Featured Investigator: Amy Tishelman, PhD

Amy Tishelman Headshot

June 2022: Amy Tishelman, PhD

Research Associate Professor
Boston College
Department of Psychology and Neuroscience

Dr. Amy Tishelman is a clinical and research psychologist, and a Research Associate Professor at Boston College in the Department of Psychology and Neuroscience.  She previously worked at Boston Children's Hospital (BCH) for close to three decades where she last held the position as Director of Clinical Research in the Behavioral Health, Endocrinology, and Urology (BE-U) Program and Gender Multispecialty Service (GeMS) at Boston Children’s Hospital (BCH). These programs provide clinical care to youth, young adults, and families related to differences of sex development (DSD), intersex conditions, and gender. She was also a Senior Attending Psychologist at BCH and an Assistant Professor at Harvard Medical School. Dr. Tishelman previously worked extensively in the areas of child maltreatment and trauma. Dr. Tishelman has been awarded several NIH grants as an MPI or Co-I, investigating well-being and/or gender development in children and adolescents, and youth/young adults with DSD. She also co-authored a clinical report for the American Academy of Pediatrics (AAP), published in Pediatrics, on fertility and sexual function counseling for at-risk pediatric patients. Dr. Tishelman was selected by the World Association of Transgender Health (WPATH) to be the international leader in developing new global standards of care for prepubescent children, and by the American Psychological Association to co-chair a national task force on DSD. She is on several journal editorial boards and speaks and publishes frequently in her areas of expertise.

Q: What are your current research interests?
A:
 
In a general sense, promoting the well-being of children, adolescents, and adults with vulnerabilities to trauma, stigma, marginalization, and even negation; more specifically, and currently, research designed to support the well-being and beneficial clinical care practices for youth and young adults who identify as Intersex and/or have been diagnosed with a sex trait variation (also referred to as a difference of sex development [DSD]) and their families; research designed to support the well-being of trans/gender diverse children, adolescents, young adults, and their families. 
I am honored to be a clinical researcher in these areas—and profoundly grateful to NIH for providing funding to me and others for SGM clinical research that is so deeply necessary.  Debates and political discourses are raging and can have potentially profound detrimental effects on SGM communities. In my opinion, well-designed and rigorous research efforts are key for helping to resolve controversies in these fields based on sound science rather than assumptions and opinion.  I must express particular gratitude to the SGM Office. Over the years, I’ve called from time to time to discuss research priorities and approaches, and the Office staff has been consistently available and responsive.  I am thrilled—truly—by the NIH support for a relatively new line of research funded through the SGM Office and NIMHD, to develop a self-advocacy tool designed to benefit clinical care for youth across the broad spectrum of sex trait variations (also known as Intersex or DSD). This research is informed by past mixed-methods NIH-funded research on care experiences and predictors of well-being in youth and young adults in the Intersex and sex trait variation communities (with myself and Canice Crerand as MPIs) and grounded in community collaboration. It would be simply impossible without the contributions of all involved, including my investigator colleagues, Canice Crerand and John Strang, and many other community stakeholders who have contributed their time and wisdom to ensure that the new measure (The VISTA: The Variations in Sex Trait Advocacy Tool) is a true reflection of community needs. The VISTA is designed to be disseminated as a tool to transform clinical care in a clinical practice area that has been permeated by insensitive and even harmful clinical practices.

Q: Tell us about your career path – how did you end up where you are now?
A: 
I’ve had a rich and varied career path driven by a dynamic interaction between my research and clinical endeavors.  When I began graduate school in clinical psychology, I was unsure of what I wanted from my career, and thus was fortunate in the sense that I sought out and received training in several diverse areas, including pediatric psychology and neuropsychology, interpersonal violence and trauma, and human development and psychopathology. When I reflect on my career, I would say that I have developed two primary areas of expertise: sex and gender diversity as well as interpersonal violence and trauma. I’ve also been trained as a pediatric psychologist, and have worked in many pediatric subspecialties, including childhood obesity, GI pain, developmental medicine, and urology.  This wide-ranging background has profoundly informed my research questions, my clinical work, and my broader professional efforts. My first professional employment was as a tenure track clinical psychology professor at Binghamton University, and although I walked away from that position to go to BCH, I learned an enormous amount about teaching, conducting independent research, research supervision, and leadership. I found my true passion for research through clinical work and the knowledge gaps I encountered while working directly with patients, leading to the most meaningful projects of my life—my efforts to support the science of SGM care. I owe my current passions to the strength of the young people and their families who have entrusted me with their care, often at times of great vulnerability. I am deeply thankful that I can fulfill my intellectual interests in ways that matter to me emotionally, and hopefully have meaning in the wider world. 

Q: What organizational challenges have you faced?
A:
 No comment.  There have been many, and I prefer to dwell on the positives. 

