[00:00:00] Adam Walker: From Susan G Komen, this is Real Pink. A podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:17] Welcome to the Komen Health Equity Revolution podcast series. Each month we invite in patients, community organizations, healthcare providers, researchers, and policy advocates to discuss strategies and solutions that drive the health equity revolution forward for multiple populations experiencing breast health inequities.
[00:00:35] What happens when your gender journey and a breast cancer diagnosis collide? In this special pride month episode of Real Pink, our guests are Ash Davidson, a trans masculine activist who went for a gender affirming top surgery and left with a breast cancer diagnosis. And Scout, Executive Director for the national LGBT Cancer Network.
[00:00:56] They’ll help us dive into the challenges and care gaps trans and non-binary people face when navigating a breast cancer diagnosis. And together we’ll explore what true gender affirming care looks like. How to self-advocate in a medical system not built for everyone, and why inclusive trauma-informed support isn’t just kind, it’s lifesaving.
[00:01:16] Welcome to the show, Ash and Scout.
[00:01:19] Scout: Thank you so much. Happy to be here.
[00:01:21] Ash Davidson: Thank you very much for having us.
[00:01:23] Adam Walker: Yeah I’m so happy to have you. This is an important conversation. So, so Ash, let’s start with your story. How you first learned about your diagnosis and what you were expecting going into top surgery.
[00:01:34] Ash Davidson: Sure. So I, you know, I’ll start with the second part of that question, which is I had started a gender transition about four months before I had top surgery scheduled. So what I mean by that, and I think just to kind of do a quick disclaimer, gender transition means a lot of different things to a lot of different people.
[00:01:53] For me, the things that I was really looking forward to in terms of my own transition were starting testosterone therapy and having top surgery. I started a low dose testosterone therapy in June of 2022 and I, in October of 2022, I had top surgery scheduled. And I cannot tell you the the level, the height of the expectations, the excitement everything that I felt like my life was coming to was leading up to top surgery.
[00:02:26] And it was…
[00:02:26] Adam Walker: And can you also define what top surgery is too far? I, sorry I just wanna make sure everybody’s on the same page with you, if you don’t mind.
[00:02:32] Ash Davidson: Yeah, absolutely. And so top surgery I think, you know, especially when we’re talking about things like chest and breast cancer, a lot of people think that top surgery is very similar or the same as a double mastectomy.
[00:02:45] And there are some differences there. And that really, this most simple way to explain that difference is often not for every single person, but often top surgery leaves some tissue behind in order to sort of either sculpt or provide a more masculine looking chest. And that’s only if the patient wants that.
[00:03:03] Right. Got, so it’s not for everybody, but that was the surgery that I was having. So top surgery for me was not only about sort of removal, but it was also about being able to present with what we kind of, I think in society think of as a masculine chest. And again I’m careful around those words because it means something different to every person.
[00:03:25] But that’s what it meant to me, of course. And so I kind of characterize it as the stakes were very high and the expectations were even higher. And so I was going into that surgery. I had been in the gym. I was working out, I was doing a lot of chest exercises. I was working on my pecs, you know, I wanted nice pecs off outta surgery.
[00:03:44] And so I was that was the path that I was on. And so that was October of 2022 October 6th specifically. And I had the surgery and everything went well during surgery as far as I knew. 11 days after that surgery, I was on what I thought was going to be a routine follow-up call with my top surgeon.
[00:04:06] When I was informed that during surgery they had unexpectedly, no one knew it was there ahead of time, but they had unexpectedly found a tumor. They had gotten the pathology results back and I was on the phone being diagnosed with breast cancer. And you know, we’re a quick call out there too, I think.
[00:04:26] We use breast cancer and chest cancer a little bit synonymous, synonymously in this case. So I wanna kind of just caveat that as well. And so in that moment all of that expectation, all of the excitement, all of the things that I had been planning for about just trans joy.
[00:04:47] And the euphoria that I was feeling completely just kind of disappeared in the moment. And I was now sort of faced with a cancer diagnosis and what to do with all of that, and especially a very gendered cancer diagnosis. And so it was incredibly disorienting and honestly devastating.
[00:05:04] Adam Walker: I mean, yeah, that’s, I mean, that’s gotta be so hard. I mean, because you’re on a follow-up call about something you’re very excited about and it went very much the other way. How did you take that? I mean I’m sorry. I know maybe that question’s out of order, but like how did you respond to that?
