More Progress

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.

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Name Change!

A few weeks ago my partner and I went to our city’s circuit court building and submitted name change applications. I legally made my middle name, which is the name I go by, my first name and dropped my first name all together. My partner changed both their first and middle names to more gender neutral names. Annnnd we just got our court orders back in the mail saying that our names are officially changed! Now we have to do all the busy work to get our names altered on  all of our records and documents, but that’s work for another day. Today I just want to celebrate this little moment of success!

“That was dysphoria?” 8 signs and symptoms of indirect gender dysphoria » Zinnia Jones

“That was dysphoria?” 8 signs and symptoms of indirect gender dysphoria » Zinnia Jones.

I stumbled across the post linked above a week or so ago while looking for a quick and easy definition of “dysphoria” (spoiler alert: no such thing exists). After quickly skimming the post I was shocked. Nearly everything the author mentions in her post sounded like things I had heard my partner say before they started hormones, and just like the author says, all of these feelings evaporated when my partner began hormones even though it was never apparent to either of us until after they began HRT that these feelings were in any way related to their gender.

I think this post is a really, really important read for all trans* people, my partner and I both believed that they were completely alone in their experience until I found this post.

Practical Decisions

My partner and I were talking the other day about them possibly changing their name. Their birth name, which they currently go by, is decidedly a male name there’s really no getting around it. However, they’ve never really had a problem with it and have never expressed any real interest in changing it. They’re only thinking about it now, because they realize that at some point in the future their name alone will be enough to out them if they don’t change it, and that could be problematic at the very least.

This got me thinking about something that I’ve heard several other non-binary people talk about: the steps non-binary people take as part of their transition that are motivated more by practical needs (such as safety and the ability to decide who you come out to and when) more than by personal desire or dysphoria. For my partner these are things like changing their name and legal gender, for other people its things like using the pronouns “he” or “she” instead of their preferred gender neutral ones.

These practical decisions we make to protect ourselves and make our lives easier also force us to accept binary categorizations of our genders that make us invisible as non-binary people. I’m definitely not advocating against making these compromises, (we make them for our physical safety, our job security, and other very real things we need to survive) but I do lament the fact that we live in a world where they are necessary. I also wanted to write about this because its something I’d really like to have a conversation about with other non-binary people at some point.

HRT Update

On Monday I went up to D.C. with my partner for their second appointment at the LGBT Clinic. This appointment was a kind of like a very basic physical (except without the getting undressed or peeing in a cup or any of that awkward, unpleasant shit) , with some questions about their goals for transition, medical history and their family history and some blood work. The doctor was polite, friendly and professional and it was clear that she was comfortable and experienced with working with trans* people. My partner was also able to be honest with her about the fact that they are trans feminine and not a trans woman without risking being denied HRT. The whole visit was refreshingly quick and pleasant and, if results from the blood work are good, when my partner goes back in two weeks they should be able to come home with a prescription for Estrogen.

Roadblocks

LGBT Psychiatry Clinic: Hello, we’re returning your call.

My Partner: Hi! I’m calling… Um, well, because I want to start on hormone replacement therapy. I’m a trans person!

LGBT Psychiatry Clinic: Okay, and what can we do for you?

My Partner: Well, I’ll take whatever you can do to get me started on that.

LGBT Psychiatry Clinic: ….

My Partner: I guess… Ideally I’d like to begin an estrogen regimen, you know, with regular check-ins. I was recommended to call here by Dr. XXXXXXX.

LGBT Psychiatry Clinic: Is she your primary care physician?

My Partner: No. I don’t have a doctor.

LGBT Psychiatry Clinic: So how can I help you?

My Partner: Wait, I’m sorry. Is this the MCV LGBT Psychiatry Clinic?

LGBT Psychiatry Clinic: Yes it is.

My Partner: Oh. Well… As I understand it, the first thing I would need to get a prescription would be a letter from a psychiatrist or counselor..?

LGBT Psychiatry Clinic: ….

My Partner: Is that something that you do here?

LGBT Psychiatry Clinic: No, we don’t provide evaluations for sexual reassignment or hormone replacement treatments.

My Partner: Oh. Sooo… Why is there a letter T in your LGBT?

LGBT Psychiatry Clinic: If you’re experiencing any anxiety or depression relating to your sexuality, we have counselors who will see you for that.

My Partner: ….

My Partner: Now that you mention it.

Being Trans* in the South

When my partner and I were in Philadelphia for the Trans Health Conference earlier this month we were surprised to learn that it was no longer necessary for a trans* person to see a therapist and get a letter of recommendation to take to an endocrinologist before being prescribed hormones. We were told in multiple different workshops that the new WPATH Standards of Care promote the use of an “informed consent” model where a trans* person can be prescribed hormones by their primary care physician (regular doctor) as long as they sign a consent form stating that they understand the effects of hormones and the decision they are making and are capable of making said decision for themselves.

Well, if you live in the South, like me and my partner, finding a doctor, even an endocrinologist, who will prescribe hormones using the informed consent model may be impossible. In fact, my partner has been told that the closest doctors that who may be willing to work with them using the informed consent model have offices two hours away from where we live, and we live in the state capitol. I’m expecting even bleaker results as I look into possibly procuring a hysterectomy or tubal ligation and endometrial ablation. In fact the comprehensive “Transgender Resource and Referral List” for my state doesn’t even list any surgeons at all. The single trans* friendly OB/GYN listed for my area is Planned Parenthood, and I kind of doubt they’ll have much to offer me in the way of help or advice.

The reality of living below the Mason-Dixon is that while national attitudes towards queer and trans* people may be improving, the removal of Gender Identity Disorder from the DSM, DOMA being declared unconstitutional, and the new WPATH Standards of Care mean little here. Nothing has changed for us. We still have to jump through the same hoops and fight the same fights, and we still face monumental barriers to accessing necessary medical care.