The Journey is the Destination

Until very recently I appeared to most people a successful and conservative middle-aged white businessman. At 41 years of age, my career arc landed near the top of my field and saw me pulling in a very respectable income. Along with my wife of 12 years, I lived in a new home in a newer suburban development. You know the type: similar in style and size to the several houses surrounding it, and nestled in a quaint neighborhood complete with gated entrance and pithy street names like Serenity Drive, Tranquility Lane, and Patience Knoll. Yes, it really is tranquil where I live. Well, except for the geese and ducks squawking in the pond below. Oh, the tragedy of first world problems.

In the summer of 2012, I considered suicide. Not seriously, but serious enough. On more than one daily commute I propelled my car upward to 140 mph, and wondered to myself how long the pain would last should I collide with something. Then there were times during the day where my mind would drift to secluded places I had visited in my travels. If ever I should make a final exit, I believed it would have to be a place my beloved could never find. Though we own no firearms, I found myself discretely researching guns online. When my wife caught me one night, I plaintively pleaded “for protection” because you never know what shenanigans may break out in your gated cookie-cutter community. I also spent a lot of time simply engaging in one mindless endeavor after another. Burning through the family savings helped out a bit with that, but I could never find an escape that would last long enough to keep my thoughts buried for long.

I hated that period of my life, and am not proud of it for a minute. I hated what I was doing, and hated the torment my loved ones suffered watching my downward spiral. I hated the duplicity of keeping secrets and telling lies. I hated the daily business meetings that demanded my full attention when I was falling apart inside. Mostly I just hated me.

In October of 2012 my life changed forever. With my wife’s encouragement, along with that of a few close friends, I sought professional help. The truth is that I knew what was bothering me. In fact, I had known it since I was a child. My entire life I had been deeply ashamed of being me, and fearful of being discovered. I had seen shows like Jerry Springer and Cops, and read the hateful online comments accompanying articles about people who were different. I was afraid of being labeled a freak or pervert. I was terrified of the emotional, physical, and societal consequences of speaking my truth.

Over several months, and with the help of a therapist, I learned a lot about myself. I learned there were a lot of others like me and that it is okay to be different. I began to learn how to validate myself for simply being me. I don’t need to always be in motion, nor do I need to measure my value by some external yardstick. I am a decent person the way I am. I am an intelligent, accomplished, responsible and caring person. I value my family above the world, and hold dear my relationships and the people closest to me. I just happen to also be someone who has a deep sense of gender misalignment.

In February of 2013, I came out as transgender to my wife and several close friends and family members. Since that time I have made a determined and deliberate effort to explore what it means to be gender variant, and consolidate the duality of my prior existence into an authentic individual life. Put another way, I want to get to know the girl I kept hidden so deep inside during my youth and adolescence, and then celebrate the woman she is becoming because she is a part of me. I like to think of this as a “mid-life adolescence” instead of the more common “mid-life crisis.” I am unifying the two parts of my life into one, and celebrating who I am for the first time in my life.

On the surface my appearance has gone from clean-cut male with short hair, khakis, oxfords, and sweater vests to pierced ears, long hair, skinny jeans, and cardigans. Laser has removed much of my five o’clock shadow, and HRT will soon begin to soften and round out my features. If my coworkers at the office have noticed, nobody has really said anything. Sensitive to my financial position during my transition, I want to minimize disruptions by remaining a valued employee. I am still the first one in the office and one of the last to leave. In fact, my output on the job has never been better.

My therapy sessions, while less frequent, are also a key part of maintaining an even emotional balance. While my decision to transition and gender identity may not put me in the middle of society’s bell curve, I embrace the knowledge that I am a pretty normal person. In fact, there are a lot of people just like me. I’ve met several and you would be surprised how many are your coworkers, baristas, cashiers, social workers, bankers, and businesspersons. Some have fully transitioned and are now “stealth” to the world at large, while others are fearful of coming out due to the stigma I mentioned earlier. Some may be misinterpreted as gay, which is what I imagine many think of me (though, ironically, I remain exclusively attracted to women.)

