Crowdsource Request: Being a transgender ally and unconscious bias

Save the Date: : 2nd Annual LGBTI Health Symposium, Southern California Permanente Medical Group

As I do from time to time, I’m requesting help for a discussion I’m honored to lead/participate in at the 2nd annual LGBTI (Lesbian Gay Bisexual Transgender Intersex) Health Symposium, hosted by the Southern California Permanente Medical Group (and is open to all), on May 2-3, 2014. The very first one was last year, see: Clinicians from the future practice the medicine of inclusion – Kaiser Permanente LGBT Health Symposium | Ted Eytan, MD

The theme of this year’s symposium is unconscious bias, sometimes called implicit bias (which you can learn a lot about here). I have started to learn about implicit bias and it’s pretty clear a person could (and does) earn a PhD in studying it, so my goal will not be to discuss implicit bias as an expert.

Instead, I’d like to recount my (amazing) journey as a transgender ally. I didn’t ask to be an ally, I didn’t know what it was to be an ally (you can read about that here at the University of Southern California web site), I think it asked me.

I’m not finding much literature on implicit bias around transgender people, much less implicit bias around allies. I’m not looking to discuss bias directed toward allies, more to discuss the bias I have seen directed toward minorities as an ally. Make sense? 

With that in mind I have some questions that I’d love help with, please respond in the comments or tweet me (@tedeytan) or contact me directly.

  • Do you have experience as an ally, for any LGBTI group, and/or people who are transgender?
  • If so, what has it been like? Have you encountered bias toward yourself or toward the people you are supporting? If you would, write about an experience or experiences you’ve had.
  • What would you most want to learn / dialogue about in a discussion about implicit bias and people who are transgender?
  • Do you know of any articles/people/resources that would be useful, specifically for allies, specifically for people who are transgender?
  • Do you have any information on changing implicit bias toward people who are transgender?
  • If you are not an ally but know one, what have you observed?
  • And finally…(well, nothing’s final): How would you title a session like this? 

Post away in the comments, either answers, or more questions. I’ll be writing more as I learn.

And, in preparation, I created a photographic journey of my ally-ness, which now has spanned almost 3 years. Like I said above, it’s been amazing – the people, the experiences, the beauty of the human spirit…


From: Susan Maasch

“Any trans ally , even those working with adults should be aware of the needs of trans children as well, Children, youth, resources, asking front desk people to refer to child by correct pronouns and names, asking them what pronoun and name they want to use, giving parents resources, making sure underserved areas have resources for trans youth and about their medical needs, and helping to advocate for transgender medical care coverage for children and youth. (Lupron, the standard of care for transgender/transsexual youth is about $1500-1600- a shot in most places) Keeping the trans child in the dialogue,etc. Please see our website, there are some good podcasts there as well that are educational, . On facebook at Trans Youth Equality Foundation ( standout page and articles) we are a national 501c3 organization serving families and youth and providers. great hearing about your work. Let us
know how we can help. Susan Maasch/Director TYEF”

Ted: Very thoughtful questions, and I so applaud you for reaching out to your followers for ideas and resources regarding this topic. It shows great humility on your part, which I respect immensely.

I was just looking for my reference to to see if they had an IAT for gender identity. Unfortunately they do not. I also see that you have already referenced them in your blog. HOWEVER, you may want to reach out to them and encourage them to develop one, as you and I believe this body of work is important. Maybe they are already developing one, and would love an opportunity to use it or test it…

With regard to your questions… I, of course, am a trans-ally. I recognize that I had implicit bias about transgender people and have worked to overcome those biases, however, I recognize that they still exist and I continue to deal with and work on them. I have not had any negative bias toward me as a result of my being an ally. I certainly have encountered a negative bias from others around transgender individuals.

IF a transgender IAT existed, that would be a great starting point for people to register their own bias… but since there is not one you can’t do that (unless Harvard is already developing one and planning to roll it out soon.)