[00:05:23] Ash Davidson: No, I think it’s a perfect question and it’s a question that I think is a really natural one for people to ask and..
[00:05:28] Adam Walker: Yeah.
[00:05:29] Ash Davidson: You know it, there’s no way to take it, right? It is, it was such a shock. I don’t wanna go too long here, but I’d had a, I had sort of worked up the nerve to have a a mammogram six months before top surgery. And I didn’t wanna do that mammogram for a lot of reasons. But I worked up the nerve to do it and I had it, so I literally had, and I was cleared on that mammogram, so I had no reason to think that anything like that would happen during the surgery.
[00:06:00] And so I was headlong into all of these ideas of what I thought my post-surgery life was going to be. Yeah. And so to have that turn on such a dime and in such like a way again, this gendered cancer that felt like all of a sudden I was thrust back into this thing that I had kind of been trying to
[00:06:19] distance myself, or at least redefine myself in. Yeah. And now I was you know, the very first appointment I had, I was in a pink gown in a breast cancer surgeon’s office. And I, there was whiplash is a way to describe it again that feeling of devastation. But it was just this complete feeling of disconnect.
[00:06:42] I just, I was unable to really process the information that was happening at the time.
[00:06:47] Adam Walker: That is so, so tough. I appreciate you sharing that. That’s absolutely gotta be just unimaginably difficult. Yeah. I mean, Scout, you know, from your perspective, from your work with the LGBT Cancer Network, how common is Ash’s experience
[00:07:02] among trans folks that are navigating cancer and why is it so overlooked?
[00:07:08] Scout: Well, you know, obviously it’s not common to find cancer to start off with, but it is kind of more common than we realize because we know that about 40% of us throughout our lifetime are gonna get this news in one form or another.
[00:07:21] And so one of the problems and challenges with Trans folks is that A)
[00:07:25] it’s hard to get us to screen body parts we don’t think we have, because in our of our body, some of these things don’t exist. Other things do exist, right? So there’s that to start with. Second of all, we’ve got a history of being disrespected in the medical arena. So we often don’t even have primary care providers.
[00:07:45] We did a lot of actually story gathering with Ash and others last year, and we were listening to stories and unfortunately too many of us did not have a medical home. We might have been seeing a doctor for like hormones or something like that, but that didn’t include like the screenings that we really should be getting.
[00:08:00] So first of all, you gotta have a provider that you trust enough and has a good relationship with you, and you know, to be honest, despite, you how motivated I am on this and how educated I am on the risks. I’m often standing in front of audiences and I still don’t have all my screenings done because you know, you may trust that one doctor. But once they say, okay, I’m gonna refer you to someone else to get something done, you always gonna ask yourself, is today a good day to be disrespected while naked?
[00:08:26] And the answer is almost never yes to that, no question. So we’ve just got a series of hurdles that we experience routinely, and most of them have to do with providing, with finding welcoming and respectful providers. Unfortunately, in this political climate, our concerns about that are rightfully growing right now.
[00:08:47] Adam Walker: Yeah, so let’s talk about that. Let’s talk about like gender affirming care in breast cancer. What does that look like? What are some barriers trans patients face that cisgender patients might not face?
[00:09:04] Scout: So really the issues were gonna be a delayed screenings in the first place because of that access to care problem.
[00:09:11] B. Then when we get a di, if we get a diagnosis, we’re likely to have fewer options in the first place to even think about what it is we can do, because it’s likely been found later in the trajectory than it should have been found. Right? And then once we have that diagnosis. We then suddenly enter into a frequent flyer program of like seeing providers left, right, and center.
[00:09:33] And the problem with that is, is that, you know, a friend of mine is getting her cancer treatment in an incredibly welcoming one of the, I would tell you, it’s one of the best, most welcoming cancer centers in the country. And yet she transitioned during her diagnosis because she’s like, I’m not gonna face something that could be life-threatening and not live my authentic, real, true self.
[00:09:54] Right? So she’s like, that’s it. I’m gonna, if this is my last chapter, I’m going out as me not pretending to be someone else. And as she talks about every time she goes in for chemo, she sees about 10 different staff at that welcoming hospital.
