Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Book Review of “Tomorrow Will Be Different”

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Clinicians are well positioned to be advocates for transgender persons and communities. In listening compassionately to our patients' personal narratives, we can understand how to best meet the needs of each individual.

I could tell immediately Andy Cray was a fellow Midwesterner when I met him at a 2014 White House Briefing on LGBTQ issues: outgoing, polite, and cautiously optimistic. The story of Andy is interwoven with that of Sarah McBride’s in her memoir “Tomorrow Will Be Different: Love, Loss, and the Fight for Trans Equality.” While Sarah is well known as the first openly-transgender individual to address a major party convention in 2016, she was already a prominent and accomplished advocate.


Coming Out

Like memoirs by leading transgender advocates and public figures, Sarah takes us through her childhood and lays out how our assumptions of gender failed her and other youth. There we learn of the unique struggles faced by transgender youth and adults.



Interspersed throughout Sarah’s narrative are the staggering statistics of discrimination and violence committed against transgender individuals, particularly transgender women of color. The 2015 U.S. Transgender Survey provides some of the most up-to-date and comprehensive statistics on the experiences of transgender individuals.


Family Support

What is striking in Sarah’s narrative is that her drive and ambition to improve the well-being of Delawareans and, later, anyone she could reach is bolstered and supported by her family. Sarah shows us the privilege and power of family acceptance. Sarah acknowledges numerous times the value and importance of family acceptance, which has been born out by the work of Dr. Caitlyn Ryan and the Family Acceptance Project.


Sarah makes a call for change to advance such support and acceptance of all LGBTQ individuals.


It will be because of advocates and activists who dreamed of a different world. It will be because of the allies who stood up and spoke out. ~ Sarah McBride


As clinicians, we are natural advocates and must continue to be so for transgender persons and communities. As a clinician and researcher focused on the unique health care needs of LGBTQ patients and families, the value of personal narrative cannot be overstated.