The Day I Decided to Be Out and Proud as a Transgender Medic

This Trans Day of Visibility, we’re publishing a series of essays from trans writers who pose questions about what being visible has meant for us. Who is seeing us? How do we want to be seen? And at what cost? You can read all essays from the series here.

We walked into the hospital to pick up the patient. Our call is to transfer them to the Children’s Hospital an hour south. Little did I know this “kid” would rapidly confirm my career as a medic and why being an openly transgender medic matters.

At the time, around a year ago, I’m a paramedic student, in the process of completing ride-outs. Essentially an unpaid internship with the aim of obtaining on-the-job experience and demonstrating competent skills knowledge. The pressure is through the roof, I’m broke, and I’m riddled with anxiety, over-analyzing everything. Oh, and COVID, there’s lots of COVID. Because I’m a masochist, I also figured continuing my transition from female to male and having top surgery weeks before my ride-out was a great idea. Logistically speaking, it was. Emotionally? The jury is still out.

I made the decision to not openly identify as trans on the job. I acknowledge what a privilege this was to have this option available to me. My voice was deep and I had just enough hair on my face to pass as cis. The last thing I needed was to have awkward conversations with potential coworkers. So back into the warmth and safety of the closet I went. It was defeating, ridden with shame and if I could go back and do it again, I wouldn’t have.

I walk up to the nursing station and wait to be acknowledged. Nurses are the rulers of the healthcare world. Not doctors. Nurses. I know if I get the approval of the nurses, I’m in.

An illustration showing a pink and yellow cloud in the background with a medic's bag in the foreground.

Artist: A. Andrews.

“We’re looking for…Amanda?” I stutter.

The nurse, without looking up, responds, “Oh ya, the transfer, one second.”

One second means when I am good and ready for you. I say thank you and wait patiently, trying not to hover. My partner is setting up the stretcher, a ritual in itself. Undo the belts, lower the bed, unfold the sheet, drape it over the bed, turn on the monitor. She, too, waits.

A few minutes later another nurse approaches and asks, “You’re here for the transfer right?”

“Yes, thank you” I reply. Manners always. She briskly walks over to the room where our patient is and starts running through her report.

The report is arguably the most important part of healthcare. Think of it as a game of telephone but you have to get it right. Accurate transfer of information ensures the consistency of care for the patient. There’s an overwhelming weight of responsibility when you are aware that your actions affect the well-being of another human. More often than not, one small, seemingly insignificant detail is the information that completes the picture, solves the mystery if you will. It is your job to not miss that detail. If nothing else, get that report perfect.

I am almost running to keep up with the nurse and make sure I am hearing and understanding every word she says, when we get to the room. I look in at the patient and see… me.

They are tall, but slim, perhaps undernourished, pale as snow. Their short brown locks frame their soft face and emerald eyes, glistening with fresh tears. They wear a worn-out band shirt from an era they weren’t even born in and plaid pajama bottoms. They look exhausted, in pain, uncomfortable. The color I am sure drained from my face as my heart began to bleed into my chest.

I take a step back from the room and turn to the nurse in a hushed voice, “Amanda?” My brow furrows into a shape inherited from my father, communicating one thing: explain.

“He goes by the name of Zeke,” replies the nurse. “He identifies as male and although an aspect of his medical history, not why he is being transferred today.”

“Hey, Zeke,” I say as pleasantly as possible. “We’re here to take you to another hospital, do you need anything before we go?”

Zeke knew he was being transferred, his belongings nicely organized by the bed in anticipation of leaving. He requested to use the washroom before we departed.
My mind spun like a tilt-a-whirl. The scent of the psych ward I spent months in. The look on my mother’s face when I proclaimed I was trans after yet another suicide attempt. Then, fear.

I frantically thought to myself, Will Zeke know that I’m trans? Will he out me? What if he thinks I am just some dude? What if he doesn’t know? Should he know? What does it matter?

Then, as if the universe was sending me a message, my partner asks me, “What’s her story?”

My blood boiled. The fog swirling in my mind quickly dispersed and I looked my partner dead in the eyes. “He,” I said. “He.”

