Londyn Smith de Richelieu, the director of the Mayor’s Office of LGBTQ Affairs in Baltimore, has filed a complaint alleging that she was discriminated against this past May by the Center for Transgender and Gender Expansive Health at Johns Hopkins Medicine.

Smith de Richelieu, who is the first person to occupy that role in the Mayor’s office, said in a complaint to the city’s Office of Equity and Civil Rights and in an interview with The Banner that the center, led by Dr. Fan Liang, denied her facial feminization surgery, claiming that Smith de Richelieu was being aggressive and used profanity with Liang’s staff. Smith de Richelieu, who is a Black transgender woman, said she was triggered by what she called false, stereotypic characterizations.

“That is a complete lie,” she said. “I don’t even curse.”

Smith de Richelieu said she also made a patient complaint with Johns Hopkins as a result of her interaction with Liang’s office and plans to file a complaint with the medical board.

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Smith de Richelieu said she was surprised by the mischaracterization of her because all of her encounters with Liang were pleasant, including her last meeting with the surgeon before she was informed that her procedure was canceled.

She wants an apology from Liang, who is the medical director of the Center for Transgender and Gender Expansive Health and an assistant professor of plastic and reconstructive surgery at Johns Hopkins. Smith de Richelieu also wants Liang’s office to get cultural competency training “so that other Black trans women do not have to go through this.”

The Office of Equity and Civil Rights did not return requests for comment about the complaint.

Kim Hoppe, vice president of communications for Johns Hopkins Medicine, said she was not aware of any complaint filed with the Office of Equity and Civil Rights. Citing “Federal HIPAA rules,” Hoppe said she was prevented from “discussing anything that might infringe on patient privacy” and declined to comment.

Liang is a Harvard Medical School graduate who previously worked at the University of Maryland Medical System’s R Adams Cowley Shock Trauma Center, where she served as an assistant professor of surgery. Her patient rating on the Johns Hopkins Medicine website is a 4.9 out of 5, based on feedback from 47 patients.

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Smith de Richelieu said she was devastated when she was informed May 11 that her surgery on May 16 was going to be canceled.

“I really wanted my surgery,” she said, recalling falling to the floor in tears as she realized she would not receive the surgery. “The sad part is that I now don’t feel comfortable with her [Liang]. I don’t feel comfortable being under anesthesia with her.”

Smith de Richelieu said she is unsure when or how she will get the surgery.

“Unfortunately, we [in Baltimore] do not have a lot of surgeons” specializing in this procedure, she said. “I have to go out of network and out of town. The only other option is to go out of state.”

Surgeries that help transgender women appear more feminine are essential, many say.

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In the six past years Smith de Richelieu has undergone two vocal surgeries and has seen a speech therapist to soften her voice. The surgery she wanted to receive was facial feminization surgery with Liang.

Smith de Richelieu said that the remaining surgeries that she needs will better help her present as a woman. “It’s the one thing that causes me problems,” she said in reference to people being able to spot that she has less feminine characteristics.

Phillip Westry, the executive director of FreeState Justice, a Baltimore-based legal advocacy organization that seeks to improve the lives of low-income LGBTQ Marylanders, said he was disturbed by Smith de Richelieu’s allegations, “especially given the fact more trans folks will be seeking care following the passage of the Trans Health Equity Act.

That legislation, which was signed into law by Gov. Wes Moore earlier this year, requires Maryland Medicaid to cover gender-affirming care and procedures for transgender patients. The law takes effect Jan. 1, 2024.

“FreeState Justice will be looking into the matter to assure that trans Marylanders are not being denied access to gender-affirming care,” Westry said, adding that this was the first time his organization has heard about such an allegation against Liang.

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Smith de Richelieu said she informed FreeState Justice about her complaint to ensure that other Black trans women do not have similar experiences with medical professionals performing gender-affirming care in Maryland.

The Williams Institute, a think tank at the UCLA School of Law, estimates that there are 1.6 million transgender people in the United States, including 24,000 in Maryland.

Londyn Smith de Richelieu poses for a portrait in Baltimore's Mount Vernon neighborhood, Thursday June, 1, 2023. (Kaitlin Newman/The Baltimore Banner)

Maryland and Baltimore, in particular, are considered sanctuary spaces for the trans community. Johns Hopkins Hospital has long been a destination for patients seeking gender-reassignment surgeries.

The transgender community has also gained visibility locally and nationally. Maryland native Isis King, for instance, broke ground with the Amazon Prime series “With Love,” becoming one of the few transgender actresses to take a leading role in a major studio-backed romantic comedy.

Even so, transgender people continue to face obstacles. The ACLU has identified hate crimes, violence, workplace discrimination, affordable access to health care, and the rights and safety of transgender people in prison, jail and detention facilities as top issues facing the community.

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Smith de Richelieu said her complaint against Liang and Johns Hopkins Medicine is bigger than her.

“Gender-affirming care is life saving,” said Smith de Richelieu. “Calling a Black woman aggressive when she is advocating for herself is not OK.”

She also points to the statistics on crime against the trans community and the overall vitriol they face as well as the current political climate in this country. According to an Everytown for Gun Safety report, known transgender killings increased 93% from 2017 to 2021. Black trans women represented 73% of those homicides, even though they make up an estimated 13% of the transgender population.

“It is in my purview to protect the community. I’m scared that she [Liang] will not be able to deal with the community,” she said, adding that with the passage of the Trans Health Equity Act will result in Liang and Johns Hopkins Medicine having access to more federal funding. “We’re about to be filling the coffers of Hopkins and her. She’s a gatekeeper. That’s dangerous.”