{ "id": "p16022coll97:199", "object": "https://cdm16022.contentdm.oclc.org/utils/getthumbnail/collection/p16022coll97/id/199", "set_spec": "p16022coll97", "collection_name": "Tretter Transgender Oral History Project", "collection_name_s": "Tretter Transgender Oral History Project", "collection_description": "
The Tretter Transgender Oral History Project (TTOHP) collects, preserves, and makes accessible oral histories of gender transgression, especially as theyintersect with race, age, sexuality, citizenship, class, and ability. The project seeks to document the power and vision of trans movements for justice through the stories of activists working to imagine another world.
\n\nThe first phase of the Tretter Transgender Oral History Project was led by poet and activist Andrea Jenkins—who became the first Black transgender woman to serve in office in the US after she was elected, in 2017, to the Minneapolis City Council. This phase of the project sought to document the life stories and experiences of transgender and gender non-conforming people, with a focus on people living in the upper Midwest as well as those often excluded from the historical record, including trans people of color and trans elders.
\n\nThe second phase of the Tretter Transgender Oral History Project is led by trans studies scholar Myrl Beam. This phase of work seeks to document histories of trans activist movements and politics in the US, and is grounded in the belief that trans movements for justice are about more than rights: they are about survival, and about creating a new, more fabulous, more livable, and more expansive world––one not structured by racialized gender norms. The oral histories collected during this phase document the transformative power of trans movements, and the stories of trans activists who are building them.
\n\nFor more about the project, visit: https://www.lib.umn.edu/tretter/transgender-oral-history-project.
", "title": "Interview with Nathan Levitt", "title_s": "Interview with Nathan Levitt", "title_t": "Interview with Nathan Levitt", "title_search": "Interview with Nathan Levitt", "title_sort": "interviewwithnathanlevitt", "description": "Nathan Levitt is a white trans man and family nurse practitioner based in New York City. At the time of this interview, he worked in the office of Dr. Rachel Bluebond-Langner, who specializes in gender-affirming surgeries. In the interview, Levitt discusses the evolution of practices in trans health care. Specifically he recounts his experiences as a nurse practitioner, the increased understanding of trans health care within the nursing field, and the shifts in trans health coverage among insurance providers.", "date_created": [ "2019-09-07" ], "date_created_ss": [ "2019-09-07" ], "date_created_sort": "2019", "creator": [ "Levitt, Nathan" ], "creator_ss": [ "Levitt, Nathan" ], "creator_sort": "levittnathan", "contributor": [ "Beam, Myrl (interviewer)", "Billund-Phibbs, Myra (project assistant)" ], "contributor_ss": [ "Beam, Myrl (interviewer)", "Billund-Phibbs, Myra (project assistant)" ], "notes": "Forms part of the Tretter Transgender Oral History Project, Phase 2.", "types": [ "Moving Image" ], "format": [ "Oral histories | http://vocab.getty.edu/aat/300202595" ], "format_name": [ "Oral histories" ], "dimensions": "0:17:58", "subject": [ "Tretter Transgender Oral History Project Phase 2" ], "subject_ss": [ "Tretter Transgender Oral History Project Phase 2" ], "language": [ "English" ], "city": [ "Washington" ], "state": [ "District of Columbia" ], "country": [ "United States" ], "continent": [ "North America" ], "geonames": [ "http://sws.geonames.org/4140963/" ], "parent_collection": "Tretter Transgender Oral History Project", "parent_collection_name": "Tretter Transgender Oral History Project", "contributing_organization": "University of Minnesota Libraries, Jean-Nickolaus Tretter Collection in Gay, Lesbian, Bisexual and Transgender Studies.", "contributing_organization_name": "University of Minnesota Libraries, Jean-Nickolaus Tretter Collection in Gay, Lesbian, Bisexual and Transgender Studies.", "contributing_organization_name_s": "University of Minnesota Libraries, Jean-Nickolaus Tretter Collection in Gay, Lesbian, Bisexual and Transgender Studies.", "contact_information": "University of Minnesota Libraries, Jean-Nickolaus Tretter Collection in Gay, Lesbian, Bisexual and Transgender Studies. 111 Elmer L. Andersen Library, 222 - 21st Avenue South, Minneapolis, MN 55455; https://www.lib.umn.edu/tretter", "fiscal_sponsor": "This project is funded through the generous support of The TAWANI Foundation, Headwaters Foundation and many individual donors.", "local_identifier": [ "tohp414_190" ], "dls_identifier": [ "tohp414_190" ], "rights_statement_uri": "http://rightsstatements.org/vocab/InC-EDU/1.0/", "kaltura_video": "0_fi909eey", "page_count": 0, "record_type": "primary", "first_viewer_type": "kaltura_video", "viewer_type": "kaltura_video", "attachment": "200.pdf", "attachment_format": "pdf", "document_type": "item", "featured_collection_order": 999, "date_added": "2020-05-19T00:00:00Z", "date_added_sort": "2020-05-19T00:00:00Z", "date_modified": "2020-05-22T00:00:00Z", "transcription": "Nathan Levitt, RN, FNP\nNarrator\nMyrl Beam\nInterviewer\nInterview Date: September 7, 2019\nInterview Location: Washington, D.C.