[00:10:12] And nine of them call her, he and misgender her or use the wrong name and only one of them does it correctly. So if you can imagine, compound this like every inch of treatment is like you’re bracing yourself. Am I gonna show up like this and you’re gonna call me she or am I gonna show up like this and you’re gonna use a dead name that my closest friends don’t even know
[00:10:32] because that’s what’s still on my insurance. Or even take the other piece of the equation. We often take hormones as a part of our transition. Some cancers are hormone interactive and we have absolutely no information about how the hormone interactive cancers engage with the hormones.
[00:10:49] So
[00:10:50] we have experiences of, like another friend of mine, they were going, they, their transition and trans mask as we’re talking about here.
[00:10:57] And their providers took them off their hormones to do that transition. because they were worried about what would happen with the cancer. They didn’t even ask this person about it. They didn’t even say like, what do you think about it? How’s it gonna affect your emotional health? How’s it gonna check, affect your stability?
[00:11:12] Things like that. They just made the decision. It took them off.
[00:11:15] And as
[00:11:15] a result, this person who you. Internally identifies as male now is kind of stopped at non-binary because that’s all that they can pass as and all that they feel comfortable with. So we also then have the, like the lack of research compounding the issue.
[00:11:30] So between the issues of delayed screening and then really kind of dignity and respect and patient safety, lack of research, we’ve just got a host of issues that unfortunately other people aren’t dealing with.
[00:11:43] Ash Davidson: If I could just add a quick anecdote from my own experience that I think will really reflect what Scout just said is that that idea of the misgendering that happens when you’re going for treatment.
[00:11:57] When I was doing chemotherapy I went to a cancer center and again a lot of the people that I would interact with did use the right, they did use the right pronouns. And I was treated with dignity and respect. But there was something about the actual system throughout the cancer system of, you know, information that gets put into a computer.
[00:12:16] And so I would go for my appointments, but before I would get called back for my chemo infusions, I had to do blood work labs every time, right. And so I, you know, you picture this, you’re in this cancer center. There’s 50, 60 people in a waiting room. I live in Austin, Texas. Austin is a more progressive place, but I am in central Texas.
[00:12:37] And what would happen every single time they would announce me in a waiting room packed full of people as Ms. Davidson. I don’t look very much like a miss anything. And I would stand up in that room and I’m sure that this wasn’t the case, but I felt like Every single one of those eyes followed me across the room.
[00:12:59] And not only did that just sort of feel like, you know, that’s like a sort of threat to your own psychological safety. I had the experience of going in for chemotherapy and having to worry about the fact that somebody might follow me out to my car afterwards and physically harm me. And that is not something that people often think about or face.
[00:13:21] When they’re getting cancer treatment. But that’s the things that we do go through as trans people, and that’s the danger of misgendering in those situations as well. Not only does it make you feel terrible internally, it really is a threat to your safety. And so I think like when we have, like, that anecdote is a very sobering one, but it’s one that was really true to my experience and I share it a lot because I really want people to understand why the, like, why that’s important because no one goes to chemo and worries about
[00:13:49] about somebody beating them up in a parking lot.
[00:13:52] Scout: Except us.
[00:13:54] Ash Davidson: Right?
[00:13:56] Adam Walker: I mean I’m at a loss for words. I really appreciate you sharing that, and I Sure. I cannot imagine how difficult that is.
[00:14:12] Ash Davidson: It’s why I do this.
[00:14:13] Adam Walker: Yeah. Yeah. I mean, It’s rare that on this show that I’m at a loss for words, but I’m just, I’m at an absolute loss for words.
[00:14:20] I’m I’m sorry that you have to experience that.
[00:14:24] Ash Davidson: Thank you.
[00:14:25] Adam Walker: Thank you. So I guess continue talking about misgendering. And I think you already mentioned it. But like, talk a little bit more about what role that plays. The medical trauma, the lack of inclusive forms the language in the cancer center. The fact that they call you miss when they call your name.
[00:14:51] Like talk, I mean, can you talk a little bit more about that? Sure.
[00:14:55] Ash Davidson: Yeah. I think even to the point that I was making earlier about the systems and putting things in the computer when I would get called back you know, and they would use the wrong pronouns and the wrong you know what was that, an honorific?
[00:15:09] Anyway, when they would call me Ms. Davidson I would immediately ask the person who called me back. Could you fix that in the computer? Can you make sure that this doesn’t have, can you update my chart? Right?
