Dr. Danielle Kaufman, formerly David Kaufman, is a board certified radiologist at Kaiser Permanente in Santa Rosa, California, where she is chief of nuclear medicine. After 20 years of marriage, Dr. Kaufman came out as gay to his wife, who surprised him by coming out at the same time as a lesbian. They divorced, but remain close friends and parents of their children. After living for three years as a gay man, Dr. Kaufman had another realization: she was transgender, and now calls herself Danielle. Dr. Kaufman is the author of a critically acclaimed book, Untying the Knot: A Husband and Wife’s Story of Coming Out Together (Addicus Books, 2013).
I talked to Dr. Kaufman about some of the professional ramifications of her gender identity transition.
What effect did coming out at gay, and then as transgender, have on your medical practice?
Truthfully? None, whatsoever. Being gay doesn’t show and patients would have no way of knowing my sexual preference. It was actually frustrating at times because I felt I was going through this huge positive change and no one could even tell.
I did change my style of dress going from straight to gay to be a little more feminine and flamboyant, but I don’t think that was that big a deal. My gender expression change does show, of course, but I’ve only gotten one patient comment. A middle-aged male patient asked what was wrong with my voice. I just said, “This is my voice.”
I am a radiologist, though, and only briefly see one or two patients per day. One of my colleagues said point blank, “We don’t care whether you’re a man or a woman. We only care that you can read films.” Honestly, my general impression is that nobody really cares. It’s just left for me to sort out.
How did you talk to your coworkers and colleagues about your sexual identity?
I sent an email to my colleagues in radiology and all the doctors in the medical center. I received so many positive replies (none negative) that it took me two days to respond to all of them.
Of course, coming out gay didn’t really change my appearance; [since] changing to female gender expression, I’ve found that most of the time, people who knew me as David don’t even recognize me at all as Danielle. This has held true throughout the medical center.
Initially, when I spoke to my radiology colleagues, I briefly said, “I realized I’m transgender and I need to transition to female gender expression.” I emphasized two things: First, the pain of gender dysphoria [the formal "diagnosis" psychiatrists use, formerly known as gender identity disorder] is almost beyond comprehension; it’s far worse than one would think. Second, this has absolutely nothing to do with sex. This is about my identity, who I am as a person. Whom I’m attracted to is way down the road and quite unimportant right now.
I take not being recognized as Danielle as a supreme compliment: Danielle is so different from David that you wouldn’t even recognize me. Truly, the difference between coming off looking like a man or looking like a woman is far vaster in scope than most people realize. There are profound differences between the genders in how we do or say pretty much everything. Just wearing women’s clothes is a small thing. Having feminine mannerisms is probably a much bigger deal (and it’s much harder to master). Most of my female coworkers (radiology techs) wear androgynous medical clothes; they look definitely female because they have feminine mannerisms (and pretty feminine faces).
How have patients reacted?
My perception is that patients can tell, but accept me anyway. I was actually quite worried that patients would be upset and want a different doctor, but that hasn’t happened. The Kaiser Permanente organization has been extremely supportive, and they basically suggested I just ride with whatever reaction I get.
During my transition, at times I was flamboyantly female even while still presenting as a man. I often appeared as a man, but with bright red fingernails and makeup. If patients asked about my fingernails, I did what the human resources person advised: “Just tell them you like red fingernails.” The KP organization didn’t seem worried about it at all, so I tried to stay calm. For the most part, it’s a total nonissue.