Shortly after starting to work on a Ph.D. in immunology at Mayo Clinic Graduate School of Biomedical Sciences in 2017, Jordan came out as nonbinary transgender.

"Most people don't know what nonbinary means, so I'm fielding questions every day about my gender," says Jordan, who doesn't identify as strictly male or female. "You don't come out once. You come out the rest of your life."

Despite feeling supported by the graduate school, Jordan was not like everyone else.

"I only know one other trans person doing research in all of Mayo Clinic," Jordan says. "If isolation is true for me, I figured it must be true for others."

"A lot of credit goes to T.L. for bringing this forward," says Rachel Halsrud, operations manager for Mayo Clinic Graduate School of Biomedical Sciences. "It was a wake-up call. The school has a passion for diversity, and a commitment to support and encourage students to be true to themselves."

Acceptance and inclusion on campus

The LGBTI community is diverse, unified only by an acronym, a history of discrimination, and many health disparities. Although social acceptance of LGBTI people has been increasing, some within Mayo keep their sexual orientation and gender identity private rather than risk their physical, academic, or professional safety, says Jimmy Luckey, J.D., chair of the LGBTI Mayo Employee Resource Group (MERG) in Rochester.

"Acceptance is huge," says Luckey, who is gay.

So is inclusion — the feeling of belonging to a group of similar students and faculty.

"Seeing mentors you can identify with is incredibly important for students," Luckey says. "Without someone like you there in that role, it creates a lot of discord in yourself."

Discrimination continues to underlie multiple health disparities for LGBTI populations, including higher rates of HIV and other sexually transmitted infections, substance abuse, unhealthy weight control and perception, smoking, depression, anxiety, suicide, homelessness, violence, and victimization.

"Trauma bleeds into their own sense of self-worth and their career," Luckey says. "We're better at helping others than we are at healing ourselves."

Never fitting the mold

Jordan knows firsthand how this feels.

As a youngster in Wisconsin, Jordan often was called a tomboy, an old-fashioned term for a girl who didn't go for dresses and dolls. As a young adult, Jordan chose the look of an athlete with short hair and sportswear to blur a female figure.

"I didn't fit into whatever mold society tried to put me in," Jordan says. "I was always nonbinary, but I didn't have the vocabulary to express that. I thought I was a broken girl."

After 23 years of wondering and questioning, discovering the correct definition of self was empowering for Jordan, who recently wrote an essay about being a trans scientist in ASBMB Today: "I've never felt more myself. I'm more confident. I'm finally so sure of who I am that I do not care if other people like it." (ASBMB stands for the American Society for Biochemistry and Molecular Biology.)

An advocate is born

Personal struggle, compassion and determination eventually turned Jordan into an advocate for LGBTI students.

Joining the LGBTI MERG in Rochester provided an education in advocating change within a complex organization. The group aims to achieve a more inclusive environment for LGBTI staff and patients.

"What about the needs of LGBTI students?" Jordan asked the group.

Luckey created an LGBTI student subcommittee in 2018, now the LGBTI MERG Student Group, to pursue improvements for students and named Jordan chair. That same year, Mayo adopted a Gender Transition in the Workplace policy, procedure, and guideline that provides transgender staff with resources to manage a gender transition in the workplace. As written, however, they do not apply to students. 

Initially championed by Jordan, a Gender Transition for Students policy, procedure, and guideline are in final approval phases within the Mayo Clinic College of Medicine and Science.

Now a third-year student in the Protein Misfolding Lab of Marina Ramirez-Alvarado, Ph.D., Biochemistry and Molecular Biology, Jordan has worked with the college's Office for Education Diversity, Equity, and Inclusion, and school administrators to create a similar policy for transgender students and make the environment more respectful for LGBTI students. Much of that involves revising policies to be gender-neutral, such as altering references to what men and women should wear in the dress and decorum policy.

Queer and proud

Katie Linder, a third-year student at Mayo Clinic Alix School of Medicine, is bisexual and has been with her female partner since the second year of college. But she prefers to call herself queer. Still used as a slur by some, the word has become a badge of honor for Linder.

"Claiming it as our own conveys a sense of power," she says. "It encompasses my sexuality and my world view. It acknowledges a spectrum of experiences that are outside of the norm."

Linder joined Mayo's LGBTI student subcommittee, and became a member of the medical school's Diversity and Inclusion Council. She became co-chair of LGBTI in Medicine in April after helping organize the group for medical students in Rochester.

"The reality is that there are similarities in the need for advocacy for all gender-non-conforming people," Linder says. "We don't have to agree on what it means to be part of the community to work for each other. The common ground is discrimination, which is rooted in gender-related phobias."

She has been involved in the medical school's effort to incorporate sexuality topics in the curriculum, such as transgender and intersex health in Anatomy, scenarios for interaction with LGBTI patients in Basic Doctoring, and a lecture on hormones and gender-forming therapy in Endocrinology.

"The school can't ignore that we will be treating people who are part of the queer community," she says.

Sparking change in STEM

While attending advocacy training, Jordan took on the challenge of planning an advocacy event. Knowing that sexual and gender minorities in science, technology, engineering, and mathematics (STEM) often don't dare come out, Jordan wanted to create a spark for change.

The LGBTI student subcommittee organized LGBTI in STEM Day. Sponsored by the LGBTI MERG and the college's Diversity, Equity, and Inclusion, the event promoted inclusion and individuality with education on gender identity and sexual orientation, discussion of health issues, and networking.

Mayo supported the event to make a statement against discrimination, says J. Luis Lujan, Ph.D., the college's assistant dean for the Office for Education Diversity, Equity, and Inclusion: "It let people in science and medicine know that it's OK to be who they are."

Signs of progress

"In the two years I've been here, Mayo Clinic has made a lot of strides forward to become more inclusive," Jordan says.

Jordan has worked on creating LGBTI literacy programming for the graduate school and Mayo Clinic College of Medicine and Science as a whole. The college has incorporated the person's preferred pronouns — they or them for Jordan — on email signatures. The LGBTI student subcommittee is advising the schools on revising application forms to be more inclusive. LGBTI in Medicine has compiled resources and a process for transgender students undergoing transition while in medical school, including how to change the student's name.

"We need to compete for and retain LGBTI students," Dr. Lujan says. "Potential students need to feel they will be welcome and accepted at Mayo Clinic."