June 25, 2023 • 20 mins
Dr. Bobbie Rimel works as an OB-Gyn in the Cedars Sinai Medical System and also handles gender-affirming care. Her spouse is a professional financial advisor/investor. The doctor tells us about the fairly new practice of gender-affirming care while her spouse tells us about raising their Jewish son in a world filled with racism, bigotry and ignorance.
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Episode Transcript
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(00:00):
We're now talking with Bobby Rimel.She is a doctor OBGYN with the Cedar
Sinaite Group, and today, doctor, I wanted to talk a little bit
about your role not only as aas an obgyn, and I know you
have a specialty in oncology, butyou also have a specialty in dealing with
gender affirming care. And first ofall, what is genderfirming care? Sure?
(00:21):
So, gender affirming care, specificallyin my role as a gynoclog guncologist
is to provide gender affirming surgeries forpeople assigned female at birth who wish to
have their uterus tubes ovaries removed.That's part of the care that I provide,
and then any other gynecologic or cancerrelated care that's required to affirm their
(00:43):
gender. When you say gender affirming, is this like in the old days
we so says a sex change operation? Or are you just doing one portion
of this? You know what Imean what the mainstream calls are. So
we really refer to gender as anoutward presentation of how a person looks or
perceives is perceived to look. Sexis a biologic variable. It is a
(01:08):
sex assigned at birth and obviously canbe defined by a person's chromosomes or what
kinds of genitals they have. Along time ago, people would refer to
something as a sex change operation.That's not really what I do. I
remove the parts of the traditionally femaleanatomy that the person wishes to have removed,
either for gender affirmation, for cancer, or for other medical reasons.
(01:33):
When did you start doing that work. I began doing gender affirming care in
twenty twelve. What kind of changesare you seeing from twenty twelve to now,
Well, there's a lot more peoplewho are seeking gender affirming care than
when I started in twenty twelve.I'm also seeing a lot more people who
have previously been excluded from care.So pre twenty twelve was pre Obamacare,
(01:57):
so I've seen a lot more peoplehave access to healthcare than previously, which
is very exciting for me. I'mseeing a lot more people who are gender
non conforming or gender non binary whoare pursuing other kinds of surgical opportunities that
maybe had been excluded from those opportunitiesbefore. And I'm seeing more young people
(02:20):
so age less than twenty five thanI did initially. Who's the youngest patient
you've ever had? The youngest patientI've ever had was eighteen eighteen. The
difference now from then, Why doyou think you have a higher number of
people coming to you for care thanyou did before? Well, I could
only hypothesize, but my guess isthat the culture has come around to understanding
(02:46):
that there are children and adolescents whopresent with feelings that they're not in they've
not been assigned the right gender,that their body isn't exactly the way it
should be. Often this present veryearly in childhood two, three, four
or five six years of age,and children they are allowed to express these
feelings will be very consistent about that. And parents that understand this and are
(03:12):
willing to take the steps to affirmthat child's experience and gender. Those kids
grow up to be young adults whowish to have surgical opportunities presented to them.
And that's the difference that I'm seeing. So when someone in their late
teens and early twenties comes to youand says, well, let me let
me rephrase. Do you have peoplethat come to you in their late teens
(03:34):
early twenties that are still kind ofon the fence, They're a little confused
about it, and what kinds ofhelp are they seeking? When they come
to you like that, or arethey already coming to you with a specific
issue by the time folks get tome. People come with a very specific
issue because what I'm offering is somethingvery specific, which is a surgical removal
of gonads. So it's a veryspecific thing. But there are lots and
(03:59):
lots of people who seek gender affirmationhelp through therapists, through psychologists, through
psychiatrists, through medical and chronologists,through other types of surgeries. Those surgeries
may include anything from changing voice tochanging genitals to help with what we call
(04:20):
a transition, so changing from agender presentation that maybe was assigned with their
sex at birth to a gender presentationthat's more affirming to the gender that they
feel is right for them. Haveyou ever run into a challenging case,
a case where you just it justwas like you scratch your head and you're
like, I don't know how I'mgoing to tackle this. I don't know
how I'm going to handle it.I've had a patient come to me who
(04:43):
was in their eighties where surgery wasvery important to them emotionally, but medically
was not as safe as it mighthave been had they been much younger,
and my concern for them was ifthis was the right thing for them to
do, because I didn't want toharm them, sure, but I also
(05:05):
wanted to provide them with the carethat they wanted. And it took us
several consultations to find a plan thatwe were both reasonably comfortable with because they
really just were quite old and Ididn't want to harm them with surgery.
