Dr. Michael Marshall's death an 'irreplaceable' loss for transgender health services in Alberta

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Four years ago, Dr. Michael Marshall entered a room like he always did — with a burst of energy.

It was where he made a vivid first impression on Glynnis Lieb, who described Marshall as a “ball of colourful life,” talking to her a mile a minute.

At the time in 2018, she laughs, he was trying to talk her out of money. While they’d eventually become partners, their first meeting was at a work function. She’s the head of the University of Alberta’s Institute for Sexual Minority Studies and Services, and he had recently moved to Edmonton from Red Deer to establish the gender health program at the U of A Hospital. Like everything else in his life, Marshall was full of ambition and ideas about the future.

Marshall, a psychiatrist specializing in transgender mental health, died unexpectedly on Sept. 23, cutting short his work caring and advocating for gender-diverse people. He was 45 years old.

Lieb said she’s still waiting for answers about the cause of his death. He’d recently suffered a head injury, but it’s unclear if that contributed in any way, or if there was another medical issue at play.

Marshall connected with and treated hundreds of gender-diverse people in Alberta since he arrived in 2015. He was renowned for his expertise and advocacy focused on dismantling barriers to gender-affirming care, the spectrum of procedures and services that trans people may pursue to align their body and physical appearance with their gender identity. Marshall stressed that this care can be not only be life-changing but life-saving.

“Not being oneself leads to a degree of disquiet, unhappiness that is understandable by most people,” he said at a workshop for health workers learning about trans patient care in 2019.

“It is important that people live their true selves, because it’s a fundamental human need.”

That session was part of his national and international work to educate medical professionals about giving safe, competent service to trans people and the broader 2SLGBTQ+ community.

“He became a global voice for recognizing that people deserve access to affirming care, and people know themselves and their wishes should be respected,” Lieb said.

“Higher rates of mental health problems aren’t linked to being gender diverse, they’re linked to being ostracized and stigmatized and bullied.”

As Lieb sees it, Marshall had already packed seven average lifetimes into his four-and-a-half decades, with a life and career that took him from his home in Saint Lucia to a stint in the British armed forces, becoming a practising physician by the time he was 24 and working in Scotland, then Canada.

He and Lieb were parents to six sons. Lieb’s biological son and five boys adopted from Saint Lucia — all members of the same family that they wanted to ensure weren’t separated.

“He moved with dizzying speed,” Lieb said.

“And he couldn’t understand why the rest of the world couldn’t keep up.”

‘The potential of people like us doesn’t have an endpoint’

Adebayo Katiiti also met Marshall for the first time in 2018, walking into his clinic as a patient after waiting a year and a half for care. Long wait times for referrals for gender specialists and affirming procedures are a well-documented issue in Alberta and beyond, and part of Marshall’s work was aimed at reducing the delays.

As a Black transgender person, Katiiti says there’s a legitimate fear of judgment or mistreatment by doctors. But during the appointment, Marshall disclosed that he was trans, too.

“For me, seeing a Black trans person in that position — it was like, the potential of people like us doesn’t have an endpoint,” Katiiti said.

“Society has deemed us unworthy of life. Seeing Michael do his work and carrying that candle for us showed us that you can reach wherever you want to reach, despite your identity.”

Marshall was one of only a handful of psychiatrists across Alberta who specialize in serving transgender people. His loss is yet another blow to efforts to fix the care deficit that leaves many suffering while they wait for the affirming care they need.

In Katiiti’s view, Marshall’s leadership and lived experience are irreplaceable.

“The space that has been left by Michael’s passing is huge,” he said.

“He wasn’t perfect, but he has given life and joy to many trans communities. I’m one living testimony of his work … The community and the entire world need to name him as a hero.”

Marshall left the U of A Hospital gender program the year after he arrived, speaking publicly about how it was a difficult decision, but he felt he wasn’t getting enough resources and funding to adequately meet the community’s needs.

He went on to found the LGBTQ+ Wellness Centre, which brought numerous services for trans people under one roof. But the community need still outstripped resources, and Marshall was continually looking for more support and funding.

Dr. Bill Gibson, a geriatrician who knew Marshall for almost 20 years, said they had been discussing the need for trans people to keep getting appropriate, affirming care as they age. The two doctors wanted to try to integrate that into the Wellness Centre too.

“He was absolutely passionate about what he knew to be right,” Gibson said.

“He was clear with me that if I let him know that I’d seen injustice and not challenged it instantly, he’d be absolutely on me, saying, ‘Look, come on. You’ve got to stand up. You’ve got to use your privilege here.’

“Now I’ll be in a situation and I’ll think, ‘If Michael found out what I was doing about this, how would that go down?'”

Speaking to the Edmonton Journal three years ago, while Marshall detailed the barriers and challenges trans people face in their everyday lives, he underlined how that isn’t the whole story.

“In the face of discrimination, in the face of victimization, in the face of stigmatization, minority stress, trans people thrive, too,” he said.

“And I feel it is important we shine a light on that.”

masmith@postmedia.com

@meksmith