It can be summed up in two words: be careful, and please try to warn before you ask about really intimate stuff. Genitalia and trans, for example, being "really intimate stuff".
There's a background to this, obviously; I got a nice, yummy cystitis the other day (die e. coli, die) and had to see a doctor. My usual GP wasn't around (bless him, he needs his vacations, too), and so I took the first doctor I could get. Now, as I'm sure y'all know, cystitis means an infection is having a party in your urethra, you need to pee like mad and it stings and it's all very nasty, really. You need to see a doctor. DIY-ing is not an option, even though cranberry juice can help. You don't want any nasties in your urethra, and you definitely don't want them in your kidneys. And also, you having a trans background, it might be it's got something to do with surgeries - not very likely if it's been years and years, but it might; and the doctor sure as hell won't know, unless you 'fess up.
Trouble is, I hate explaining my background to people. It's a vile affair, and there's no way to make it comfortable to me. So. When the doctor asks me (he's very polite and affable and all) if I'm on any meds, I tell him I'm on HRT. I take a calculated emotional risk. He proceeds to ask the specific meds (I start getting uneasy at this point because I can tell where this is headed, right there, right then) - I tell, and start cursing silently to myself for telling. He then proceeds to ask me if this is because of trans. Which feels just about horrible, and I feel like I've been stripped naked against my will. I fumble on about it, get the prescription for an antibiotic (well duh, an UTI is an UTI, and my symptoms fit the description to a T).
Afterwards, I feel violated. Yes, I know, I'm sensitive, but blow me, I am. And I don't feel that's really to be faulted; I've had to explain this trans stuff against my will to a number of doctors in order to get the treatment I needed. It's one pact with the devil - yeah, you get the treatment you desperately need, but the price is that you need to play by their rules, and the rules for women brand you as trans: slightly off-the-rocker, pathetic/deceiving (take your pick, girl!) mental case. This seems to be considered as a permanent feature, even when you've gotten all the treatment you wanted and no longer fit the diagnostic criteria.
I took up this experience (it wasn't an experience from hell, but it was nasty - I'm not used to being identified as trans without my prior consent; the last time it's happened must've been, I dunno, like a decade ago. Yes, I'm one lucky, and healthy, bitch.) with him later that day, and sent him an e-mail describing my experience of the visit. He called back, explained stuff and, well, he's ok in my books now.
In retrospect, what I think he could've done differently is at least give me a warning he's going to ask me an extremely personal question. That might've given me some time and mental space to prepare myself. My rationale for this is that there's really no universal solution to asking about genital configuration; while I'm able to produce more-or-less precise information on mine, I'm pretty sure most people aren't. A question about genital configuration would simply be unintelligible to them, and asking, point blank, if you've got a penis, a vulva or something else is potentially just as invasive (or maybe even more) than asking someone about trans. I would prefer such questions, but I'm pretty sure many more people couldn't take it. And there's no way for the doctor to tell as far as I understand it.
Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts
Thursday, 2 August 2012
Monday, 1 February 2010
Ever have a doctor misgender you?
Ok, I might as well admit up front that the question is somewhat rhetorical for trans women, at least. I've been misgendered so many times in epicrises it's not funny any more - it's just stupid. I have been able to have it corrected a number of times, and I think misgendering no longer occurs in my medical papers, but I've to admit I haven't checked for a while.
Think about it for a while, though.
Some trans women get referred to as "genetic men" in their medical records. Not only is it false (the whole term is so full of fail you just need to take my word for it if you can't think yourself through it), but it is also intensely demeaning - it's like the dear doctor's trying to drag you down to gender hell again.
In general, we're supposed to trust our doctors. Trans women, on the whole, don't. It's pretty damn clear why, innit? No respect or trust for us, no respect or trust comes back.
It isn't rocket science. Trans women are referred to as women. Trans women are given trans woman -specific medications (i.e. none of that stupid menopause-level HRT - most of us are definitely not in our menopausal age). Trans women are listened to. Our needs and wishes are to be respected. No stupid patronising. And if our doctor visits are not about our trans-related medical needs, leave the trans bit alone. It's just not relevant.
Think about it for a while, though.
Some trans women get referred to as "genetic men" in their medical records. Not only is it false (the whole term is so full of fail you just need to take my word for it if you can't think yourself through it), but it is also intensely demeaning - it's like the dear doctor's trying to drag you down to gender hell again.
In general, we're supposed to trust our doctors. Trans women, on the whole, don't. It's pretty damn clear why, innit? No respect or trust for us, no respect or trust comes back.
