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Pride 2017: Doctor pioneers advances in trans health

by Sari Staver

Dr. Dan Karasic. Photo: Sari Staver
Dr. Dan Karasic. Photo: Sari Staver  

For his entire career, Dr. Dan Karasic, a psychiatrist, has fought for equal rights for people marginalized by society.

From his stint as a trainee at a Department of Veterans Affairs hospital in Los Angeles in the 1980s, where he advocated for equal care for people with AIDS, drawing blood when hospital staff wouldn't, to recent times when he promoted a more modern view of transgender health within the psychiatric field, Karasic, a gay man, has gained the admiration of colleagues.

Chosen earlier this year to chair the 2017 inaugural World Professional Association for Transgender Health-sponsored conference aimed at U.S. membership, held in Los Angeles in February, Karasic has a long list of awards and accolades, including the 2012 UCSF Chancellor's Leadership Award for LGBT Health.

A past president of the Association of Gay and Lesbian Psychiatrists, Karasic leads a peripatetic personal life, commuting on weekends to Los Angeles where his husband of seven years, Ryan Thomson, is a Hollywood talent manager.

Trans scholar Jamison Green, Ph.D., a past president of WPATH, said in a phone interview that Karasic was "one of the first psychiatrists to be active helping support human rights for the transgender community."

"Dan really helped elevate us outside of city hall in our push to obtain services, rights, and protections," said Green, a longtime consultant and policy adviser on trans issues. Within the LGBT community, Karasic "advanced the inclusiveness of the T," he added.

"Not only did Dan step up, but he has always been very conscientious about not speaking for us, but letting transgender people speak for themselves," Green said. "Dan clearly understood the traumas, pressures, and marginalization we have experienced and, without ever saying as much, always makes sure we know we are valued."

Another colleague, Lin Fraser, a psychotherapist in private practice, added her perspective. In a telephone interview with the Bay Area Reporter, Fraser said, "Dan is not only a brilliant, pioneering and compassionate psychiatrist, but he's also a strategist in the trenches, always thinking about how to change the environment to improve access to services for people who are transgender."

Soft-spoken and reserved, Karasic does not like to talk about his accomplishments, but when pressed during an interview at his office at the UCSF Alliance Health Project, he acknowledged being proud of his efforts to "depathologize trans identity" by pushing for reform of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) diagnosis from "gender identity disorder" to "gender dysphoria." The latter refers to the dysphoria (distress) a person experiences as a result of the sex and gender they were assigned at birth.

He also cited his work advocating for the right to correct legal identification documents without surgery or other onerous restrictions, and in fostering communication between trans health advocates and health professionals.

Currently a health sciences clinical professor of psychiatry at UCSF, Karasic co-leads the gender team at AHP; is the psychiatrist for the Transgender Life Care Program and the Dimensions Clinic at the Castro-Mission Health Center; works with trans and HIV-positive people at Zuckerberg San Francisco General Hospital; and trains health care providers in trans health.

Karasic has helped educate other health professionals through his writing. He co-edited "Sexual and Gender Diagnoses of the Diagnostic and Statistical Manual (DSM): A Reevaluation" and authored the chapter, "Transgender and Gender Nonconforming Patients" in the second edition of "Clinical Manual of Cultural Psychiatry."

Karasic, 57, said that his early life was very privileged. In the 1960s, the Karasic family moved from Philadelphia to Los Angeles, where he rubbed shoulders with the children of celebrities at Beverly Hills High School, but after a family financial crisis and his parents' divorce, he lived in his car for several months.

Things brightened when Karasic was accepted to Los Angeles' Occidental College (where he met Barack Obama) and later, with loans and scholarships, to Yale Medical School in New Haven, Connecticut.

As far as his ability to handle a full calendar of jobs and volunteer advocacy gigs, Karasic said, "Growing up, I had a very intellectual upbringing. Having two very brilliant parents really helped me in terms of figuring out what it meant to study. I also learned to be independent, because, well, my parents really weren't all that great at parenting."

He said that his mother influenced him.

"My mom was a tremendously positive influence on me because she was a no-limits kind of woman in an era that set limits on what women could do," Karasic said. "She moved to the U.S. to go to medical school but when she got here, at first was turned down by many schools who were then favoring men returning from the war. Also, later in her career, my mom developed her own line of skin products, which she sold on QVC. She wouldn't take no for an answer. I try to remember that philosophy."

 

For more information on the UCSF Alliance Health Project, visit https://ucsf-ahp.org/.

 

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