June 29, 2021

Maryssa Lyons is a PGY-1 psychiatry resident at Tower Health – Brandywine Hospital. They are one of the lead organizers of Drexel University College of Medicine and Tower Health’s virtual LGBTQ+ Health Symposium, a virtual professional development and educational event that will take place on Wednesday, June 30, 2021.

Can you tell me a little bit about yourself?

I'm Maryssa, I use they/them pronouns. I grew up in central, rural Michigan. I went to the University of Michigan for undergrad and studied neuroscience, and I graduated medical school from Central Michigan University College of Medicine. I'm a PGY-1 psychiatry resident at the Tower Health – Brandywine Hospital General Psychiatry Residency Training Program.

What drew you to psychiatry as a field?

I've been interested in psychology and mental health from a really young age. Both of my parents struggled with mental illness, as have I, and a lot of other people in my family. So mental health was just always something of interest, and something that was really topical and pretty crucial to my development. The empathy and ability to advocate for yourself or for a patient as a mental health professional are skills that I had to build from a young age, as I navigated my parents' illnesses.

Going into undergrad, it was really a question of whether I was going to get my PhD in psychology or go get my MD and be a psychiatrist. I chose to get my MD, because when else in my life would someone force me to learn a bunch of biology? It seemed like such a novel thing to do. It was quite the experience; I don't regret it, because I think it gave me a more well-rounded perspective, being that I do come from such a psychologically interested and interpersonally oriented life experience. It has given me a solid background to understand people in a different way.

What brought you to Tower Health – Brandywine Hospital for your residency? After growing up in a rural area, what made you interested in providing health care to a rural community?

My medical school focused on providing rural medicine, with the idea that people from this school were going to be primary care physicians in rural areas. I ranked this residency really highly because of the connection with Drexel University College of Medicine and the fact that I will have opportunities to practice in Philadelphia and opportunities to receive training to work with the LGBTQ+ community.

My eventual goal is to work with LGBTQ+ youth and adults and specialize in that as a psychiatrist. Being part of the LGBTQ+ community is a really nuanced thing that a lot of mental health care practitioners do not have enough experience in. Growing up queer in the rural Midwest was definitely enough for me to be sympathetic to the cause and to relate to queer patients in rural areas, to say nothing else. Through my experience and those of my friends, I’ve seen the mental health tolls homophobia and transphobia take on people, especially in inhospitable environments – it is incredibly detrimental to mental health. So I understand the limitations there might be in working in rural environments, but I also appreciate the really unique opportunities you have in connecting with patients in those spaces. As a physician, you can be the person who sees someone as themselves for the first time. I think that's such an honor.

What are some simple things that current or future physicians can do to be more affirming for queer and transgender patients?

That question makes me think of a psychological theory, this idea that an individual is more than the sum of their parts. I really like the idea of taking a gestalt approach to health care, where you need to know what the individual parts of a whole person are. You need to know what's going on in multiple aspects of a person's life to understand the sum of who they are.

Not everyone will want to say what pronouns they use or feel comfortable taking that step, so I like to let them choose whether or not they want to do that. If they don't want to share that information, you can just work based on your assumptions, or default to gender neutral language, which is what I tend to do.

I also think it's important to be comfortable taking a full history that's relevant to your function with that patient, on that day. So for me, I might ask myself, 'Do I always need to ask my patients about their entire sexual history?' In some cases, I do not – I only need to ask what is relevant to their current concerns. If their sexual history is relevant, then I do need to know, 'What kind of sexual acts are you performing? What sort of people do you engage in sexual activity with?' I think it's really about thinking, 'What do I need to know to do my job?' and then just asking the questions you need to know, without making any assumptions.

What do you feel you and other health care providers are giving patients through care that is affirming of their gender identities and romantic or sexual orientations?

