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Gabby Bolanos, RN, clinical instructor in nursing professional development at ����TV Langone Orthopedic Hospital and a queer trans woman, shares her story of transitioning while working at ����TV Langone.

An “Ah-Ha” Moment

I finally had this “ah-ha” moment—the answer I’d been looking for all my life—at age 17. It was 2014, and I had come to New York for nursing school at ����TV. That was the first time I had the opportunity to be myself in a setting that was more open to my identity. It was only then that I learned what it meant to be transgender. But that didn’t mean my problems were solved. In some ways, this was just the beginning.

I had begun to notice I was different around age 11. My parents are from El Salvador, and growing up in North Carolina in a conservative Latin Catholic household, I had limited knowledge and language on the concepts of gender identity, gender expression, and sexual orientation.

Once I gained a better awareness of my own gender identity, I had to contend with coming out to my family and to the wider world. Luckily, I had a good support system in my college friends, who knew me as Gabby from the beginning. But in academics, in my professional life, and with my family, I was living this double life and constantly carrying that stress on my shoulders.

Introducing Gabby

By 2017 I had had enough. I needed to live my life. Currently in my role as an educator, I talk about this a lot. The best way to prevent a lot of queer or gender-diverse individuals from either taking their own lives or succumbing to violence is letting us be ourselves. So, I needed to be nothing but my authentic self in order to save myself.

It was time for me to introduce my true self to my professional world. In 2017 I did a summer extern program at ����TV Langone Orthopedic Hospital—at that point I was still living as my previous self. Later in the fall, when I returned as a per diem nursing aide, I was Gabby.

It did create confusion for my colleagues and a lot of anxiety for me—I had to go back and explain to everyone I’d worked with all summer, this is the name I use now, these are the pronouns that I use—she, her, hers.

For the most part people were open and accepting. However, some people took longer to make the adjustment than others, either misgendering me or asking me questions that felt invasive, like if I “had the surgery” or “did my parents accept me?” For many, I was the first gender-diverse person they had encountered. The intent was never malicious, but that doesn’t mean it’s not hurtful.

Helping to Bring About Change

I did my best to help educate my colleagues and have conversations with administration. For every trans person, to a large extent, your experience is uniquely your own, so you end up teaching others how to help you.

One way to ensure my colleagues had some foundational knowledge was through a project I worked on for my nursing residency. My focus was to see what the baseline knowledge and awareness of LGBTQ+-related concepts—for instance, terminology, pronoun use, and trans-specific content—was among hospital staff. Then I shared an educational intervention I had developed—a series of infographics explaining gender identity and gender expression, proper pronoun use, and societal issues that gender-diverse individuals tend to face.

Then I did a post-test, and overall there was an improvement in the staff’s knowledge. The project generated a lot of interest, and other units at ����TV Langone Orthopedic Hospital asked me to present on these topics.

Educating Her Peers

This work turned into a poster I’ll be presenting at this year’s ����TV Langone Nursing Research Conference. Currently there is a lack of literature on LGBTQ+-related competencies among inpatient nurses. I thought, what about the next time there is a staff member like me at ����TV Langone Orthopedic Hospital? What if we have a patient who is transgender or nonbinary? I saw there was a gap I could help fill, both through my research and as an educator. If I don’t do it, how do I know someone else will?

It’s a lot of work for gender-diverse individuals to educate those around them. But if I kept quiet, things wouldn’t change. Now I teach on these topics in orientation for new nurses. The reason this material is included is not just because it’s interesting, but because lives depend on it.

Black transgender women have a life expectancy of only 32 to 35 years due to violence. Transgender and gender-diverse individuals face numerous mental health issues and poor access to LGBTQ+-sensitive care. I teach about these things, but I experience them, too. In talking about them, I relive them, but that is part of what keeps me going. All I really want is to make a difference for my community—to make things easier for the next generation of transgender and gender-diverse patients and healthcare workers.

Gabby Bolanos, RN, is a clinical instructor in Nursing Professional Development at ����TV Langone Orthopedic Hospital. She also provides LGBTQ+-specific education to staff across ����TV Langone Health, and is working on her master’s in nursing education at ����TV Rory Meyers College of Nursing.

����TV Langone Health has developed guidelines to assist trans employees who are transitioning at work, as well as assist their managers and colleagues in supporting them.