Episode 66 - Dr. Zoë Julian: Protection and Self-Advocacy In Healthcare Settings For Queer, Trans, or Non-Binary People of the Global Majority
This episode opens with Josie speaking about a recent invalidating and frustrating experience at a doctor’s visit, which prompted this re-run of the conversation with Dr. Zoë Julian (they/them), a Black and queer educator and obstetrician-gynecologist.
Zoë and Josie discuss ways for queer, trans, and non-binary People of the Global Majority to find medical care that fully supports them on their fertility journey, and how healthcare providers and community workers can protect and support their queer, trans, and non-binary patients and clients.
[ID: A beige background and orange semi-circle. Text reads: The Intersectional Fertility Podcast Episode 66: Dr. Zoë Julian @doczo and Josie Rodriguez-Bouchier @intersectionalfertility.]
Read Zoë's article: Community-informed models of perinatal and reproductive health services provision: A justice-centered paradigm toward equity among Black birthing communities
Take the course Structures & Self: Advancing Equity and Justice in Sexual and Reproductive Healthcare.
Follow Zoë on Twitter and Instagram.
Donate to Indigenous Women Rising, and National Network of Abortion Funds.
Let us know your thoughts in the Free Intersectional Fertility Qmunity. Or, join the Paid Intersectional Fertility Qmunity for bonus content and webinars. ($26/month, cancel anytime)
Episode Transcript:
Disclaimer: This is an automatically generated transcript edited to be more readable. It may not be 100% accurate.
[00:00:00] Josie: I'm Josie Rodriguez-Bouchier, and this is the Intersectional Fertility Podcast, where ideas and identities intersect to deepen our understanding of fertility and ultimately our Whole Selves.
[00:00:32] Hello friend, welcome back to the podcast. I'm so happy to have you here today. So, today I wanted to bring back one of my absolute favorite episodes with Dr. Zoe Julian. Today we talk about ways that queer, trans, non binary folks, and especially those of the Global Majority, can protect themselves in medical settings and find the care that they need and deserve.
[00:01:00] And then we also talk about ways that healthcare practitioners can support their queer, trans, non-binary, BIPGM patients and clients. So, this is a topic near and dear to my heart, and one that I feel extremely passionate about.
[00:01:16] Recently, I had a very disappointing, frustrating experience at the doctor, which I'm sure y'all can relate as queer folks, you know, it's not just a matter of going to the doctor. We also have to assess where we're going to be treated safely and equally and with the care that we deserve, right?
[00:01:40] So yeah, I had a really, I don't know what the word for it is really, but when I went to the doctor, they had, in their intake forms, options for pronouns and places, you know, to put gender, you know, different genders than just cis female, cis male, and, you know, things like that in their intake form.
[00:02:02] So, these cues that, hey, we're LGBTQ+ friendly, right? And they were actually listed as LGBTQ+ friendly in the, you know, according to their website and the listing that I found through my insurance. Which is why I picked them. So, a privilege that I hold is that I can choose whether or not to disclose my gender and my pronouns.
[00:02:28] And if I don't feel like I'm in a safe space, I can pass as cis or as straight or heterosexual. So, you know, this is a privilege that I have, absolutely. And a lot of folks do not have this privilege and they don't present in a way that they can pass. They have visual cues, you know, that people will read them as queer, or trans, or any of the above.
[00:02:54] So this is something that I'm actually struggling with on my own is kind of how I'm, how my gender is perceived by others versus how I feel on the inside. So that's kind of, that's a different topic, but something that I'm going through as well. So I made the decision to go ahead and disclose my gender and my pronouns and that I'm married to a woman and you know, all of that.
[00:03:17] So then I go in with the doctor and it was as if they didn't even look at the paperwork that I turned in. They misgendered me the entire time. They did not use my pronouns. They assumed my partner was a cis man. They asked the gender of my kids in just like light conversation. It was appalling and psychologically taxing to say the least.
[00:03:44] I felt humiliated. I felt Like I was not getting the care that I deserved. I felt like less of a person. I felt invisible. I felt so angry at our medical system here in the US and what we have to subject ourselves to just to go get basic care, not to mention the whole financial side of things and how appalling that is as well.
[00:04:09] So I came home and I vented to my wife and cried and it was awful. It really, it took a huge toll on my mental health, just that whole experience. And I'll say it was quite common, you know, it's quite a common experience that queer folks go through when we decide to go see a doctor finally.
[00:04:30] And also, you know, it wasn't nearly as harmful, dramatic as some of the other experiences I've heard from patients that I work with and, and, you know, other friends and colleagues who have had way worse experiences than that at the doctor. So I just, I'm feeling like this is something I know that there are a lot of healthcare practitioners that listen to this podcast and you know, it's up to us as health care practitioners to make changes and to learn and listen and believe people's lived experiences and make changes in our practice.
[00:05:12] It's up to us. This is something that we have control over and we can create better environments, safer spaces, you know, for queer, trans, non binary people of the global majority. So, a couple of days ago, I created a training in our Intersectional Fertility Paid Community, and it's called Inclusive Practices for Healthcare Practitioners and Support People.
