Supporting transgender care: A conversation with Frances J. Hayes, MD, MBBCh
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Author of the Endocrine Society’s Clinical Practice Guideline on testosterone therapy for hypogonadism, Frances J. Hayes, MD, MBBCh, is nationally recognized for her expertise in testosterone deficiency.
Throughout her career, Hayes has dedicated herself to bringing best practices and efficiency to better patient experience at Massachusetts General Hospital and has played an instrumental role in establishing specialty clinics like the transgender health program that provides multidisciplinary care to pediatric patients and adult patients alike. For her work in endocrinology and transgender health, Hayes is honored with the Vigersky Outstanding Clinical Practitioner Award at the ENDO annual meeting.
Hayes, who serves as the associate clinic chief of endocrinology at Massachusetts General Hospital, shared with Healio her passion for gender-affirming care, admiration of Malala Yousafzai and efforts to never drop the “glass ball.”
Healio: What was the defining moment that led you to your field?
Frances J. Hayes, MD, MBBCh: I was always drawn to the cognitive specialties, but it was a case in my final year of medical school that made it clear to me that endocrinology was the one.
I helped to work up a complicated case of Cushing’s syndrome, who was sent to Professor Joe McKenna, my attending and subsequent role model/mentor, for a second opinion. As I watched all the pieces of the puzzle come together and lead to the diagnosis of ectopic Cushing’s syndrome, I became hooked. I realized that endocrinology ticks so many boxes incorporating intellectual stimulation, opportunities for research and the pleasure and privilege to be able to take care of patients over their lifetime.
Healio: What area of research in endocrinology most interests you right now and why?
Hayes: Transgender health. This is a rapidly expanding and evolving field where research has not been able to keep pace with clinical practice. The rationale for the care we provide transgender patients is more often than not based on studies conducted in the cisgender population. While there is still much to learn, I am confident that research done in the next decade will guide and inform gender-affirming care so that it can be done effectively and safely.
Healio: What is the best career advice you’ve received?
Hayes: The best career advice I received was from my mentor, Bill Crowley. Bill has one of the sharpest intellects of anyone I know and has had an extraordinary career as a clinical investigator and mentor. Over the years, I have learned so much from him, but there are two things that stand out.
The first was his mantra that “perfection is the enemy of productivity.” I think endocrinology tends to attract people with OCD traits, and I know that I have a tendency to keep working on something until I feel it is “perfect.” Bill’s advice was not that one should not strive for excellence, but rather that the extra time it takes obsessing on how to get something from 95% to 100% can often be spent more productively by moving on to the next task.
The second piece of advice I have never forgotten is “never drop the glass ball.” Bill used the analogy of a juggler balancing many balls in the air, all but one of which is rubber. The single glass ball, which will shatter if dropped, symbolizes one’s family while the rubber balls represent the things that compete for our attention on a daily basis.
Healio: Whom do you most admire and what would you ask that person if you had 5 minutes them?
Hayes: That would have to be Malala Yousafzai, the youngest person to win the Nobel Peace Prize. The courage she showed by continuing to fight for the rights of girls to an education despite the attempt on her life by the Taliban is both extraordinary and inspirational. I would ask her the secret to being fearless and if she ever has any self-doubt.
Healio: What are your interests outside of practicing medicine?
Hayes: I have always been a bookworm, which may not be that surprising given that I grew up in Ireland, a country which has produced several Nobel Laureates in literature. As a kid, I was never happier than when I had my head in a book. If I were to find a silver lining to the pandemic, it would be that I have had more time to devote to reading. I am grateful that my book club is one of the few pleasures that I have been able to continue, albeit virtually.
Over the years I have come to realize that I am an extrovert. I really enjoy meeting up with friends or having people over for drinks or a casual dinner. Most of all, I love to spend quality time with my husband and two teenage boys, my way of ensuring that the delicate glass ball stays safely in the air.
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