Ms. D. was never my “regular” patient. I did answer her call lights, adjust her IV pumps, and help with other activities as I saw the need or colleagues – Ms. D.’s “regular” nurses – asked. Ms. D. had terminal lung cancer. Ms. D. was formerly Mister D.

Yes, Ms. D. was transgender. She was in the middle of her transformation, and I honestly felt sadness when I did care for Ms. D. Not because she was transgender and I was uncomfortable. No, I was saddened because Ms. D. thought her cancer diagnosis was a plague from God for her transgender sins.  It was heartbreaking to hear – from her and from her nurses. No matter her nurses’ and physicians’ medical model cancer explanations, she would not be swayed. God was punishing her with lung cancer. He had to be. Her cancerous lungs were right beneath her silicone breast implants. No amount of discussions from healthcare providers or clergy convinced her otherwise.

Ms. D. needed palliative chemotherapy and surgery, but before she started that journey, she decided to take a different path – one that surprised us altogether. Ms. D. requested her silicone implants be removed. After still more discussion, the healthcare team honored Ms. D.’s request. And after the surgery, Ms. D. asked to be called Mister D. It was a confusing time for the healthcare team, but I am sure it was nothing in comparison to the confusion Mister D. was feeling. Not too long after his lung resection, Mister D. left for hospice care. I never saw him again.

Ms. D.’s thought of her cancer origin initially hit me hard. Why? What? I replayed it over and over again in my mind. I thought a lot about sexuality, religion, culture, emotions, family, cancer, care, you name it. I have thought about Mister D. on many occasions since then, too. I thought about him as I read the Oncology Nursing Society’s January Connect focused on the LGBT population. I thought about him again as I read about the stigma that still exists within the transgender community, including a story of a healthcare provider refusing to care for a transgendered person. And I’ve thought of him often as my organization works on a project related to the LGBT population.

I continue to think of him. A past collision of sorts with future impact. Mister D. will never know the impact he made on my life – both professionally and personally.