Peter Asante, MD, FAAP
Trustee, Washington Chapter of the American Academy of Pediatrics
Co-Chair, WCAAP Equitable Care Work Group
“Growth is uncomfortable, because if it were comfortable, we wouldn’t move! Transitions never occur when things are easy.”
Jayde Ruth
When I precept residents who rotate through my clinic during their rural primary care rotation, I tell them that a key to greater mastery as a primary care provider is to learn to be comfortable with the uncertainty of providing medical care, particularly in an under-resourced setting. Some days you feel on competent and proficient. Other days you feel like you have more questions to look up than answers.
And yet, the questions will keep coming.
These questions will challenge our thinking.
This uncertainty will expand our scope of practice.
Many new and/or big projects start with a thought, a question, a challenge. But many also never get implemented due to fear and/or self-doubt. In the last 2 years, our doubts and fears have been exacerbated by the uncertainty of how we partner with youth and families to provide evidenced-based care, which in the context of this pandemic, feels like a race against time and public opinion.
When I started the Teen Health Clinic at Yakima Pediatrics in April 2016, I could not have imagined what it would be today. I am grateful to our patients who asked us questions that challenged us and thereby fueled our expansion, the most recent being the formalized establishment of our gender clinic in 2021. Even then, as we launched this arm of the Teen Health Clinic, we were not comfortable with taking on all aspects of gender care, particularly a workflow on prescribing and managing puberty blockers. But a conversation with a colleague forced the issue, motivating us to push past our discomfort with adding another service line while we were mastering another. Personally, this was a real area of growth for me to become more comfortable with. In this process, it was invaluable to have such great mentorship and support, because pushing the bounds of medicine should not be a solo venture. We should feel like we all have the capacity to uplift others while we climb.
In 2022, the Equitable Care Workgroup is excited to start this year’s webinar offerings with a two-part series on providing gender-affirming care to our gender diverse youth in Washington State. We are hopeful that in the same way pioneers in this field have been galvanizing support for this expansion of our healthcare facilities to be safer spaces for comprehensive care in service to our communities, that we can share lessons learned and pass on practical resources for all clinical spaces to start making impactful change for our patients and families from minoritized and marginalized populations.
The work of anti-racism is also about inclusivity. It is about being seen. It is about seeing others who are told they cannot take up space. It is implementing for the marginalized, with awareness that all will benefit.
If there is anything I have learned in the past 2 years, that inspires me to be a better medical provider for my patients it is this: implementing new programs in healthcare to support my patients is a challenge in this resource-limited world we live in. But with a little bit of courage and humility, we can leverage our infrastructures to generalize the work that some are doing for many. I hope that as we do this work of expanding our scope of practice to care for the historically disenfranchised, we all remember that the level of difficulty affirms that this work is necessary and good. Our youth deserve to be seen. And we, members of the Equitable Care Workgroup and WCAAP, see you as medical providers with the capacity to create a compassionate nonjudgmental space for them. Supporting each other allows us to push past our fear, our doubt, and our uncertainty…to achieve greater mastery at uploading the best values our medical institution has to offer the patients and families we serve.
“The days you are most uncomfortable are the days you learn the most about yourself.”
Unknown
Join us on March 23 at 7:00am for the first in our 2022 Equity Webinar Series:
Equitable Care: Gender-Affirming Care
Part 1 of a 2-part series on gender-affirming care; the second webinar in the series will be held in June. Our thanks to Juanita K. Hodax, MD, Co-Director of the Seattle Children’s Hospital Gender Clinic and Matt Goldenberg, PsyD.
- Learn how you can create a clinic environment that is affirming to gender-diverse youth
- Learn why this is important in pediatric health care and inclusive of pediatric mental health
- Find out about resources for supporting gender-diverse youth in Washington State.
Many thanks to Community Health Plan of Washington and Amerigroup for making this series possible.

