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“I Know Who I Am”

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July 13, 2021

The author is Mackenzie P Lerario, MD, NYS CPS/CRPA-p (They/them/Doctor) is a board-certified vascular neurologist, physician activist, telehealth advocate, peer specialist, and social work student at Fordham University with a field placement at the National LGBT Cancer Network.  Dr. Lerario has >30 peer-reviewed publications in prominent medical journals and frequently presents their work at major international conferences.  They were the founding medical director of the NewYork-Presbyterian Mobile Stroke Treatment Unit Program. 

As an openly-identifying pansexual, transgender and nonbinary neurologist, they are a member of the World Professional Association of Transgender Health and the Gay and Lesbian Medical Association.  They serve on multiple regional and national organizations as a volunteer advisor on promoting equity and inclusion for sexual and gender minorities, including the American Heart Association and American Stroke Association.  They are a founding member of the Gender Equity Working Group of the LGBTQIA+ Section of the American Academy of Neurology.  They are the founding director of Greenburgh Pride in Westchester, NY.

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Trigger Warning:

The following may contain language not suitable for young children and contains reclaiming of LGBTQ+ slurs for empowerment purposes.

I am…

  • Mackenzie
  • They/them (or Doctor)
  • A physician,
  • An activist,
  • A student of social work,
  • A certified peer specialist and recovery coach,
  • A speaker,
  • A writer,
  • An academic,
  • A clinical researcher
  • A partner,
  • A friend,
  • A parent,
  • A child,
  • A colleague,
  • A neighbor,
  • And a local community member.


I am also transgender…


Therefore, most people know me as…

  • Michael
  • He/him (without ever asking my pronouns).
  • And a physician.
  • But the transgender physician,
  • The transgender activist,
  • The transgender social work student,
  • The transgender peer specialist and peer advocate,
  • The transgender friend,
  • The transgender parent,
  • The transgender child,
  • The transgender colleague,
  • The transgender researcher,
  • The transgender


I am so much more than my gender, and I don’t appreciate my gender coopting the entirety of my complex identity as a human being.  If my gender is the first thing thought of when mentioning me, then that person probably doesn’t know me well enough to be describing me.


But I understand why others use this word so frequently to label me.  When I walk on Main Street and Broadway in Tarrytown or Beekman Avenue in Sleepy Hollow, I see many healthcare practitioners, activists, students, specialists, parents, children, neighbors.  But I don’t see many people who look like me.  That is, other transgender people.


So I shout my identity, not because I want to, but because I feel I have to. 


I have to…

  • To be seen,
  • To be heard,
  • To be listened to,
  • To be respected,
  • To be provided the same level of dignity, service, privilege and compassion I was so easily granted before I came out and transitioned.


I shout to Tarrytown and Sleepy Hollow, that I am…

  • An openly-identifying transgender community member,
  • Out and proud,
  • Willing to stand up for myself
  • And speak my mind,
  • Unapologetically
  • And authentically as myself.


I will not hide…

  • My face
  • Or my form
  • My scars
  • My vulnerability
  • My messiness
  • My beauty
  • And my many, many wonderful imperfections.


I am uniquely different.  And I will not make myself less comfortable, so that others who hate me, misunderstand me, or choose to remain ignorant of me, can be more comfortable in my presence.


I will no longer…

  • Hesitate before using the woman’s bathroom,
  • Allow someone to point and laugh at me on the streets of Tarrytown without confronting them,
  • Make concessions that my pronouns are “too hard“ to get correct,
  • Date in secret because others are afraid to be seen with me in public,
  • Walk away in shame if I am verbally and/or physically assaulted in my own neighborhood,
  • Believe that “other” is an appropriate option for my gender identity and sexual orientation on government and healthcare forms,
  • Listen to those who say my “life would be easier” if I presented as femininely as possible,
  • Believe that I need to be paid less, work harder, or need more degrees because I am a gender or sexual minority, or because I am a woman,
  • Shave my face or body hair because others pressure me to do so as a woman,
  • Accept that my lived experience is not considered the valuable expertise it is,
  • Advocate that a DSM-5 diagnosis should be required to get medically-necessary healthcare,
  • Allow my boundaries to be transgressed so I can fit into a gender binary world that doesn’t accommodate me,
  • Or remain silently complicit when others receive similar injustices because they may look different, sound different, or be different.


However, even in 2021,

Even after the US Senate confirms a transgender woman to a federal government position for the first time,

Because I am openly transgender,


Many people I meet can’t believe I am…

  • A physician,
  • A colleague in their line of work,
  • A parent,
  • A good houseguest,
  • Or a friend,
  • A partner to take home to parents,
  • Or a neighbor in their community,
  • Or employed as something other than sex work,
  • Or mentally healthy,
  • Or competent,
  • Or stable,
  • Or even worth a damn.