[00:15:21] Adam Walker: Yeah.
[00:15:22] Ash Davidson: And I would literally see someone type something and I would be like, okay it’s fixed now.
[00:15:29] And the next time I would come back in, I would be misgendered again. And so there was, there is a disconnect from a systemic standpoint that was preventing that update from being made in a way that protected me. And so that’s one issue. But yeah, when you talk about inclusive forms, the very first cancer appointment that I had, I sat and I went into you know, again, a breast cancer surgeon’s office and had to fill out paperwork.
[00:16:01] And I had a form in front of me that was, you know, the torso of what we think of a woman. Again, even men get breast, you know, cisgender men get breast cancer. You know, as a trans masculine person, just even having to sort of sit there and look at that, that, that form and that diagram, what it did for me is it made me realize immediately that I was in a place that I didn’t belong.
[00:16:29] That services that, everything around this type of cancer wasn’t for me. And so what that really did, it had an incredibly pervasive impact on my entire cancer experience. And while the physical part of going through chemo and radiation was hard I found myself eventually in the middle of my treatment
[00:16:55] in basically a mental health crisis. Because not only was I just managing my cancer diagnosis, if we go back to the reminder that I had just started therapy..
[00:17:05] Adam Walker: Right.
[00:17:05] Ash Davidson: I had just started transitioning. That is an incredibly difficult process to go through. I think there’s a little bit of a misconception that when people transition it’s just all amazing, right?
[00:17:17] We are just, we just transition and everything’s beautiful and perfect, and we’re in, you know, a constant state of gender euphoria. It’s not that it is incredibly introspective and there’s a lot of things that we go through as trans people that require reflection in unpacking our pasts and our futures.
[00:17:35] And it is a really intense process to go through and doing that coupled with cancer care and being misgendered and worrying about my safety and all of these other things and feeling like I didn’t belong and feeling like this deep sense of isolation. I kind of characterize it as this, which is rationally I knew that I wasn’t the only person in the world who’d had this experience.
[00:17:57] Adam Walker: Right.
[00:17:57] Ash Davidson: But emotionally, I felt like the only human being who had any idea what I was going through. And I also couldn’t find the resources at the time because I was so overwhelmed by everything to find those stories or to find those people. And so I found myself sort of this, this inflection point where I was so consumed by depression and anxiety because of all of it.
[00:18:20] I then had to dig myself out of a mental health crisis along with the rest of it. And so that’s the outcome of all of these things they just stack up. Yeah, and it can be really pervasive and just really difficult to get through.
[00:18:36] Adam Walker: Fighting for your mental health while fighting cancer is not something anyone should have to do.
[00:18:41] Sure. I really appreciate you sharing that. Yeah. How can healthcare providers do better, you know not just on the clinical side, but emotionally, logistically, culturally? I mean, I think you’ve already touched on a few things, like have a system that actually updates appropriately would be a, probably a good start, but any other thoughts on, from either of you about how they can do better?
[00:19:03] Scout: So you know, there are things like the healthcare equality index, which gives some hint what are more welcoming hospitals, but these days I would’ve to say that particularly again with the political environment where it is going. Even if your hospital’s welcoming, you know, another of my friends was treated as incredibly welcoming hospital and got a very unwelcoming provider.
[00:19:23] So this is really down to the provider level that we’re looking to those providers to give us some clue. That you’re not going home and putting on a red hat, that you are going to treat us with dignity and respect all the way through our treatment process. That if there’s a problem with pronouns or with the honorifics, that you’re gonna try hard to fix it in the system and you’re gonna stay there and do more than we’re able to do from the front desk.
[00:19:48] Try and make sure it’s fixed before our next appointment. So we’re looking for any kind of sign. And one thing that’s good is we’re kind of used to reading small signs because we’re trying to figure out where we’re safe in the world. Right? You know, you can have, you know, it started off with like an earring in one little place would be the hint.
[00:20:02] That kind of stuff. We’re used to reading those tiny indicators. So there’s a lot of easy things any provider can do who can, to make this clear for us, one of the most powerful is simply introduce yourself. Hi, I’m Dr Scout, my pronouns are he, him. What brings you here today? It’s a really simple and very loud way of saying whatever your pronouns might be or whatever your experiences as minoritized, population number of any type.