Q: What advice do you have for trainees and researchers who want to work in this area or are interested in applying for NIH funding? 
A:
Be true to yourself and the communities you are working to serve. Be authentic and honest. Expect challenges and surprises. Be grateful when your work is appreciated and notice if you are mistreated or if your work is minimized. Monitor to avoid burn-out and take steps to give yourself time and space to create a more balanced existence. Academics can be infused with a toxic culture at times—try to make the systems better if you encounter difficulties.  Find friends for your professional journey within or outside your institution, and hopefully, they can be colleagues as well. Make sure you have personal supports when you need them.  Try to have fun while you do your work.  Make sure your research achievements are not designed for self-promotion, but that your work is driven by its potential positive impact.  Don’t expect perfection—forgive others, forgive yourself too and never be dishonest in your scientific work or your interpretation of research. Find mentors but also sponsors if you can (a sponsor is an individual advocating for your success within an institution and is often a leader within that context). And make sure to recruit advice from within and outside NIH so that you don’t fruitlessly submit grants with no hope of funding.  On the other hand, if you believe in something deeply, don’t give up too easily. 

Q: Do you have any specific advice for working with and involving SGM populations in research?
A: Over the years, it has become increasingly apparent that it is critical to work in partnership with, and deeply involve, SGM populations in research. I received a lot of early feedback informing my research directions from my patients, which led me to understand that they themselves are key subject experts. Research approaches that exclude stakeholders may at best be condescending and at worst harmful. Failing to partner with the SGM community risks research which doesn’t hold much meaning, and we don’t have time and resources for wasted efforts. I feel it is not possible at this point for me to function as an effective researcher in the absence of a genuine partnership with those whose lives and well-being ultimately hinge on the outcomes of the work. For instance, the current VISTA project I mentioned above is only possible after years of working closely with the broad intersex/sex trait variation communities; the generous partnership and contributions of stakeholders are directly informing the development of the tool itself. 

Q: Who inspires you?
A: I would love to make this the longest answer of all.  In brief, I am most inspired by individuals who maintain authenticity even in the face of stigma and hardship. This sometimes includes individuals in the SGM communities and others who have been marginalized by their diversities.  I am also inspired by those who make their lives meaningful in large and small ways and do so while retaining personal integrity—which to me means striving to do their best while also accepting personal limitations. I am inspired by the intelligence and insights of the Boston College community and especially my students, who have kept me on my toes for the last 30 odd years. I also want to promote recognition of the countless clinicians who change lives quietly and profoundly every day, and by their patients who seek care when it can be hard.  Most of all, I am inspired by those who have faith in research—including those individuals who entrust researchers with access to sensitive and confidential information while serving as research participants. It is humbling. 
The researchers I have collaborated with in trans/gender diverse and sex trait diversity research are some of the bravest and intellectually incisive individuals I have ever known or worked with; the cross-pollination of ideas during these collaborations yields important critical innovations and scientific progress. I have been so grateful to be working alongside the co-chair of the American Psychological Association Intersex/DSD Task Force.  Amy Lossie is an inspirational friend and colleague who has educated me tremendously, as have the rest of the task force members.  And I have had the good fortune to work with an incredible set of colleagues, many now friends—stakeholders, clinicians, and groundbreaking researchers—to develop the Child Standards of Care Version 8 for WPATH. I am especially grateful for this opportunity to highlight two personal mentors. First, Eli Newberger founded the Child Protection Program at BCH. He hired me at BCH in 1992, and his leadership and vision have shaped me indelibly as a professional and as a person.  He demonstrated kindness each day, not for any publicity but because he is a brilliant mensch. Although he retired from BCH long ago, I have been lucky enough to remain close personal friends with him and his wife, Carolyn Newberger, my wonderful former psychology supervisor at BCH, also now a lifelong friend.  Another personal hero is Norman Spack.  He hired me at BCH as the first Director of Clinical Research in the transgender and Intersex/DSD services, ground-breaking services he co-founded. He understood the immense need for clinical research to support SGM communities. Norm has used his talents as an instrument to change the world for the better, with the arms of his innovations reaching out in countless directions.  His work paved the way for inestimable young people worldwide to receive life-changing (and sometimes lifesaving) gender-affirming medical care.  He co-founded these pioneering services, not to promote his own career but instead simply to help youth.  I’ve been most profoundly inspired by the youth and families I have been entrusted to work with throughout the 30+ years of my career.  The older I get, the more moved I am by the wisdom and courage of my patients. The most significant lesson I’ve learned is that as a clinical researcher I am not the most important person. I am acting with and on behalf of others. 

Q: Any final words of wisdom?
A:
I am not sure this is wisdom, but these are my final words.  I am grateful to anyone who is working on SGM research.  Promoting this research is a vital way to pay witness to the countless contributions and unique experiences and needs of the diverse LGBTQ+ communities.  So, persevere folks/folx!

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