As part of the Patients & Provider series, we’re introducing “Patient Perspectives” – what it’s like to go to the doctor as a trans person.
Sarah turned to social media to find a trans-friendly provider, and realized what a difference having someone competent in trans health can make. They used to feel like they needed to conceal things from their doctor, but to their own surprise, trans people, can, should, and actually are treated with dignity and respect at the doctor’s office if under the care of a competent provider.
What It’s Like To Finally Find A Trans-Friendly Doctor
by Sarah Cavar
My description of my current, trans-friendly doctor would have shocked me if you showed it to me a year ago. I was under the impression that trans-friendly health providers were the stuff of daydreams, not real life.
With my old doctor, the one who treated me and gave me checkups for more than a decade, I felt deeply uncomfortable. I felt that we were rivals, and to “win” at the appointment, I had to conceal things. Even (especially) when I was extremely ill, I dreaded seeing her. For all of the years I saw her, she never thought to ask me about my gender or sexuality, instead relying on the assumptions that I was a girl who exclusively dated men. It was suffocating to sit through appointments, biting my tongue as she demanded information on my “mental health,” which she had for years so tightly monitored and controlled. I could only imagine how controlling she would become if I revealed yet another “wrong” thing about my brain.
My search for a new doctor began in a local “Queer Exchange” Facebook group. I posted a short paragraph describing my needs, my dysphoria, my desire for top surgery and possibly T, and my desperation for someone who would see me as I am and respects that person. I hit “post” and sat back, waiting for much-needed information to appear in the comments. It wasn’t that I trusted this group of people in particular to advise me on anything, but rather, that this was one of my only options.
The comments on the post that I made repeated the same several names again and again. I appreciated each comment, but despite having more information, I was terrified to make a call for fear of contacting the wrong person by accident, or getting hostile feedback from someone who is in fact not trans-friendly at all.
I finally gained the courage to contact a doctor after a real-life recommendation from a peer. A trans guy in one of my classes came up to me the following day, speaking of my post euphemistically. It made me angry, the way that I was grateful for the whispers and careful language. The way that saying the words, “I’m looking for a doctor who will understand my dysphoria” felt like undressing in front of a crowd. He gave me some names and locations. He told me who at the college’s health center to speak with about referrals.
To find a trans-friendly provider, I had to become many things: a self-advocate who knew what (and what not) to disclose at a given time, to a given person; a time-management machine who was able to carve out appointment times via brief phone calls made between classes; an expert in my own insurance plan, both on its own and in comparison to my school’s insurance. I spent time online researching what language to use when describing one’s relationship to gender, so that I didn’t slip up and say the “wrong” thing, and deny myself care forever as a result. This is not hyperbole. This is a near-ubiquitous part of life when you are trans and seeking gender-affirming care.
The day of my appointment finally came, after months of research and deliberation. I was incapacitated by fear. Shaking, I followed the nurse’s voice from the air-conditioned lobby into the doctor’s office office. I sat on the crinkled wax sheet, elevated on the examination bed, waiting to prove myself as trans enough for transition. The moment I met my doctor, however, she assured me that it was not her job to decide how trans I was. When I explained, heart pounding, that I was not a trans man, but rather nonbinary, she didn’t blink an eye. These were the first good signs of many.
Most of this doctor’s clients are trans (there are precious few doctors who even respect trans clients, never mind actually helping us) – it shines through not only in her extensive knowledge about hormones, surgery, and other gender-confirming processes, but also in her gender-bedside-manner (if you will). Not to mention, her social-justice oriented and up-to-date knowledge on LGBTQ issues make appointments even better. She doesn’t say “women” when she is speaking about people who can get pregnant. She does not ask me if I have a boyfriend; she asks me if I have a girlfriend, because I felt safe to tell her I was gay in my first appointment.
I have spoken to her about all of the things I could never talk to other doctors about. I share the psychiatric medications I’m on with ease, because unlike so many others, I do not have to worry about mental illness becoming an excuse not to receive gender-confirmation care. This is perhaps best discussed by Sam, the amazing blogger behind “Let’s Queer Things Up!”:
Imagine having no idea when you’ll be permitted to access the care that you desperately need – that you’ll remain imprisoned in a dysphoria-induced hell until you pull it together and become acceptably sane for your doctors.
I come out of all appointments feeling more confident than I felt going in.
The safety I feel in appointments may strike other trans people as shocking. It is a reflex among us to remain silent, only selectively disclosing information about ourselves. We become more comfortable sharing information with strangers in Facebook groups because they are oftentimes safer than the doctor’s office. At the time I first made that inquiring post, I did not consider the irony of the situation. Now, I remember it and I am saddened. The people who are most able and qualified to help us medically are the people that we most fear. And in most cases, our fears are justified.
I am grateful, but I am also frustrated, that the majority of us can only daydream of health professionals who treat us with respect. We are so accustomed to hiding aspects of ourselves that not to hide is strange – especially when you are like me: not only trans, but specifically nonbinary, not to mention mentally ill and with detailed, professional diagnoses that my doctor is privy to. For many who lack the privileges I do, this combination would sentence them to poor care forever. Since I returned from my most recent visit, I have been considering this at length, becoming increasingly incensed at my own surprise that I am treated decently at the doctor’s office.
There are many aspects of justice for trans people that I am passionate about, but now, healthcare will remain firmly at the forefront of my mind. I think, though, that it will be from now on: justice for trans people will not exist until our basic human right to safe and effective healthcare is respected.
Sarah Cavar is an undergraduate at Mount Holyoke College, majoring in Critical Social Thought (focusing on pathology as it relates to gender and ‘madness’), and minoring in Mandarin Chinese. When not studying, they enjoy guzzling coffee and reading + writing fiction. Follow them on Instagram or Etsy.
Finding a Trans-Friendly Provider
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