\nThe Tretter Transgender Oral History Project, Phase Two\nTretter Collection in GLBT Studies\nUniversity of Minnesota\nPage 1 of 7\nMYRL BEAM: Thank you so much for agreeing to participate. I'm hoping you could just start by\nintroducing yourself and talking about the work that you do now, and where you live, that kind\nof stuff.\nNATHAN LEVITT: Sure. So, I'm Nathan Levitt, I'm a family nurse practitioner. I live in Brooklyn,\nNew York. I work in Manhattan, in New York, and I've been doing trans health work probably\nnow for...maybe 20 years. That ages me a little bit! [laughter] I am trans-identified, 41 years\nold, and I did previously work as a registered nurse, and then more like a social justice activist,\nbut now I'm doing nurse practitioner work in specifically the gender affirmation surgery field.\nBEAM: Okay, beautiful. And specifically you work with a particular surgeon, in...?\nLEVITT: Yeah, I work with Dr. Bluebond-Langner, who's a plastic surgeon, also with a urologist,\nDr. Zhao, and a team of other people, a social worker and a nurse, and we provide many gender\naffirming surgeries.\nBEAM: Okay, I would love to ask you more about that in a moment, but first, I'm hoping you\ncould chart for us sort of your journey into trans health care.\nLEVITT: Yeah. So, I have lived in a lot of different places. I grew up in Florida, and then I moved\nto Atlanta for undergraduate, where I did psychology and women's studies and I got very\ninvolved in LGBT work there, working specifically with LGBT youth. So I did a lot of LGBT youth\nwork, and social justice work, and then started to understand some trans health work, but it\nwasn't until I went out to the Bay Area, to Oakland and San Francisco, that I started to really\ninteract more and come out as trans myself, and also try to navigate health care myself at that\ntime, so that's...2000, I guess, maybe? And it was just incredibly difficult, very different than it is\ntoday, not that today is perfect, but just trying to figure out how to find providers that were\neducated on trans health. So, I ended up teaching myself a lot, and you know working with\ncommunity, we taught each other a lot about hormones, and about surgery, and\nabout...general things, like screenings and, you know, what to talk to your provider about to get\nthe things that you needed. We talked about the script that we needed to say so that we could\nall get things that we needed.\nBEAM: What was the script, like, the short version of the script?\nLEVITT: Well, at that time, it was - and I think that people still feel that they need that script\ntoday, but it had to be that, or at least they felt that it had to be that: that you've known all\nyour life that you're trans, which for me is not my personal experience, I actually came out what\nPage 2 of 7\nI guess is considered later on in life, like 21, but it wasn't something where I had a very...where I\nhad a childhood where I was feeling dysphoric, or anything like that....\nBEAM: Persistent and insistent, whatever.\nLEVITT: Yes, exactly, I didn't have that, but at that time if you said that to a provider, a therapist\nor a provider, that you didn't know all your life, but you were still interested in transition in\nsome way or another, then...we wouldn't get the services we needed, because we didn't sort of\nfit into that model of what trans people are supposed to say. So, we would all sort of, you\nknow, consult with each other, like, This is what you say: You've known all your life, and it's\nalways been this way, and also that you feel strictly a man or a woman, too, which for me at\nthat time was not how I identified, I identified more as, I think, what would now be seen as\nnon-binary, at that time I used \"genderqueer,\" which I feel like people still use that term, but...I\ndidn't necessarily feel like a man or a woman, but that was not at all something you could say in\nthe medical establishment. So there was a lot of like, saying the things you needed to say to get\naccess to hormones, or even just, you know, trans care in general, and it was actually an\ninteresting community time, because we were talking a lot to each other about who to go to\nand what to say. And I think we did a lot of, really educating ourselves on health issues that\nnobody knew about at the time. You know, researching the effects of hormones - as non-medical\npeople - now I'm a medical person but at that time I wasn't, so we ended up just trying\nto find allies and, you know, research things that we really didn't know much about, just\nbecause no one was giving that information to us at the time.