It isn't rocket science. Trans women are referred to as women. Trans women are given trans woman -specific medications (i.e. none of that stupid menopause-level HRT - most of us are definitely not in our menopausal age). Trans women are listened to. Our needs and wishes are to be respected. No stupid patronising. And if our doctor visits are not about our trans-related medical needs, leave the trans bit alone. It's just not relevant.
Thursday, 29 October 2009
Things I should've been writing about but haven't
I'm reading more of Haraway and liking it quite a bit. Do yourself a favor and read her, if you can.
I should write something about Serano. Whipping Girl is turning out to be a watershed for many trans women, myself included. It's not so much about the content - many bits of the terminology were out there before Julia took it and put it together in such an appealing way - but it's precisely the totality of it that opened my (and by the look of it, many others', too) eyes to the depth cissexist thought permeates the world around us. Some good bits about how plain ol' sexism works, too - even in progressive circles.
I should write something about spirituality. All this politics dovetails my beliefs and they influence each other. I'm probably a Marxist, too, it seems. :D
I probably should write a bit about my new hobby, but I'm not too sure if I want to because of the problems disclosure might cause me. I should write about the difficulties a trans woman faces with health care professionals and other, supposedly helpful, people.
I'm physically too tired to do most of this. I'm not ill, just exhausted, but in a good way. I'm doing sports. Which is another thing I probably should reflect on. Oh well.
I should write something about Serano. Whipping Girl is turning out to be a watershed for many trans women, myself included. It's not so much about the content - many bits of the terminology were out there before Julia took it and put it together in such an appealing way - but it's precisely the totality of it that opened my (and by the look of it, many others', too) eyes to the depth cissexist thought permeates the world around us. Some good bits about how plain ol' sexism works, too - even in progressive circles.
I should write something about spirituality. All this politics dovetails my beliefs and they influence each other. I'm probably a Marxist, too, it seems. :D
I probably should write a bit about my new hobby, but I'm not too sure if I want to because of the problems disclosure might cause me. I should write about the difficulties a trans woman faces with health care professionals and other, supposedly helpful, people.
I'm physically too tired to do most of this. I'm not ill, just exhausted, but in a good way. I'm doing sports. Which is another thing I probably should reflect on. Oh well.
Tuesday, 15 September 2009
On the limits of theories, both social and biological
I quoted Nan Boyd in my last post about desperate attempts to save the foundations of sexual nationalisms. What I mean, more specifically, is that I find the attempts to save a clear-cut binary sex, or gender division rather funny: no clear binary exists, not in a biological sense (there's the pesky intersex, plus we don't exactly know how bodily sexing goes, and in order to have a clear binary, you really do have to know), and certainly not in a social sense - just go see your local genderqueers for a proof.
Moreover, there are some other fundamental problems, too: when we speak of biological sex, we are applying human-invented categories to phenomena we observe in nature, and it's pretty clear to me that the categories themselves are socially constructed, too - they're sure rooted in biology, but they're just as deeply rooted in human needs to categorise and dominate the world. There's no disentangling the social from the biological, or vice versa.
Which brings me to my point: sex and gender are interrelated in multiple ways, and we don't have a complete picture of how this happens - and it may well be we shall never have the complete picture. You see, when we're observing something outside ourselves, we have to classify it to be able to express the observations to anyone else in language - and when we do this, we're already bringing in the socially influenced apparatus of language, and, in effect, shall never have such a thing as pure, unbiased results. We can certainly try, and I'm not so pessimistic as to think we'll always be badly wrong, but I am confident we shall never get it totally right. We'll always be somewhat wrong. Strangely enough I find the thought comforting.
My second point is, social construction is on its own insufficient to explain sex or gender. If all gender really is socially, and socially only constructed, why does it fail so badly? Why does the construction make such a botched job of building two, and two only, genders and sexes? Why do people rebel against it? And on the other hand, why so many people do accept one of the two socially sanctioned genders (myself included)?
What I see, in my culture (big city, middle class, educated - I'm basically your privileged white girl except for the trans plus queerly sexual bits) is people who mostly toe the line when it comes to gender. They seem to be mostly happy with their sexed bodies, too. This is not to say they're happy with the very real inequalities between sexes and genders, but I think you'd be hard pressed to find a substantial amount of women, or men, who are intensely unhappy about there being sex/gender combinations such as "women" and "men". The unhappiness lies - or is made to lie - rather solidly in the margins: those who do not want to, or cannot live the binary in the way they want, or need to.