And with that said, I honestly don’t know who I will become in the end. I think part of growing up is figuring out who you are, and paradoxically I am doing that for the second time at age 41. Even though I see a million things wrong when I look in the mirror, I no longer hate the reflection. Having survived the first adolescence, I have the prescience to realize it gets better on the other side. For now I am enjoying this journey as best I can. And the journey has not been all rainbows and unicorns, with my marriage a painful casualty of my transition. However, suicide is now the farthest thing from my mind. If anything, I now feel the brevity of life and want more. I have so much to live for, and so much I want to experience. I am starting by simply being me, being happy, and living.

Antonia J is forty-something and newly female, before which she spent much of her adult life as an alpha male meat-head. Known as Toni to her friends, she has set foot on four continents while traipsing through fourteen countries at all corners of the globe. She has served as a member of senior management at two Fortune 500 companies and an Ivy League University. Along the way she has accumulated three college degrees, lived for a time in the Caribbean and Middle East, and somehow finds herself now rooted in West Michigan (though dreaming of palm trees and ocean breezes). She is extremely grateful for a close group of amazing friends, an employer who celebrates diversity, and her fuzzy slippers in the winter.

Community Programs & Services – 2013 Accomplishments

“Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome.”

Booker T. Washington

It’s the beginning of a new season. As I reflect on our previous seasons, that combined to create our first year, I am amazed at what we accomplished. FY2013 was one of the most challenging times in my 25 year tenure with UMHS. We came to the table optimistic but determined to do our part to address the financial deficit within the health system; working together to create OUR plan.

Despite the challenges, we accomplished some amazing tasks that support our health system and our community, both internally and externally.

Accommodations Program

– We made 11,574 reservations for patients, families and visitors to UMHS via the Patient and Visitor Hotel Accommodations Program – that’s an average of 965 reservations per month! The onsite Med Inn Hotel averaged 100% occupancy for 12 months. And, we launched our partnership with the Ann Arbor Mennonite Guest Home – a six year project to bring additional lodging to our patients and their families.

Adolescent Health Initiative

– Lauren Ranalli, Director of the Regional Alliance for Healthy Schools (RAHS), was successfully hired as Director of the Adolescent Health Initiative and we received a grant from MDCH to hire a program manager. Physician Adolescent Champions have been identified and with medical director, Maggie Riley, MD (Family Medicine) we are firmly on our way to doing great work. Planning for the first state-wide conference on adolescent health in Michigan is, also, underway for April 2014. The conference will focus on translating knowledge on working with adolescents to practice.

Ann Arbor Meals on Wheels

– We marked 2 million meals served (since the late 1980’s) with a celebration and open house in January 2013 that recognized our staff, volunteers, donors and funders for support for nearly 40 years. Our annual volunteer-driven golf fundraising event, The Judy Fike Golf Outing to benefit Ann Arbor Meals on Wheels, raised over $25,000 this year which will be used to provide meals to area homebound seniors and others.

Comprehensive Gender Services Program

– The Gender Program saw the largest increase in new client enrollment for calendar year 2012 with 108 new clients (a 40% increase our previous high of 43 new patients in 2007) since the program’s inception in 1995. (Notably, that growth shows no sign of slowing, as the program has enrolled 158 new patients to date in 2013.) In addition, the program created two support groups: one for the parents and guardians of gender-variant children, and the second for spouses and partners of transgender adults. The program also increased its ties with the Disorders of Sexual Development clinic and maintains a strong connection to Family Medicine, Plastic Surgery, Urology and Reproductive Endocrinology in providing support for our clients. The first gender variant youth and sibling event will be held at CPS in October in direct response to the increasing needs of this special population. The UMHS-CGSP is the only university-based, multidisciplinary gender program in the United States.

Friends Gift Shops

– Provided over $200,000 in grants to support patients and family programs within the health system (this includes $150,000 in core awards given to support Child & Family Life, Social Work Guest Assistance Program (GAP), Trails Edge Vent Camp (for ventilator dependent children) and the Patient Education Advisory Committee). Some of the other awardees for FY2013 include the East Ann Arbor Surgical Center, Adult Medical Observation Unit, Transplant House, the Brandon NICU, the Depression Center and Canton Radiology.