\nBEAM: How did you move into the medical field more formally?\nLEVITT: So, I started doing tans health work in more education, and it was like community\neducation, and then I moved to Boston, did a little work with the LGBT health center there, and\nthen eventually moved to New York and got involved in our LGBT health center in New York,\nwhich is Callen-Lorde, and I started doing trans health education for community and providers,\neven though I wasn't- I'm working now in a health field, but I wasn't, you know, a health\nprofessional necessarily. But what I noticed is that there was just no information, specifically for\nnurses, because I felt really identified with nurses and the kind of care that they provide. Very\nwell-intentioned nurses that just had no information in nursing school whatsoever on trans\nhealth. Whether it's medical, either medical students or nursing students, and so that sort of\nbrought me to, I think I want to try to make change from within that field. Before that I wanted\nto be a professor in gender and sexuality studies, which I think would have been a great field as\nwell, but I got very drawn to health care, more because I was experiencing a lot of barriers, a lot\nof providers that knew nothing about me, and I had to spend 20 minutes of my 20 minutes that\nPage 3 of 7\nI had with a primary care provider educating them on what trans health is. So that's when I\ndecided like, I think the way for me to make the change I want to make is to actually go in\nthrough nursing, and then eventually became a nurse practitioner as well. So, it's really just\nseeing the barriers myself as a trans person, seeing what other people were going through, and\nalso talking to medical professionals who had no education on it whatsoever, and I felt like I\nwould make more of a change if I went into the field versus training from outside, although that\nwork was really great, I think there was a way in which I had a different kind of voice when I\nwas a nurse myself to speak to other nurses.\nBEAM: And what has that experience been like? What kinds of changes have you been pushing\nfor, and how has that process been for you?\nLEVITT: So, the field of nursing, I think, is quite conservative. It was really difficult to go from\nsocial justice work to nursing school, and there was a lot of pushback, even bringing in, at least\nwhen I went to school, even bringing in gay health issues, or anything that was not straight and\ncis. So, nursing school was very, very difficult. And, what I ended up doing is, in my last\nsemester I took an independent study and went through all of the curriculum, and basically - I\nshould have gotten paid for it, I think - I went through all the curriculum and pointed out the\nplaces that you could bring in trans health; LGBT health, but specifically trans health. I basically\ntook all of the course material and brought in case studies, came out with a bunch of different\nthings of how they could really integrate it, and met with the curriculum committee, and this is\nat NYU [New York University], in undergraduate. So, it was a slow change, but I think some of\nthe pushback was people feeling like, Well this is the way we've always done things. This is how\nwe teach things, this is what's on the boards exams...we're not gonna bring in this field of\ninformation we don't know much about, but when provided with the actual materials, you\nknow - like, for example, if we're talking about a patient that has diabetes, we can make that\npatient trans. So it's the same case study, but now we're also dealing with some other issues. So\nthat's how I started, was like, educating within nursing, and then sort of doing it in medical\nschool, sort of doing it for social- social work people and departments, and kind of all the health\nprofessional world, of...how to train within school, and then also kind of getting into orientation\nprograms, like, new staff that start at hospitals or health centers, getting in there to do some\ntraining, and I just noticed it just wasn't being done. I mean, nowadays it's being done more,\nalthough there's still a lot more work to be done, but it wasn't being done, it wasn't mandatory,\nso people that didn't want to learn about it didn't have to. But it was tough, I mean, it was\nreally tough in nursing school. I did undergraduate and graduate nursing school, and they were\nboth really tough with bringing in trans care, and it was so needed. I mean, we were having...we\nhad trans patients. And no one knew how to take care of them.\nPage 4 of 7\nBEAM: Since you have become a nurse practitioner, what has your trajectory been like?