Since you brought it up, wasthat a case of someone in their eighties
(05:25):
finally having the courage to come forwardand get something, get some surgery done,
or get some sort of care done, or is that a situation where
they just it kind of was likea switch that was flipped. I've seen
both. I've had someone come intheir late seventies who basically woke up one
(05:46):
day and felt that the life theyhad led previously was not authentic and felt
very strongly that their gender needed tochange, and that patient went on to
pursue a bunch of orge reason isvery happy currently. And then I've also
seen it where a patient essentially endureda life that was not affirming to them
(06:09):
and they felt very bad for manymany years, and then their partner died
and they felt free to move ina different direction and really so they were
living one life while married or witha partner and then decided to live a
different life or their true life ifyou will. Yeah, does that happen
more frequently than not? Oh gosh, I wouldn't say frequently. These are
(06:30):
all single, single things that havehappened. I couldn't say about a population
level. What about the very firsttime you did something like this is kind
of a gender firming care When youdid that transition from being an obgyn and
then all of a sudden you're doingthis, Did you see it differently or
did you have to prepare differently forthis or was it just another day at
(06:51):
the office. Well, obgyn encompassesall of the necessary care for people assigned
female at birth that include foods,all reproductive care, whether that's for contraception
or childbirth, or the medical causesof painful periods, It doesn't really matter
what it is. My specialty trainingis actually in the cancers of the reproductive
(07:14):
system, of varying cancer, unioncancer, cervical cancer, and because of
that, I have specialized surgical skillsthat allow me to perform these surgeries quickly
and efficiently and in difficult settings.So patients that may have abnormal anatomy,
patients who can't have an exam beforehand, a variety of situations. And my
experience as a lesbian woman and asa queer person allowed me to be welcome
(07:40):
in spaces where transgender patients were,and so they sought me out because I
was an out lesbian doctor doing hysterectomies, and so that's really how that returned
a big comfort zone for people thatare going through that. You're with a
seater Sini system, which is oneof the most respected in the medical field.
(08:01):
Are you seeing now more and moreof these hospital groups and medical groups
starting to embrace the gender firming carepart of this? Yeah, I think
that we're really seeing medical not justin California where things are a little different,
you know when it comes to thesekinds of things, but like mainstream
across America. Are you do youknow this? Absolutely? So? I
think my experience is that I knowlots of providers who across the country are
(08:28):
adopting more gender firming care as opportunitiesfor patients that may need it. People
who have the same training that Ido may feel more able or more capable
of offering these surgeries. I speakon this topic frequently and try to get
the word out. There are obviouslycertain considerations that need to be taken into
(08:48):
account, most specifically making patients feelcomfortable when they're in our space and make
sure that their needs are being metand that we're not making any assumptions about
their future reproductive issues, their futurereproductive wishes, making sure that the playing
field is fair for them to accesscare as much as possible, not providing
(09:09):
any extra obstacles, like extra formsto fill out or forms that are written
in a really gendered way. Youcan imagine women's health is often written with
she her everything, or makes alot of assumptions about a person's desire for
future child rearing which they may ormay not have, so eliminating some of
those barriers are really important, andI'm seeing that happen nationally. Insurance companies
(09:35):
are they are they on board withthis, and for the most part,
many of them are. There areguidelines, they're called the Wpath guidelines,
and they provide a framework for usto provide careful and considered care to transgendered
individuals, and those guidelines are alsoa framework for insurance companies to understand what
(09:56):
are the requirements for a person tomeet those requirements and thus be able to
have their surgeries paid for. Youtalked about that your focus is in oncology.
