“I think I see a happy young man,” smiles Lindsey Warner as he touches his beard.  “I close my eyes and sometimes I don’t even know what I look like, because I’ve been in flux for so long.”

The UCF medical student’s new identity has been two years in the making – oftentimes physically painful and emotionally raw. And as Warner prepared to graduate May 17 as a physician, he reflected on why in the middle of medical school he decided to transition from being female to male.

As a child of two physicians, Warner was raised in the small rural community of Tangerine, about 45 miles northwest of UCF’s College of Medicine. Growing up, he says he didn’t understand his feelings were gender dysphoria — when a person’s gender identity does not match their physical gender. As a woman Warner initially believed he was gay and had come out as a lesbian in his teens.

He still remembers the first day of medical school and the traditional White Coat Ceremony, where students are recognized as colleagues in healthcare. “I remember the pictures they took and the dress I wore for the White Coat Ceremony and going with my mom to pick out the dress,” Warner says. “It had taken two years to get into medical school and I felt like I had finally made it. I liked being the person my parents wanted me to be, in fitting that role and looking the best I could, given the body I was born with.”

But as time went on, the stress and challenges of medical school as well as family pressures – his mother developed breast cancer, his father was diagnosed with colon cancer – led Warner to confront his gender identity.

“I was pushing myself academically, but also emotionally — taking care of my parents. They weren’t really coping very well and I was trying to help out with my younger sister and managing medical school,” he says. “It became too uncomfortable for me to live in a body I wasn’t 100 percent identifying with.”

“It became too uncomfortable for me to live in a body I wasn’t 100 percent identifying with.” — Lindsey Warner, UCF College of Medicine graduate

He began taking testosterone injections during his first year of medical school.

“My mom had noticed my voice dropped and I think everyone kind of knew,” he says. “My mom was just like, ‘We love and support you. You’re a great child.’ ”

His father was equally as accepting, but Warner says it was difficult for his parents to let go of old habits. Occasionally they still referred to Warner as her.

He announced his gender change to the world via Facebook and was relieved with the positive responses he received, even from conservative relatives he thought might reject him.

He says College of Medicine faculty, staff and students have been equally supportive. Fellow Class of 2019 medical school students Annie Chen and Ambika Anand have been Warner’s roommates for the past four years.

“Having watched Lindsey’s transition, I feel instinctively protective of him,” says Chen. “We talked about what we thought was different with Lindsey at the beginning of med school and at the end. And really, besides the beard, there’s not too much.”

A New Identity as a Physician-in-training

While people in Warner’s inner circle were supportive, he worried about revealing his new gender to professional medical colleagues. He began fourth-year hospital rotations as a man, looking significantly different than he did during his first clerkship training the year before.

“It was such a deeply personal decision for me… and then I’d have to share it with the rest of the world.” he says. “I was literally freaking out inside. Everyone could see I was different but didn’t know where I fit in.”

He worried about awkwardness. How would patients react? How or should he correct people who called him by the wrong pronoun?

“I remember noticing that my female student was wearing a man’s shirt and man’s tie and wondered whether he was identifying differently,” says Heather Fagan, a pediatrician at Nemours Children’s Hospital, the UCF College of Medicine’s assistant dean for students, and Warner’s advisor.

Fagan explained that the hospital needed to transition with Warner.

“Everyone respected Lindsey for the physician he was becoming,” she says. “It was very simple. It wasn’t about the person. It was about the infrastructure and how we could change our system and get people on board with that.”

She says the hospital’s surgeon-in-chief announced to the hospital staff, “This is one of our own. We’re going to be respectful and starting today he now identifies as a man.” And from then on, Warner used the men’s locker room to change for surgeries.

Warner and Fagan say patients were accepting of his transition. During hospital rounds, a young boy asked Warner if he was a girl or a boy.

“I looked at him and then his mom and I’m like, ‘Sometimes, not everyone is one or the other,’ and his mom said, ‘Yep honey, some people don’t identify as either’ and we went on with the exam,” Warner says.

But what Warner didn’t expect was how differently he was treated as a male medical student compared to being a female.

“It’s much easier to be a male than female in the medical field,” he says. “When you are female, the nurses don’t know who you are and why you are there and in their way, and if you’re a male they assume you are a physician until you tell them otherwise.”

Some of the doctors he worked with as a woman didn’t recognize him as the same person and he was surprised by their different approaches.

“When I moved about the operating room as a male versus and as a female, the amount of interaction I get with male providers and guidance…it’s like an odd brotherhood, camaraderie that I didn’t know existed among men. It’s all new,” he says.

The Future

A month before National Match Day, when graduating medical students learn where they will do their residency training, Warner chose to undergo “top surgery” to make his chest more masculine.

Warner says that throughout his transition journey, he has had to be his own healthcare advocate — finding the right mental health counselors, an endocrinologist for male hormone treatment, the right surgeon. Those challenges helped shape his career goals in medicine.

“I want to do pediatrics endocrinology with the aim of providing gender-affirming care to teens,” he says.

With those dreams, Warner’s first choice for residency was Children’s Hospital Colorado in Denver, a training program and community he says welcomed him as a transgender physician. Four weeks before the residencies were announced, his father, Scott Warner, passed away from colon cancer.

“He knew I was going to Colorado. He said I’d get my first choice,” Warner reflected, moments after opening his match letter during ceremonies at the College of Medicine. The letter said he was going to Denver. “It’s tough. I always hoped he’d be here…this is for him.”

On Match Day and at commencement, Warner was surrounded by his mother, Dinah Warner, a dermatologist, his 93-year-old grandmother and his sister, Sarah. All were beaming with pride. His grandmother hugged Warner and praised him for all his hard work during medical school.

“I’m so proud of the doctor he is becoming,” his mother says, “but I’m most proud of how kind he is, always looking after people even when life hasn’t been easy.”