[00:05:36] So if you are not yet in the paid community, and you're interested in learning more about this topic, and you're a healthcare practitioner, or a community worker, a doula, or someone who works in a support role, I highly recommend joining, if for no other reason, just to listen to this particular training.
[00:05:52] It's 26 dollars a month, you can cancel at any time. And you just go to my website, intersectionalfertility.com, and you can click on Qmunity, and that's spelled with a Q for Queer Plus Community. And you'll be prompted to fill out an account, and then you'll be part of the free Qmunity. And then once you're in the free Qmunity, you can find the paid Qmunity and click on that, and it will prompt you to upgrade your membership there, and then you'll have access to this webinar.
[00:06:21] And then you'll also get access to the past webinars that I've done. I do one a month and the community has been around now for, I guess, three months. Cause now there's three webinars in there. So the past two that you'll also get access to are a training called What Boundaries Have to Do with Fertility and How to Improve Yours, it's one of my favorites.
[00:06:43] And then How to Use Acupressure to Increase Your Fertility. That's a real good detailed one on exactly how to use acupressure points. And how to use them on yourself specifically to increase fertility. And all of the webinars at this point do have handouts attached to them. So if you're a handout person, if you like to print out the slides of a presentation and have something to take notes on and have something tangible to take away with you so you can refer back to it, there are some slides attached to each of those webinars.
[00:07:14] So head on over there if you're interested in learning more about that, and I really hope you enjoy today's episode. It's, you know, it's both from the perspective of protecting yourself when you go to the doctor as a queer, trans, non-binary person who is seeking support in the health care system. And then we also do touch upon what we can do as health care practitioners, you know, towards the end of the episode.
[00:07:41] These two offerings, I think are really complimentary. So I recommend listening to this episode and then heading over to our Qmunity and listening to the training that I just did a couple days ago, or vice versa. And I would love to hear your thoughts, you know, on this episode. So when you come over and join us in the Qmunity, you can also find this episode and comment below it and continue the conversation there.
[00:08:05] So, all right. Thanks for listening to my rant today. And. Y'all are the best. I'm so grateful for you that you keep showing up and wanting to learn and listen to these episodes and, and people's lived experiences and stories. It's just, it's so important that we all do our work in this way.
[00:08:26] So I appreciate you, and I will see you in our Qmunity.
[00:08:38] Zoe Julian is always Black and queer, working toward our collective liberation as an educator, scholar, and practicing obstetrician gynecologist. Their work in health services research, clinician training, and sexual and reproductive clinical care is deeply informed by queer reproductive justice praxis, and critical race theory.
[00:09:01] They are the lead creator of Structures and Self: Advancing Equity and Justice in Sexual and Reproductive Health. A community engaged curriculum designed to teach healthcare workers how systems of power and oppression inform their practice and how to leverage their privilege to disrupt harmful norms.
[00:09:21] Ultimately, they hold themselves accountable to Black, queer, trans, and non-binary communities lifting up Black women and fems with their ancestors and descendants in mind. Zoe is committed to radically reimagining healthcare systems and training paradigms beyond their oppressive origins toward a decolonized liberated future.
[00:09:51] All right. Welcome back everyone, and welcome to the podcast, Zoe.
[00:09:56] Dr. Zoë: Thank you.
[00:09:59] Josie: It's so good to have you. Will you share with us your pronouns and where and the world you're joining us from today?
[00:10:05] Dr. Zoë: Absolutely. I'm Zoe Julian, my pronouns are they/them to all. She/her to some, and I'm joining from indigenous unseated Muskogee Creek territory, known by most as Georgia in the United States.
[00:10:22] And I'm really excited to be joining you today, Josie, and hope your listeners find today's conversation impactful.
[00:10:32] Josie: Cool. I know that they will. Yeah, it's such an honor and a pleasure to have you here, Dr. Zoe. I've been looking forward to this conversation for so long.
[00:10:40] Dr. Zoë: As have I, so I'm really happy to be here, especially on Juneteenth. Which is a really special, in some ways a special day for me, and I'm sure for others who are Black Americans, descendant from enslaved Africans on this continent. And yeah. I'm just excited to be engaging in a conversation with you today.
[00:11:06] Josie: Oh, amazing. Yes, today's Juneteenth when we're recording and I'm just so honored to be spending some time with you today. Thank you. So what is the story that led you to become an OB/GYN?
[00:11:21] Dr. Zoë: I really love this question, and sometimes it feels like I'm far away from this origin story because my why has evolved over time. But I came to medicine really and came to the field of OB/GYN, with the intentions of being able to care for people in some of their most vulnerable times in life.
[00:11:45] I think there's something really sacred about the beginning and end of life and the ways in which birth and passing and death can be cyclic in some ways. And I felt like as an OB/GYN that would provide me opportunities to hold people through those really intense special, sometimes really vulnerable transitions.
