"I am not an inconvenience..."


"For context, I am a trans individual and that is not something I came to realize until college. When I was 12-13 roughly (existing as a female, my sex assigned at birth), I was aware that I was supposed to attracted to men and that wasn’t happening. I wasn’t sure what to do with this information and I didn’t feel like the word lesbian suited me. I wasn’t aware that there were bi people or any other options. I sat on that until early high school when I came out to a few friends as bi. I went to a Catholic high school so it was a pretty conservative environment where queerness was not encouraged. I was provided with very strict definitions of gender and relationships so I didn’t have the room to think creatively about that for myself and how those concepts interacted.


I didn’t feel like I was exclusively attracted to women, but I also didn’t think I could call myself bi as I hadn’t been attracted to the men I have interacted with in real life. It never occurred to me that non-binary identities even existed. I didn’t really see myself existing in a typical *heterosexual* relationship with a guy. Eventually, I was like I *guess* am a lesbian, but I hate this.


I went to a historically women’s college. I realized when I got there that being referred to as a woman and part of the school’s community kind of made me want to barf. Eventually I realized that that feeling was because I am trans. I initially came out as non-binary, then as a trans guy, and now a trans guy with non-binary sprinkles (but we don’t talk about that for the most part because it is confusing for others). It is part of how I identify, but not part of how I really interact with the world. After coming out as trans I realized I am in fact bi, and I am into people who are not women, but in a gay way. I also have had some aromantic leanings, but it is one of those things that I realized while in a relationship that I am really happy in, so it again is more of a thing that I now know about myself rather than part of how I interact with the world.

 

The process of untangling how I was raised and my current identities is ongoing and messy. At some point, I tried on pretty much all of the major queer identity labels (or fully spent multiple years of my life identifying as some of them!). It’s a little weird because even though it was never a word that felt right for me, as a result of spending about 5 years as a teen identifying as a lesbian/bi woman, a lot of my queer cultural references come from these communities. These were also labels I held while in my toxic high school environment so it’s one of those things where I feel discrimination against wlw (women who love women) communities very personally, but I am not actually part of the wlw community because I am not a woman. It doesn’t necessarily bother me, but it does feel weird sometimes. It also means that when I am talking to other queer men, I don’t necessarily have the same cultural references and experiences. There have certainly been moments where I feel like I have a weird perspective on something or I become passionate about something that affects a subset of the LGBTQ+ community that I used to be a part of but that I don’t identify with anymore.


As I have started to present more masculinely, I am realizing how that comes with different forms of privilege in my life. I am now having to dial back on aspects of myself that I wouldn’t have to as a female presenting individual, but now would not really be in my lane if I said or did certain things as a masculinely presenting individual. For example, I just started a PhD program and I have a lot of friends now that I think know that I am trans but we have not explicitly talked about it. Some of those friends are queer women and like to talk about being queer women, and I am thinking *YES I am here for this* but also that would be a little weird for me to say based on how I present. In general during college (a historically women’s college) a vast majority of the people I saw (dating and friends) were women! So it was normal for people to compliment each other on appearances or platonically touch one another (like hugging a friend) and I want to partake in that still, but I also know that based on my presentation that could be taken as really creepy. So I consciously think about that and dial it back often, especially with people who don’t know that I am trans.


I am in a chemistry PhD program and with older professors it can be a dude/bro-y field. I’ve noticed that as a masculine presenting individual, I won’t get questioned if I do something dumb in lab. Because I have been on the other side of that and definitely have been on the receiving end of gender related discrimination in academic environments (more in high school than in college as I was at a historically women’s college). Aside from being a person with empathy and general observational skills, I have been on the other side of that discrimination and it really grinds my gears. I’ve found that it is a *vibe* related thing rather than anything super explicit and is coming from senior faculty members who I can’t exactly call out, which can be super frustrating.