Thus, the (political) problem of sex and gender is manifold: part of it is just plain ol' oppression - patriarchal, cisarchal, classist, the lot. Part of it is that binary sex and gender really seem to fit a large majority of people, and thus it's rather hard to see a future development where sexes and genders would be significantly more complex, and would thus open up the possibilities more easily for those who need or want them. Thus, a wholesale queering of everyone and everything is, in my opinion, an utopia: all very nice, but it's not going to happen because there's insufficient demand, and the benefits are not tangible enough for the majority to get really excited about. Heck, there's very little tangible benefit from seriously queered gender and sex to me now, as it is.
Going back to theories, a large part of the reason why current theories on sex and gender are so insufficient in my opinion is that there's so little research into how gender and sex works for the majority. So far, almost all research into sex and gender has focused on the "non-normative", on the "abnormal" bits, and as far as I can see, majority sex and gender has largely been ignored - it has been taken for granted, as if it was a simple question: "duh, everyone knows what a woman is". As if! I'd really like to see, say, a majority feminist organisation, or our national health system, really dig into its own practices of sexing and gendering - how does it do those, who are included in practice, who are excluded, why, what are their solutions to the practical problems of sexing and gendering that happens on the margins - as far as I can tell this isn't even documented, let alone analysed. The results should be interesting (probably shocking, too, in many ways).
Moreover, there are some other fundamental problems, too: when we speak of biological sex, we are applying human-invented categories to phenomena we observe in nature, and it's pretty clear to me that the categories themselves are socially constructed, too - they're sure rooted in biology, but they're just as deeply rooted in human needs to categorise and dominate the world. There's no disentangling the social from the biological, or vice versa.
Which brings me to my point: sex and gender are interrelated in multiple ways, and we don't have a complete picture of how this happens - and it may well be we shall never have the complete picture. You see, when we're observing something outside ourselves, we have to classify it to be able to express the observations to anyone else in language - and when we do this, we're already bringing in the socially influenced apparatus of language, and, in effect, shall never have such a thing as pure, unbiased results. We can certainly try, and I'm not so pessimistic as to think we'll always be badly wrong, but I am confident we shall never get it totally right. We'll always be somewhat wrong. Strangely enough I find the thought comforting.
My second point is, social construction is on its own insufficient to explain sex or gender. If all gender really is socially, and socially only constructed, why does it fail so badly? Why does the construction make such a botched job of building two, and two only, genders and sexes? Why do people rebel against it? And on the other hand, why so many people do accept one of the two socially sanctioned genders (myself included)?
What I see, in my culture (big city, middle class, educated - I'm basically your privileged white girl except for the trans plus queerly sexual bits) is people who mostly toe the line when it comes to gender. They seem to be mostly happy with their sexed bodies, too. This is not to say they're happy with the very real inequalities between sexes and genders, but I think you'd be hard pressed to find a substantial amount of women, or men, who are intensely unhappy about there being sex/gender combinations such as "women" and "men". The unhappiness lies - or is made to lie - rather solidly in the margins: those who do not want to, or cannot live the binary in the way they want, or need to.
Thus, the (political) problem of sex and gender is manifold: part of it is just plain ol' oppression - patriarchal, cisarchal, classist, the lot. Part of it is that binary sex and gender really seem to fit a large majority of people, and thus it's rather hard to see a future development where sexes and genders would be significantly more complex, and would thus open up the possibilities more easily for those who need or want them. Thus, a wholesale queering of everyone and everything is, in my opinion, an utopia: all very nice, but it's not going to happen because there's insufficient demand, and the benefits are not tangible enough for the majority to get really excited about. Heck, there's very little tangible benefit from seriously queered gender and sex to me now, as it is.
Going back to theories, a large part of the reason why current theories on sex and gender are so insufficient in my opinion is that there's so little research into how gender and sex works for the majority. So far, almost all research into sex and gender has focused on the "non-normative", on the "abnormal" bits, and as far as I can see, majority sex and gender has largely been ignored - it has been taken for granted, as if it was a simple question: "duh, everyone knows what a woman is". As if! I'd really like to see, say, a majority feminist organisation, or our national health system, really dig into its own practices of sexing and gendering - how does it do those, who are included in practice, who are excluded, why, what are their solutions to the practical problems of sexing and gendering that happens on the margins - as far as I can tell this isn't even documented, let alone analysed. The results should be interesting (probably shocking, too, in many ways).