\nLEVITT: So, I became a registered nurse, I worked in a hospital setting and at an LGBT health\ncenter, and I did that for five years. And then I felt like I wanted to continue to advance my\ncareer so that's when I became a nurse practitioner, and that has been really interesting,\nbecause I started doing primary care for everyone, but then started a trans program at a\ncommunity health center, and doing primary care with trans people there was just so much to\nlearn, and what I found difficult was that it got relegated to the one person. So it was, I'm the\nperson that does all the trans health care, but then there's all these other providers that are\ndoing primary care with trans people, but didn't want to do the trans care part. So it would be\nlike, \"I'm going to manage your diabetes or your asthma, but then go somewhere else for your\nhormone care or anything related to being trans.” So, being a nurse practitioner, I've also had\nto meet with and work with medical providers to say, Trans care is actually primary care. It's\npart of what you're doing, right? And it's actually not that difficult, but...but it went from going\nbeyond, you know, \"Use the right pronouns and the right name,\" which is incredibly important\nbut also, \"What is the clinical information for this community?\" So, I think as a nurse\npractitioner, it allowed me to sort of get my foot in the door with medical providers and\nmedical schools, which has been really helpful. I think there's still a lot, a lot of work to be done,\nour people don't feel like- they're not getting it in their professional schooling, so they don't\nfeel like it's important.\nBEAM: How do you feel like, in that period, trans health care has changed?\nLEVITT: I mean, it's changed a lot. It's gone from me going through, not seeing a single provider\nthat understand what trans health is, spending the majority of my time with providers\neducating them...also surgeries itself, now that I'm working the surgery field, have only recently\nbeen covered by insurance. So, there was a way in which people didn't have access to surgery\nthe way that they do have now, especially since Medicaid is covering it, or most Medicaids are\ncovering it. So, I've noticed a change in access, I think that people can now get, if they're\ninterested in hormones and surgery, they're able to get it more easily than I was able to, and I\nthink that people don't necessarily have to say the same kind of script, although that's very\nspecific to New York City, I think in other places there's probably still the \"things you have to\nsay,\" and people aren't as educated...but, in some ways what's interesting is that- so, my\nexperience was, that nobody knew anything about transition, and now I notice that providers,\nespecially cis providers, want to show that they're so educated that they actually push people\ninto things that they may not be interested in; so, I've had a patient say to me, \"I told my\nprovider that I was trans, and he said, Okay, we're gonna start you on hormones, and we'll get\nyou connected to the surgeon,\" and that person was like, \"I just want you to call me this name.\"\nPage 5 of 7\nThat was it, I didn't actually need anything else! So, it's interesting how people don't necessarily\nunderstand that trans care is large, I mean, it means so many things, it means wellness and, you\nknow, how to take care of yourself, and self care, and all of that.\nBEAM: And that providers still have a sense that there's a, sort of, trajectory.\nLEVITT: Yeah, like you have to be a certain way. So I guess in some ways that hasn't changed as\nmuch, certainly non-binary folks or people that identify as genderqueer experience issues\nwithin the medical establishments that want to put you into this, like...\"You have gender\ndysphoria, and then this is how you cure your gender dysphoria, by hormones or surgery,\" so,\nthat's not everyone's narrative.\nBEAM: Have you found that...now that surgeries are being covered more...what is the process\nlike for folks getting surgeries now that they're covered by insurance? Does that empower the\ninsurers to have a greater role in determining trans health care?\nLEVITT: I think that...I mean, there's definitely more access for people that could never have\nafforded surgery before, so that's a huge change. I wouldn't say all insurance companies are\ninvested in what that actually means, and also they are still making decisions about what should\nbe covered or not covered, like for example, maybe a vaginoplasty or a chest surgery is\ncovered, but sometimes not facial feminization or, depending on the insurer, they may consider\nthat still cosmetic, which...most of these surgeries were considered cosmetic by insurance\ncompanies before, so, they're still kind of deciding what is and what is not \"cosmetic,\" which is\nridiculous, and it also depends on who you talk to at what insurance companies. We do a lot of,\nyou know, our patients have to have gender-affirming benefits, and if they don't, that's going to\nget denied. So then we are kind of pushing back against the insurance company, appealing\nthese sorts of things. So, some of them are more on board, and some of them aren't, so I think\nit's...it still takes a patient navigator or insurance navigator for the patient, to help them know\nwhat language to use with their insurance company, or what's covered and what's not covered.