I am so much happier and more myself since coming out and deciding to transition. Maybe this is a masculinity related thing, I am still trying to figure out how to guy. Sometimes, not most of the time as it is not how I want to present myself in my daily life, I want to (ex. for Halloween) wear a dress and makeup because they are pretty. I want to be emotional with my friends or cry in the lab if something goes poorly. I know I can do those things, but I feel like my *man credibility* is very thin. Sometimes I feel a sense of mournfulness because I have had a lot of really close relationships, like with my mom and sister, that have really changed because. It is not necessarily in a bad way or in a transphobic way, but it is different, which sometimes is sad despite the fact that I am happier overall.

 

Before I came out as queer, I had a lot of weird symptoms like extremely painful periods that would cause me to miss school and vomit. Sometimes they would last for 2 months and then I wouldn’t menstruate for 6 months. My mom was like ‘this isn’t normal’ and sought out gynecological care for me. Some of it was suspect and could have been done a lot better… I definitely wasn’t being sent to trauma informed providers or people who were used to working with teenagers. I was 12 and really didn’t want or was ready for a transvaginal ultrasound. It was bad.


This continued throughout my teens. In retrospect, on top of the pain, I definitely experienced dysphoria around menstruation. I had a lot of issues getting on birth control because my school at the time didn’t let students take birth control (I basically went to one of the most conservative Catholic schools in the country). At one point, I was prescribed birth control and my school found out and totally freaked out. It was ridiculous… like, do you want me to bleed out in calculus, because I will!

It turns out that I have endometriosis, lots of it! Luckily since I have started T (testosterone) it has pretty much gone away (at least the symptoms). Although it wasn’t the reason I started T, it has been super helpful. Technically you can be prescribed T for endo, but no one ever told me that because they assumed that a cisgender (presenting) woman wouldn’t want that.


For 10 years I was pretty much always at the gynecologist. Honestly, I started being sexually active pretty young, probably younger than I would want it to have been if I could redo being a teenager again. The gynecologist was already asking about my sexual health and I was hoping to get STI testing for free since I was already there. I shared with various doctors (I saw many as I was not being successfully diagnosed) that I was sexually active. They would always recommend that I take a pregnancy test, especially since I was taking birth control. I would try to convey that it was not the kind of sex I was having and the gynecologist would say something really wild about HIV or ‘are you really sexually active though?’ or ‘you have to take a pregnancy test anyways’.


This was also an issue at my college’s health center. I had a couple of concussions my freshman year and had to go in a bunch of times for testing. Every time I went in they would send me to take a pregnancy test because I was on birth control. Yet, I had never had a type of sex that could result in pregnancy or even been with a partner with a penis in years. They would ask if I was sure! I mean, I am pretty sure I would remember that. After that in college, I had to take plan B for certain reasons and I told my healthcare providers because I had some weird reactions to it. After that, the campuses health center essentially spent the rest of the time I was in their care basically being like ‘prove to us that you aren’t pregnant,’ even though, again, that would have been literally impossible for almost all of my college career. To get my T prescriptions (through a different local health center) I would have to get a pregnancy tested every 3 months as being on T and being pregnant at the same time can cause a lot of issues. Each time I went to my university’s health center I would have to convince them that I didn’t somehow miraculously get pregnant in between those tests.


I’ve had other various health issues off and on, not necessarily related to my queerness. A lot of it is just incredibly poor luck in regards to my health. For example, I have a lot of allergy based and immunological symptoms that partially meet the diagnostic criteria for Ehlers Danlos Syndrome. I’ll go to the doctor and be like, ‘my entire hip is dislocated and I have a weird rash’. Although this isn’t necessarily intertwined with my queerness, but I now use a different name from my legal name so sometimes people will see my legal name and expect someone different. For example, I have a Walgreens reward card under ‘Gabe’. I went to get my flu shot at Walgreens, I had to use my legal name (I can’t change my name on my insurance until I get it changed legally through social security which I can’t do until I change things on the state level but I can’t change things on the state level until I change things through social security! Listen, I am just a tired grad student here!) when booking the appointment. When I showed up they were fully convinced I had a twin and showed up to my twin’s appointment by accident. I told them that I was this person and I didn’t have a twin. The man was like ‘um let me go check in the back’ and eventually came back and said ‘okay *deadname* let’s go’. I would really like it if it could not be an entire comedy of errors every time I went to the doctors office. I think healthcare is now where I interact with my legal identity the most. And when I pick up my prescriptions, the people at CVS insist on screaming my birth name every time. I now live in an area where I feel like safety as a trans person is maybe a concern, and I am now outed in public every time I pick up a prescription!