Sunday, 30 August 2009
Why STP2012 doesn't feel right
Yay depathologisation? Err, no.
The fine folks at STP2012 are asking for "the despathologization of the trans identities (transexual and transgender) and their retirement from the manuals of disorders (teh DSm from the American Psychiatric Association, which’s newly revised version is due in 2012, and the CIE from the World Health Organization, due in 2014)"
Umm, count me out from the ICD (CIE) bit.
I don't identify as trans-something. Other people label me as trans (fuck I hate this identity shit. See iden-bugger-tity for a further explanation).
I do think it's not necessarily pathological to be trans, but yeah, for me having a dissonant body was pathological. And damn I'm happy my body no longer feels like it has all kinds of features not requested - I'm happy, too, that my endocrine works with me instead of against me. What I was before medical treatment was pathological. I was sick.
It just wasn't a mental pathology. It was a bodily pathology. But it was a pathology, and I cannot support a flat-out depathologisation of something that very well felt totally pathological to me. Removal from the lists of mental diagnoses? Oh yes.
Removal from the list of all diagnoses? Well, no, not in my opinion, no.
I suspect this might have something to do with the different meanings of "trans": for some it's an identity, for others it's a label - and it has these several, overlapping meanings. Say, trans as pathology is something I'd define as existing until the said person with a trans pathology has that pathology cured, whatever the method. HRT, surgery, change of lifestyle - anything. Trans as an identity I don't really get, and I'm yet to come across an explanation. Trans as a descriptor, a label for people who are not cis I do get, and in that respect I'm definitely trans. I think trans has all those meanings, and while there's nothing pathological about identifying as trans or about being trans wrt cis, I'm of the opinion that there is something pathological about some trans bodies - pathological enough that the bodies need to be fixed. I hope this could be taken into account when going for political changes. Otherwise I see public funding for treatments diminishing from the very little there is now, and even less than the practically nonexistent research into trans bodies, which I think there's a desperate need of. Public funding helps the poorest, most vulnerable, and medical research into trans bodies helps the medical treatments become safer, saner and more effective, thus helping more.
The fine folks at STP2012 are asking for "the despathologization of the trans identities (transexual and transgender) and their retirement from the manuals of disorders (teh DSm from the American Psychiatric Association, which’s newly revised version is due in 2012, and the CIE from the World Health Organization, due in 2014)"
Umm, count me out from the ICD (CIE) bit.
I don't identify as trans-something. Other people label me as trans (fuck I hate this identity shit. See iden-bugger-tity for a further explanation).
I do think it's not necessarily pathological to be trans, but yeah, for me having a dissonant body was pathological. And damn I'm happy my body no longer feels like it has all kinds of features not requested - I'm happy, too, that my endocrine works with me instead of against me. What I was before medical treatment was pathological. I was sick.
It just wasn't a mental pathology. It was a bodily pathology. But it was a pathology, and I cannot support a flat-out depathologisation of something that very well felt totally pathological to me. Removal from the lists of mental diagnoses? Oh yes.
Removal from the list of all diagnoses? Well, no, not in my opinion, no.
I suspect this might have something to do with the different meanings of "trans": for some it's an identity, for others it's a label - and it has these several, overlapping meanings. Say, trans as pathology is something I'd define as existing until the said person with a trans pathology has that pathology cured, whatever the method. HRT, surgery, change of lifestyle - anything. Trans as an identity I don't really get, and I'm yet to come across an explanation. Trans as a descriptor, a label for people who are not cis I do get, and in that respect I'm definitely trans. I think trans has all those meanings, and while there's nothing pathological about identifying as trans or about being trans wrt cis, I'm of the opinion that there is something pathological about some trans bodies - pathological enough that the bodies need to be fixed. I hope this could be taken into account when going for political changes. Otherwise I see public funding for treatments diminishing from the very little there is now, and even less than the practically nonexistent research into trans bodies, which I think there's a desperate need of. Public funding helps the poorest, most vulnerable, and medical research into trans bodies helps the medical treatments become safer, saner and more effective, thus helping more.
Thursday, 30 July 2009
Pap smears, doctors, medicine - sometimes things just run smoothly
Had a pap smear today: yeah, I know, it's not absolutely necessary, but since the municipality suggested I have one on them, I thought, what the hell, might as well.
I was, of course, nervous as hell before. It's not exactly unusual for trans women to be a little wary of health care professionals, as they have rather unpalatable tendencies to misgender and otherwise belittle and denigrate us - I was prepared to be treated weirdly, but still hoped for the best. That's likely due to my dear spouse, who reminded me that it might go well, too.
