Doctor Chris Carey has delivered thousands of babies as a gynecologist, and every time, the reaction is the same. The smile on the mother’s face, no matter her circumstances, is pure joy. This is the same look, Carey claims, that trans women have on their faces the first time they see their new genitalia after bottom surgery.
This look is exactly why Carey does what he does. He doesn’t deliver babies anymore, but he’s still very much involved in the women’s health world. As director of obstetrics and gynecology at Denver Health, he could have focused on a lot of different areas of women’s healthcare. However, when he noticed the startling lack of resources available to trans women looking to undergo surgical transition, he decided to dedicate his work to their treatment.
He began learning about sexual reassignment surgery and vaginoplasty early on in his career, when he realized how few surgeons were studying it. Carey took courses to become more proficient in counseling folks with gender dysphoria and travelled around, honing his skill and working at different hospitals that needed his guidance. Eventually, he made his way to Denver.
“I came here in 2005, and about four years ago, I began to focus more on patients here and identified a large number of transgender patients in our practice here who we felt like we really weren’t providing the care they needed. Some of that was the surgical care, so I said I could do the surgery.”
Carey updated his education on providing sexual reassignment surgery and sought help from some other prominent surgeons who were already familiar with the procedure. His goal was to be able to help with trans healthcare every step of the way. Carey realizes the hurdles that trans people face every day with their identities.
“This is not a choice,” he said. “No one chooses to be transgender. It happens. And the condition of gender dysphoria needs treatment. Being transgender and having gender dysphoria means different things. The dysphoria is the dis-ease, the bad feelings, the condition, and that condition needs treatment. Not everyone needs a surgery, but some do.”
Carey has been interested in the treatment of sexual conditions like dysphoria since his career began, and he has noticed a trend in the way people facing issues with sex and identity are treated. While there are a lot of resources for those who are pregnant or just seeking advice about cis women’s sexual health, there are not a lot of resources for those with specialized needs like sexual reassignment surgery. Furthermore, even when surgery is an option, it is often expensive and not accompanied by proper follow-up care. This is where Denver Health strives to be different.
“The surgery is one step in transition for patients,” Carey explained. “It’s a really big step, and it’s important that when it occurs, patients realize they still have to deal with issues that they had before, and they now have to learn how to act and interact. It changes the way they feel about themselves and the way they feel about interactions with other people. There is still an immense amount of learning that has to go on, so what we are doing is offering those services post-op and helping people through the transition.”
In addition to offering post-op counseling and other traditional follow-up services for those who have just received surgery, Denver Health also provides physical therapy for the new vagina post-surgery, including dilation and other services to keep it functional. They also help explain to patients what sensations they should be expecting to experience, and how these sensations should feel. Although all the same nerves are present, they are now functioning in entirely new ways, and they provide patients the tools to know how to deal with this.
“Learning to have a vagina, learning to have feelings inside a vagina, everything is different,” Carey explained. “You have to learn, and it’s all unconscious learning, but we have to help patients learn those things, learn that the muscles around the vagina are different; the space was not there before. So we are offering that service. It is a little different than most other surgical services where people fly to a city and have the surgery and then leave. We are continuing to follow patients for months and learning to work more on the counseling, the post-up counseling. You’ve had the surgery; now what? How is this changing your image of yourself, your relationship with other people?”
While these are all very important components to a successful surgical transition, many trans women feel that vaginoplasty is out of their realm of possibility. Even if they could find someone who is able to perform the surgery, they would never be able to afford it. At Denver Health, this isn’t a concern, as Medicaid can be used to pay for sexual reassignment surgery. In fact, Colorado state law mandates that surgery for trans folks be covered by Medicaid, as this is deemed a necessary surgery. Denver Health embraces this progressive policy and makes sure that everyone has fair access to the surgery.
A recipient of one of OUT FRONT’s Power Awards for 2018, Carey is being honored for doing more than just proficiently performing a surgery that is difficult and not available most places. By choosing to spend his life performing such a tricky procedure, and one that many people still don’t recognize is a necessary and needed service, Carey is making Denver into a safe haven for trans women who wish to transition and then get used to their new bodies.
He doesn’t see this as some heroic act, or major political statement in favor of human rights or trans advancement. As a sworn healthcare professional, he saw a need and a lack of provided care, and he is now filling that niche.
“To me, the most important thing is, these are people, patients, who need treatment, and we have an obligation to treat them,” he said. “That’s why we are doing it at Denver Health. We have people that were not getting care, so that’s why we decided to go down this path.”
Photo by Veronica L. Holyfield