I think it's just the feeling of safety. I've had times in my life where – honestly, I’m still not out to my primary care doctor. I like her a lot, she's a lovely woman, but I get so nervous still that my physicians aren't going to be gender affirming. And I can't imagine if you are someone who is less health literate than I am, getting health care and walking into a potentially hostile environment where you may have difficulties advocating for yourself. I think that is a gross injustice, and in an ideal world it wouldn't happen. In my ideal world, people of any gender identity, sexuality or romantic orientation can go to the doctor and be treated as an individual person. They’d be seen for who they are in their life experiences and receive appropriate health care based on that. I'm of the opinion that health care is a human right, so honestly, the fact that people aren't being seen as holistically as doctors would like to imagine they are is approaching a human rights violation in my mind. We need more qualified individuals.

You’re a lead organizer of this year’s College of Medicine and Tower Health LGBTQ+ Health Symposium. For people attending the event to become a more qualified provider or just to see what presenters have to say, what would you say they can expect? What do you hope they learn from the symposium?

I really hope that a big takeaway is an ability to understand what kind of different genders and sexualities people can have, and to have a less pathologizing approach to these normal variations in the human experience.

Subject areas I wanted covered in the symposium were based on a couple of things. I definitely wanted to address physician competence and preventive medicine for LGBTQ+ communities and also stigmatization, especially around transgender people, among physicians and medical students. I think it's important for physicians to know things like the basic health care screenings that may get skipped, and things that physicians don't ask about because of how they may be thinking of patient demographics. It's also important to know what health concerns are more prevalent among different communities. It comes down to how we frame health care concerns, for instance, 'Women do not commit acts of domestic violence' or 'Cisgender women are the people who have eating disorders.' We have these ideas in our heads, all these scripts we learned in medical school about demographics, but they're always very cisheteronormative. When you get into the research on certain issues, you realize, ‘My community is at risk for these things, and no one has ever told me.’ I really wanted the symposium to address that. Otherwise, symposium topics came out of things I've come across generally, from my work or my personal experience, or in hearing about friends' experiences.

How do you feel like being part of the LGBTQ+ community influences your work in organizing an event like this, or impacts how you approach psychiatry?

For me, growing up in the rural Midwest made it a lot harder because my community was really small. Being a young person in the early 2010s, there was this really big nonbinary erasure, this idea that you could only be trans if you were binary trans. It really held me back in my own development of my concept of self and development of my identity, and it really drew out how long it took me to come out. So a lot of my experiences have been shaped by the experience of a lack of a community or feeling unaccepted in a community. Once I started to see nonbinary representation when I was in college, it gave me ideas of who I could be and different lenses through which to see myself. It made me want to be the supportive, inclusive person that I wish I had in my life: the person who, if there's not enough seats at the table, builds a bigger table.

And who have you been working with in putting the symposium together?

The main people I have been working with come from the Drexel University College of Medicine LGBTQ Professionals in Medicine executive board – they have been really instrumental in all of this. Shout out to all of them, they're crushing it. I've also been working with Dr. McCrea and with my program director, Dr. Sudak.

We recently reached out to some LGBTQ+ Philadelphians on the Facebook group Queer Exchange Philly, so we can put together a community panel for the symposium, because we want to make sure that people of all different experiences get represented. With people who are already in medicine, it skews toward people who are more likely to be white and more privileged, but we want to have as many perspectives as we can on the panel. We don't want the event to become something like, 'This is a symposium made by nonbinary people, on how to care for nonbinary people.' I will only ever be able to give my perspective as a white, assigned female at birth, nonbinary person from rural Michigan. That is my perspective. I don't know what the intersectionality of being a person of color and being queer is. I think it's important to try to let that be known and to make sure we have a wider view.

What are you most looking forward to about the LGBTQ+ Health Care Symposium?

I'm looking forward to having a bunch of people sit and be educated about something I'm so absurdly passionate about. Aside from that, I organized the topic on LGBTQ people and eating disorders because I wanted to learn a bunch about it. I cannot think of a better way to spend my time than sitting down and learning that. Technically it was for everyone, but it was mostly for me.

I can't explain it enough, how strongly I feel, 'This is going to be my life's work.' Today is my day off and I attended a training on dialectical behavioral therapy with LGBTQ clients, and how to discuss intersectionality and things like that within this kind of process. Dialectical behavioral therapy can be really structured and has firm tenets, and applying those two ideas of intersectionality and LGBTQ experience specifically was super great.