But those are the same people who can never understand what I survived, what many others like me have survived.  The pain of coming out and performing a public gender transition in an area with too little gender diversity.


The depths of…

  • Rejection,
  • Stigma,
  • Ridicule,
  • Tokenism,
  • The bystanders,
  • The onlookers and the lookey-loos,
  • Other people’s palpable schadenfreude,
  • The suffering
  • And hate,
  • Self-loathing,
  • The violations,
  • The insincerity,
  • The gaslighting,
  • And the emotional labor…


That I have come back from,

starting the moment three simple words left my mouth:

Those words were: “I am transgender.”


The difficulties of being transgender in a society that allows multiple US states to even consider taking healthcare away from tens of thousands of innocent, gender-expansive children.  Multiple US states still allow for conversion therapy of sexual and gender minority children and adolescents.  And some argue that homophobia and transphobia is nonexistent… That being gay is no longer a “big deal”.


If you are a human, you are capable of being transphobic and homophobic.  And if you are cisgender heterosexual, you likely have not fully confronted the many personal implicit biases that come with accepting the full spectrum of gender and sexual diversity.


And if coming out and transitioning proved anything to me, it is that I can survive anything and everything life throws at me.


“I am transgender.”


Those three words have gained me:

  • The control
  • The perspective
  • The patience
  • The tact,
  • The empathy,
  • The self-love,
  • The freedom,
  • The education,
  • The acceptance,
  • The lifestyle,
  • The culture,
  • The credibility,
  • And the expanded humanity,


To be a…

  • Strong,
  • Independent,
  • Boundaried,
  • Healthy,
  • Focused,
  • Determined,
  • Loved,
  • Successful,
  • Forgiving,
  • Confident,
  • Productive,
  • Critically-thinking,
  • Open-minded,
  • Human being.


So I leave here today the same:

  • Openly transgender,
  • Nonbinary,
  • Genderfluid,
  • Genderpunk,
  • Gender nonconforming,
  • Queer,
  • Pansexual,
  • Dyke,
  • Tranny,
  • Shemale,
  • Faggot,
  • Sissy,
  • Former straight cisgender male,
  • Whose gender was incorrectly diagnosed by my mom’s obstetrician before, during and after my birth. That is to say I was “assigned male at birth.”


Who is also…

  • Neurodiverse, in recovery from mental health disorders and substance addiction,
  • Disabled,
  • A survivor of the abuse of our current healthcare system which ignores the basic science and biology of gender and sexuality,
  • I am an Italian American, another queer Roman Catholic turned atheist because too often hate speech is allowed to advocate as religious speech,
  • Who sings to themselves while dancing to headphones on the streets of Tarrytown,
  • Who will tell you my pronouns and gender and help educate you if you do not know what that means.


I will fight– with every ounce of privilege and power I still retain after a gender transition– to make this area more inclusive, more diverse, more accepting, and more inviting to brave queer folks who may wish to better enjoy the beauty and charm of the Hudson Valley.


Leave here today how you may…

  • Give to the cause,
  • Volunteer for the cause,
  • Sign a petition for the cause,
  • Correct others who are counter to the cause,
  • Educate yourself and others about the cause,
  • Inquire at your next doctor’s visit why they didn’t ask you your pronouns,
  • Stand up for a stranger, friend, colleague, fellow student, or family member who is misgendered,
  • Hire, promote, pay fairly and mentor more transgender and nonbinary people,
  • Find out if your school, organization, business, or institution has a written gender transition policy and if it covers gender-affirming medical care,
  • Contribute to police reform initiatives,
  • Learn that sex work is work, and transgender sex workers have the same human rights as anyone else,
  • Stop assuming a person’s gender just by what they look like.
  • And so many others I am too tired to continue to say. Please read a book or a website or a pamphlet or attend a lecture, or talk about gender and sexuality openly with the people in your life.


But, however you leave here today, you will not take away from me my right to shout proudly my identity and educate others on it.  And there are no longer any hurtful words or actions in response to my gender and sexuality that I haven’t already been hit with before.  So let’s dust ourselves off, stand up one more time, and take action to fight back against the gender binary and heteronormativity.


And if you believe the fight ends on July 1st… reconsider.  I am gay every day of the year.  Let your rainbow flags fly in July.  Continue to wear pronoun pins.  celebrate and support us every day.  Learn, make mistakes, grow, do better.  Because we can, and that is what it means to be human.

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