Well, it did. And I explained that sorry, I haven't got a cervix, nor do I have an uterus, but yes, I do have a vagina, and it's got a skin graft at the bottom of it, so unless you mind that, go ahead and take the smear. Which the friendly nurse proceeded to do, very professionally. It nipped a bit, but nothing else. Five minutes in all.
I'm feeling hopeful.
I was, of course, nervous as hell before. It's not exactly unusual for trans women to be a little wary of health care professionals, as they have rather unpalatable tendencies to misgender and otherwise belittle and denigrate us - I was prepared to be treated weirdly, but still hoped for the best. That's likely due to my dear spouse, who reminded me that it might go well, too.
Well, it did. And I explained that sorry, I haven't got a cervix, nor do I have an uterus, but yes, I do have a vagina, and it's got a skin graft at the bottom of it, so unless you mind that, go ahead and take the smear. Which the friendly nurse proceeded to do, very professionally. It nipped a bit, but nothing else. Five minutes in all.
I'm feeling hopeful.
Monday, 4 May 2009
Fighting back
We really need to. I can't be happy and content in a world where cis boys brutalise trans girls.
I can't stand the exotification of me and my peers, I'm not a new, empty continent for cis academics to colonise. I already have a civilisation. I already have a culture. It's mine. It has words and contexts and concepts for my life, my things - and y'know what? It's not a cis playground. Not even if cis intentions are good. It's my space, and I decide who enters, and on what conditions, and I decide, too, if they have to leave, or are invited further in.
I will not tolerate a medical establishment that's intent on exotification and othering of non-cissexual people. We're people who need medical help - we're not guinea pigs for testing the latest theories on transsexuality. We don't, actually, need much research on transsexuality - I couldn't care less why I am, or was, this way. I care a lot about my health, my hormonal balance, my overall health. Do they research that? Nah. Of course not. Are our endocrine systems routinely checked for any possible oddities? If you're lucky and know what to demand. Are our HRTs monitored carefully? Well, yes, if you're lucky and know what to demand. Does your ob/gyn know what to look for? Yes, if you're lucky and know... I think you can see the pattern here.
How do we go about changing it? To be honest, I haven't a clue. Educating only takes you so far, and it's incredibly slow, and doesn't seem to have the power to bring about the kind of sea change I want. It's too slow, and too tedious, and too damn classist if every transitioner has to explain everything to every single doctor they meet - the poorest haven't got the resources to get the same doctor time and again, nor can they choose as easily as, say, I can.
I have educated my doctors. Both my GP and my ob/gyn are well aware of my bodily differences, and my HRT is monitored and managed well. But it's not enough! It's not good enough that one middle-class, educated, white trans woman can get what she needs - it should be routine for everyone, not just me.
How the hell does one take on the whole medical establishment?
I can't stand the exotification of me and my peers, I'm not a new, empty continent for cis academics to colonise. I already have a civilisation. I already have a culture. It's mine. It has words and contexts and concepts for my life, my things - and y'know what? It's not a cis playground. Not even if cis intentions are good. It's my space, and I decide who enters, and on what conditions, and I decide, too, if they have to leave, or are invited further in.
I will not tolerate a medical establishment that's intent on exotification and othering of non-cissexual people. We're people who need medical help - we're not guinea pigs for testing the latest theories on transsexuality. We don't, actually, need much research on transsexuality - I couldn't care less why I am, or was, this way. I care a lot about my health, my hormonal balance, my overall health. Do they research that? Nah. Of course not. Are our endocrine systems routinely checked for any possible oddities? If you're lucky and know what to demand. Are our HRTs monitored carefully? Well, yes, if you're lucky and know what to demand. Does your ob/gyn know what to look for? Yes, if you're lucky and know... I think you can see the pattern here.
How do we go about changing it? To be honest, I haven't a clue. Educating only takes you so far, and it's incredibly slow, and doesn't seem to have the power to bring about the kind of sea change I want. It's too slow, and too tedious, and too damn classist if every transitioner has to explain everything to every single doctor they meet - the poorest haven't got the resources to get the same doctor time and again, nor can they choose as easily as, say, I can.
I have educated my doctors. Both my GP and my ob/gyn are well aware of my bodily differences, and my HRT is monitored and managed well. But it's not enough! It's not good enough that one middle-class, educated, white trans woman can get what she needs - it should be routine for everyone, not just me.
How the hell does one take on the whole medical establishment?
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