It started in medical school, when I witnessed a stark reality of the hidden curriculum: a transgender patient referred to as “it” by an attending physician. Over the years, I saw more subtle but no less harmful behaviors—snickers, misused pronouns, and quiet biases.
Today, transgender identity feels more politically charged than ever. But beyond the politics, what’s it like simply to be transgender? What challenges do transgender patients face—physically, medically, socially, and emotionally? And how do you navigate a world that sees you differently after transitioning?
In this episode, Dr. Jailyn Avila shares her story. We cover the deeply personal aspects of transition, from conversations with her wife and kids to navigating professional dynamics as an internationally recognized expert. Dr. Avila offers candid insights into her experience as a physician presenting as both male and female, practical advice for providing better care for transgender patients, and strategies for addressing pronouns and mistakes with grace.
Guest bio: Jailyn Avila is a board-certified emergency medicine physician, transgender woman, wife, and mother of three. She has been heavily involved in medical education with an emphasis on bedside ultrasound and runs Core Ultrasound, delivering online educational content. In 2021, Jailyn began her gender transition and “completed” said transition in 2023. Jailyn is currently Core Faculty for the UHS SoCal MEC Emergency Medicine Residency in Temecula, California where she also functions as the Associate Ultrasound Director and the Director of Faculty Development.
Mentioned in this episode:
- Awake + Aware 2025
- Our free resources to address pain points in medical practice
We Discuss:
Coming Out to Her Wife
Feelings of gender dysphoria began at a young age for Jailyn but were suppressed due to her conservative upbringing. Early expressions of femininity (e.g., cross-dressing) were done in secret and clashed with societal expectations, creating a deep internal conflict.
The fear of rejection competed with the pressing need for personal authenticity, making it increasingly difficult to hide her gender identity from her wife. Disclosure became inevitable as Jailyn realized that suppressing her true self was unsustainable. Through honest communication, she explained that wearing women’s clothing alleviated stress and discomfort. A central focus of the conversation was reaffirming her unwavering love and attraction for her spouse.
Navigating Gender Identity and External Friction
Transitioning and embracing gender identity involves multiple layers of friction. Internally, self-acceptance was hindered by internalized transphobia, shame, and the emotional toll of suppressing authenticity. Interpersonal challenges included addressing fears with her spouse, clarifying misconceptions about being transgender versus sexual orientation, and supporting children through societal teasing. Societally, rigid gender norms, political resistance, and the pressure to “pass” created significant external barriers. Professionally, transitioning impacted workplace dynamics, reduced leadership opportunities, and required navigating biases while maintaining visibility. Structurally, healthcare gatekeeping and the financial burden of treatments added further complexity.
Balancing Personal and Professional Identity
Jailyn’s established professional presence, including national lectures and awards, made embracing her true identity even more daunting. She faced the challenge of balancing authenticity with the expectations tied to her visibility in the field. Self-acceptance required her to confront deeply ingrained fears, including the childhood prayers she once whispered, hoping she could change. The overlap between her personal and professional lives added another layer of complexity to coming out. Even so, her enduring love for her work and her dedication to professional engagement became anchors, offering stability and a sense of normalcy through the transition.
The Gradual Process of Transition
The transition process began with deep introspection and therapy, giving Jailyn the tools to address her internal struggles and clarify her path forward. Early steps included taking testosterone blockers and starting low dose estrogen, all while continuing to present outwardly as male. Gradually, she began learning makeup techniques, adjusting skincare routines, and undergoing top surgery—small but significant milestones that helped align her external appearance with her internal identity. These incremental changes, experimentation, and small successes built her confidence and proved that transitioning was achievable with effort and persistence.
One of Jailyn’s primary goals was to live as the same authentic person at home and in public, shedding the exhausting duality of a hidden identity. This journey required extraordinary effort—emotionally, physically, and financially. She faced significant barriers, such as insurance gatekeeping, high out-of-pocket costs for medication and procedures, and societal expectations around passing. With the steadfast support of her family, Jailyn found that achieving authenticity brought immense relief, alleviating lifelong stress while fostering a profound sense of wholeness.
Navigating Work and Social Dynamics
Supportive workplace relationships played a significant role in easing Jailyn’s process of coming out professionally. While some coworkers made missteps, such as asking inappropriate questions, she responded with patience and used these moments as opportunities for education.
Jailyn’s early and consistent advocacy for transgender experiences in her professional environment fostered greater understanding and inclusivity. Therapy proved invaluable, offering strategies to manage workplace dynamics and maintain emotional balance as she navigated her transition in a highly visible and often challenging setting.
Experiences as both a Male and Female Physician
Transitioning gave Jailyn a stark view of the differences in how female physicians are treated compared to their male counterparts. Professional advancement, which had once seemed natural, became notably more difficult, underscoring systemic gender inequities within the medical field. This shift provided her with unique insights into both privilege and bias, deepening her understanding of the challenges faced by women and queer professionals in medicine.
While transitioning affirmed Jailyn’s authenticity, it also exposed the societal and professional obstacles tied to gender identity. The experience highlighted pervasive biases in professional environments, offering her a firsthand perspective on the barriers that hinder equity and inclusion.
Managing Emotions: The RAIN Method
One of the most effective tools in therapy for Jailyn was the RAIN method—Recognize, Acknowledge, Investigate, and Nurture—which provided a structured approach to managing complex emotions. Naming emotions accurately became the first step in addressing them constructively, while accepting them as valid, rather than judging them, fostered emotional growth. Investigating the root causes of these feelings offered clarity, and nurturing them focused on taking actionable steps within her control to resolve issues.
Caring for Transgender Patients
Respecting pronouns and patient demographics is a fundamental aspect of compassionate care. Updating patient information in electronic medical records (EMRs) is easy and staff should be trained to avoid both intentional and accidental misgendering. These efforts build trust and create a safe healthcare environment where individual needs are acknowledged. Even small changes in communication and procedural practices can have a profound impact on patient dignity and comfort.
When mistakes occur with the use of pronouns, a brief acknowledgment and correction are sufficient; over-apologizing risks shifting the focus to the provider rather than the patient. Ultimately, kindness transcends differences, serving as the cornerstone of meaningful, respectful, and effective care.
Impact on Family and Children
Children often adjust to a parent’s transition more easily than expected, thanks to their natural flexibility and openness. Simple, age-appropriate explanations about gender identity help them understand and accept the changes. When social challenges like teasing arise, addressing them through calm, thoughtful conversations helps keep things normal and manageable. For Jailyn, transitioning not only reduced her stress but also brought positive changes to her family dynamics, strengthening their bond.
Understanding Gender and Biological Variations
Biological variations, such as intersex conditions, underscore the complexity and diversity of human gender identities. Gender identity exists beyond binary definitions, encompassing a broad spectrum of experiences. For many transgender individuals, societal invisibility or discrimination tied to appearance creates additional challenges, often leading to safety concerns that make public disclosure of their identity risky. By recognizing and understanding the richness of biological and gender diversity, we can build a more inclusive society.
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