Doctors, Healthcare Givers and Transsexuals: Discrimination Happens Part One
Given their high degree of education, you would think that doctors, and healthcare givers in general, would be quite forward thinking and accepting of the transgendered. I have not always found that to be the case. In the years of my transition and since I have had two less than ideal experiences with healthcare givers. One I would simply call curiously educational. The second one I found genuinely troubling.
Let’s start with curiously educational. (Next time around I’ll talk about genuinely troubling.) When I was about three months into my therapy my therapist agreed to recommend me for Hormone Replacement Therapy. We both did a great deal of research on endocrinologists in the Philadelphia area and selected a reproductive endocrinologist with a long record of treating transsexuals and who had an excellent reputation in the transgendered community. I called his office and scheduled an appointment. When the receptionist asked me the reason for the visit, she didn’t miss a beat when I said I was a transitioning transsexual. (She asked all the right questions (M to F or F to M, what name is on the health insurance, what gender is on the health insurance, etc.)
I’ll never forget that first visit. I was the only man in the waiting room. I was on the way to a meeting with one of my clients, so I was wearing a suit (charcoal grey pinstripe with a red patterned power tie). I was surrounded by women desperate to become pregnant. They were probably all thinking: “why’s he here? He isn’t with his wife. He came in alone.”
Finally a nurse came and called my name. She was so young. She couldn’t have been more than 19 or 20. As we walked to the doctor’s office I noticed that she kept quite a distance away from me, more than normal in such situation and her body language said “highly uncomfortable about something” to me. She didn’t make small talk the way you do in a situation like this and there was something in her eyes when she looked at me. It was fear. It was great fear.
I greatly liked, and still greatly like, my endocrinologist. He came into room, shook my hand and sat down at his desk. The only thing on it was a file folder with the medical history I had provided. He put his hands together, rested them on the file folder, and looked me straight in the eyes. In a quiet voice he said: “Why do you want this?” I looked back into his eyes and said, in an equally quiet voice: “because I need to be a woman”. He thought for a moment and then said, “Fair enough. Let’s see what I have to work with.” He then opened the file folder and started reading my medical history. (Talk about a defining moment in one’s life!)
On my next visit the Doctor determined which protocol he was going to use on me and wrote the prescriptions. He made a point of handing the script to the nurse, making her hand them to me. Yes, it was that same nurse. And that look of fear was there again. The body language that said “I don’t want to be doing this” was there again. As she handed me the two prescriptions I could tell that she didn’t want to touch me. It was extremely disconcerting. On the one hand here was an endocrinologist who was completely accepting and supportive and on the other hand was this nurse who obviously wasn’t.
I never saw that nurse again. Whether she got fired or left on her own, I don’t know.
My treatment protocol requires me to visit my endocrinologist every two weeks to receive an injection of estrodial. (Yes, I know I can do it myself, but I’m deathly afraid of needles!) Over the course of the first year of treatment I started to pick up this weird vibe among the nursing staff. Some of them were completely comfortable with me and some weren’t. Nothing overt ever happened. They were always professional and polite, but you can tell. (It’s an innate instinct we all have.) Some of them would chat with me and remember things about me from previous visits and then there were the ones who didn’t say much of anything and just administered the injection as quickly as they could.
The day I came in and told them I had legally changed my name was very illuminating. The Trans -friendly staff were all genuinely happy and excited for me. The receptionist, the same person I had spoken with on the phone when I called to make that first appointment, made a big deal out of it. (She excitedly explained to me that I now get a new color file folder!) The others didn’t say a thing. They didn’t even congratulate me. They were also the ones who had trouble calling me Ashley instead of Craig.
About a month after my name change went through, something interesting happened. One day I got a letter from my endocrinologist’s practice announcing that my doctor and one of his partners, who was also well-known for treating transsexuals, were leaving to join another reproductive endocrinology partnership. And it was all going to happen in less than a month.
This was very curious. My understanding was that my doctor was one of the founders of the partnership. In my last two visits I tried to find out what was going on, but nobody was talking. (I think they had strict orders not to discuss it.)
The first of the month came and it was time to visit my doctor’s new office. I walked in and there was the receptionist who had made such a fuss over my name change. And, I found out during my visit, most of the rest of the nursing staff who had been kind and accepting. The nurse who administered the injection was a new one. While she was preparing it she said she was reading a good book and wondered if I had ever heard of it: “Trans-Sister Radio.” (She’s been my favorite ever since!) She asked me if there were any other books I would recommend. (I suggested, “She’s Not There.”)
As I was leaving I ran into my doctor. I asked him how he liked his new office. He said it still needed a few things, but it was coming together nicely. Then he smiled and said: “More importantly, how do you like it.”
That was my first experience with healthcare as a transsexual. Next time, I’ll talk about the other experience I mentioned and give you my ideas on being a transgender consumer of healthcare services.
(I’ll tell you this much: it involved my long-time internist, a doctor my whole family went to for 20 years, a man who was there with me through both my parents’ final illnesses and eventual death, a man who, repeatedly over the years, called my friend. And what happened in the end was creepy beyond words.)
Photo credit: stock.xchng.