 

There is a specific interaction I had with a provider that lead to me raising my standards for what I expect from healthcare providers. I went to a PCP for GI issues that were mysterious. The doctor essentially diverted the conversation saying, ‘Seems like you are trans. What kind of surgeries are you having?’ They also were doing a weirdly invasive physical examination that was deeply unrelated to my GI issues and would not stop asking inappropriate questions about bottom surgery and insisting that I remove my binder for a visit where there was no reason for me to undress. It was deeply uncomfortable. I am normally a very chill person, but I ended up firing her.


I started going to Fenway Health in Boston for my PCP, which I generally really like. There are some drawbacks, like they are wildly overbooked all of the time, which is maybe just a sign that there needs to be more trans health providers. That being said I don’t feel as anxious and like I am going to die all of the time when entering a healthcare setting. I am not fearful that someone is going to scream my birth name in the waiting room or look at my chest when I am seeking care that is totally unrelated to my chest. Even though that is very basic, I now have some set of minimum standards and will be upset if those standards aren’t met.


In college I got a cartilage piercing and it turns out I am allergic to titanium so that turned into something that I had to go to the dermatologist for. I was not able to get into Fenway’s derm. I went to one near my house. When I called, I told them that the name on my insurance was not the name I use and do not use that name. This shouldn’t have to happen, but I now refuse to let my healthcare providers (accidentally or purposefully) walk all over me. Outside of Fenway (the only explicitly queer/trans healthcare center I have been), I don’t have a good sense of how attainable this goal is, but it would be really nice if it were the norm rather than something I have to commit to for myself. I hope things are moving in that direction!


Every issue I have had at Fenway is just about how difficult it has been to get appointments- like I had to wait 1.5-2 years to see a psychiatrist at Fenway. They have such a long wait list for psychiatric care that I have kind of given up on seeking that care, which is sad. The access issue is extremely difficult. I hope they can expand soon. I love them for my routine care, but as a person who frequently has things wrong with my body (bordering on chronically ill, but I hesitate to call myself that) I can’t anticipate what is going to go wrong with my health until it happens! So I can’t make an appointment multiple months in advance or know what specialist I will need to see. So I have had to leave Fenway when it comes to specialist care or unplanned care.


Most people I have interacted with have been more clueless than queerphobic. It hasn’t occurred to people that I might not want to hear my deadname or might have queer sex or things like that. I am hoping it is one of those things that if they were just less clueless they would care. I hope it is not irreparable, not a thing where we have to wait for all of the older clueless doctors to retire. Of course there are also those who are just not good doctors...

 

I am constantly worried about being an inconvenience to others. So advice I’d give to my younger self would be to remind myself that I am not an inconvenience or being pushy. Self advocacy and care is expecting my healthcare providers to have a basic understanding of my identity and needs...and to expect them to not do overtly bad things. That it is not pushy, it is basic self advocacy and care. If I am in a healthcare setting and something bad happens, I can say something to someone about what is happening and why I am uncomfortable. Up until recently I was too nervous to say anything to healthcare providers about my feelings about certain interactions or what my needs are. It is not an inconvenience.” -Gabe H (he/him/his)

Note: deadname is a name that a trans person no longer uses, typically their legal name given at birth.




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