[00:20:32] I’m trying to make sure that I’m leveling the playing field and I wanna treat you as a whole person. Another thing you can do is you can put one of those signs we see like in bakeries all the time, but almost never in healthcare establishments, all races, all genders, all ethnicities are welcome here. Another thing you can do is make sure that you do have good stuff on good information on your forks.
[00:20:53] When you’re doing data collection, you’re not just asking for married or single or you’re not just asking for male or female, but you’re thinking about things like partner non-binary folks, different things like that. And then another thing which I think is actually big these days is you can do the badge game bling because you know, we all have to wear our credentials.
[00:21:10] If you’re in, if you’re a clinician. So you have to have, you know, like layers of badges that you have on you at all times when you’re in the medical environment. And people can put things on that. Like you can put a tiny rainbow flag on that. You can put one of my favorite is so I snuck off before. I don’t know if you can see that easily, but the, you are safe with me button.
[00:21:28] Adam Walker: Oh, I love that.
[00:21:29] Scout: With rainbow up top Trans flag on the bottom. All it’s saying is like, I care about patient safety. Yeah, everybody’s patient safety.
[00:21:37] Adam Walker: That’s right.
[00:21:38] Scout: Yeah. And that means safety in the waiting room in my office and in the parking lot when you leave too. So there’s just so many easy ways, but the important thing is right now, silence is not
[00:21:51] Equitable silence leads us to think that you’re part of the growing wave in this country that is incredibly anti-trans. So the one thing that I say, you’ve got to do the loudest is do something so we can tell that you’re gonna treat us with dignity. That’s gonna go so far.
[00:22:09] Adam Walker: I really appreciate what you said, that silence is not, I think you said silence is not equitable.
[00:22:14] I think that was the word you said. Right? And I think it’s easy for those that aren’t experiencing what you are to think, oh, I, if I don’t say anything, it. I value your point like that silence is not, especially in this environment, silence is not. That’s a good, that’s a good mantra. I think ..
[00:22:39] Scout: Unfortunately feeding, you know, disparities and discrimination right now, because the society we live in Yeah.
[00:22:45] Is not equitable towards us. So if you’re silence, you sound complicit with the way everything.
[00:22:52] Adam Walker: That is a profound statement. I really appreciate you sharing that. Ash, anything you wanna add to any of that?
[00:22:59] Ash Davidson: No, I think, you know, I think Scout really covered it, and so I just wanna sort of echo all those things and again, that, that point about silence is you know as it feels like the world around us is trying to erase our existence and tell us that we are less than and tell us that we don’t deserve the same type of treatment.
[00:23:20] Even during this, you know, an illness like cancer that, that silence. Truly is deafening and it’s isolating. And that’s, you know to continue to further that isolation really goes to the point that Scott made about the lack of equity.
[00:23:41] Adam Walker: I appreciate you sharing that.
[00:23:42] So, so Ash back to you, what did help you feel supported during your treatment and what could have been maybe a little more helpful?
[00:23:53] Ash Davidson: Sure. You know, I think I alluded to this or mentioned this earlier and to the fact that I really struggled to find resources and stories of people that looked like me during the most active part of my treatment.
[00:24:07] I was just too overwhelmed. And I’ve made this point before you know, when you go to a, when you get a diagnosis and you go to your cancer center, they’re gonna give you a binder and they’re give you a bunch of information that has resources in it. The binder I got had not a single queer related resource in it whatsoever.
[00:24:28] So when you’re trans you, the resources do not come to you. You have to go find them. And that’s a pretty tall order to ask of somebody who’s going through cancer treatment. And so to be frank I didn’t have the resources at all when I was going through treatment. I was kind of on an island by myself.
[00:24:48] And it wasn’t until I started to kind of feel a little bit better. I got through the bulk of my actual active treatment and I started to make sense of what I had gone through. The thing that, that I was left with, the most pervasive feeling that I was left with at that point was, this cannot be the way, it’s where are all the people and no one should have to experience this way.
[00:25:17] And so literally, I started going on Instagram and searching for things like queer cancer or trans cancer. Whether it was a hashtag or whether I Googled it or whatever. And I started to find a couple of different organizations on Instagram and you know, through Googling it where one of the first organizations I found they just had stories of, and it was, you know, they’re actually a Canadian organization called Queering Cancer.
