Newswise — LOS ANGELES (June 19, 2024) -- He’s a U.S. Navy hospital corpsman who has provided medical care to troops in the clinic and to troops fresh off the combat field.
The landscape may change, but the compassion and kindness that Elijah, 31, brings to frontline medical care are constant. Elijah, who asked that only his first name be published to avoid potential discrimination, said he first learned his go-the-extra-mile approach from his father, who also served as a hospital corpsman in the Navy.
And then, Elijah said, he learned even more from the care he received at Cedars-Sinai, as a patient of Maurice Garcia, MD.
Garcia, a pioneer in gender-affirming surgery, is director of the medical center’s Transgender Surgery and Health Program.
In April, Garcia helped Elijah complete a seven-year surgical transition from female to male—and to a more authentic life.
“Patients often tell us that surgery profoundly improved their quality of life,” said Garcia, professor of Urology. “Being able to provide that experience is a wonderful feeling.”
Elijah’s experience as a Garcia patient inspired Elijah’s philosophy on how to treat his own patients—service members and their families.
“I experienced what care should be at Cedars-Sinai, and that’s how I try to do my job,” Elijah said. “I’ll go out of my way to help people feel at ease, to let them know I’m advocating for them. I’m respectful and kind. That’s one way I can give back, in gratitude for how I was treated.”
Expanding Care for a Growing Community
The U.S. Census Bureau reports that 1.7 million Americans identify as transgender—someone who’s gender identity and gender roles align with the sex that is opposite the one they were assigned at birth. Although many transgender people opt not to have gender-affirming surgery, which aims to align physical appearance with gender identity, a recent study in the medical journal JAMA Network Open found that the surgeries nearly tripled in the U.S. between 2016 and 2019.
The increase is attributed in part to more insurance coverage of the procedures, as well as to more people identifying as transgender.
Garcia has dedicated his career to caring for patients who require genital reconstructive surgery, including transgender and non-transgender people. He established the medical center’s Transgender Surgery and Health Program, the first of its kind in Southern California.
Last year, Cedars-Sinai expanded its offerings to meet the needs of the entire LGBTQ+ community with the opening of its LGBTQ+ Center, where board-certified specialists provide genital reconstructive surgery as well as expertise in sexual medicine.
“We want to offer our wealth of expertise to many disparate groups,” Garcia said. “For example, people who are intersex—which means they have differences in sex development—can benefit from our innovation in reconstruction surgery for transgender patients. Our priority is to welcome and be respectful of each group, recognizing their unique differences. This approach can be found from the front desk to the operating room, where everyone knows how to give excellent care and speak in a respectfully, culturally appropriate way.”
How and When He Knew
Elijah was born with female genitals and raised as a girl. He was in third grade when a classmate asked if he used the girls’ bathroom or the boys’ bathroom. He hadn’t really thought beyond the fact that he loved sports, enjoyed hanging out with boys and had nothing in common with girls.
As a young adult, he realized he was physically attracted to women, but he never felt that he was a fit in the lesbian community.
Out of the blue when he was 22, his girlfriend asked if he ever felt that he was a guy.
“I was caught off guard and wasn’t sure how to answer,” he said. “But I knew I didn’t feel like a girl.”
He began to research gender dysphoria—a feeling of distress when assigned and experienced gender are mismatched—and what it meant to be transgender. He watched YouTube videos about what transitioning to the opposite sex involved.
“I knew that men could become women, but I did not know that women could become men,” he said. “It sounds silly now, but you didn’t hear about it as often.”
Elijah had recently joined the Navy. There, he began the first steps of transitioning. He met with a military psychologist and behavioral therapists. A year later he began hormone therapy; chest surgery and a hysterectomy followed.
Elijah met Garcia and team, including Transgender Surgery and Health Program key partners Edward Ray, MD, the plastic surgery lead, and BJ Rimel, MD, the obstetrics and gynecology lead, in February 2020 to discuss completing his transition with genital reconstructive surgery.
Garcia remembers that Elijah came in with a grounded optimism.
“From our first consultation, our team was struck by Elijah,” Garcia said. “He acknowledged possible setbacks and voiced that he was prepared to manage them. He was focused on the bigger picture.”
Elijah was impressed by the amount of time that Garcia spent with him, his approachability and his highly regarded expertise and experience—Garcia has developed groundbreaking procedures that are specific to Cedars-Sinai.
“Dr. Garcia gave a straightforward, detailed rundown of what I could expect with surgery,” Elijah said. “He thoroughly answered every question.”
Over the next four years and four surgeries, Elijah benefited from that thoughtful and careful approach.
A Committed and Compassionate Team
Garcia noted that gender-affirming surgeries at Cedars-Sinai are not cookie-cutter, but rather, tailored to each patient’s body and desired outcome.
“We are interested in what each patient wants. We ask questions, we listen, and then—because we have the expertise to accommodate those requests—we move forward,” Garcia said. “It takes a certain humility to say to a patient, ‘Let’s talk about how to best accommodate you.’ But that is our culture—we’re flexible, we’re committed, and we’re focused on the best possible outcomes.”
After seven years of what felt like a constant transition, Elijah said he is ready to simply live authentically.
“Dr. Garcia and his team are dedicating their lives to people like me, making sure we feel seen and heard, and that goes a long way,” Elijah said. “It’s lifesaving work. If I had not transitioned, I would probably be miserable.
“I hope that the patients I see can benefit from the experiences I’ve had. I hope my story helps others who may be going through what I did.”
Read more in Cedars-Sinai Magazine: LGBTQ+ Patients | How to Connect With a Caring Doctor
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