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Liam Directo is a driven, lifelong learner. An ambitious goal-setter. A passionate OHSU School of Nursing student. And a courageous advocate for transgender people.

Their go-getting, fearless attitude has put Directo on a mission to improve the health care system — by working to provide accessible transgender-affirming care as a transgender person.

Shifting the culture

For many transgender people, the doctor’s office is far from a safe or welcoming place.

Many avoid seeking medical care because they fear being mistreated. They also continue to face significant barriers in accessing health care.

Transgender people are more likely to lose their job, resulting in a loss of health insurance. If they are insured, many plans will deny coverage for medically necessary care. Stresses like these can also contribute to health disparities, including higher levels of suicide, according to the National Center for Trans Equality.

“Visibility is so important,” Directo said. “We live in a time when it’s scary to be visible, and I want to take it on head on; I want to bring it out into the open. Things are starting to change.”

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Directo is working toward that change. They have had a long-standing interest in health care — and in helping people. Early on in their career, Directo worked as an emergency medical technician on an ambulance in Colorado. In Portland, they worked as an EMT at a sobering station, then at a local clinic assisting transgender and gender variant people.

Today, they’re a first-year student at the OHSU School of Nursing, with the goal of becoming a family nurse practitioner who focuses on providing high-quality care for vulnerable populations.

“We live in a time when it’s scary to be visible, and I want to take it on head on; I want to bring it out into the open. Things are starting to change.”

Their own experience served as a catalyst for this career change. Throughout and after their transition, Liam often felt vulnerable, scared and unsure of how to navigate the health care system.

“The impact that it had on me made me realize that I needed to be caring for people like me,” Directo said. “I’m really needed in this environment. While I’ve had great care, I’ve never had a trans provider. The trans population is underrepresented, especially in health care.”

A priority at OHSU

OHSU launched its Transgender Health Program in 2015 to ensure patients receive respectful and quality health care, regardless of their gender identity. The program works with OHSU providers to help them understand and meet the unique needs of transgender patients. It also helps patients navigate complex health systems that haven’t always supported them.

OHSU School of Medicine and School of Nursing are also incorporating trans health care into the curriculums.

For the past two years, Directo has volunteered about 200 hours to the program, helping to create change throughout the hospital. This included walking the campus and finding bathrooms that needed gender-affirming signage.

Directo has also lectured on their experience as a transgender person, and how important it is to be intentional about their interactions with vulnerable populations.

“Transgender people often avoid care because they are afraid of not being treated with respect, regardless if it’s unintentional,” Directo said. “OHSU is putting effort into people who are going to better the health care system. Seeing the effort that the School of Nursing is doing to train the nurses of the future to care for transgender people is incredible.”

Most recently, OHSU has expanded access to care and services with the growth of the OHSU Transgender Health Program, including hiring new staff members and creating fellowships in gender-affirming surgical care — making OHSU one of the largest and most comprehensive transgender health programs in the U.S.

Moving forward

Directo has been hard at work since they were 17 years old. They worked full time as an undergraduate student, taking prerequisite courses for nursing while also volunteering.

They anticipated having to work during nursing school to help maintain their student loan debt and housing costs.

With the rising costs of living and high interest rates for loans, taking on student loans can be stressful. Financial pressures like these can deter students from attending school. Philanthropy helps ease the burden for students, providing opportunities for them to attend — and focus on — school.

“Being able to put all of my energy into school, rather than work, is life changing.”

This past fall, Directo received the OHSU Presidential Scholarship, providing a full-ride scholarship for the entirety of the nursing program. Directo can now focus on transforming health care for transgender people.

“This scholarship took a big weight off my shoulders,” Directo said. “I don’t have to worry about finances and can focus on school. Being able to put all of my energy into school, rather than work, is life changing.”

The work Directo is pursuing is life changing, too.

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