[00:25:43] I’m gonna give them a shout out. The second place that I found was the LGBTQI+ Cancer Network. Those two were the very first resources I found, and the first thing I did was send a message on Instagram and I had no idea what I was even saying other than like, I don’t know what just happened to me. I went through this thing.
[00:26:01] I feel terrible. But I think I have this like, kind of wild story that I’m not finding anywhere. And so I exist. I didn’t even know what I was asking for or why I was necessarily even reaching out. I just needed to connect, right? Like I just needed to connect. And that was, that started this like snowball effect of a handful of things.
[00:26:23] One, me realizing through using my voice, and I was writing a little bit at the time too. Through writing about my story, through sharing it I started to feel better and it also kind of created this effect where I realized if I keep talking that’s the way that I prevent other people from feeling the way that I felt.
[00:26:43] And so it became this thing that became almost accidental advocacy, right? I was just trying to make myself feel better, and through doing that, I realized that there was something here and that I could actually make an impact and make an effect. And so I became part of this idea of also I want to help create the resources too.
[00:27:02] Not only do I wanna find them for myself, but how do I help create resources for people moving forward? And so that was the whole thing. I mean, that was really, it was that there, there are resource resources out there as we know. There are few and far between. We need more. They need to be, they need to come to us.
[00:27:21] We shouldn’t have to find them all. The more that I stand up, the more I use my voice, the more I talk about this stuff, and the more that other people like me feel safe enough, feel okay enough to be able to do that themselves, the more we start to fill in those gaps and that’s how we create the resources, or at least that’s one way we create those resources.
[00:27:40] Adam Walker: I mean you’re doing it. You’re right now you’re doing it. I mean it’s kind of amazing. You’re being the answer that you needed. And that’s why we’re here for this conversation. And I so appreciate that. Thank you. So, Scout you’re nodding your head a lot. What, can you speak a little bit more about, like what the top resources or tools are that you wish every trans person that’s at risk for cancer knew about or had access to?
[00:28:05] Scout: Well, I would say the thing that I really want the most doesn’t exist yet. Okay. Because we’re trying hard to create resources for people so they can get it in those binders that they get of information. But we still only have a few things. And just to be clear, 85% of the queer folks we recently surveyed about their cancer journey said that they were given zero information about the experience, Ash’s experience is really common.
[00:28:32] But as a starting point, there are support groups, and that’s one of the things that I think everybody should think about. We offer them twice a week free on Zoom all year long. You know, even through the holidays like that, you can definitely start there. But the other piece of the equation really is we need to find the welcoming doctors, and that’s really what
[00:28:50] is only barely existing right now. If anything, we have some large medical systems taking off their healthcare quality index designation as being welcoming because of the current environment. So we really need doctors to step up more. We’ve got lists of welcoming screening doctors and welcoming treatment doctors on our website, but they’re really incomplete.
[00:29:10] We could use a lot more people to say yes, I want to be on that list. So it’s a call out to providers again, speak up. Silence is dangerous for us right now, especially. Yeah. And help us populate those lists so that you know, people like Ash when they’re looking for stuff can find a lot more of those direct resources. We also have some stories online, but as we always say, with all of the cancer organizations out there, don’t wait for us to create everything because we’re a tiny organization, we can’t do things that fast.
[00:29:38] Adam Walker: Right? Yeah.
[00:29:38] Scout: So, you know, I really kind of, our, one of our big points has been everybody do a little bit and make sure that, you know, if you’re doing anything related to cancer, that you’ve got some queer content there too. And then send it to us so we can assemble it in one place and make sure people can get turned onto it as quickly as possible.
[00:29:55] Adam Walker: Love that. So, so I’d ask you both to answer this one. For people listening, especially trans folks, allies, or even providers. What’s one thing they could do today to support more inclusive and gender affirming care?
[00:30:10] Scout: All of us are going to see providers, right? So all of us know if the environment where we see providers is silent on the idea of being welcoming.
[00:30:19] And I’m not just saying for Queer populations, I’m saying for all the different populations under attack right now, all of those different underrepresented and historically discriminated against populations. So if you are going into a doctor’s office and it looks generic, neutral, silent to you. Ask your doctor why they’re not doing more to be welcoming for the people who have historic barriers to care.
[00:30:42] All they need to do be put up one of those signs, all rages, all ages, all races, all ethnicities, blah, blah, blah, are welcome here. Like we just need a tiny sense where you stand. Yeah. It’s not asking you to change the world or land a person on the moon. Put up a sign saying that we’re welcoming, that we are welcome there, and safety is really gonna change.
