Two physician leaders will help shape Penn’s LGBTQ+ Health program

Dovie Watson, MD, MSCE, and Katharine (Katie) Dalke, MD, MBE, grew up more than 1,000 miles apart—Watson in Oklahoma City and Dalke in Pittsburgh—but they shared a common experience: not always feeling like the medical establishment saw and respected them.

“I’ve had providers who make a lot of assumptions about what I’m getting up to, and it’s never flattering,” said Watson, of her experiences as a patient who is both Black and bisexual. “And I would stop going to those doctors. It feels terrible to be judged in that space where you want to be open and honest. You want to get the care that you need.”

For Dalke, likewise, having an intersex condition shaped her perception of medicine from a young age.

“I, like a lot of people, was drawn to medicine because it is a helping and healing profession. However, I had also experienced it as a profession that could harm,” Dalke said. “And it took a while for me to be able to reconcile that tension. The way I understand it now is that my health care providers were doing the best they could, but there were so many unanswered questions and uncertainties that they had to make decisions off of assumptions and their best guesses.”

Both physicians will assume new leadership roles with the Penn Medicine Program for LGBTQ+ Health in July. Watson, an infectious disease physician and researcher who specializes in HIV prevention and health equity in the LGBTQ+ population, will serve as director of research and evaluation. Dalke, a psychiatrist with a focus on LGBTQ+ health equity who is engaged in health policy work on the state and national levels, will serve as the director of strategy and alignment.

The new roles complement the continuing work of Kevin Kline, MD, who started as the program’s inaugural medical director in 2023.

Growing LGBTQ+ health at Penn Medicine

Since the Program for LGBTQ+ Health launched in 2013, it has evolved from a faculty-driven passion project into a system-wide initiative that meets the sometimes-unseen needs of LGBTQ+ patients. The program offers navigation services and access to physicians across a wide range of specialties, from primary care to behavioral health to dermatology, who are trained in LGBTQ+ inclusive care. The program served nearly 400 patients this past fiscal year and received nearly 2,000 patient requests since 2022.

“This work is often seen as something unique, but it’s also just part of what quality care should look like for every patient,” said Rose Thomas, MPH, the program’s director of operations. “We’re fortunate to have a diverse group of faculty and staff who are deeply committed to carrying it forward.”

Dalke and Watson bring their skills and expertise to their new roles at a moment when the program is adopting a new strategic plan, developed with input from across the health system, that focuses on clinical care, the work environment, and community engagement. A key initiative will be creating a community advisory board, an effort supported through a gift from the late Bob Schoenberg, founding director of the Penn LGBTQ Center.

In her new role, Watson, an assistant professor of Medicine in Infectious Diseases, will be a resource for the many Penn researchers who are studying different aspects of LGBTQ+ health. She hopes to ensure that Penn’s research in the field is truly community-engaged and taps into the wisdom and needs of Philadelphia’s vibrant LGBTQ+ community, and “to figure out how to do that in a sustainable way that’s not extractive of the community.”

Dalke, the Benjamin Rush Associate Professor and vice chair for clinical operations in Psychiatry, will be the program’s liaison with the health system and university.

“My role is oriented to helping the program be successful in achieving its strategic goals and priorities,” she said. “Penn has led academic health care organizations in this area for a long time, and while we have a lot of internal support, there are many external headwinds to navigate.”

The commitment to LGBTQ+ health started early for both Watson and Dalke. When Watson moved from Oklahoma, where her queer identity was not often affirmed, to attend Cornell University, she immersed herself in the local queer community and dreamed of combining her lived experiences with her professional future.

Watson went to Chicago for medical school and her residency, where she began working in HIV research—an interest she continued during her fellowship training at Penn Medicine.

Dalke became involved with patient advocacy with organizations focused on sexual and gender minorities while a student at Haverford College. The experience motivated her to pursue medicine.

She attended the Perelman School of Medicine and stayed at Penn for her residency training. Meeting E. Cabrina Campbell, MD, a professor of Psychiatry and the first openly LGBTQ+ woman in medicine she had worked with, was a pivotal moment for Dalke.