[00:12:09] And from a practical standpoint, I really enjoyed being able to care for people in multiple different settings. Being able to keep a certain amount of continuity with the people I was caring for, where I wasn't necessarily having to pass on major aspects of their care to other practitioners. But I think relationships over time.
[00:12:30] And as a person who likes to solve problems, for better or worse, being able to do some of that for folks, especially through procedural care and surgical care also felt really satisfying to me. So that is what initially brought me to the field as I was making my way through my training and trying to decide what path I wanted to take.
[00:12:54] Josie: Gotcha. I love that. Yeah, being able to build relationships with your patients and not have to outsource their care. Yeah. That's really cool. And I'm curious too, how has your, why evolved. You mentioned that it's evolved.
[00:13:09] Dr. Zoë: Yeah, yeah. Significantly. And in parallel, I think with how I've evolved as a person. As well as how society has evolved or sometimes devolved over the last several decades.
[00:13:28] As I made my way through my training and recognized ways in which, at least in the medical industrial complex and quote unquote mainstream avenues for healthcare, how much in dissonance, the environment and the systems are to my why. And that became really challenging and at times felt like a betrayal. As a person who was entering into what I believed to be an altruistic people focused system.
[00:14:03] And in some of my formal education, but really in a lot of informal education from trusted advisors, mentors, community colleagues, and teachers. I learned a lot more about the history. Not just medicine, but specifically of obstetrics and gynecology. And illuminated a lot of important learning and unlearning for me
[00:14:29] So really the evolution of my why is born from that, a kind of reckoning that I had to go through to determine how I was gonna move forward. And so for me that my why has really evolved into, for one, centering Black and indigenous, especially queer and trans, non-binary and gender expansive people in sexual reproductive and perinatal health across that spectrum.
[00:14:52] And if I say that that's what I'm doing, then that forces me to kind of radically reimagine how it should be delivered. Is delivered. And also how people are trained, clinicians are trained to care for our communities. And it's still in my evolution, is still in processes, I think is true for all of us. As we learn more and unlearn more and remember more.
[00:15:22] Remembering a pre-colonial way of being. Then it forces you to keep changing and growing. So yeah, I'm really thankful for the different experiences I've had personally, professionally and in the interdependent in. Which have really helped shape where I'm at now, and hopefully the trajectory I keep moving on.
[00:15:44] Josie: Yeah, nice. I've learned from you in the past and I was, had my eyes opened so much to the racist roots of OB/GYN. The history of it, it's just, I mean, shocking and not shocking, that everything has roots in racism, really. Just the details are Wow. Just being in that field, I can imagine how difficult that would be to reckon with that past.
[00:16:17] Dr. Zoë: And I think for that reason, most people don't reckon with it. It's really hard. And they either don't know it, don't choose to seek it out, learn some, but compartmentalize it away. And I think I have a somewhat unique, I'm not alone in my positionality, so I don't wanna speak as if I am, but I think I do have a, a unique, a less common positionality.
[00:16:44] Being Black and queer and non-binary and an OB/GYN. And I feel both descendant of people and communities who were violated, exploited, continue to be. As we can see, current day with so much anti-trans and anti-abortion legislation, like the attacks on our bodily autonomy is ever persistent. Pervasive throughout all of history.
[00:17:12] And also, I recognize that I made a choice to join a profession whose legacy is that exploitation, that oppression, that violation. And so it's, it becomes harder for me actually to identify myself as an OB/GYN with that truth. I've been trying on different ways to reorient myself to the clinical work that I do, and it's still in process.
[00:17:38] Josie: Yeah, totally. Do you have, I'm curious, do you have much like ability to reimagine the system within the institutions that you're in, or are you kind of trapped in a way?
[00:17:50] Dr. Zoë: Hmm. I think yes and yes. So I work in several different settings, and that is with intention and by design because of the different kind of goals that I have in my work.
[00:18:02] One of them being around training future healthcare providers. So that in some ways forces some proximity to traditional institutions of the medical industrial complex. And there isn't a ton of room for reimagination on a macro scale but I do think that there's value in dropping some radical seeds in people's minds. Especially with the learners that I work with. I mean, even being forced in my current setting, even being confronted with a person who is not cis and is a physician. Is a radical, is a part of a radical existence. Which it shouldn't be. And I would love to not always be radically existing in a place.
[00:18:49] Exhausting and not sustainable. And I know that, so I try to move with intention in the different spaces I work and try to give myself some balance between spaces where. The capacity to radically reimagine is limited or the way it looks is narrow, and spaces where I feel like there is alignment in my values and the values and the praxis of the leadership and the staff and the other people who are in that environment and the folks who seek care there.
[00:19:26] And that provides me a little bit more room to dream. And then I also try to keep a practice of dreaming on my own. That like trying to separate your job and your work if you're in a point in your career or in your path where those things aren't perfectly aligned. And so how to preserve my work, especially when. My job and the environment of my job does not create, is not conducive to my work.