Housing Bureau for Seniors

– Celebrated 30 years of serving area seniors and their families. The yearly conference, Senior Living Week that provides education and information about aging in place, resources to support housing transitions and contact with experts in the field of housing and aging support celebrated its 15th anniversary. One of the highlights of HBS, our HomeShare Program is the only official program of its kind in the state of Michigan and has proven demonstrably effective in the community as an alternative method for allowing seniors to remain in their home.

Interpreter Services

– Launch of two innovative new classes – Interpreting in Palliative Care and Interpreting in Mental Health, both new classes are the one of the firsts trainings of their kind offered nationally. In addition to these two new courses, we successfully offered professional trainings classes for Bridging the Gap, Medical Terminology and Body Systems and Foundations for Medical Interpreter (formerly Medical Interpreting – Basic Skills ASL). These course offerings make our program a standout for promoting medical interpreting as a profession. The next step on our journey is the accreditation of our training program.

Program for Multicultural Health

– Partnered with the brothers of Kappa Alpha Psi Fraternity, Inc. to present a successful African-American Men’s Health Symposium with significant contributions from Dr. Ken Jamerson, Frederick G L Huetwell Collegiate Professor of Cardiovascular Medicine and Professor of Internal Medicine (former medical director, Program for Multicultural Health), Brian Frey, UM School of Public Health Intern, Community Programs and Services, and Dr. Rohan Jeremiah, Paul D. Cornely Postdoctoral Scholar, UM School of Public Health. This symposium was Phase I of our partnership with Kappa Alpha Psi Fraternity, Inc. The symposium had barely closed before discussions began for Phase II — a Midwest regional symposium in 2014. The symposium also provided an opportunity to create an African-American Male Community Health Advocate group for the community. We are excited to train men how to educate other men on health issues (e.g. Hypertension, Diabetes, and Prostate Cancer) that are disproportionately experienced by African-American men.

– We enjoyed a successful summer teaching over 40 children (between the ages of 5 and 12) about nutrition. The children, summer camp participants at either the Parkridge Community Center in Ypsilanti, MI or Peace Neighborhood Center in Ann Arbor, MI learned about healthy eating, made health snacks, and participated in “taste-testing” vegetables and fruits not normally a part of their diet. (https://www.med.umich.edu/multicultural/‎)

Regional Alliance for Healthy Schools

– We experienced a period of transition within our program. Jennifer Salerno, the long-term director and visionary for RAHS left to pursue other endeavors. Lauren Ranalli, MPH, was hired to take her place at the helm. Lauren hit the ground running in March; working to successfully manage the challenges created by the merger of two school-districts. Economic challenges for both Ypsilanti Public Schools and Willow Run Community Schools districts drove a merger which had the potential to affect three (3) of our school-based health centers. Following the merger, we efficiently closed the Ypsilanti Middle School health center and moved those services to the Lincoln Middle School. This move expanded services in the school district and provided support for our Lincoln High School school-based health center. We were the award recipient of nearly $400,000 from HRSA to improve the Ypsilanti High School Health Center. The award will allow us to renovate our clinic space to provide more privacy and efficient flow for students visiting the school-based health center.

– Developing the next generation of “leaders and best,” staff and students attended “Advocacy Day” (students, accompanied by RAHS staff, visited Michigan State Legislators to garner support for school-based health centers) in Lansing and participated in Project VOICE on the UM Flint campus.

Volunteer Services

– Reorganized and streamlined volunteer training and orientation sessions successfully. Created a process to efficiently onboard non-student volunteers (retirees, stay-at-home parents, and others). Allowing equal access to community volunteers to support our patients, their families, faculty, and staff. But more importantly, we continue to average close to 2,000 volunteers providing support to our institution.

This is, by no means, an exhaustive list of our many accomplishments during FY13. I would still be writing!! Instead, this is just a sample of the excellent support we provide to the University of Michigan Health System and our patients, their families and friends and the community. We are a valuable resource. We will continue to flourish to provide quality and consistent energy and passion in support of the vision, mission and goals of the health system.

The best is, truly, yet to come!

“Success in any endeavor does not happen by accident. Rather, it’s the result of deliberate decisions, conscious effort, and immense persistence…all directed at specific goals.”

-Gary Ryan Blair