Is there any nexus between gender firmingcare and oncology? I mean,
are you finding that those two thingscross. I think the skill set cross
is quite a bit. I'm dealingwith patients that are dealing with a life
(10:18):
threatening condition. In some ways,many many transgender individuals are discriminated against.
Suicide is an incredibly terrible problem inthe community, and by providing them with
gender affirming care, we hope toprovide them with lives that are rich and
full and thriving. So in thatway, it's very similar to cancer care,
where I'm trying to save somebody's life. I find that the same skills
(10:43):
that I use to create space andto be compassionate and kind and imagine what
the other person might be going throughdo help me deliver that care. At
least I hope it does. Wewere talking a little bit before that there
had been this sort of myth ofaround own hormonal therapies and having it tied
(11:03):
to cancers, and do you wantto talk a little bit about that?
Sure, So There are a lotof concerns about hormone replacement therapies causing or
increasing the risk of cancers in womenassigned female at birth who are taking hormone
replacement therapies such as menopause therapy,and we have lots of large, longitudinal,
(11:26):
big population studies to help us understandwhat that is. But for individuals
taking gender affirming hormone therapy, wherethe hormone of choice would be testosterone for
someone born female, that is reallychallenging because we don't have large population studies
to guide us, and we aremaking some guesses about what happens to folks.
(11:50):
Thankfully, the data that we dohave suggests there's not an increased risk
of cancers related to those hormones.But we need more careful than considered longitudinal
studies that are done to support thetrans community in this way. You know,
I noticed online when I was lookingat the CEDARS site about their transgender
(12:11):
surgery and health services and the genderfirming care. At least Cedars is taking
this so seriously. I mean,there are a lot of medical professionals assigned
to this and it's a it wouldappear it's becoming a really big part of
medical care. I'd say that's accurate. Providing a firming care to a population
(12:33):
that's been marginalized and underserved is amission of Cedars Sinai. The transgender and
LGBTQIA plus community is a part ofCedars mission. I feel confident as a
Cedars employee that the mission of Cedarsis to take great care of Los Angeles
and we're really lucky in Los Angeles. In my opinion, we have six
percent of the people in Los Angelesidentify as LGPTQ plus and that's a really
(13:00):
exciting thing for us, and forCedars to take that on, I think
personally is a wonderful mission. We'retalking with doctor Bobby Rymel. She is
an obgyn with a specialty in oncologyin the Cedar Sinai system and we've been
talked to her about gender affirming care. Very fascinating information. And doctor,
(13:20):
you're married, I want you tointroduce me to your partner. Sure,
So this is my wife, EmilyLarr. We met at you met at
Yale. Okay, So Emily,welcome, Nice to have you here,
nice to be here. And areyou parents of children? We are,
okay, So tell me about yourkids. We have two kids. The
(13:41):
older one is Abby, she's fifteen. She is a great kid, very
serious about school, very funny,very just one of my favorite people to
be around. Our younger child isSaul. He's eleven. He's also an
absolutely great kid, very sort ofdifferent personality, but very passionate about what
(14:05):
he's interested in and a real expertin what he chooses. You know,
raising kids today and with the samesex marriage on top of that, and
then the sort of the hostility thatexists out there, can you talk a
little bit about are you comfortable talkinga little bit about how you are raising
(14:28):
these two young kids and kind ofwhat the direction is. I mean,
are they in public school? Theyare not. We've chosen private school for
them. And is that one ofthe reasons or did you just have other
academic reasons or I think there's acomplicated set of reasons. So, Okay,
each of our kids has some attributesthat make private school a better fit
for them, but also private schooldoes allow us to pick an environment where
(14:56):
we feel comfortable as parents. Sobut would you have that fear let's say
you didn't have the private school option, I mean, would there be that
fear that you would be putting yourchildren through a public school given all the
hostility today. So when our olderdaughter was born, we lived in Saint
Louis, which is a much smallercity in Missouri, and we certainly had
a lot of concerns. There wasone of the reasons that we chose to
(15:18):
move to Los Angeles was much larger, much more diverse, and where being
queer parents is not It's unusual,but it's not unheard of. In Saint
Louis, it was unheard of,and I certainly would have had significant concerns
in the public school system in LosAngeles. I don't know. I don't
(15:39):
think so, but maybe what doyou think. I don't think in Los
Angeles it's the same kind of issue. I think that California has just a
different sort of normalization of all kindsof people. I certainly don't feel like
the weird one when I go toany kind of event here, which I
think is makes it really different fromwhen we lived in the Midwest. Yeah,
(16:00):
I would say that because we arein a lot of ways, we're
very traditional, and I think thatin Los Angeles in a way that's recognized.
