Humans of DFCM—Dr. Robyn Moxley
Providing care from the very first days to the very last is a hallmark of family medicine. For Dr. Robyn Moxley, focusing on care in these areas is key to supporting 2SLGBTQIA+ communities.
Dr. Robyn Moxley, MD, CFPC, knew she wanted obstetrics to be part of her practice from the first day of residency. Now a Department of Family and Community Medicine (DFCM) faculty member, she co-leads the obstetrics division at Sunnybrook Health Sciences Centre and is focused on supporting the 2SLGBTQIA+ childbearing community.
Today, as well as practicing family medicine obstetrics, Dr. Moxley works with older adults in long-term care. Having taken over a locum position, she fell in love with geriatrics and the opportunity to become deeply connected to the person and, often, their family members.
Recounting a memory of throwing a 100th birthday party for a long-term care resident, she highlights how important geriatric care is.
“He was just so happy. He has advanced dementia, so his communication is really limited, but that day you could just see he felt cared for and valued, and he wanted to reflect that back to everybody and the way he did it was by repeatedly asking if everybody had had enough cake,” she says. “It was the brightest I'd seen him in a long time and the most I'd seen him thinking about the people around him.”
Providing care from the first days to the last is a hallmark of family medicine. For Dr. Moxley, focusing her practice in these areas is a fundamental part of her efforts to support 2SLGBTQIA+ communities.
“I came out when I had already been working for a few years, and it was a huge paradigm shift for me when I really started to realize how much our society has been built around the needs of straight and cisgender people,” she says. “The same goes for the health system, it is not designed to meet the needs of queer and trans patients, especially in childbearing and later years.”
Noting that healthcare providers can be caught off guard by the presence 2SLGBTQIA+ community members in obstetrics and geriatrics, Dr. Moxley is doing what she can to make services in these areas more inclusive.
“Everyone needs to be able to access healthcare at all stages of life, but in obstetrics and geriatrics, healthcare providers don’t always expect they will be caring for people who are not cisgender or are in queer relationships. It seems like it catches a lot of providers off guard when someone's pregnant and for example, they don't identify as a woman, or an older patient is queer or transgender.”
In the 2SLGBTQIA+ community, older adults in particular may have endured years of interpersonal, institutional, and structural discrimination based on their sexuality and gender identity. To provide more inclusive care to this often-neglected population, we need to throw out the assumption that the ‘normal’ way to be is straight or cisgender, explains Dr. Moxley.
The first step, she says, is being aware of your biases, leaving your preconceived notions at the door and educating yourself using resources like Rainbow Health Ontario.
As is the case in all family medicine, providing person-centred care and family-based care relies on building a trusted relationship. In order to do that, you really need to understand who the person is and create a space where they can feel safe to be true to themselves which might include disclosing how they identify, explains Dr. Moxley.
“Everybody's experience and everybody's needs will be different, so we should not make assumptions about what a person wants based on how they identify. Once you get to know someone on a personal level that becomes so obvious — we just need to take the time to build that trusting relationship.”