“It was really the first time that I thought, ‘Oh my gosh, I can actually be my whole self at work,’” she said.

Lived experiences help both physicians connect with their patients. Dalke doesn’t share her personal background with patients, but they sometimes find her past interviews about growing up intersex.

Once, as a medical student, Dalke shadowed a pediatric specialist and encountered a patient with an intersex condition similar to her own. The child and her grandmother began whispering in excitement and then the grandmother interrupted the specialist to tell Dalke, “I’m so sorry, but I think we recognize you from Oprah.”

Years later, that same patient, now grown up and expecting her first child, called Dalke and asked for advice on breastfeeding as an intersex woman because she wasn’t sure where else to turn.

“It was this incredible experience of coming full circle and realizing that being willing to be open could have a really significant impact on people’s lives,” Dalke said.

It’s a perspective she carries while caring for young-adult patients transitioning from pediatric care and supervising psychiatry residents who provide supportive care to LGBTQ+ adults.

“Even though my experience is very unique in a lot of ways, every LGBTQ patient I’ve ever seen has dealt with shame, stigma, and not being sure how to be out in different kinds of life spaces—like work or school,” she said. “And so I think there’s something really powerful, in particular for young patients, to see a person who is out and has made this a part of their career. It gives them a glimpse of a positive future.”

It’s the same for Watson, who maintains a weekly outpatient clinic for patients with HIV and other infectious diseases.

“I have patients who have been living with HIV for decades say, ‘You are the first Black HIV doctor I’ve ever had,’” Watson said. “That’s very meaningful. And because it’s intra-community conversation, they don’t have to code switch with me. I understand and acknowledge and affirm how they’ve had harmful experiences in health care and with health care providers. I don’t get uncomfortable or defensive, which is the case for a lot of other providers. I have the most amazing patients, and it’s just so rewarding and fun.”

Watson is also committed to improving patient care through research, and she’s particularly interested in equity-centered implementation science. Research shows that Black patients have the highest rates of new HIV diagnoses but the lowest usage of pre-exposure prophylaxis (PrEP), a highly effective treatment that can prevent HIV when taken correctly and consistently.

PrEP requires an ongoing relationship with a medical provider, and Watson knew from her own experience how interactions with providers can alienate patients. As a result, she has shifted her research focus from questions of why patients may not engage with PrEP therapy, to understanding and addressing factors among providers and health systems that ultimately affect PrEP provision, including racial biases and overlapping stigmas based on race, gender, and orientation.

"We are actually the gatekeepers, and we’re also the problem,” she said. “And so my research is mostly figuring out why aren’t we doing it well? How can we help and support providers and practices to make sure that Black folks are getting the care that they need and deserve?"

Watson also serves on the public policy committee of the American Academy of HIV Medicine, which gives her a national lens on emerging advocacy issues.

Dalke’s scholarship has focused on intersex mental health, particularly on how clinical decisions made for children with sex variations impact their long-term outcomes, including mental health and medical mistrust. She’s also interested in the mental health of people who are transgender.

Dalke is especially proud of her collaborative policy work: She serves as chair of the Pennsylvania Governor’s Commission on LGBTQ Affairs and previously served as a member of the Sexual and Gender Minority Research Office Working Group at the National Institutes of Health. She has contributed to the World Professional Association for Transgender Health (WPATH) Standards of Care, National Academies consensus reports, and to a report on intersex conditions for the Office of the Assistant Secretary of Health.

Experiencing collaboration and connection at these different scales—with individual patients, with other Penn Medicine programs, and with state and national groups to support more patients collectively—presents these new program leaders with an opportunity for optimism, even amid mounting challenges for many people in the LGBTQ+ population.

“There’s a lot of community knowledge and resiliency that I think we sometimes forget about at Penn,” Watson said. “Folks have come from all kinds of different training experiences and lived experiences, and not all of that has been easy. And we can actually leverage that strong commitment to community, that strong passion for doing this work, to support each other.”