I’ve started seeing a therapist at the trans* clinic in DC and I will have a letter supporting my decision to get a hysterectomy by August! My therapist, (who is a really awesome trans man) also recommended two more surgeons for me to get in touch with, one in DC and one in Maryland. Things are moving along faster than I ever expected and I’m really excited that this is going to be possible for me, but I’m also starting to really stress out over the financial aspect of it.
If my insurance covers my surgery at all, I will still be on the hook for up to 5,000 dollars before the insurance starts paying, and I just can’t afford that. I will also have to be out of work for 6 weeks. I can’t really afford that either. If they refuse to cover it at all then I’ll just be have medical debt for the rest of my life.
On an equally stressful note, my mother just found out that I’m doing this and is being totally unsupportive because she believes that “what [I’m] doing is wrong” and that I might change my mind.
TLDR: I’m making more progress than I ever thought possible and that’s exciting, but I’m still poor and my parents still don’t get it.
On Monday May 5th I went up to DC for an intake appointment at an LGBT clinic (the same place that prescribes my partner’s hormones). Turns out that in order to see a therapist at the clinic I have to be a medical patient with them first. (This is because they only provide mental health care as a supplement to the medical care that they provide, so they don’t have the resources to take on mental health patients independantly.) So I scheduled a regular doctor’s appointment for June 18th with the same doctor who sees my partner. After that they will put me on the waiting list to see a therapist. So I guess this is what progress feels like…
At the Philly Trans Health Conference in June of 2013 I met two med students who were presenting a workshop about hysterectomies. Later I talked with them via email to see if they could recommend any nearby OB/GYNS who were trans* friendly and might be willing to give me a hysterectomy or an endometrial ablation and tubal ligation. They recommended four doctors, most of them in Washington DC and Maryland. I also talked to a friend of mine, fellow blogger Karen of trans*forming family and she recommended three more doctors. Of the seven doctors that were recommended to me only three are “in-network providers” (covered by my insurance) and none of those three are in my state. I also found on doctor in Pennsylvania who is considered an “in-network provider” by my insurance on the WPATH website using their “Find a Provider” search.
I called two of the doctors and emailed the other two. One doctors’ office told me straight up that they do not provide care to transgender patients. Another had an automated phone system with no option to ask a human some questions (their website was also very pink and had lots of flowers). I crossed them both off my list.
My emails got much better results. A doctor in Winston-Salem, NC emailed me back saying that he does provide care for transgender patients and what he would need from me in order for me to get surgery through him. The Doctor in Pittsburgh, Pennsylvania also emailed me back and asked me to call him. I talked to him on the phone today and he also said he was willing to see me and told me what I would need to do to get surgery.
Unfortunately, both doctors believe I am a trans man, and require a letter from a mental health professional in order for me to get surgery and that’s not the least of my problems. My insurance deductible (the amount of money I have to pay before my insurance starts paying) is $5,000 dollars, and I don’t have that kind of money. Despite all that, I am pretty excited. For the first time it seems like a hysterectomy might really be possible for me!
The publication of this post will be the official beginning of my concentrated effort to obtain either a subtotal hysterectomy (also known as a partial or supracervical hysterectomy) or an endometrial ablation and tubal ligation.
With a subtotal hysterectomy I would have my uterus removed along with my fallopian tubes, but my ovaries and cervix would be left in place. An endometrial ablation is when the lining of one’s uterus is burned away. In people with light periods there is a fairly good chance that this can completely end menstruation after only one treatment and the process can be repeated until all of the uteran lining is completely destroyed if necessary. A tubal ligation is when one’s fallopian tubes are surgically cut, blocked, or closed to prevent eggs from reaching the uterus.
Basically what I’m trying to achieve one way or another is the end of my menstrual cycle and permanent infertility. I am not sure which procedure(s) would be the best course for me at this time, and I also have several concerns/barriers to access of treatment that I have to address:
1. I live in the South, so finding a doctor nearby who is willing to do this for me may be difficult.
2. I am non-binary, so finding a trans-friendly doctor nearby who actually believes I’m “trans* enough” for surgery may be difficult.
3. My health insurance is not trans inclusive and is just generally shitty.
4. I am poor, I cannot afford to pay out of pocket for these procedures or take a lot of time off of work to recover.
5. I have a low body weight. I don’t weigh much and I never have and I am concerned that this might make me unable to undergo surgery (you can’t eat for 24 hours or so before a hysterectomy), especially combined with my history of post-anesthesia nausea.
I mention all this now because these are the major things I am going to address in my posts relating to my quest for surgery. I want there to be a clear record of what my concerns and challenges were when I started and how I overcame them for anyone who might be in a similar position with similar concerns, because there’s not a whole lot of documentation on this stuff.