For the past couple of days, I have felt a little sick — achy, chills, fatigue, and bordering on a fever that never really materializes. It’s probably some kind of flu. Or maybe I’m just overtired. The one thing I do know is that it has nothing to do with the fact that I’m trans.
About two years after I transitioned — after I had been on hormones quite a while, had chest surgery, done the name change, paperwork, gotten through all the hassles, and had more than settled back into my life — I got pneumonia. I had been working 10-12-hour days and had been exposed to several people who were very sick. It was inevitable that, as overworked and exhausted as I was, my immune system would be compromised, and exposure to all these sick people would do its damage.
When I got better and got back to work, one of my coworkers suggested that I had probably gotten sick because of my transition — that transition that I went through two years ago! Yep — that’s probably what did it, all right!
When we talk about medical care for trans people, we generally think of hormones, surgeries, and various other procedures that have to do with transition. We (and by we, I mean both trans and non-trans people) forget that trans people get sick just like everybody else. We get colds, we get the flu, we get pneumonia, infections, cancer, and even really bad splinters. We have to go to the doctor for a variety of reasons.
The problem is that a lot of trans people are reluctant to seek medical care, even for problems that are not related to their trans status — especially if they don’t have a regular doctor who knows them.
Money is certainly an issue for many of us in the U.S., both trans and non-trans, which is why I support universal health care (gasp — socialized medicine, where our government’s money — really, our money — goes to helping the people rather than bankers and big business).
But I also support mandatory training for all medical personnel on trans issues as part of their basic course of study. (You thought I was going to say mandatory “sex changes,” didn’t you? No, I only support those for Sarah Palin and Bill O’Reilly.)
The majority of medical care that a trans person will receive over his or her lifetime will be non-trans-related. It will involve regular checkups, colds and flu, diabetes, broken bones, heart problems, cancer, various infections, and general yuckiness — just like non-trans people.
We don’t always have to come out to a doctor under these circumstances, but if he or she is going to be poking around at our chest or asking us questions about what medications we’re taking, it’s probably going to come up. And this is why many trans people fail to seek medical care — including regular physicals and preventative care. We just don’t want to have to deal with it all the time.
I have a regular doctor that I will go to if my symptoms get worse, and if I think there’s really something that a doctor can do. But many trans people don’t have that luxury.
So while I think it’s important to continue the ongoing dialogue about “trans medical care,” involving the things that we need for transition, I think it’s equally important to continue — or to start — a dialogue about “medical care for trans people,” involving routine and not-so-routine illnesses that we get along with everyone else.
We need to make sure that our general health is just as important to us as our medical needs for transition. And we need to make sure that the importance of our general health is equal to that of non-trans people in the eyes of the medical establishment.
Thoughts?
Great (and important) post.
I think we also need to draw lines and educate health care professionals ourselves.
I’m in Northern California…and therefore extremely lucky to have sympathetic…even eager…health care for the most part. The women who have given me my first mammograms were extremely informative and gentle…and my primary care doctor is very amenable to my input. Most professionals are willing to learn from me. But sometimes that willingness becomes intrusive.
I had a weird situation last summer with a new allergy specialist. During our first interaction I said something in passing about my transition when she was asking about the list of meds I take. There was a point at which she crossed a line between professional interest and general curiosity…and she asked rather bluntly “Have you had surgery?”
I was pretty stunned. I stammered a little and offered my general response about not being able to afford it. The rest of our interaction seemed to center mostly around her fascination with my gender status. I’m always happy to be a teacher…to answer questions…but in the end I left that office without many of my allergy and asthma questions answered. Then, of course, I couldn’t get a hold of her later. She’s very busy and important you know…
So I dumped her. I should have but did not write her a letter explaining why I decided against working with her. Her office assistance was surprised and a little rude when I canceled my next appointment(s).
I explained the situation to my primary care doctor (who had recommended her). He was surprised. I thought it was important for him to know.
I think if we take our little stands…be clear and draw boundaries (which I should have done in the moment)…and demand a certain level of service…maybe everyone wouldn’t be so surprised anymore about the things that are offensive and uncomfortable to us. I realize that it’s easier for me to say this while living in such a progressive place. But I guarantee you I would say the same thing if I still lived in the Detroit area.
BTW…my new allergy specialist is fabulous…and our rather lengthy off-topic chat at my first appointment was about the state of health care in this country…a much more stimulating conversation than the state of my genitalia…!!
I avoided doctors for nearly forty years even though we have tax paid for health care Now I have a wonderful doctor and she seems to care about me. Since we are in the catchment of a teaching hospital there are often students involved, I make sure they become aware of trans issues, start them young.
Caroline xx
Another reason: The doctor/nurse calling out the wrong name in the waiting room. I came out 3 years ago, but I my legal name was changed in October. Having to explain the name thing again and again to doctors, nurses and staff of all sorts was enough to keep me from seeking help unless it was absolutely necessary. The name issue seems to be what often starts the whole “so, you’ve had surgery?”-talk during transition, at least in Sweden.
Luckily my dad’s a doctor (and he’s so cool with having a trans son most people wouldn’t believe it), so even though he lives in another part of the country I’ve always had someone to call. And luckily, I live in a country with universal health care.