[00:19:57] Josie: Right. Oh, I love that. Yeah. I love that distinction. That's really important. I'm curious, what motivates you to do the work that you do? I know you've kind of talked on it a little bit. Is there anything more to say about that?
[00:20:08] Dr. Zoë: I think really at this point, and it, I see the baby roots of it, even back when I first entered the field, is that I've always been social justice oriented in how I saw healthcare functioning in society. And so now, I'm building my understanding and frameworks and practice towards liberatory frameworks and really thinking about healthcare as a, or health and healing, and not just wellness, but really healing and wellbeing as essential to a collective liberatory future.
[00:20:43] And so how do I like start to align as much of my jobs with that kind of goal, with that journey is really like the, I think the central question in my work always. As someone who, who comes from a physician background as opposed to folks who may come from other healing and care practitioner work that isn't so steeped in white supremacy, capitalism, patriarchy, heterosexism, all, you know, ableism, all the things, right.
[00:21:16] So that is really a guiding question for me and what helps anchor me is staying in close proximity and community to not just practitioners who are outside of that space. Which is one of the places where we met with king yaa's work. But also just staying in proximity in community with people who do nothing having to do with the health field.
[00:21:44] Health professions, wellness, and wellbeing like artists and organizers and other people who are invested in liberatory work, and have other perspectives, experiences, gifts, challenges. Really trying to like, think about community care. As a way for us to all evolve and not just, this is a thing I have to figure out by myself. Yes. Yeah. Because that's a lot too, so.
[00:22:13] Josie: Totally, steeped in whiteness.
[00:22:17] Dr. Zoë: Mm-hmm. Absolutely.
[00:22:19] Josie: Yeah. I love that. So I would love to talk about a little bit about how QTBIPGM can advocate for themselves in Western medicine settings or mainstream quote unquote mainstream medicine settings. What are some ways that QTBIPGM can advocate and protect themselves when interacting with Western medicine and specifically on their fertility journey or anything kind of reproductive health related?
[00:22:46] Dr. Zoë: Mm-hmm, yeah. I think that this is a really core question because while we are, while many of us are working towards this liberatory future, we also have to reckon with the material reality of the system as it is, right?
[00:22:59] And so I think, the things that come to mind for me are one, to always require, demand someone else to bear witness to your care experience. I think as we talked about, you know, the hyper focus on individuality and, and people as individual units to be cared for as if we are not interdependent to everyone and everything around us is one of the first violences of western medicine and the medical industrial complex.
[00:23:35] And so I think, as much as I would encourage people to bring a friend, bring a partner, bring a trusted community member, bring somebody with you. And Covid has made it challenging. A lot of care environments have limited the amount of visitors you can have in hospital settings. Or being able to have people come back with you to exam rooms in office settings or outpatient settings.
[00:24:02] But I think in most places in the United States, at least, we're at a place in this pandemic where really there should be no excuse for a person not to have a support person with them in a care interaction. Yeah. And sometimes office settings will say, oh, you don't need a person because we'll have a chaperone, quote unquote, to be in the room with you during exams.
[00:24:23] But it is critical, especially for our communities, that your person is self-designated. And it's somebody that you already know and trust and can bear witness to whatever positive or negative things occur during that interaction. So I think that that's really important part of self-advocacy. I think, thinking ahead of time to our, to at least, you know, if you're a verbal processor. , talk it out with someone, write it down, but what your priorities are for that interaction and bringing that up early with the person who you're gonna be engaging with. I think is key.
[00:25:04] I think you as the in, as a person seeking care, be able to articulate for yourself, like, what is it that I want to get out of this interaction? Goals. And so it's a bit easier to require that those goals be prioritized when you're actually in the interaction and hopefully articulate those things a bit better.
[00:25:23] And then I think the other thing, not just in self-advocacy, but when things don't go the way that you want, even if you self-advocate, is you are always allowed to remove yourself from the interaction and how safely one can do that varies, right? Depending on how the interaction is a lot of times that can be navigated by healthcare staff in a really punitive way, but you always get to leave.
[00:25:50] The office or the hospital is not jail, right. You get to leave. And I, I encourage people to do that more thoughtfully, mindfully, and again, with the support of other people in their community to usher them through that. I think it's really important that folks don't settle for care, quote unquote, that isn't caring.
[00:26:18] If you leave an interaction feeling disrespected, silenced, certainly violated or abused, that is not an environment to return to. And I think often folks feel trapped, like they don't have very many options, and you have to endure this kind of environment in order to get the thing you need.
[00:26:39] And sometimes that might be the case. I don't wanna discredit, you know, or pretend that access to gender affirming care, especially when it comes to hormone therapy and procedures or surgeries, is limited. So that is also part of the reality. But you, you get to determine where your no lies and you get to honor it.
[00:27:00] Josie: Yeah, totally. Yeah. Those are great suggestions. And then I'm wondering too, like, how can QTBIPGM not only feel protected, but also supported, if that's possible in Western medical settings? What kinds of things should they look for, ask for? Know before seeing a doctor or visiting a clinic?