[00:31:04] Since we all go to providers, and all engage providers, we can ask for that.
[00:31:09] Ash Davidson: I think my answer to that too is if you are someone who finds yourself, and I’m this is not a message to trans people and potentially not even to queer people. It’s probably a little bit more directed toward, towards allies, but if you are someone who finds yourself in the face of the context, in the environment that we are in today, being silent, ask yourself why.
[00:31:35] Think about why your response to the attacks that are happening against folks like us is to be silent. Ask yourself why. And then I think after you reflect on that and ask yourself why, I think the next step is really have a hard look at how you can change that. Because all of the dialogue that’s going on around trans people right now, whether it’s in sports, whether it’s in healthcare, whether it’s in policy, whatever it is.
[00:32:06] We are such a tiny percentage of the population.
[00:32:09] Adam Walker: Yeah.
[00:32:10] Ash Davidson: There is absolutely no way that we can defend ourselves against the slew of attacks that are happening right now. And we have to rely on other people. So if your response is silence right now, check that.
[00:32:28] Scout: And you know, I will say there’s an opportunity for that’s probably gonna be coming up really soon because we’re about to get a Supreme Court decision based upon Skrmetti.
[00:32:36] And while that is going to potentially support states ban on youth care, another piece of that same thing could potentially affirm the fact that trans people are not a protected class in
[00:32:48] this country.
[00:32:49] Which could unleash even more discrimination against us in a lot of different venues. So there is gonna be a response and there are gonna be ways to speak up.
[00:32:57] Yeah. As that decision unfolds. And if it goes that direction, which we fear, that’s not a moment to be quiet.
[00:33:05] Adam Walker: Yeah. Yeah. That’s great. Great advice.
[00:33:10] So talk about why you’re here. Why? I mean I think you we’ve talked about it, but like definitively why is it important? To share these stories, especially during Pride month, and what does that visibility mean to each of you?
[00:33:26] Scout: You know I’ll start I’ve worked in health and health disparities with queer communities for my whole career, and I feel like so many of them cluster and to a really crisp focus under the umbrella of cancer.
[00:33:42] Because again, you become the frequent flyer of so many medical providers all at once already facing something that could be a life threatening situation. You do not need the social isolation, social exclusion, and discrimination stacked on top of that. So I really do feel like if we can get the health world fixed around cancer for the queer communities, we can get it fixed around all of the other issues because this is such a nexus point of so many things.
[00:34:13] Ash Davidson: I think for me it’s there’s, I think it’s twofold for me. One, I’m here to dispel myths and dispel misconceptions, right, of what trans people are, of who we are. But also to put a face to it telling personal stories brings a humanity to concepts that are very easy to keep at a distance if you don’t have to face them.
[00:34:38] And so I realized again, like we talked about earlier, that I realized the power in my voice, and part of the power in my voice is to be able to sit here and say, you can’t deny me. You can deny me all you want. You’re gonna have to try a little bit harder because now this isn’t just a concept that exists out there in space and time.
[00:34:58] I’m a human being and I deserve all of the wonderful things that everybody deserves in the world. And so by putting a face and a name and a story out there it makes it harder to deny. And I think it also, I will say this, one of the things that I’ve learned about going through cancer and being an advocate and walking into rooms where I am always, almost always
[00:35:21] the only one that looks like me. If again, we think about breast, if we think about breast cancer who are the people we think of when we think of breast cancer? They don’t look like me. But what I’ve realized about going into those rooms is that the distance between our lived experiences is shortened because of our cancer experience.
[00:35:41] And that bridges the gap more often than not. And then I think the second reason that I’m here is due to gender affirming care. And that’s what I was talking about, dispelling myths. And I just wanna say the fact, and I will underscore this at every opportunity that I get, is that without the access that I had to gender affirming care and the affordability, my top surgery was covered by my insurance, I paid $250 out of pocket for my entire surgery.
[00:36:10] So without that access and the affordability of it, my cancer would’ve been found later, my prognosis would’ve been worse. My top surgeon actually referred me to an oncology team that she sort of helped vet ahead of time for me. And without those things, without those my cancer experience was already hard enough.
