Nervously adjusting their suit jacket, Jeremiah Lee sat anxiously in the passenger seat of their mother’s car. They stared out the window at the budding flowers on the bare trees and the light drizzle of rain. Printed out resume in hand, Lee recited in their head answers to interview questions as they pulled in to Howard University.
A couple of weeks earlier, Lee saw an advertisement from their school’s internship coordinator, Ms. Brown. The advertisement was for a 10-week, live-in, pre-pharmacy internship at Howard. Here, Lee had the opportunity to work in a research lab that looked at the disproportionate rates of African American women with chronic weight illnesses and how their cells were using energy.
“This was where I realized you can actually help people at a very micro level, looking at their race, identity, class, culture—those social determinants of health,” Lee said.
“After that, I realized this is definitely something I’m interested in. Pharmacy was more than I expected,” Lee said.
Lee is now a first year master’s student in regulatory sciences at the USC Mann School of Pharmacy and Pharmaceutical Sciences. Their interest in STEM—and in changing the world—has led them to study the exclusion of transgender and non-binary people in clinical drug trials.
Originally, Lee’s research was focused on trials for PrEP, or pre-exposure prophylaxis, which is the medicine taken to prevent contracting HIV. They noticed a disconnect in the trials involving transgender women where the trials didn’t measure negative interactions with hormone therapy.
They explained that in the trial process there were categorizations for age, race and sex, but not for gender. Medical environments can already be hostile for transgender people so this miscategorization steers them away from these trials.
“Trans women are not recognized as women, but rather lumped in with males. [Then there is] a lack of representation of that community [in] not even thinking about recruiting them, despite the reality of greater exposure and disproportionate risk of acquiring HIV,” Lee said.
Teresa Delfín, an adjunct professor of communication at USC who focuses on queer issues, expanded on this concept in terms of what she sees with queer students today.
“If we’re talking to doctors who started practicing 20 years ago, those categories were different 20 years ago,” Delfín said. “They might think they know everything, but then it might be that their [categorizing] forms are not asking the right questions.”
“There’s a tremendous need for continuing education around issues of gender and sexuality and taking an interest in some of these more intimate issues,” Delfín said.
In their Christian house in the suburban East Coast, Lee explained that being queer wasn’t something they discussed. “I grew up in a Christian Korean household, so that environment was very much hush hush,” Lee said. “You didn’t really talk about certain things, especially gay issues.”
Lee first learned about HIV sitting in their portable health classroom in the fifth grade. Their teacher handed them and each of their classmates a flier on STDs. They flipped through the pages and came across the one for HIV—where the flier explained that the disease was bloodborne and it could be injected through dirty needles.
At the time, Lee didn’t understand the full extent of HIV. When they got to middle school, they started hearing HIV described as “the gay disease”—and decided it wasn’t their problem, as most middle schoolers did.
Then Lee started watching the show, “Queer as Folk” which first aired in December 2000. The show follows a group of gay men in Pennsylvania, specifically a couple where one of the partners is HIV positive and the other is not.
“Through that show, I was getting the lens of, it’s more than just a gay disease. It’s disproportionately burdening the gay population,” Lee said.
Later on in high school, Lee began to understand transgender identities and the importance of transgender rights. “I was raised up in a pretty sheltered environment where I wasn’t being told this information. I had to find it out,” Lee said.
It was around this time that Lee participated in the pre-pharmacy internship that propelled them into an interest in pharmacy. They applied to different colleges with different STEM majors, and coming into USC as a biology major, they knew they were interested in a pre-pharmacy track.
In their undergraduate courses, the ones that stood out to Lee were courses with Assistant Professor of Clinical Pharmacy Tam Phan. Phan teaches multiple courses related to their studies as an HIV specialist. Lee said that these courses were another place that launched their interest in PrEP trials.
“[They were] one of the few students who actually demonstrated their passion and curiosity for something that they find that there’s a need in the community for,” Phan said. “It’s really rewarding to see that students who hear lectures or who get involved in my classes then follow or want to learn more about HIV.”
It was also around this time that Lee went on PrEP themselves. Growing up in the environment they did, it took them a while to come to terms with their identity. Even at the doctor’s office, they waited for their parent to step out of the room before discussing PrEP with their provider.
Lee explained how learning about the pharmaceutical world drove them to studying these disparities in clinical trials, but their life experiences played a role too.
Lee saw the disconnect in the LGBTQ+ community between queer and transgender people and how a lot of queer people don’t have the same understanding of transgender issues. So, they looked inwards to their fellow transgender community.
“That’s something that I see a lot of in trans communities—we have to stick to our trans community. No one else is really going to get us, but also no one is really going to accept us,” Lee said.
Lee wants to see change in the world and recognizes that this starts locally.
“My research is 22 years of seeing homophobia, seeing transphobia, and now wanting to do something about it,” Lee said.