In Saint Louis, it was beinga same sex couple was sort of
the only thing about us and madeus very unusual and avant garde in all
settings. So, now, speakingas parents and residents in the Los Angeles
(16:26):
area, what do you make aboutall of this recent news in this outrage
about school curriculum and I mean,obviously you don't have to deal with it,
or do you have to deal withthat in the private school setting about
how they teach the students about LGBTQplus lifestyle and or transgender. Do you
have an opinion on that? Well, So, with respect to private school
(16:49):
I would say that we've chosen schoolswhere it's not an issue, where the
teaching would you know, be inkeeping with our values, you know.
With respect to the public school system, I think that the mission of a
public school, as opposed to aprivate school, should be for the betterment
of society. And I think thatpublic schools should teach about diversity as a
(17:15):
value because that's an American ideal.So in that sense, I think that
they should teach about LGBTQ people sortof as part of teaching about many many
kinds of people, not as aspecial category. But Bobby, what do
you think about you know, peopleprotesting and the countering of this. Where
do you think that stems from.I think it stems from a lack of
(17:38):
understanding of what it really is tobe a homosexual. Like it's literally just
about sex. That's it. That'snot really anybody's business. In my opinion,
I think that who you love iswho you love, and it is
what it is. But I can'timagine a situation where somebody's needs to pro
(18:00):
test that, Like, it justseems like so unnecessary to me. So,
raising your kids at home and theyget to be in the environment of
having a same sex couple, whatis your hope and goal for them?
You know, when they become adultsthemselves and they walk away from you and
they're on their own, what isit? What are the values you want
(18:21):
them to have when they leave yourhome. I want them to be happy.
I want them to respect the happinessof the other people in the world
around them. I want them tolook at the world as a place where
they are responsible for doing good thingsand being kind to others. That's it.
(18:42):
I would agree with all of thatand really just echo that I want
them to be kind to everyone andto try to find a place of understanding
that everyone has value sort of regardlessof what they're doing, whether or not
they agree with them, and thatnot just around lgbt Q issues, just
(19:03):
around all issues. Sure, haveyou talked to them about how to handle
someone who discriminates against them because ofyou or or if they because you also
told me that you you're a Jewishcouple as well, so you've got that
on top of the other, andso I'm wondering, how do you teach
your kids to handle that if itmight come up. Well, we try
(19:26):
to encourage them to be clearly aboutwhat's important to them and what's going on,
and if someone is excluding them,to ask why, and to get
to the real heart of the issue, if it's because they are uninformed or
they're ignorant about the true situation,to try to educate them. If it's
(19:48):
a situation where nothing good is goingto happen, then to back away appropriately
and to write the appropriate letters andattend to the appropriate guy of things that
you do when something is unjust.I think that's how we would do it.
Okay, excellent, Well, Emily, Bobby. I appreciate your time
(20:11):
and thank you for being so candidand being open with us, so we
really do appreciate it. Thank youfor having us. Thank you, he
said, She said, They Said. Is a production of the KFI News
Department for iHeartMedia, Los Angeles andis produced by Steve Gregory and Jacob Gonzalez.
