April 16, 2019
Robyn Johnson-Barbee finally feels like her true self. It was a feat that seemed impossible for most of her life. But she did it – with the support, encouragement and expertise of specialists at The University of Kansas Health System, in Kansas City, Kansas.
While her path was long and often painful, she has no regrets. "I would do it all again," says Robyn, a transgender woman of color. "I want to share my story so other transgender people have hope and find the resources they need."
A history of abuse
Throughout her life, Robyn experienced a long history of abuse and depression. "I was sexually molested by my uncle and my mother beat me, so I grew up in a number of different foster homes. Some of those homes were abusive, too."
Robyn always identified as female although she was born male. "I struggled through school," she says. "When I was older, I made the determination that I am a woman." Further complicating an already tumultuous life, she was the victim of a hate crime and she is HIV-positive.
In general, members of the transgender community experience much higher rates of abuse, crime and depression. HIV rates are also much higher. The Centers for Disease Control and Prevention reports that as many as 28% of transgender women live with HIV, while 56% of African-American transgender women live with the condition.
"This is a completely disadvantaged population," says Meredith Gray, MD, a board-certified gynecologist who specializes in transgender surgery at The University of Kansas Health System. "The rate of HIV in this demographic is beyond the rate in some third-world countries. It's a shocking health disparity. We take all this into consideration as we plan and care for our patients."
Kimberly Vandergeest-Wallace, PhD, a clinical psychologist with The University of Kansas Health System, says Robyn's situation is not unusual. "A lot of depression and suicidal ideation in transgender people can be situational," she says. For many, mental health issues are linked to frustration and distress over the struggle to transition and all the stress being transgender can pose to relationships, employment and medical care.
"This is different from true clinical depression because in many cases, once they are able to begin and then complete their transition, these issues resolve," she says.
Finding her way
Despite her depression, Robyn was determined to find the resources she needed to successfully transition. In her 30s, she learned about the program at The University of Kansas Health System. That's where she met Judy Gay, RN, program coordinator.
"Some patients are coming from a really bad place," says Judy. "They ask me if it's going to be worth all they've lost. We see everything from heartwarming to heartbreaking situations – and we're here for everyone."
Robyn met with Dr. Gray to discuss surgery. "She didn’t give me false hope," she says. "She really made me feel confident about myself and the process."
When the day arrived for her vaginoplasty, the feminizing genital surgery, Robyn admits she was scared, even to the point of having second thoughts. "I went through with it because I knew that’s what I wanted – to feel like a whole person as a woman," she says.
Robyn takes female hormones, which feminize her voice, develop breast tissue and reduce facial and body hair. She's looking forward to completing her transition with breast augmentation. Although she's feeling better about her body and life, Robyn must still manage her mental and emotional health. She continues to work with her care team to help her overcome her psychological challenges as she completes her physical transition.
"We're here to help at whatever stage our patients are at," says Dr. Vandegeest-Wallace. "For those who need follow-up mental healthcare, we continue to provide it. We strive to give transgender people a voice, allowing them to feel seen and heard, which empowers them. For some, it's the first time they've had that kind of interpersonal communication in a supportive way."
Robyn is now dedicated to helping others in similar situations.
"I want other people in the transgender community to know about these resources," she says. "Even if you have other problems in your life, this is one thing you can do – become who you really are."