Jenny Siegel ’01: The Power of Medicine

Jenny Siegel ’01, medical director of the Center for Transgender Medicine and Surgery Department at Boston Medical Center, reflects on the patients she serves.

When Jenny Siegel ’01 was applying to college she thought she might like to pursue medicine, but it was at Smith that she finally realized why. “I started to see that medicine could be used as a tool for social justice,” Siegel says. “I went to medical school with this very clear idea that working within the healthcare system could be a way of improving not just the health but also the wellbeing of marginalized populations.”

That guiding principle has been at the heart of Siegel’s work as medical director of the Center for Transgender Medicine and Surgery Department (CTMS) at Boston Medical Center (BMC), which provides transgender and non-binary individuals of all ages with comprehensive medical care, from primary care to mental health services to surgical needs.

Siegel has been working with transgender and non-binary populations since her days as an intern and later when she came to BMC in 2011, but it was only in 2016 that the CTMS was formally established, making it one of the few departments of its kind in the country.

She credits Mary Harrington, Tippit Professor in the Life Sciences at Smith, for inspiring her to follow her passion for medicine. “She is the epitome of a woman succeeding in science and in health,” Siegel says. “I have long admired her, and wouldn’t be where I am without her.”

Here, Siegel reflects on the changes she has seen in providing care to transgender people, what still needs to be improved and why she is so inspired by her patients.

In the beginning
I was lucky enough to do my residency training at San Francisco General Hospital, a county public hospital, which exposed me to the needs of patient populations that have often been marginalized or underrepresented within society. I saw how powerful medicine could be, especially for transgender individuals, who choose to medically transition, and interface quite tightly with the healthcare system. I myself am a member of the LGBT community, and for me, LGBT health and transgender health has been very much woven within my practice.

Patient-first care
I am a primary care provider within the CTMS, but I’m also the clinical and administrative lead for the whole program, which means I do a lot of coordination across the various departments that serve our patients. I manage a central team that includes a project manager, a peer navigator and a nurse. We do educational trainings, clinical updates, research, budgeting, and community outreach and advocacy.

A strong community
The transgender community is really a set of communities that are super diverse and incredibly resilient in the face of so many social and legal policies that aim to disenfranchise them. I see how strong and resilient this community is, but there are a ton of challenges as well—legal discrimination, social discrimination, the Trump administration’s efforts to redefine gender in a way that we don’t understand it to be. A lot of states, including Massachusetts, have had anti-transgender ballot initiatives. These types of social stressors have a profound impact on people’s mental and physical health.

Joy in transition
There can be a lot of sadness in medicine—serious illness and death. Gender-affirming care is generally a positive experience. People are able to align their bodies with their gender identity. Sometimes in healthcare we don’t have the tools to make people feel better, but in this area, we actually do have some tools to positively impact people’s lives. That’s definitely fulfilling for me.

A growing awareness
There are a ton of health disparities facing the transgender community, resulting in higher rates of mental illness, HIV, suicide and bullying. Members of the transgender community report shocking rates of verbal abuse and inappropriate questioning in the healthcare system. The fact that healthcare providers realize we need to do better is a huge improvement, yet much more needs to be done to fully address these health inequities.

What is getting better
More elements of gender-affirming care are now protected under the Affordable Care Act, which has led to at least partial coverage by many insurance companies and Medicare. For a long time, it wasn’t recognized as medically necessary, even though it has always been. Also, it’s heartening to see more transgender and non-binary individuals joining the health professions, something that we need to continue to promote.

Creating welcoming spaces
Historically, we have not asked people about their gender identity, much less provided people with training as to what to do with that information. Asking these questions allows people to be seen. It’s so critical because when you see your healthcare provider you need to feel that you can be honest about everything that’s going on in your body and in your soul.

No one should be left behind
The whole transgender community has faced marginalization, but then within the transgender community there is division. It’s worth noting that when you look at intersecting identities, transgender women of color have faced exceedingly worse health outcomes than other members of the transgender community, much less the general population. I think that’s something we really need to be careful about: making sure that health outcomes for all members of the transgender community are growing, not just for some.

Smith’s lasting impact
I grew up in a small town in North Dakota. For me, as somebody who’s openly lesbian, to get to Smith and to meet the LGBT community and to be embraced by it was huge, and it’s where I met some of my first transgender friends and started to understand some of the issues they were facing. As I look at the long thread of what has led me to where I am, those late-night conversations at Smith about what’s important in the world have stayed with me.