The associate producer is Nick Paliocchini andthe filled engineer is Tony Sarantino.
We're now talking with Bobby Rimel.She is a doctor OBGYN with the Cedar
Sinaite Group, and today, doctor, I wanted to talk a little bit
about your role not only as aas an obgyn, and I know you
have a specialty in oncology, butyou also have a specialty in dealing with
gender affirming care. And first ofall, what is genderfirming care? Sure?
(00:21):
So, gender affirming care, specificallyin my role as a gynoclog guncologist
is to provide gender affirming surgeries forpeople assigned female at birth who wish to
have their uterus tubes ovaries removed.That's part of the care that I provide,
and then any other gynecologic or cancerrelated care that's required to affirm their
(00:43):
gender. When you say gender affirming, is this like in the old days
we so says a sex change operation? Or are you just doing one portion
of this? You know what Imean what the mainstream calls are. So
we really refer to gender as anoutward presentation of how a person looks or
perceives is perceived to look. Sexis a biologic variable. It is a
(01:08):
sex assigned at birth and obviously canbe defined by a person's chromosomes or what
kinds of genitals they have. Along time ago, people would refer to
something as a sex change operation.That's not really what I do. I
remove the parts of the traditionally femaleanatomy that the person wishes to have removed,
either for gender affirmation, for cancer, or for other medical reasons.
(01:33):
When did you start doing that work. I began doing gender affirming care in
twenty twelve. What kind of changesare you seeing from twenty twelve to now,
Well, there's a lot more peoplewho are seeking gender affirming care than
when I started in twenty twelve.I'm also seeing a lot more people who
have previously been excluded from care.So pre twenty twelve was pre Obamacare,
(01:57):
so I've seen a lot more peoplehave access to healthcare than previously, which
is very exciting for me. I'mseeing a lot more people who are gender
non conforming or gender non binary whoare pursuing other kinds of surgical opportunities that
maybe had been excluded from those opportunitiesbefore. And I'm seeing more young people
(02:20):
so age less than twenty five thanI did initially. Who's the youngest patient
you've ever had? The youngest patientI've ever had was eighteen eighteen. The
difference now from then, Why doyou think you have a higher number of
people coming to you for care thanyou did before? Well, I could
only hypothesize, but my guess isthat the culture has come around to understanding
(02:46):
that there are children and adolescents whopresent with feelings that they're not in they've
not been assigned the right gender,that their body isn't exactly the way it
should be. Often this present veryearly in childhood two, three, four
or five six years of age,and children they are allowed to express these
feelings will be very consistent about that. And parents that understand this and are
(03:12):
willing to take the steps to affirmthat child's experience and gender. Those kids
grow up to be young adults whowish to have surgical opportunities presented to them.
And that's the difference that I'm seeing. So when someone in their late
teens and early twenties comes to youand says, well, let me let
me rephrase. Do you have peoplethat come to you in their late teens
(03:34):
early twenties that are still kind ofon the fence, They're a little confused
about it, and what kinds ofhelp are they seeking? When they come
to you like that, or arethey already coming to you with a specific
issue by the time folks get tome. People come with a very specific
issue because what I'm offering is somethingvery specific, which is a surgical removal
of gonads. So it's a veryspecific thing. But there are lots and
(03:59):
lots of people who seek gender affirmationhelp through therapists, through psychologists, through
psychiatrists, through medical and chronologists,through other types of surgeries. Those surgeries
may include anything from changing voice tochanging genitals to help with what we call
(04:20):
a transition, so changing from agender presentation that maybe was assigned with their
sex at birth to a gender presentationthat's more affirming to the gender that they
feel is right for them. Haveyou ever run into a challenging case,
a case where you just it justwas like you scratch your head and you're
like, I don't know how I'mgoing to tackle this. I don't know
how I'm going to handle it.I've had a patient come to me who
(04:43):
was in their eighties where surgery wasvery important to them emotionally, but medically
was not as safe as it mighthave been had they been much younger,
and my concern for them was ifthis was the right thing for them to
do, because I didn't want toharm them, sure, but I also
(05:05):
wanted to provide them with the carethat they wanted. And it took us
several consultations to find a plan thatwe were both reasonably comfortable with because they
really just were quite old and Ididn't want to harm them with surgery.