[00:27:21] Dr. Zoë: Mm-hmm, yeah. I think using folks front facing either websites, social media, other materials to help you provide you some litmus test. For how affirming or supportive an environment may be.
[00:27:37] If you don't see anything about pronouns on a website. I'd be leery if you don't see anything that specifies gender affirming care as a tenant or a service that's offered. I would be leery. Looking at photo, what, what kind of stock images are used on people's, you know, publications, media? Do you see the same type of person?
[00:28:03] Same phenotype all over their. There's stuff and that person does not look like you or anyone in your community, probably not the place to go. And you know, all of these things I think are not new skills that folks within our communities have to use. We use. all types of interactions throughout our lives, and unfortunately, healthcare is no different.
[00:28:27] So I think relying on those same skill sets when it comes to this environment is really important. I think asking questions before you arrive, asking things about how experienced practitioners are with the specific services that you're seeking, or the specific care that you're wanting to engage in is important.
[00:28:49] And you're allowed that. Yeah. And if you feel uncomfortable, then you don't have to move forward in that specific environment. So I think those help to identify ways to pinpoint what may be supportive areas versus not. Also, if you've been able to identify a supportive provider in a specific, for a specific service, ask that person.
[00:29:13] Because part of our job, quite honestly, I think our obligation, our responsibility is to seek out colleagues that we can refer our patients or clients to who are seeking environment or seeking care in an affirming environment. And so push the people that you trust to take care of you to do that.
[00:29:34] If they haven't had it already. That's part of, I think how you holistically care for people is just to, it's not just within your space.
It's also how can I facilitate access to other spaces? So, yeah. I'm not sure if that's entirely different from your first question about advocacy, but I think the having a, someone to bear witness bringing stuff with you that makes you feel safe.
[00:30:00] If you've got a, a weighted blanket, Or something with a healing scent, some type of oil or you know, I walk around with a pouch of lavender, which helps, I can smell and helps bring me back to a calm space when I need it. It's fine if those things aren't provided in the space, you still get to bring those things with you in order to take care of yourself.
[00:30:23] Josie: Oh yeah. I love that. That's, yeah, that's a great suggestion. I'm thinking too, like fidget toys. Yeah. I love those. And then I wanna talk about, too, about maintaining body autonomy during the queer conception journey. How can folks do that? Or is it possible, or what are your thoughts around that?
[00:30:45] Dr. Zoë: Mm. I think maintaining your bodily autonomy is definitely possible. And I think that it is not the default incentivized mechanism of Western medicine when it comes to a fertility journey. So I think as much as you can, really focusing on creative and generative ways to move through the process, which at some times is easier to do outside of a fertility facility than it is within it.
[00:31:17] And again, I think it's, it's another opportunity for thinking expansively about who are the different providers and practitioners who are aiding you in a fertility journey? If you do find yourself engaging with a physician, probably someone who is specialized in reproductive endocrinology or infertility.
[00:31:37] And that is helpful to you, great. But that doesn't have to be your only source of support during your journey. And so what is it like to work with someone like you, Josie? To work with folks who specialize in Chinese, Eastern indigenous, other types of practices to help support fertility, I think is important.
[00:31:57] And asking your Western provider, what they think about other providers may also help you to navigate if this is gonna be a good fit for you. If this is a person who is open to other ways of doing things or not. I think that that can help a person maintain bodily autonomy. I do know that fertility journeys can be sometimes really dysphoric, sometimes really disorienting to your own relationship with your body.
[00:32:23] Yeah, and I think just people allowing themselves as much grace as possible as you navigate through probably a lot of complex feelings is also part of maintaining your bodily autonomy. Right, it's not just the decisions that you, you make with regard to when and how, and with whom or with whoms organs or with gonadal production.
[00:32:49] But also the grace that there is no right way to, to make your way through a fertility journey, especially as a queer person. So, yeah, those are some of my thoughts. I'm curious what some of your thoughts are, Josie. I feel like you are an expert at this question much more than me.
[00:33:14] Josie: Oh gosh, I don't know about that. Yeah, I mean, I love a lot of what you said is just also to to find those folks who, where you feel affirmed. Cause they are out there and I think in a lot of instances it might be virtual. If you're not in a place where you can interact with these practitioners or healthcare providers in person, depending on what your access level is.
[00:33:42] I think that's been kind of the gift of the internet. Is to find those communities. And like you said, to find other people who are similar to you and where you can feel like you're in community. And so you're not by yourself. And that yeah, the fertility journey is not linear. And especially as a queer person. So yeah. I don't think I have anything else to add besides what you said. I loved what you said.
[00:34:15] Dr. Zoë: Something that's spoke for me with what you said about engaging with folks virtually is also, I think virtual care experiences can also be protective. Right, so like if physically going to this building or this place incites, anxiety, stress, fear for you,
[00:34:37] Are there virtual options where you can be in your own environment, where you can maintain more of your bodily autonomy, maintain more of your sense of control over the interaction? Is also a really useful byproduct of our ever growing virtual world. And virtual engagement is, it can be, I think both protective cuz it can help create distance. And in otherwise it can be more, build more connectivity.