“Oh, right. Yeah, I heard that” they responded.

Zeke returned from the washroom and plopped himself on the stretcher. As we strapped him in, I began. “Zeke, my name is Fisher and my pronouns are he/him… what pronouns do you prefer?” Zeke responded. It was as much for providing comfort to Zeke as a silent message to my partner to reinforce how important getting his pronouns correctly were.

We laughed, we cried a bit and we sometimes sat in comfortable silence. In that “mood-lit” ambulance, for those minutes, we were just us. No patient, no medic. Us.

We loaded him into the ambulance for our journey. As Zeke and I sat in the back, just us, I found myself acting like a worried mother. Trying too hard to care for this “kid” while simultaneously trying to qualm my own fears.

We sat in silence for a bit. I turned on what I call the “mood lighting”. Soft, bluish purple tinged lights that frame the cupboards on the inside of the ambulance. Converting the harsh clinical environment from exam room to the coziness of a bedroom.

Eventually, Zeke and I talked about school, his boyfriend who was incredibly supportive, his eating disorder and how it makes him feel. He described his desire to find community and support but not knowing where to look, or how to access it. He was tired. Of being in and out of medical facilities. Of fighting with himself. I told him I could empathize. I shared my own battles with mental health, my stays in facilities, resources I used as a trans man. We laughed, we cried a bit and we sometimes sat in comfortable silence. In that “mood-lit” ambulance, for those minutes, we were just us. No patient, no medic. Us.

The increasingly bumpy ride told me we were in the city, Zeke and I’s time together was coming to an end. The ambulance pulled into the bay of the hospital. My partner opened the back doors, automatically turning the harsh fluorescent lights on. Shocking our sight and reinstating the status quo of our situation, of society.

Immediately after transferring care of Zeke to the children’s hospital, I came out to my crew. I walked out of the closet for the last time.

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Fisher Kowalczyk

Fisher has written 1 article for us.


    • as a queer healthcare worker this gave me so many feelings (and I definitely cried). I always wear my official rainbow [organization I work at] lanyard to display my ID card, so patients/clients can know that there is someone like them looking out for them. thank you Fisher, and may you keep safe in this never-ending pandemic. <3.

  1. Ooof I was the “volunteer patient” to get practiced on for a genderqueer friend’s EMT class and our finding was that the other EMTs in training were not! Always! Great! About respecting gender identity. A trans EMT friend has also experienced that and stayed closeted. I hope wherever you work that you have reasonably supportive coworkers and bosses <3

  2. Could someone please add the warning “DO NOT READ DURING LUNCH BREAK – YOU MAY CRY” before this essay? Alternatively, could someone please fine the Author $100 for Excessively Amazing Writing Skills?

    It was beautifully done — so delicate and yet so powerful.

    I confess I hadn’t read the essay description before reading it, so the images were sort of happening in my head like it was a short movie, and I had no idea where I was going.

    I was having such a hard day at work today. I work with victims of violent crimes, and as we all know, unfortunately, many of them are part of the 2SLGBTQIA+ community.

    After dealing with an awful case earlier today, your essay caught me off guard.

    The part about the ambulance, the lighting, everything – wow. I stopped halfway through my comment to check Spotify to pick the best soundtrack for the ambulance scene in my head. And after 18 minutes of deliberation, I selected “Ben Howard – Promise.”

    But now, dear Author, it is also time for me to turn the harsh fluorescent lights on. Shocking my sight and reinstating the status quo of our situation, of society. And here I go back to the awful case…

    Thank you for the ride, by the way.

  3. As a teacher I face this dilemma daily…to come out or not at my work place. It gets tricky because I’m not out to my close family, and in a small place there is always the chance they will find out through someone else. Anyway, nowadays I try to come out a naturally as possible when the chance is presented. And there is always some visual distinctive on my backpack or clothes for my students to see.
    Thank you for being out, and thank you for dedicating your time to a such amazing and difficult profession as medicine.

  4. LOVE this piece! The day I was accepted to medical school was the day I decided to leave the closet behind. Never regretted it and now I’m taking the lead on the trans health curriculum for my residency program. Here’s looking towards a brighter future :)

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