Since you brought it up, wasthat a case of someone in their eighties
(05:25):
finally having the courage to come forwardand get something, get some surgery done,
or get some sort of care done, or is that a situation where
they just it kind of was likea switch that was flipped. I've seen
both. I've had someone come intheir late seventies who basically woke up one
(05:46):
day and felt that the life theyhad led previously was not authentic and felt
very strongly that their gender needed tochange, and that patient went on to
pursue a bunch of orge reason isvery happy currently. And then I've also
seen it where a patient essentially endureda life that was not affirming to them
(06:09):
and they felt very bad for manymany years, and then their partner died
and they felt free to move ina different direction and really so they were
living one life while married or witha partner and then decided to live a
different life or their true life ifyou will. Yeah, does that happen
more frequently than not? Oh gosh, I wouldn't say frequently. These are
(06:30):
all single, single things that havehappened. I couldn't say about a population
level. What about the very firsttime you did something like this is kind
of a gender firming care When youdid that transition from being an obgyn and
then all of a sudden you're doingthis, Did you see it differently or
did you have to prepare differently forthis or was it just another day at
(06:51):
the office. Well, obgyn encompassesall of the necessary care for people assigned
female at birth that include foods,all reproductive care, whether that's for contraception
or childbirth, or the medical causesof painful periods, It doesn't really matter
what it is. My specialty trainingis actually in the cancers of the reproductive
(07:14):
system, of varying cancer, unioncancer, cervical cancer, and because of
that, I have specialized surgical skillsthat allow me to perform these surgeries quickly
and efficiently and in difficult settings.So patients that may have abnormal anatomy,
patients who can't have an exam beforehand, a variety of situations. And my
experience as a lesbian woman and asa queer person allowed me to be welcome
(07:40):
in spaces where transgender patients were,and so they sought me out because I
was an out lesbian doctor doing hysterectomies, and so that's really how that returned
a big comfort zone for people thatare going through that. You're with a
seater Sini system, which is oneof the most respected in the medical field.
(08:01):
Are you seeing now more and moreof these hospital groups and medical groups
starting to embrace the gender firming carepart of this? Yeah, I think
that we're really seeing medical not justin California where things are a little different,
you know when it comes to thesekinds of things, but like mainstream
across America. Are you do youknow this? Absolutely? So? I
think my experience is that I knowlots of providers who across the country are
(08:28):
adopting more gender firming care as opportunitiesfor patients that may need it. People
who have the same training that Ido may feel more able or more capable
of offering these surgeries. I speakon this topic frequently and try to get
the word out. There are obviouslycertain considerations that need to be taken into
(08:48):
account, most specifically making patients feelcomfortable when they're in our space and make
sure that their needs are being metand that we're not making any assumptions about
their future reproductive issues, their futurereproductive wishes, making sure that the playing
field is fair for them to accesscare as much as possible, not providing
(09:09):
any extra obstacles, like extra formsto fill out or forms that are written
in a really gendered way. Youcan imagine women's health is often written with
she her everything, or makes alot of assumptions about a person's desire for
future child rearing which they may ormay not have, so eliminating some of
those barriers are really important, andI'm seeing that happen nationally. Insurance companies
(09:35):
are they are they on board withthis, and for the most part,
many of them are. There areguidelines, they're called the Wpath guidelines,
and they provide a framework for usto provide careful and considered care to transgendered
individuals, and those guidelines are alsoa framework for insurance companies to understand what
(09:56):
are the requirements for a person tomeet those requirements and thus be able to
have their surgeries paid for. Youtalked about that your focus is in oncology.
