Being from a marginalized community myself,
being a Two-Spirit person,
being an Indigenous person,
I know how scary it can be
to access care from the health care field.
- Dr. James Makokis is not your average family physician.
He's the only doctor working with transgender patients
in Enoch First Nation,
a Cree reserve of 2,400 people in central Alberta.
Many of his patients drive up to 8 hours and walk miles along dirt roads
to see this Two-Spirit Indigenous specialist who makes them feel safe.
"Two-Spirit" is a contemporary English term
to reflect gender diversity that Indigenous Nations have always had.
- In our language [Navajo], we say “nádleeh.”
So “nádleeh” means “ambient being."
So if you think about energetic forces inside of body,
it's like these two forces that oscillate back and forth.
It's not just male, it's not just female, it's male–female, back and forth, all the time.
- For the past three years, Dr. Makokis has crafted his unique approach to transgender care
by bringing together Indigenous and Western teachings.
And his biggest contribution is his openness about his own identity.
- James has a helped me accept myself because he accepts himself.
He made me feel comfortable in my own skin.
- I don't know what other doctor can help a young boy become into a Cree warrior man.
- Enoch Health Center or Maskêhkosihk, which means “where the medicines grow” in Cree,
is a 30-minute drive from Edmonton.
- Just getting to clinic.
This is where I usually keep my stuff.
We don’t have much space here,
so this is kind of how I make it work.
That’s my little locker.
- This is where Dr. Makokis sees patients from 9:30 a.m. till late afternoon.
- We try to make it GLBT-friendly.
So we have some rainbow stickers everywhere.
This is the washroom. So, it’s a gender-neutral washroom.
- And because many in Alberta can't access transgender care elsewhere,
they come here, to the Enoch reserve.
- So Leah actually has a really important part of her story,
where she was in a darker place
and it was very difficult for her not accepting who she is as a trans woman
And that's something completely different where she is today.
– When did you start on hormones?
– October 26th, 2018.
– What are some of the changes that you've noticed?
– I just feel myself finally.
My anxiety’s gone down, I feel happier, I feel like I'm complete or on my way to be complete.
– Well, I lived in fear, in secrecy.
Being born in the late 50s and growing up in the 60s, 70s,
there was no internet, there was no one to talk to.
And so I carried a lot of this inside.
I can recall many times in my life where I actually thought of suicide.
And I’m glad I never acted on it.
I come from a large French Catholic family.
I always knew I was different.
When I came out to my family, or “let them in” as I like to call it now,
there were some painful things said to me, but they were all true.
Painful things like I was always withdrawn, downer to be around.
I accept who I am. And I am Leah. And I’ve always been Leah.
- Some of the challenges of doing transgender care is fear.
Fear within the medical community that we're harming patients.
Fear that we are hurting children or youth by disrupting their development.
And fear because we're actually changing the physiology of people.
- Since he was a teen, Dr. Makokis saw his Cree Two-Spirit identity
as part of who he was.
But it was different for his husband, Anthony.
When they first met, he was still grappling with what it really meant to be Two-Spirit.
As Indigenous people, we've always had gender diversity
and sexual diversity in our Nations before colonization existed on Turtle Island.
With the imposition of colonization, Christianity, residential schools, the Sixties Scoop,
a lot of those teachings of gender diversity have been lost
and a lot of people are searching for their identity as Two-Spirit people
and the roles and responsibilities that come with that.
- We're often like,
“Oh man, what is it like not to be Native?”
Because other people are talking about trips or nature or whatever.
And we're like, talking about, you know, opioid crisis,
We're talking about suicide, we’re talking about very difficult things that we deal with in our community.
- By 4:30 in the afternoon,
Dr. Makokis' schedule is only getting busier.
He's on his way to the South Common Medical Center for back-to-back appointments till 8 p.m.
Alright, so here's our clinic at South Common.
He's the only specialist who can prescribe hormones and other trans medicine there.
So, we’re just gonna get settled in and then start seeing patients right away.
So for him, the long hours are all worth it.
– Remind me again, you've been on testosterone for ...
– Almost three years now.
– Yeah, three years.
– And I first started seeing you when you were 11? – Yeah.
- Remembering my very first testosterone shot,
it's almost like it happened yesterday.
It solidified that I'm going to be here.
That gave me hope.
– He [Emery] told us right after he turned 11, really nonchalantly.
Of course, we reacted as it was normal and we’re expecting it.
Actually, he used the word “gender dysphoria,”
which I had to look up afterwords.
He wanted to be known as a boy, acknowledged as a boy.
And he had a list of names for us to help him pick to transition into becoming a man.
Emery was bullied from the ages of grade 1 to 4.
And so he had serious bladder issues ‘cause the bullying happened in the bathroom.
It took Dr. Makokis to advocate and really respond and acknowledge
that the physical issues my son had was a result of my son holding his bladder
from bullying that happened for many years in a school.
- Being Two-Spirit in my community means that I am fully who I am.
I'm not shy about that.
I don’t pretend to be someone else.
Two-Spirit people are very gifted individuals
and they can do many different things
if people don't stifle their growth and development.