[00:36:32] But without the access that I had to gender affirming care, my experience would’ve been much worse. So the point is gender affirming care is just healthcare. It’s just another way for people who face significant barriers to care to get Their basic healthcare needs met because once you get into the gender affirming care cycle of things, those, those practitioners do the same that my top surgeon did.
[00:36:58] Which is refer you to other basic healthcare providers that can treat you with dignity and respect. So that’s the dispelling myths part, is the gender affirming care we think of as hormones and surgeries for trans people. And it is that a hundred percent, but it is so much more than that as well. And I think that is a really important point that I wanna underscore for people, especially today when gender affirming care is being attacked and erased and politicized and, and shoved in a corner as some
[00:37:28] Thing that, that is an evil thing out there, and it’s the exact opposite of that. It’s the, it’s a way for people to just get their basic healthcare needs back.
[00:37:36] Adam Walker: Appreciate you sharing that Ash. Yeah. So last question. How has your experience shaped your view of resilience, identity, and healing?
[00:37:51] Ash Davidson: I think I left I’m left with the sense of I know very well that there was still a lot of privilege and a lot of fortune that I had through my care cancer experience. And that, you know it’s sometimes when you talk about resiliency to someone who has had cancer, I think I’m always a little resistant to say, oh, well, I’m resilient, even though I know that’s true.
[00:38:19] But I think what I, what I, what What I wanna draw the point is a little bit what I talked about earlier, which is when you, when the common thread between people is cancer, we’re all part of a club that nobody wants to be a part of. It’s, it starts to become a thing where it’s really less about the things that, the differences between us and about sharing that experience with cancer.
[00:38:44] And I think what I’m left with in terms of healing within, in terms of resiliency is that, the most important thing is to lean on yourselves, lean on your community, and fight as hard as you can. But this isn’t a fight like this is this is just a thing that happens to people. And we’re not, we can, you can call us warriors, you can call us fighters, you can call us all of these different things.
[00:39:19] But we are just regular people placed in extraordinary circumstances who just do the best that we can to get through it as unscathed as we possibly can. Yeah. We’re just people and that’s it. And so in terms of healing. Healing that the most amount of healing I felt and that I continue to feel is just by using my voice.
[00:39:42] And it’s just by doing things like this. And it’s just by talking about what I went through and whether people wanna listen to it or hear it or not. And whether I walk into rooms that are welcoming or potentially even somewhat hostile, I often don’t even always know. But at the end of the day, I know that by showing up and doing it, I’m gonna heal even more.
[00:40:00] And by healing myself, ideally, let, hopefully. Somebody else hears this and it helps them heal and it helps them not feel like the only person in the world going through the thing that they’re going through. Yeah. And so that’s really I think, the path for me, and that’s like the real lesson in healing is if you feel like you can, if you feel like you’re safe enough, if you feel like you want to your story means something.
[00:40:24] Adam Walker: That’s right. That’s right. Scout, any final thoughts from you?
[00:40:29] Scout: I’m gonna leave Ash for that mic drop. I got zero to add to that.
[00:40:34] Adam Walker: Well well I’ll say this, Ash. Your story is remarkable. I appreciate you being the person that you needed. You know, you solving the problem that you needed solved, and you are undoubtedly making an impact on so many people that you’ll never know.
[00:40:54] And, and I, I admire that. I really do. So thank you for what you’re doing and thank you both
[00:41:00] for joining me on the show today. This has been a really amazing conversation. I appreciate you taking the time to have it.
[00:41:08] Ash Davidson: Thank you for having me.
[00:41:09] Scout: And thanks to all the people who are listening who’ve decided that they’re gonna speak out as a result.
[00:41:15] We need it. We appreciate it.
[00:41:17] Adam Walker: That’s right. That’s right. And thank you for joining another episode of the Komen Health Equity Revolution podcast series. We’ll continue to galvanize the breast cancer community to support multiple populations experiencing breast health inequities to advance and achieve breast health equity for all.
[00:41:32] To learn more about health equity at Komen, please visit komen.org/health equity. And to learn more about inclusive and gender affirming resources and support, please call our Komen Patient Care Center at 1 8 7 7 4 6 5 6 6 3 6. Or email helpline@komen.org to get started today.
[00:41:57] Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit real pink.Komen.org. And for more on breast cancer, visit komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam. You can find me on Twitter at AJ Walker or on my blog adam j walker.com.