Is there any nexus between gender firmingcare and oncology? I mean,
are you finding that those two thingscross. I think the skill set cross
is quite a bit. I'm dealingwith patients that are dealing with a life
(10:18):
threatening condition. In some ways,many many transgender individuals are discriminated against.
Suicide is an incredibly terrible problem inthe community, and by providing them with
gender affirming care, we hope toprovide them with lives that are rich and
full and thriving. So in thatway, it's very similar to cancer care,
where I'm trying to save somebody's life. I find that the same skills
(10:43):
that I use to create space andto be compassionate and kind and imagine what
the other person might be going throughdo help me deliver that care. At
least I hope it does. Wewere talking a little bit before that there
had been this sort of myth ofaround own hormonal therapies and having it tied
(11:03):
to cancers, and do you wantto talk a little bit about that?
Sure, So There are a lotof concerns about hormone replacement therapies causing or
increasing the risk of cancers in womenassigned female at birth who are taking hormone
replacement therapies such as menopause therapy,and we have lots of large, longitudinal,
(11:26):
big population studies to help us understandwhat that is. But for individuals
taking gender affirming hormone therapy, wherethe hormone of choice would be testosterone for
someone born female, that is reallychallenging because we don't have large population studies
to guide us, and we aremaking some guesses about what happens to folks.
(11:50):
Thankfully, the data that we dohave suggests there's not an increased risk
of cancers related to those hormones.But we need more careful than considered longitudinal
studies that are done to support thetrans community in this way. You know,
I noticed online when I was lookingat the CEDARS site about their transgender
(12:11):
surgery and health services and the genderfirming care. At least Cedars is taking
this so seriously. I mean,there are a lot of medical professionals assigned
to this and it's a it wouldappear it's becoming a really big part of
medical care. I'd say that's accurate. Providing a firming care to a population
(12:33):
that's been marginalized and underserved is amission of Cedars Sinai. The transgender and
LGBTQIA plus community is a part ofCedars mission. I feel confident as a
Cedars employee that the mission of Cedarsis to take great care of Los Angeles
and we're really lucky in Los Angeles. In my opinion, we have six
percent of the people in Los Angelesidentify as LGPTQ plus and that's a really
(13:00):
exciting thing for us, and forCedars to take that on, I think
personally is a wonderful mission. We'retalking with doctor Bobby Rymel. She is
an obgyn with a specialty in oncologyin the Cedar Sinai system and we've been
talked to her about gender affirming care. Very fascinating information. And doctor,
(13:20):
you're married, I want you tointroduce me to your partner. Sure,
So this is my wife, EmilyLarr. We met at you met at
Yale. Okay, So Emily,welcome, Nice to have you here,
nice to be here. And areyou parents of children? We are,
okay, So tell me about yourkids. We have two kids. The
(13:41):
older one is Abby, she's fifteen. She is a great kid, very
serious about school, very funny,very just one of my favorite people to
be around. Our younger child isSaul. He's eleven. He's also an
absolutely great kid, very sort ofdifferent personality, but very passionate about what
(14:05):
he's interested in and a real expertin what he chooses. You know,
raising kids today and with the samesex marriage on top of that, and
then the sort of the hostility thatexists out there, can you talk a
little bit about are you comfortable talkinga little bit about how you are raising
(14:28):
these two young kids and kind ofwhat the direction is. I mean,
are they in public school? Theyare not. We've chosen private school for
them. And is that one ofthe reasons or did you just have other
academic reasons or I think there's acomplicated set of reasons. So, Okay,
each of our kids has some attributesthat make private school a better fit
for them, but also private schooldoes allow us to pick an environment where
(14:56):
we feel comfortable as parents. Sobut would you have that fear let's say
you didn't have the private school option, I mean, would there be that
fear that you would be putting yourchildren through a public school given all the
hostility today. So when our olderdaughter was born, we lived in Saint
Louis, which is a much smallercity in Missouri, and we certainly had
a lot of concerns. There wasone of the reasons that we chose to
(15:18):
move to Los Angeles was much larger, much more diverse, and where being
queer parents is not It's unusual,but it's not unheard of. In Saint
Louis, it was unheard of,and I certainly would have had significant concerns
in the public school system in LosAngeles. I don't know. I don't
(15:39):
think so, but maybe what doyou think. I don't think in Los
Angeles it's the same kind of issue. I think that California has just a
different sort of normalization of all kindsof people. I certainly don't feel like
the weird one when I go toany kind of event here, which I
think is makes it really different fromwhen we lived in the Midwest. Yeah,
(16:00):
I would say that because we arein a lot of ways, we're
very traditional, and I think thatin Los Angeles in a way that's recognized.
