Jess: Love Thy Neighbor

Jess Ting, MD, has learned to thrive without road maps. As a kid, he taught himself to play the upright bass and went on to study at Juilliard. Now he’s blazing trails in transgender medicine and surgery. “It’s a great field because it’s so young,” Dr. Ting says. “There’s lots of room to innovate.” Among Dr. Ting’s innovations—a completely new approach to vaginoplasty, called the Peritoneum Vaginoplasty. In this audio portrait, Dr. Ting talks about how innovation happens and what he’s learned from his transgender patients.

Dr. Ting is Director of Surgery at the Mount Sinai Center for Transgender Medicine and Surgery.

For more Real, Smart People, visit our website.

Links:

• Center for Transgender Medicine and Surgery
• LGBT Health at Mount Sinai
• Transgender and Gender Non-Binary Community Resources in NYC

Episode Transcript

Dr. Jess Ting (00:01):
The oldest patient we had operated on was a
77-year-old woman.
And, I will never forget, I sawher right across the street in
that building.
And when she first came in shewas so nervous.
She couldn't really talk.
And at the end of theconsultation, I'm like,"Okay,

(00:21):
great.
Why don't you go see Elsa andshe'll give you a surgery date."
And she was just almost intears.
She was like,"Well, I thoughtyou were going to turn me down
for surgery and tell me that Iwas too old." And she was like,
"Well, Dr.
Ting I've waited my whole lifefor this.
I've wanted this since I wasfive.
And I'm now 77.

(00:47):
My name is Jess Ting and I'm aplastic surgeon and I'm also the
Director of Surgery at theCenter for Transgender Medicine
and Surgery at Mount Sinai.
How I became a transgendersurgeon is almost accidental.
I was a plastic surgeon for 15years.
And in 2015, Mount Sinai decidedto start a program.

(01:08):
To me, it sounded fascinating.
So I did the training, and inthe beginning I was just going
to do a little bit of thisoperation.
It was just going to be a partof my practice.
But once we started doing theoperations and just seeing how
transformative they were forpatients, I was like, wow, there
is no way I can go back to doingplastic surgery.
When there are this many peoplewaiting for surgery and can have

(01:33):
this kind of change in theirlives from it.
As you may or may not knowthere's an extremely high
suicide rate in this population.
And that's because transgenderpeople, when they have to exist
in these bodies that they feelare not suited to their gender,
it causes a lot of distress andpain and trauma.

(01:55):
And before we started ourprogram in New York City, there
were no places to getgender-affirmation surgery in
New York, in New York State.
It's been almost four years now.
I've done about 1500 surgeries.
They're terrifying operations.
It's not like plastic surgery.

(02:15):
In these operations, if you makea mistake someone can get—they
can die.
They can bleed.
And the operations are moredifficult.
And at the same time, they'renot as well-developed.
I probably shouldn't say this,but, you know, I get nervous
before almost every case.
I'm always thinking abouteverything that could go wrong.
And how do I avoid that fromhappening?
And what do I do if thishappens?

(02:36):
How do I get out of thattrouble?
So that's at a granular leveland at a higher level, a lot of
times when I'm operating, I'mlike, why do we do that?
Why did I just do that?
I think we could do it this wayinstead.
And I think that's going to worka lot better.
Sometimes they're littleincremental improvements and
changes that we make andsometime there are big ones.

(03:09):
So before I was a doctor, I wasa musician.
I grew up in Queens, went topublic school, and there was an
orchestra class.
And the teacher's like,"Okay,who's going to play the bass?
You, Jess, you're tall, so youplay the bass." And I was like,
"Okay." And I just, I loved it.
It's very deep and sonorous.
And when you played it justvibrates the floor, vibrates

(03:31):
your whole body.
My family we didn't have theresources to pay for a teacher,
so on the one hand not having ateacher was a handicap, but on
the other hand, it freed me todo things in my own way.
And it's the same way with thesesurgeries.
It's a great field because it'sso young.
So there's a lot of room toinnovate, to expand, to invent.

(03:56):
About three years ago, a patientcame to me and brought me a
scientific article about thisoperation.
It was an old operation that GYNsurgeons would do to create a
vagina in women, cis women whowere born without one.
And this patient asked me if Icould do this operation in her.
And I looked at the article andI was like,"No, no, it wouldn't

(04:19):
work because the female anatomyis different." But when I went
home that day, I couldn't getthat thought out of my mind.
And one day like three weekslater in the shower, I was like,
you know, actually there is away we can take an aspect of
that operation and apply it towhat we do in vaginoplasty.

(04:40):
It was a way of creating a morelife- like lining of the inner
vagina using a tissue calledperitoneum that we take from
inside the abdomen.
So that idea is something thatwe do now almost in every
operation.
And I think has improved ouroutcomes changed the way that I
do the operation.

(05:02):
You can be a very, very goodmusician, just having the
techniques and having the hands.
But to be a great musician—andI'm not saying I'm a great
musician—but to be a greatmusician, I think you have to
have the attitude that you'redoing it for the greater good,
you're playing for an audience.
It's all about communicating.
And I think the same applies tobeing a great physician.

(05:26):
Ultimately what we do is for thegreater good.
Moments of greatest satisfactionare seeing the changes in our
patients and what we do.
A patient will come back aftersurgery.
And they'll just say,"Wow, thisis incredible.
This has changed my life." Thatis really cool.
And that happens a lot.

(05:48):
Looking back on the person who Iwas, seeing myself through the
lens that I have now, I justrealized I was a much more rigid
person.
Just didn't have a fullunderstanding of the human
experience, no understanding ofwhat the trans experience was
and how horribly trans peopleare treated.

(06:11):
If I had a billboard in TimesSquare, I think that the message

I would put on it would be (06:15):
love thy neighbor.
Be willing to accept people whoare not like yourself.