Mikey Shock: Advocating for Competent Care for LGBTQIA+ Patients

Mikey Shock is a 24-year-old transgender woman and young adult cancer survivor getting her PhD in clinical psychology with a focus on queer and transgender identities, health disparities, and the psychological effects of cancer survivorship. In January 2022, Mikey had just moved to Tucson, Arizona from Maryland, to pursue a bachelor’s degree. She envisioned building a future centered on understanding and supporting queer and transgender communities. But what should have been an exciting new chapter soon became tenuous.

It began with shortness of breath and a persistent cough. Climbing a single flight of stairs left Mikey exhausted. When she sought care at her campus health center, she was told that it was likely allergies or asthma. Over the next several months, Mikey was prescribed multiple medications, but none provided relief. And as her symptoms continued to worsen, each doctor’s visit left her feeling dismissed and frustrated. “They didn’t hear me. I kept telling my doctor that something was seriously wrong,” she recalled.

By the fall of 2022, she could barely leave her apartment. Determined to advocate for herself, she returned to her doctor once more. “I told him, ‘I’ve been on the bathroom floor for a week… I’m throwing up just walking down the sidewalk.’” After Mikey insisted on further testing, her doctor ordered a chest X-ray and, within an hour of the scan, told her to go to the emergency room immediately. Mikey’s right lung had collapsed and was filling with fluid. At the hospital, imaging showed a large mass in her chest.

On September 30, 2022, Mikey was diagnosed with Hodgkin lymphoma. “I was 2,000 miles from anyone I knew,” she said. “I had never been more alone or scared in my life.” Her fear extended beyond a cancer diagnosis. Each health care interaction brought new anxieties. “Before any interaction, I was worried that I was going to be discriminated against.” Although Mikey received affirming and respectful care, she emphasized that many LGBTQIA+ patients often face significant barriers to safe, competent care.

In late 2022, Mikey’s treatment began with 8 chemotherapy sessions over 16 weeks, followed by 15 sessions of daily radiation. Throughout this period, Mikey remained her own primary caregiver. She also continued as a full-time student, balancing an intense academic workload, internships, and a job, while undergoing treatment.

The physical toll of treatment was profound as Mikey experienced severe fatigue, nausea, hot flashes, and cognitive impairment, often referred to as chemo brain. There were times when she would be in a coffee shop and could not remember her order.

Beyond the physical effects, Mikey faced deeply personal challenges tied to her identity. After her second chemotherapy session, she lost her hair. “It was the most empowering and devastating thing,” she said. “As a transgender woman, I hold a lot of my identity within my hair, and losing it was extremely difficult. While I was surviving cancer, it felt like my gender identity was invalidated.”

In the months following treatment, Mikey struggled with exhaustion, cognitive difficulties, and physical limitations, all of which made her daily life difficult. She routinely encountered challenges with an “invisible disability,” where her limitations went unrecognized or unaccommodated.

Reflecting on her experience, Mikey considers mental health as one of the most critical and overlooked components of cancer care. “The hardest part wasn’t treatment,” she said. “It was the mental aspect of reacclimating to life, living with survivor’s guilt, and bearing the toll that my trauma took on me.”

Now in remission for more than two years, Mikey’s experience has shaped her advocacy, particularly around the need to integrate mental health care into cancer treatment. “Mental health support has to be a standard component of cancer care,” she said. “It’s not a choice. It’s critical. It’s lifesaving.”

Drawing from her experience, Mikey emphasizes the importance of ensuring that care systems are equipped to meet diverse needs. “We as queer and transgender individuals need providers who are affirming and culturally competent when we are at our most vulnerable.” She also stresses that patients should not have to fight to be heard, believed, or treated.

For Mikey, survivorship is not just about moving forward, it is about ensuring others do not have to face the same barriers alone. Through her journey, she has transformed fear into purpose. Her message to policymakers and the broader medical community is clear: “Individuals from the LGBTQIA+ community and other medically underserved populations need affirming, competent care. We are people who bleed the same and we need you to take care of us and save our lives.”