Kwame Anthony Appiah teaches philosophy
at N.Y.U. His books include ‘‘Cosmopolitanism,’’
‘‘The Honor Code’’ and ‘‘The Lies That Bind:
Rethinking Identity.’’Th e night shifts are certainly exhausting,
but they are mostly doable for me. I am
acutely aware, however, that there is no end
in sight. And there is a very limited pool of
people prepared to give up a night’s sleep.
But in helping I feel that I have lost a
friendship, as our relationship has become
so transactional. I feel as if I am no longer
seen as a friend but as a health care
worker. I want to stop, but how can I when
I know the consequences of stopping will
be so catastrophic for the family? I know
the child is not my responsibility, but I also
know there is no one else to fi ll the void.
Name Withheld
Once again, providing ongoing support
is a gift you can’t simply take back. That’s
something to consider when you off er
help in circumstances like these. You’re
entering into a commitment, even if you
don’t explicitly make a commitment.
You say you know their child is not your
responsibility. Yet assisting with the child
has now become your responsibility.
It’s also true that dependency doesn’t
justify ingratitude. Harried as they are,
they should be mindful that yours is an act
of a devoted friend and respond appro-
priately. In the meantime, let’s hope that
there is indeed an end in sight; as the pan-
demic ebbs, they may be able to return to
using professional support. If you decide
that you don’t want to see them through
this crisis, you should try to help fi nd
them an alternative — maybe by putting
them in touch with organizations, pub-
lic or private, that could help them look
after their child. Most cities have such
resources, and your friends may be too
preoccupied to do the necessary research.
The rest of us might take a moment
to ask ourselves about those whose help
we’ve come to rely upon: Are there people
we’re taking for granted?
I switched medical practices pre-Covid
and was assigned to a male practitioner.
My fi rst appointment is coming up, and
today I learned from a friend who also
uses that medical practice that my doctor
has transitioned (or is transitioning)
from male to female. Since I have not
yet met this doctor, I am wondering about
what is appropriate and whether there
should be any conversation about
the transition. Is there any reason that the
doctor should speak about it, even if it is
When you
provide people
with ongoing
assistance,
you tend to
assume ongoing
obligations.to determine whether I, a cis woman, am
comfortable seeing a trans physician?
If my friend was not a patient at this
practice and had not forewarned me, I
would have been confused to see a female
enter the exam room, because I would
have been expecting a male doctor. Is this
transition process such a private thing
that it is inappropriate to talk about it?
Obviously, I am in uncharted waters.Name WithheldYour new doctor is negotiating a diffi cult
phase of a trans life, which is handling
changes in relationships with people
the trans person knew when presenting
as another gender. You’re someone she
hasn’t yet met, and so you will meet her
fi rst as a woman. Indeed, it may not have
occurred to her that you signed up with
her when she was presenting otherwise.
She no doubt has already had to deal
with questions from patients she knewwhen she was presenting as male, and
I’m sure that it hasn’t always been fun.
You can play a small part in our import-
ant social transition from transphobia
toward trans acceptance by sparing her
from having to answer such questions
for the umpteenth time. It’s no more
incumbent on her to inquire after your
comfort level with her identity than it
would be for a physician who is Jewish
or gay or Black (or all three) to do so. Her
gender expression has no bearing on her
capacities as a doctor.
Let her decide if she wants to say
something. She has the same professional
competence as the doctor you signed up
for, because she is the doctor you signed
up for. She has simply decided that she’s
ready to live as the woman she really is.