[00:35:08] I know I've done that for meetings and other things. I just, I don't wanna be in your face right now and I don't want you to be in mine. Let's do this a different way.
[00:35:18] Josie: Yeah, exactly. Yes. And you can turn your camera off, and you can, it is really good for enforcing boundaries.
[00:35:30] Dr. Zoë: Mm-hmm.
[00:35:31] Josie: Yeah, interesting. Yeah. And also not only as a result of just the internet, but the pandemic.
[00:35:38] Dr. Zoë: Yeah, absolutely. I feel like I know I've learned a lot of lessons specifically about around boundaries during this time, and I'm grateful for it, definitely.
[00:35:48] Josie: Yeah. Same. I absolutely have as well, and even boundaries with my patients. There's been more of a distinction that wasn't there before pre-pandemic, I think it made me kind of check in about where I end and they begin.
[00:36:08] Dr. Zoë: Hmm. Yeah. I think that that, I mean that, unfortunately I haven't been in enough queer, predominant spaces professionally where that has been a challenge for me. But I can definitely see that being a challenge for me, in that kind of space.
[00:36:30] And it, I mean, it is now even sometimes with patients, but our clients, but also with my learners and being able to be like, okay we need some distance from this. Often telling me about their challenging experiences that deeply resonate with things that I have or am going through. And I am, that's hard, I think, to set up boundaries with folks who you deeply empathize with, especially if you're an empath.
[00:37:03] But it's also critical to be able to engage, I think in a meaningful, healthy, supportive relationship. Too often, especially westernized medicine, the paradigm is one of total self-sacrifice. To prioritize the needs of others, not just prioritize them over yours, but that you're not supposed to have needs. That your role in the interaction is to give, and only to give and yeah that's one of the many lies that I now have internalized as a lie, I think especially as a result of covid.
[00:37:40] Josie: Totally like that, mutual reciprocity is not part of that paradigm. Yeah. Interesting. Yeah. And then also there's such a power imbalance too, right?
[00:37:57] Dr. Zoë: Yeah. Right. Yeah. And how do you navigate that ethically? Mindfully? Cuz that and that, I think that just needs to be made more explicit.
[00:38:07] A lot of what I'm talking about, about advocacy and support, it is only required because of the inherent power dynamic in these interactions. Right? I think the burden to. To move out of that hierarchy, to flatten that dynamic, or at least to be moving mindfully through it is on those of us who are providers in these settings. Not on folks seeking care in them.
[00:38:36] Josie: Right. That really helps me transition into this next question actually. Cuz I wanna talk to you more about like from the point of view of a provider, because I know there are a lot of folks in my audience who are healthcare practitioners or community workers who support folks who are trying to conceive.
[00:38:55] What can we do as healthcare providers. To keep our QTBIPGM patients and clients as safe and empowered as possible.
[00:39:05] Dr. Zoë: Yeah. I think for one, eliciting like all of these actions, I think help to mitigate or mindfully move through that power dynamic. So I think one is it's on us to elicit people's needs and values, to create an environment that communicates, those are important to us.
[00:39:27] That is our priority for me, that's gonna center how we navigate your care interaction, and also what the goals are at the end of that interaction. And in doing that, I think what has to come next is one to believe people. When they tell you outrageous experiences, past traumas, triggers.
[00:39:49] Sometimes I think there's an inclination, especially for those of us in Western medicine to, "oh, that could never happen." That should never, that should never be the case. No, doctor, provider, fill in the blank, whatever, would do anything like that. And I think that gaslighting is, it's just as violent as the initial violent interaction, right?
[00:40:14] So if you're going to do, if you're going to do the work, do the practice of inviting people to share their truth, then you have to believe it when they share it with you. Regardless of how uncomfortable or how in conflict that is with your understanding of your reality. So I think that that's key.
[00:40:34] And then also in that, to be honest about what your limitations are in the services capacity that you have, especially to care for queer and trans people who are of the Global Majority, who are Black and indigenous, because it's not fair to waste people's time. Your intentionality is important, but your impact is what lasts with the person that you're working with.
[00:41:01] And even if you currently have a deep desire and intention to create an affirming environment in your current practice, if it is not yet that. That is something you need to be honest about. And to me that's a key part of consent, like a person can't make an informed decision about wanting to seek care from you if they don't have truthful, accurate information about what that experience is gonna be like.
[00:41:30] And so I think often that where our desire, our intention, and where our impact in reality, that boundary is where your work needs to be focused. So like if you're a provider who really wants to start offering gender affirming hormone therapy to patients. Because people keep coming in saying that that's something that they need and want, and you don't have that capacity for whatever reason, you don't have the knowledge base for it.
