Institutionalized Assumptions, Cultural Lag, and M.D. Anderson Cancer Center

In ways, this seems silly. In larger perspectives of the barrage of horrid occurrences in the world of 2018, the significance is nil.

However, society perpetuates oppression–especially, for purposes here, of the microaggression variety–and gives people little choice about how their lives are dramatized. Insisting on being heard and rejecting institutionalized assumptions constitute acts of survival and of resistance. 

As regular readers will know, I have been a patient at M.D. Anderson Cancer Center forever. 27 years now! I’m going to be 32 in a few days! People there have saved my life, and with a combination of over a dozen medications and regular visits, they make life more comfortable than it would otherwise be. I sometimes donate a few dollars to M.D. Anderson, too. It really is an important place. 

However, M.D. Anderson Cancer Center continues to exhibit symptoms of cultural lag and cultural disrespect. In its online account system, M.D. Anderson Cancer Center asks patients to fill in a box that says, “Address me as.” My response–“Andrew or Dr. Pegoda”–is below. (There’s not enough room to also list “AJP”! I also generally reserve that for family, friends, and colleagues.) 

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To my on-going frustration and at this point, great interest (it’s even kind of funny!), nurses and others completely dismiss this information–across-the-board. I am constantly called “Mr. Pegoda” even when signing an email “Dr. Andrew Joseph Pegoda,” even when my voicemail says “You have reached Dr. Andrew Joseph Pegoda’s voicemail,” even when I correct them, even when I sign in as “Dr. Andrew Joseph Pegoda.”

Part of me thinks that they don’t think a patient can also be a doctor. Part of me thinks that they don’t care. Part of me thinks they are creatures of habit. Part of me thinks they think only medical doctors are “doctors” even though the Ph.D. is actually a higher academic degree.

What I find most problematic is that M.D. Anderson Cancer Center ASK patients what they would like to be called, YET M.D. Anderson Cancer Center REFUSES to actually use this information.

The situation is more severe given that M.D. Anderson Cancer Center ask a preference and it categorically does the opposite.

At some point, the medical providers usually ask me to verify my full name, to which I reply “Dr. Andrew Joseph Pegoda.” This often meets unusual responses, being outright ignored chief among them.

One time the nurse replied, “Did you say you were a physician?!”

Today the nurse replied, “Did you say you were a doctor?! What kind?!” When I later explained that I cannot stand “Mr.” she interrupted and said “because it makes you feel old.” There was no question mark in her statement. I said, “No. Because it’s too gendered and too patriarchal.” Her reply only manifested in a look of shock and disbelief.

(I have also asked M.D. Anderson Cancer Center to fix the “J.” in my medical record. “J.” is not my middle name. I have asked them numerous times to change it to “Joseph,” and it refuses to do so.)  

And this brings me to my next point, M.D. Anderson Cancer Center makes people select between “male” and “female” under the preferences menu. As an institution of higher learning and as a premier medical institution in the world, one would think it would be more on top of science and understand–on an institutional level–that the sex-binary is absolutely flawed and inaccurate. There are as many sexes as there are people and one’s sex constantly changes. Why doesn’t it let me set my gender as “genderqueer”? Facebook does. For scientific, political, academic, and personal reasons, I do not actually identify with “male” in any typical way. Why must M.D. Anderson Cancer Center force people to pick from only two inaccurate and unscientific boxes? 

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This post probably makes me sounds cranky, but people have a right to be called what they want to be called. Hopefully, with continued pressure, M.D. Anderson Cancer Center will do something to truly remedy this situation. To no avail thus far, I have spoken with patient advocacy about this and have occasionally voiced complaints on Twitter for two years now.  

If M.D. Anderson Cancer Center addressed patients according to their wishes, patients would feel slightly better. People generally smile when hearing their name stated correctly and to their wishes.

Dr. Andrew Joseph Pegoda 

Categories: Thoughts and Perspectives

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8 replies

  1. For medical purposes, the sex (male, female) binary is actually very useful. Please note I’m not talking about gender, but sex. People have male or female DNA, which almost always tracks with their reproductive organs. If a person undergoes gender transition, and alters their body through surgery and hormone treatment, they can request to have their medical records/legal records changed to reflect their gender — but it is still useful for health care providers to know whether their hormones are delivered by internal organs or by medication.


  2. Andrew, I have read the research. And while it does lift up many interesting (but uncommon) variations on the “sex is binary” model, the research does’nt refute the fact that these variations do not prove that “there is zero solid connection between birth-assigned sex and hormones or DNA.” Like almost all biological processes, the sex binary is subject to a range of variants — for example, some people’s appendix is on their left side, not their right; some people have eyes of two different colors; some people are born with no pigment in their skin or eyes (albino people). These are all variants that do not invalidate the facts that almost all people have the more usual version of these features.

    I have a transgender nephew and a transgender daughter of a cousin. I cherish these young people, and I listen to them. They both hold that gender is binary and is fixed; that is why it was so important to them to transition, so that they could have a body that more nearly matches their experienced gender. If gender and sex are not binary and are even subject to change, why would anyone subject themselves to surgery and hormone treatment in order to attain a different body?


    • There are differences between personal experience and between research and meta studies. Personal opinions can be wrong. Your concluding question indicates that you don’t really know tye basics of trans identities. Maybe read the book Becoming Nicole Transformation of an American Family for more info or see my articles about trans identities.


  3. I am not basing my points on personal opinion, just indicating that I take these issues seriously. My relatives are not the only trans people who believe that gender is binary and is fixed. The research you cite points to the reality that some people feel uncomfortable living the lives that their sex would (typically) force them to live; and would feel much healthier and more at home in their bodies if they are able to change their bodies. It also points to the reality that people find a wide variety of ways to express their genders, and feel varying amounts of closeness to (or distance from) the culturally-defined habits that have defined gender in the past. But this research does not indicate that the sex binary is useless. But I fear we are arguing past each other..


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