August 19, 2019 | Read more »
Lem Arnold grew up in Houston and Port Arthur, TX. He went to the Massachusetts Institute of Technology (MIT) for undergraduate school and returned to Houston to attend medical school at the University of Texas at Houston. Lem worked as a pediatrician for about 30 years before retiring in 2016. He and his partner Pat live in Lafayette, GA.
BPFNA: Why did you want to go into the medical field?
LA: In college I got into biology because I took an introductory course in biology taught by Salvador Loria, who was Nobel Laureate in genetics. He was an Italian Jew who escaped Mussolini in WWII. But also he was an unbelievably strong peace advocate. And he was one of the co-founders of Medical Aid for Indochina, which started in the late 1960s and raised 6 million dollars to rebuild the teaching hospital that US bombers destroyed in Hanoi. And the subject matter on molecular biology of the gene was interesting and so it changed my life. I would not be a physician if it wasn’t for Salvador. He led the department to strike in ‘72 when they were the burning and bombing in North Vietnam.
BPFNA: Can you talk about some of your work?
LA: I was a pediatrician starting in 1980, and I joined Kaiser Permanente in 1988. With Kaiser I took on a variety of roles - an associate medical directors’ role for business affairs for a while; I was on the board of directors for a while; I served in various administrative roles; I was chairman of the department of medicine; president of the medical staff; and served as chair on several committees including two years as chair of the bio-ethics committee. I then decided I wanted to go away from administration for a while and go back to primary care because I missed it.
At that same time I got appointed to Kaiser’s National Diversity Council and was the only openly gay person on the council. The council’s focus was culturally competent healthcare. They had already produced a Latino/a, African American, and Pacific Islander handbook, so they came to me in 1998 to pull together a group to create an LGBTQ handbook. It was produced in 1999 and it was the first provider handbook on LGBTQ healthcare in the US, if not the world.
I got into education around LGBTQ healthcare and lectured many places, even internally at Kaiser. After I stepped down from the National Diversity Council in 2004, Kaiser gave me their national award for Diversity Achievement as an Individual in 2005.
I just retired from Kaiser Permanente in October 2016.
I’ve also been lecturing for 13 years at Morehouse School of Medicine on LGBTQ healthcare and I’ll keep doing that if they keep inviting me. I was on their Interregional Work Group for the Implementation of Transgender Healthcare Benefits.
BPFNA: What have you been doing in your retirement?
LA: Well when my partner Pat and I met in 1995 we ended up building a house in the country on the farm he grew up on in Georgia. And then we ended up buying the rest of the 50-acre farm from his mom. So we have our farm and also our church, Lafayette Presbyterian Church, the only church in Walker County, Georgia that does same-sex marriages.
It’s a small congregation of 40 people, and it has a good relationship with an African American Church of God that started having services in our sanctuary back in the 1930s before they had their own building. Pat is chair of the outreach committee and correctional task force that looks to find housing for people coming out of prison.
I also went back to work at a Community Health Center that about three years ago put in a grant request to help create a second school-based clinic. They had one at West Lafayette elementary school, which is in the poor area of Lafayette that used to be a mill town. So that was approved and the clinic has been in operation for three years now. They had a pediatrician there one day a week and one day at the other clinic. She gave them 60 days notice and they didn’t have anyone to replace her. So they came to me, and I agreed to work two days a week.
In pediatrics now there’s a severe shortage of pediatric specialists, there’s a shortage of pediatricians, there’s a shortage of dentists in rural areas, there’s just a lack of services in a lot of places. I’m seeing a high percentage of Medicaid patients, who are struggling to get services. It’s a totally different environment than what I was doing.
BPFNA: It sounds like you’re staying busy.
LA: Yes, and I’m still looking at things to do to fill up that desire to do something in the community.
I enjoy doing the educational process and pushing people’s minds to think about things differently. With Kaiser’s Interregional Work Group for the Implementation of Transgender Healthcare Benefits, I lectured our internist on how to do hormone therapy, our pediatricians and endocrinologist on how to work with Transgender patients, behavioral health. It requires a definite mind shift to make sure the whole interaction is respectful of their identities.
BPFNA: Can you talk more about your work with Transgender patients?
LA: Working with Transgender patients requires you to fully accept someone’s gender identity without having to ask questions because irrespective of anything that’s been done to them physically, their gender identity is a separate thing.
One of the things I’ve used in presentations is called the “Gingerbread Man” and you can find this online, but the Gingerbread Man has a brain, a heart, and an asterisk on the groin.
The brain contains gender identity
The heart contains sexual orientation or who you are attracted to
The groin contains the biological reality of what your genitals are
And they’re three independent variables. So the brain determines gender identity and that tells you whether you’re transgender or not by if that identity matches what’s down below.
Once someone tells you their gender identity there’s really no other question that needs to be asked. It’s interesting to get people to grasp that and to realize that sexual orientation is something completely different.
I think getting people to put all this together, that yes, you can be a trans man who is attracted to men and that would make you gay. Because you identify as male (gender identity), and you’re attracted to males (sexual orientation), so from a heart perspective you’re gay. Even though you were born a female, and some people would argue you’re being heterosexual, but the reality is the primary relationship is your gender identity. The primary definition is your gender identity.
So I lecture on that and talk to medical students on understanding it and understanding the difference between gender identity and sexual orientation.
BPFNA: What challenges, resources, or realizations - based on interactions with Transgender patients - have been helpful to pass on to other medical staff or students?
LA: One of the things I do is lecture on how to do a non-heterosexist patient interview. Particularly with adolescents, if you want them to eventually identify to you as being gay or bisexual you don’t immediately start asking them if they’re dating the opposite sex. So you use gender-neutral pronouns, you ask open-ended questions.
I had to learn how to do the non-heterosexist interview myself the last 10-12 years of my practice because I had probably about 12-15 kids come out to me. Some of the time when they weren’t out to their parents. I also had to deal with kids who were being harassed or bullied at school because they were perceived as gay.
BPFNA: How did you get involved with BPFNA ~ Bautistas por la Paz?
LA: Pat grew up in the Church of God in Anderson, IN and they have a Peace Fellowship. It’s a pacifist denomination, but they consider it to be a movement. The founders of it were invited to the Peace Camp that was in Atlanta about 12 years ago, they couldn't come, and they knew Pat so they called him and asked if he could go. So we went. And we’ve been coming back ever since. It really feels like a home for him and it feels like a home for me too. So that’s how we got here and we’ve stayed around because it fits with our philosophy and our thought and provides inspiration for doing things. Both of us have come to the realization that you have to give back to your community and you have to figure out ways to do that, and what feels like it comes from the heart and that fits with your philosophy.