[00:42:00] You don't feel like you have enough experience, you don't have access to those hormones logistically to bring into your clinic whatever the issue is. That is where you should be focusing your efforts, your time, your energy, and your work, right?
[00:42:18] So that you can realize that future vision and be able to provide that care. And just like we talked about with referral systems, if you don't have it, but you know your folks need it, then it's on you to figure out where they can get it and help facilitate those connections. So I think as many in Western medicine at least are becoming more aware of the needs of our communities on the whole.
[00:42:48] This isn't something you can just check a box and say, oh, we put up some rainbows in the waiting room and we're good now. Like, that's how it works. And so if you're, if this is work you're really committed to doing, then you have to actually do it. So I think that that's, that's critical. The self-study, the study of all of those who are gonna be interacting with folks seeking care.
[00:43:09] So not just the providers but the front desk staff, the other, and support staff, what the built environment looks like. That should be in alignment with the things that are online and, and public media and interactions, communications. And you don't have to do it all at once. It's not meant to be an all at once transformation.
[00:43:32] I think what, what folks, especially in our communities value more is a persistent commitment. As opposed to a makeover. It doesn't last. It doesn't last. If it's what you wanna do, make the commitment.
[00:43:52] Josie: Totally. I think people pick up on the difference on that en that like energetically of whether or not it's a cosmetic makeover versus an internal commitment.
[00:44:03] Dr. Zoë: Mm-hmm. And what kind of accountability do you have in that journey? Who are, again, this is not for you to do alone. So who are gonna be the people and spaces and information sources that help you keep accountable to your intention and can be there to say, actually, you're not really moving the way that you said you wanted to move.
[00:44:24] Let's talk about that. Let's figure out how to course correct. You know, the perfectionism is also a white supremacist construct, right? That we are supposed to be all knowing, all doing, and all of that is not true. That's not true. So you know, a plug for king yaa and all of their courses and work as not just a place to learn and unlearn, but also a place to build community with other people with the same intention.
[00:44:53] Trying to find those kinds of spaces. And in that way, social media has been incredibly connecting for me. Especially trying to move into spaces where there aren't just physicians or really aren't any other physicians. Has been really, Beautiful for me.
[00:45:14] Josie: Yeah, totally. I agree for myself as well. Yeah, definitely. A big plug for king yaa and all of their teachings, that's where we met. And then as you were talking about accountability, I was like, yes, I still meet with my accountability group from our class.
[00:45:35] Dr. Zoe: I love it. Yeah. I love it.
[00:45:39] Josie: It's so important to have that community. So every guest that comes on to my podcast, I ask this same question. I'm so curious of your answer.
[00:45:38] So in Chinese medicine, our fertility is referred to as our essence. So the more we're able to get in touch with who we really are or our essence, the, the more access we have to our fertile potential and our creative power. Do you have any practices or rituals in place that allow you to connect with your essence or what I call your Whole Self?
[00:46:03] Dr. Zoë: Yeah. Yeah. That's another thing that was really developed and fortified for me during the pandemic. And just feeling in a place of like, how am I supposed to survive this? Not just physically, but spiritually, emotionally, energetically, how am I supposed to be in this? And so that was the start for me of a lot more intention around altar practice and ancestor work.
[00:46:30] Because the only thing that could come up for me was, well, those before you survived, thrived, endured, lived, still laughed, still cried through times far more challenging, far more violent. Far more persecutory, if that's even a word. So that is in me, and how can I remember and access that? So that is definitely something that has become far more critical for me, and I'm so thankful, and I wish I'd been doing it for much longer, but I'm glad that it, that these practices have come to me when they have. It has provided a grounding space and a way to get really quiet when there's so much noise.
[00:47:21] You know, psychological noise, spiritual noise, emotional noise. Just in the ether. And it also provides me a landing place for, as opposed to moving from a reactionary place when the next violent atrocity has occurred in our society. So that has been really critical for me. I've been really, another plug for an incredibly influential person and their work. The Nap Ministry, Aka the Nap Bishop.
[00:47:57] Who is a, her teachings around rest as resistance and the radical nature of oppressed people resting. In a society that wants us to do everything else, but that I've also been trying to work with intention and how to incorporate more radical rest into my life. And that helps give me space and capacity to witness and acknowledge and affirm others' rest.
[00:48:26] So that's been really important. Therapy. And I've been blessed to be in relationship with a black queer therapist for about four, almost five years now. And is another, again, like it's not just self-care, quote unquote, it's community care.
[00:48:47] It's an interdependent care. Relationships, another place where boundaries are fortified. Like when my therapist is like, all right, time is up, I gotta go. And I'm like, no, you're supposed to be here for me as much as I need. No Zoe. That's not real. That's not real. Your therapist has a life. And then that space closes until the next time. So that even just the way that we interact as therapists and client has taught me so much more about how I interact with people I care for.
[00:49:20] The lessons that are learned and the practices that are developed during our sessions. I think the more I attempt to decolonialize my own life and figure out what that practice is in relation to the reality of the ridiculous amount of privilege I am afforded as a physician in the United States is part of the what, what bores from that. Is what fortifies my whole self.