In Saint Louis, it was beinga same sex couple was sort of
the only thing about us and madeus very unusual and avant garde in all
settings. So, now, speakingas parents and residents in the Los Angeles
(16:26):
area, what do you make aboutall of this recent news in this outrage
about school curriculum and I mean,obviously you don't have to deal with it,
or do you have to deal withthat in the private school setting about
how they teach the students about LGBTQplus lifestyle and or transgender. Do you
have an opinion on that? Well, So, with respect to private school
(16:49):
I would say that we've chosen schoolswhere it's not an issue, where the
teaching would you know, be inkeeping with our values, you know.
With respect to the public school system, I think that the mission of a
public school, as opposed to aprivate school, should be for the betterment
of society. And I think thatpublic schools should teach about diversity as a
(17:15):
value because that's an American ideal.So in that sense, I think that
they should teach about LGBTQ people sortof as part of teaching about many many
kinds of people, not as aspecial category. But Bobby, what do
you think about you know, peopleprotesting and the countering of this. Where
do you think that stems from.I think it stems from a lack of
(17:38):
understanding of what it really is tobe a homosexual. Like it's literally just
about sex. That's it. That'snot really anybody's business. In my opinion,
I think that who you love iswho you love, and it is
what it is. But I can'timagine a situation where somebody's needs to pro
(18:00):
test that, Like, it justseems like so unnecessary to me. So,
raising your kids at home and theyget to be in the environment of
having a same sex couple, whatis your hope and goal for them?
You know, when they become adultsthemselves and they walk away from you and
they're on their own, what isit? What are the values you want
(18:21):
them to have when they leave yourhome. I want them to be happy.
I want them to respect the happinessof the other people in the world
around them. I want them tolook at the world as a place where
they are responsible for doing good thingsand being kind to others. That's it.
(18:42):
I would agree with all of thatand really just echo that I want
them to be kind to everyone andto try to find a place of understanding
that everyone has value sort of regardlessof what they're doing, whether or not
they agree with them, and thatnot just around lgbt Q issues, just
(19:03):
around all issues. Sure, haveyou talked to them about how to handle
someone who discriminates against them because ofyou or or if they because you also
told me that you you're a Jewishcouple as well, so you've got that
on top of the other, andso I'm wondering, how do you teach
your kids to handle that if itmight come up. Well, we try
(19:26):
to encourage them to be clearly aboutwhat's important to them and what's going on,
and if someone is excluding them,to ask why, and to get
to the real heart of the issue, if it's because they are uninformed or
they're ignorant about the true situation,to try to educate them. If it's
(19:48):
a situation where nothing good is goingto happen, then to back away appropriately
and to write the appropriate letters andattend to the appropriate guy of things that
you do when something is unjust.I think that's how we would do it.
Okay, excellent, Well, Emily, Bobby. I appreciate your time
(20:11):
and thank you for being so candidand being open with us, so we
really do appreciate it. Thank youfor having us. Thank you, he
said, She said, They Said. Is a production of the KFI News
Department for iHeartMedia, Los Angeles andis produced by Steve Gregory and Jacob Gonzalez.
The associate producer is Nick Paliocchini andthe filled engineer is Tony Sarantino.
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