If you look at implicit bias from an evolutionary biologist point of view, you can see how the implicit bias is something that has helped species survive and allows the most fit individuals within a species to persist. Some of this “knowledge” may even be carried at the genetic level. “Behavior”, we now find, is imbedded within the genetic material of individuals, and not just within DNA sequencing (Epigenetics). We may find that “implicit bias” has some foundation within epigenetics, and is not all learned behavior. While this is interesting, the point I’m trying to make is that these biases, for the most part, are there to help us survive. They are not necessarily NEGATIVE things. As a society, we have changed so rapidly that our brains think and our society changes social mores much faster than our biology can change, so we may see that it takes a very long time for the implicit biases we have as a society to disappear. I could talk about this forever… but…

On a population level, supposing that most people have at least some implicit biases against transgender individuals and maybe biases toward L-G-B individuals as well, I think the key is understanding “what” unconscious biases are, how they are developed, and most importantly, recognizing them and being aware of them within yourself, accepting them for what they are, and working to change them (if possible) or at least change how you reaction to them.

For the symposium, my guess is that most people will be fairly liberal, many “L”, “G”, “B” and a few “T” themselves. I would expect some implicit bias to exist around transgender individuals among the symposium attendees (even among transgender invidiuals – what we would call “auto-trans-phobia” may be somewhat related to unconscious bias). I would also expect that most people at the symposium to be aware of their implicit biases. Therefore ‘teaching’ what biases ARE, is probably not the best topic. Perhaps focusing on the issue of how to work toward overcoming the implicit bias is the best idea for the symposium.

Title Option 1: “Respecting (or Understanding) Implicit Bias: Putting Unconscious Bias In Its Place!”
Title Option 2: “Dealing With Your Implicit Bias Toward Transgender Individuals”

Hope this helps in some way. Thanks. Jeff

I see the use of the word “Transgender” itself as eliciting a biased perspective and unprofessional conduct. Its an inappropriate grouping word that violates a patients right autonomy. Just like most same sex attracted people do not identify as LGB and there is a lot of research showing that to be the case the vast majority of gender non-conforming people are heterosexual. The same can be said for the majority of Intersex people in that they view themselves as heterosexual. How is forcing all of these people into the “Gay Community” not increasing their stygma? Simply put using LGBT language at all should be frowned upon by anyone in a Professional capacity on anyone but the small amount that choose to identify themselves as “LGBT” or members of the “Gay Community.”

Hello again,

I’m not sure I understand your comment. Can you comment with research references or give a little bit more information about your situation? Anonymous comments are okay on this blog as long as they provide useful context,


Years ago you requested some data from me over the use of the word Transgender. I have a word press blog. With a simple google of My Closet Door Didn’t Open into the closet door. You should be able to find it. There are two undergrad papers I wrote there. The one I wrote about youths was supported by the 2016 CDC YRBA. 2/3rds of same sex attracted high school age youth reject the LGB labels. With transgender it confuses to many issues together and will argue the professional use and promotion of the LGBTQ labels and grouping is the number one cause of mental health problems and suicide in both youth and adults. It traps people between two of groups of bullies that have no respect for individual rights. Those two groups are LGBTQ activist and religious conservatives, The LGBTQ labels and grouping become scarlet letters representing nothing good unless you are a sexual predator.
I have been in a year’s long battle with the VA that its LGBTQ+ program is not legal or constitutional. That they are doing junk research on Veterans! That they should be requiring written consent from Veterans to use LGBTQ language on them and to include them in the grouping. Now you can do real research that has never been done before! You will find out why people either accept or reject being included in it! It’s the only way to respect individual rights! Considering the results of the YRBA the last thing the military should be doing is allowing LGBTQ military service! They are using the labels most associated with poor mental health and incomplete military service. The word Transgender comes from heterosexual male fetishistic transvestism. Its use on children can be argued as ongoing sick pedophilia supporting criminal sex act. The Psychology and Psychiatry profession is overloaded with perverts that have created their own perfect criminal sex! Complain about the LGBTQ and they have trained the activist to bully and shame anyone that rejects or questions what is going on in public. They have rigged the conversation so only LGBTQ activist and religious conservatives are heard and everyone else gets shut out. You can see that happening in the courts as well. The courts are ruling on religion while ignoring the laws of all fifty states, the federal government and the scientific literature!

Ted Eytan, MD