[00:49:47] Is what fortifies my essence, is what allows me to feel grounded down and connected out. Which are always feelings I'm trying to cultivate.
[00:50:00] Josie: Beautiful. I love that, thank you. Dr. Zoe, I wish there were more of you in the world.
[00:50:08] Dr. Zoë: I'm working on it. And there, there are, you know, I think there's also the myth that, like the unicorn myth, right? That there's only one of each of us in a space and it's just not true.
[00:50:19] Part of the systems part of all these oppressive ways of being, make us think that we are alone and we are disconnected. And we are not. And I'm trying my best to find my other people. And see what we can build together.
[00:50:39] Josie: Yes. Well, I'm so glad you're teaching also the next generation of physicians and OB/GYNs. Thank goodness. So, if anyone is wanting to learn from Dr. Zoe, are you still teaching for king yaa's courses?
[00:50:52] Dr. Zoë: I am, yes.
[00:50:55] Josie: Okay, cool. So yeah, folks can head over to king yaa, which is @queerbirthworker on Instagram and keep an eye out for their birthing beyond the binary course where Dr. Zoe is a guest teacher. Is there any other offerings or places where people can learn from you or is that kind of the main one?
[00:51:14] Dr. Zoë: That's one of the main ones right now. Other places to learn about my thoughts, my general musings. Although using it less often now, but certainly my social media handles, which is @doczo, D O C Z O on both Instagram and Twitter.
[00:51:33] And then I do have some offerings through a really, I think evolving educational platform called Innovating Education and Reproductive Health. And I've been involved in some of the curriculum work there about structural determinants of health. So the curriculum I helped lead is called Structures and Self, feel free to check it out.
[00:51:50] I will say with full transparency, even the work there, I feel like my frameworks and ideas have evolved from that place. But I think it's important for people to see the path. And like see somebody's journey on how their orientation shifts over time. So I hope those are things that people find helpful.
[00:52:10] And yeah, share what you've learned too. An exchange, like everyone brings expertise, but everyone I think should always be in a place of learning, so.
[00:52:22] Josie: Totally, totally. I love that. And how do people find the course you were just talking about?
[00:52:27] Dr. Zoë: Structures and Self is the name of the course. I think it might be the first thing that pops up on Google. But also the organization Innovating Education. Their website is www.innovatingeducation.org. People will be able to reach it through there as well.
[00:52:42] Josie: Okay, cool. I'll include all those links in the show notes. And is there anything we can do to support you, Zoe?
[00:52:50] Dr. Zoë: Oh, thanks for asking, Josie.That makes me so happy, which I would love for your listeners to do, is to donate to as many abortion funds as are in your area. or nationwide, including Indigenous Women Rising, which is an abortion fund that specifically supports indigenous peoples, regardless of gender identity throughout North America.
[00:53:18] So both in United States and Canada. For those who have the means to do so to send your resources and your energy to those organizations as well as queer and trans justice oriented organizations that are supporting people trying to make their way through these heinous laws being pushed through, especially in the Southern United States, which is where I live.
[00:53:37] I feel like these two areas, while often thought of separately, are wholly interdependent for me, because the goal is the same. Which is to strip us of our bodily autonomy at every critical juncture that gives us power. That allows us to exercise our power, and so, whatever folks can do to get involved.
[00:53:59] Remember getting involved doesn't mean recreating the wheel. It means going to the experts, the elders, the people in your communities who have been doing this work forever. And figuring out how to support them and how to learn from them, and also offer your wisdom to them. And if you don't have capacity or time for that, but you do have the dollars that's needed too.
[00:54:19] So those would definitely be my recommendations for people specifically looking for where to donate their dollars and know that they'll be used ethically. The National Network of Abortion Funds NNAF is the first place to go. From that, from an abortion perspective, and they, again, they support folks seeking abortion regardless of gender identity or sexual identity.
[00:54:42] So know that you'll still be supporting queer and trans, Black and Indigenous people of the Global Majority.
[00:54:47] Josie: Wonderful. I'll include all that in the show notes. Thank you so much, Zoe, for being here today. I just respect and adore you.
[00:54:57] Dr. Zoë: Oh, the feelings are mutual. Josie, thank you for the invitation and the chance to offer whatever I've got to your listeners. I really, really appreciate it.
[00:55:07] Josie: Of course. Thanks for listening to the Intersectional Fertility Podcast. To get customized fertility recommendations based on your Whole Self Fertility Method element, join my mailing list at intersectionalfertility.com and get immediate access to my two minute quiz.
[00:55:28] If you like the show and want to hear more, tap subscribe on your favorite podcast platform, and please leave us a review. It really, truly helps. The Intersectional Fertility Podcast is hosted by me, Josie Rodriguez-Bouchier and produced by Rozarie Productions with original music by Jen Korte.
All content offered through The Intersectional Fertility Podcast is created for informational purposes only, it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.