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Meridian Park doctors helped Soell get to new 'normal'

Physicians offered support navigating cancer, identity issues


TIMES PHOTO: JAIME VALDEZ - This is Leo Soell's most prominent scar from breast cancer, left from the chest port that delivered their chemo drips.Leo Soell’s health journey was never normal. From early teenage years, they struggled with mysterious symptoms and ailments that often went unexplained.

So when Soell suspected they had cancer at age 24, it should have been no surprise that a year later, this self-diagnosis would be correct. But before that diagnosis was confirmed, Soell was met with months of health care practices that didn’t meet their needs.

In addition to their failing health, Soell was coming out as transgender and genderqueer, and doctors repeatedly expressed disbelief regarding Soell’s list of symptoms and possible explanations. Eventually, Soell was led to Megan Bird, medical director of Legacy Medical Group Women’s Specialties, in the spring of 2014.

Unlike other doctors, Bird sat down with Soell for hours, reviewing their medical history and seeking the root of her patient’s declining health.

“There’s this ethical conflict in medicine, I think, where you have to at the same time believe everything (patients) say and nothing that they say,” Bird said. “The person in front of you is not lying to you. On the other hand, (for) everything that they say, we need verification because they may have misunderstood it, the doctor may not have explained it well, the evidence may be different now, we may know more about their problem.”

As Soell sat with a friend in Bird’s office in November 2014, the lump under Soell’s arm was confirmed as cancerous — the start of months of coordinated care, life-changing decisions, and Soell’s evolving role as an advocate for the transgender community.

But before all that could fully set in motion, Soell needed a plan to become cancer-free.

Bird introduced Soell to surgical oncologist Alivia Cetas and plastic surgeon Emily Hu, both based at Legacy Meridian Park Medical Center in Tualatin. After analyzing the options and Soell’s chance for recurring breast cancer, a bilateral mastectomy was determined to be a safer route than a lumpectomy with radiation. And because of their gender-neutral identity, Soell didn’t want breast reconstruction, but opted for a more male-like chest.

Cetas did everything she could to remove the cancer, and Hu did her part to make sure Soell was pleased with the cosmetic results.

“Leo’s situation is unique in the fact of not trying to reconstruct a more feminine breast, but trying to remove the cancer, remove the breast, and trying to keep the nipple/areola complex,” Cetas said. “That seemed safe from a cancer perspective and seemed to really keep the focus on Leo and keep Leo satisfied with the outcome.”

For both Cetas and Hu, this was uncharted territory. They’d performed mastectomies and reconstructions; breast reductions were no concern. But to remove as much tissue as possible to rid Soell of cancer, while still leaving enough for a masculine reconstruction — that was new. Meanwhile, minimal scarring also was a top priority.

“In the end, I tell the patient that the goal is to get the cancer gone. Then, my goal is to try and get you back to as normal as possible,” Hu said. “We all want to look ‘normal.’ We all have different ideas of what normal is, but in our minds, we have ideas of what it is to be normal, to walk outside and not have people stare at us.”

For Soell, the surgery meant a new normal, a journey to a place they’d never physically navigated before.

They weren’t sure if they’d like it, and there were no before-and-after images from previous patients in similar situations as examples. Here, doctor support was critical for both Soell’s trans and cancer health care.

“It’s very easy to only see one side of somebody, to only see one dimension. ‘Oh. If they’re trans, they’re this, that and the other thing,’” Bird said. But “they’re just people. They want to be respected and loved like everybody else. ... They’re human beings who want to be human beings.”

Though Soell never thought that cancer would lead to a better understanding of self, the strength they gained fighting the disease through a mastectomy, chemotherapy and a hysterectomy gave them strength to fight in the other aspects of life, too. Through cancer, Soell discovered that there was no time for silence.

“Now I know to live for now, not for the past or even near future. I’m going to be my full transgender queer masculine self all the time. I finally get to be Leo,” they wrote in their journal. “This transition reeks of bravery and freedom. It’s funny to me how such horrible, constraining, painful events can lead to the release of the soul.”

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