\nI think that's still a difficult part for patients.\nBEAM: What has your experience been like having Medicaid cover surgeries in the past couple\nyears?\nLEVITT: I mean, it's amazing for what it's done for the community, because a lot of trans\npatients are on Medicaid, and so, it's brought in a lot of different patients that never had...that\nnever even thought they'd have an opportunity to have surgery, but also never could come to a\nplace like NYU, or a very large institution, and get almost all of their surgery covered. But I do\nPage 6 of 7\nnotice that, you know, some Medicaid patients don't have access to other resources, like\nhousing, or support, and so, you know...back before insurance covered this, we'd have to raise\nmoney or have resources, you know, have support and resources to have the money to pay for\nit, and that tended to have more built in housing and medical help, and medical support, and\nnow a lot of Medicaid patients don't have that as much, so it's sort of...it's more, I think it's a\nlittle bit more difficult for that patient population to also have the built in things that they need.\nBEAM: I know our time is short, so maybe we could just close by talking about what you feel\nlike....excuse me...the big challenges are that remain and the areas of tension.\nLEVITT: I think a lot of the challenges have to do with providers and patients not necessarily\ngetting the information they need to provide the best care for...I mean, for patients too, for\npatients to come in, and clients to come in and feel empowered about their own health and be\nable to make decisions about their body and their own health. I think people that want to make\ndifferent decisions like, for example, a lower dose of hormones, or a different kind of surgery\nthan what is normally seen as acceptable, can be not as understood by providers, and so that\ncan often be very difficult for people. I think we still have to come a long way with...like, for\nexample, I've worked in a lot of LGBT health centers, and that's where patients feel like they\nhave to go for care, but then we want to refer them out to places, we can't find a trans-sensitive,\nlet's say, endocrinologist, or a pulmonologist, or a cardiologist, right? So I think it\nwould be wonderful if we had everything under one roof. So, it's like, you just go to the\nspecialist that you need, and they're trans-sensitive, and it's not like you need to find the LGBT\nhealth center, which not all cities have or not all places have. So I think we still have a long way\nto go for all providers to understand that this is a part of primary care, and that whether you're\na specialist or not, you're gonna have trans patients.\nBEAM: Yeah, just family docs.\nLEVITT: Right, exactly. I think that people think there's a trans expert that you have to refer to,\nbut we're all teaching it to each other, I mean, there's some amazing protocols out there that\nare more newly developed, but there's still so much work to do in understanding this is\nimportant. And also trans people understanding that they have a right to walk in and say, \"You\nshould know my own health,\" you know, \"I should have a medical provider that knows how to\ntake care of me,\" right? So, there's a lot of work to be done there, and there's still challenges\naround the right language to use, like, I talk to providers about asking patients what language\nthey use to describe their body, because often people will use language that's traumatizing or is\njust not something that people identify with. It's very easy to do, but I just think it's not\nsomething that people feel as comfortable with. So, changing the language, changing things\nPage 7 of 7\naway from like, men's health and women's health, to more about, \"What body part do you\nhave?\" I like this expression: If you have it, check it. So, if you have this body part, here's how\nyou get it checked out, instead of, \"If you're a woman you need this,\" or \"If you're a man you\nneed that.\" So, those changes, I think some places are making those changes, but there's still a\nlot more work.\nBEAM: Okay, let's pause there. Thank you so much.", "_version_": 1710339103170494464, "type": "Moving Image", "collection": "p16022coll97", "is_compound": false, "parent_id": "199", "thumb_url": "https://cdnapisec.kaltura.com/p/1369852/thumbnail/entry_id/0_fi909eey", "thumb_cdn_url": "https://dkp5i0hinw9br.cloudfront.net/0e156ce5289a205e45236ab4c681ee3572a5cfec.png", "children": [ ] }