, I asked her for her office number and made an appointment that day for her to take over my HRT…which is exactly what happened the following week. From that day forward, Louisville started becoming flush with HRT providers following WPATH protocols.
In another totally unexpected surprise, both the UofL School of Nursing and UofL School of Dentistry wanted to accomplish the same curriculum goals for their programs, too. All the medical leadership of the University of Louisville quickly coalesced around infusing LGBTQ+ healthcare training throughout their four-year curriculums. And it wasn’t to be cool or trendy, either. Read that again. Belonging to the LGBTQ+ community is highly correlated to negative healthcare outcomes both horrible and unacceptable. You must be absolutely clear on this point: Our emphasis on LGBTQ+ healthcare in Louisville was so high because our mortality rate was so tragically high.
Back to the Louisville-area capacity for providing trans-competent mental health counseling… Carrie Hunter, at Nova Counseling in New Albany, IN has been a key figure in training local providers. Through Bellarmine University, local and regional therapists have been able to acquire continuing professional training credits in caring for our mental health through her efforts.
One of the proudest moments in my career came early in October 2015 when Dr. Al Mohler of Southern Baptist Theological Seminary convened a three-day conference of some 2,300 members of the “Association of Certified Biblical Counselors” on how to practice intensive Conversion Therapy “to lead those lost in homosexuality and transgenderism out of their sin and convert them to being heterosexual.” At the very same time, Carrie Hunter and I were training therapists at Bellarmine on how to undo the damage done to so many by harmful theology. To this day, I’m still astounded at how Louisville was the epicenter of the best vs. the most vile practices in LGBTQ+ mental health that day. I was especially proud of all the people like Chris Hartman from the Fairness Campaign, Maurice Blanchard at Highland Baptist Church, and Colleen Foley from Metropolitan Community Church of Louisville who showed up every day along Lexington Road to protest and decry the dangerous practices of Conversion Therapy…practices which are now outlawed for those under 18 in Louisville, Lexington and Covington, as well as nationwide in several countries like Germany, Canada, Ecuador, New Zealand and Brazil.
It was only a matter of time, of course, before my path crossed that of Sarah McKinney’s. To avoid violating confidentialities, let’s just say we were both consumers of Transgender Wellness when we first met in 2014. Sarah wasn’t yet out when we met, and she was employed at a very high level in the Information Technology (IT) division of UofL Health. I believe the incredible magnitude and visibility of what was happening just a block away at the UofL School of Medicine was all the encouragement she needed to convince herself that she need no longer fear any negative employment consequences that too often follow one’s decision to live full-time. She often talked about how scary that decision was and how much she regretted delaying it for as long as she did because, as we all now know, UofL supported her decision fully and without hesitation. All her fears—just like mine—never materialized, because Louisville is full of people willing to include and accept us.
Sarah was thrilled to be associated with UofL Health and the Med School. As a UofL employee, she quickly became the face of UofL Health for the LGBTQ+ community. I remember running into her one evening at a big, fancy reception at the President’s mansion in the Highlands. It was the first time I’d ever been to an event at the President’s home, so I was very excited. Sarah, on the other hand, had begun growing tired of how often her presence at events was requested by the president. She wished she could leave! She truly had become the face of our community’s embrace of its LGBTQ+ population, and she definitely preferred being out of the spotlight and somewhere quiet, calm and private instead.
The Transgender Wellness Summit was Sarah’s baby. Like me, we had both been brutalized and traumatized by growing up trans in the south. Both of us wanted to do all we could to spare others from the hardships we had experienced. So I was quick to jump on the bandwagon with her to make the Summit a reality. There was just one major problem, though…Thursday evenings were the only time during the week that were convenient for Summit volunteers to meet…and I’ve had no life on Thursdays outside my graduate school teaching duties for over 20 years now.
So I became a cheer leader that could never show up for the meetings! Even worse, the Summits would be scheduled on days when I had more pressing obligations preventing me from attending. So even though I know I’m a key figure in Louisville’s progress in Transgender Wellness, the truth is I’ve never even been able to attend a single Summit. I’ve got my fingers crossed for 2023, though!
The transgender-related medical and mental healthcare in Louisville continues to soar. Four years ago, we had to travel far out of state to seek specialties like Gender Confirmation Surgery or any kind of FFS that involved “bone-work,” for example, plastic and reconstructive surgery that involves cutting or shaving the facial skeleton (such as forehead or jaw reconstruction). Now we have Dr. Witten performing GCS and Dr. Fensterer providing those specialized plastic and reconstructive surgeries here. Both of them work at a world-class level, too, with exceptionally high reviews.
In addition, we have multiple areas of growing strength and support within all three of the area’s major hospital corporations: Baptist Health Systems; Norton Health and UofL Health. The community of mental healthcare providers has exceeded anything I ever imagined in terms of their sheer numbers and affiliations to WPATH. In terms of the licensing of mental health providers, another bill is before the General Assembly to ban Conversion Therapy statewide for those under 18.
When I think back on that drive moving to Kentucky in 1974 and all of the constant terror of living with Gender Dysphoria I had on a daily basis for the first 59 years of my life, I still can’t believe the oasis of wellness in which I now live. I’m so grateful for so many who gave me the opportunity—not only to live an entirely second life—but to be living my best life ever. I always believed all the right people and parts were here, it was just a matter of identifying them and engaging them in dialogue, networking and giving them an opportunity to share in capacity-building.
In a world where there is so much intense cultural pressure to live in conformity…In a world where too many die regretting that they never had the courage to live a life true to themselves, but chose to live the life others expected of them, instead…There’s really nothing to compare to living the reality of a dream come true. Being a transgender woman living in wellness and abundance—with more than I ever imagined for that future as a child growing up in the Appalachian coalfields—is truly my day-to-day reality now. If that’s not a dream come true, I don’t know what is.
And it all happened here in Louisville, Kentucky—Where it’s also time to begin inviting everyone to the 2023 Transgender Wellness Summit!
The Summit is a gateway to wellness for the transgender and nonbinary community. At least once a year we want to have one specific time and place where everyone can come face-to-face and be with others who all have at least one thing in common…They want to make Louisville known as a city where our transgender and nonbinary neighbors live well and have what they need to thrive.
We want people to easily discover the richness of resources here devoted to living well for anyone connected to life under the transgender umbrella. As you’ll see when you come, we have a very expansive definition of “Wellness;” too, that includes all the major community areas of life such as Education, Housing, Employment, Public Safety; Social Justice, Spirituality and ReCreation.
We want you to be grateful you came because we are confident you will leave with something that’s going to show up tomorrow in the way you do your job of living your best life. We want you to discover resources that will make such an important difference to your quality of life, that you’ll tell your friends about it and come back with them next year. Please plan on visiting!