Feeling indignant at the medical profession

[Betty K]

Today I had my first appointment -- by phone -- with a doctor specialising in LGTBQ care. She seemed nice, knowledgeable. I told her that while I'd been impatient to begin HRT about a month ago my dysphoria had recently subsided and now I wasn't so sure, so I just wanted to ask some questions. She said fine, but before she'd even answer anything she interrogated me about various gender issues: why do I want to transition, what was my childhood like, what was puberty like, am I uncomfortable with my genitals, etc. All of that was ok, though I did feel like I was doing an exam, but then she said something that really upset me. One of my questions was about the potential side effects of stopping HRT -- say if I changed my mind, or maybe if after several years I just couldn't afford to keep going (not unlikely: I'm not well off and don't have insurance), or if owing to the crazy state of the world (ie, pandemics, climate emergency) maybe one day I just couldn't access medical supplies. And she said that kind of question made her think that maybe HRT wasn't for me, I guess because it showed how nervous and indecisive I am. I was gobsmacked. I tried to explain myself but she spoke over me and I kind of spaced out and didn't hear her for a while. Eventually I did explain myself to a degree, and the call was over.

 

Afterwards I just lay on the couch and cried. It really took me by surprise: at first I didn't know why I was crying. Then I felt indignant that anyone should have this power over me. It's my body! I'm 47 years old! At least she'd said, "Don't worry, I'm not abandoning you" but why should I need her permission to take HRT anyway? I think my big mistake was in trusting her to know better than I did. To some degree I think her advice was sound: yes my life is unstable at the moment; I have no real home and no steady income, and it's probably crucial I address those issues before transitioning. But the whole experience makes me feel as if it's dangerous to show doubt, and that seems counterproductive to me. At least it reminded me how important this issue is to me: I think I'd kind of forgotten that the last couple of weeks.

 

One last thing: she also, at one point, referred to gender dysphoria as a "disorder". I forget the exact term, though I've heard it before, but I'd thought doctors didn't describe it that way anymore? She listed all the criteria for being M2F, like a checklist with a whole bunch of boxes she would have to tick if she's going to sign off on HRT. Again, it felt demeaning, like maybe my dysphoria doesn't qualify. The really upsetting thing is that, to some extent, I agree: maybe I'm not really M2F, maybe ultimately I will decide against transitioning, but in the meantime I'd really appreciate it if those people who are supposed to be helping me in my decision could keep an open mind, otherwise they're not helping me at all.

 

Was there any point in her making that comment? Was it a test in itself? (Surely not, that would be too cruel!) Does she really get so many patients pretending to be transgender? Has anyone else experienced something like this? Her clinic comes highly recommended, and as I said she seemed capable. Should I just develop thicker skin?

 

Thanks for reading. I tried to make it as short as possible! x

 

 

[DonkeySocks]

Surely somebody more knowledgeable about it will chime in but my first impression is that it's outrageous. I think your emotions and instincts on this are valid and that she's being controlling, based on your experience as related here. She might be good at the physical part of her job and not so much on the direct patient care. Just a guess. I'd be upset too.

[Betty K]

Aw thanks @DonkeySocks, that helps. This is all so new to me I don't quite trust my reactions.

[DonkeySocks]

Maybe the people who recommended her are super confident or something but I don't think you need to make any excuses for her, fwiw. Maybe she's not the right fit for your journey. Whatever happens, I hope it works out that you get what you need.

[Lexi C]

Hey Betty K.

Yeah  your conversation with her seem a bit off putting.  I mean i was ask similar questions but in a more supportive way. Your Financial background should have nothing to do with your desire to be come the person you are and ( please excuse me  if i get this wrong), but WHO THE HELL DOSE SHE THINKS SHE IS judging you like that your make up Dysphoria for kicks.

So sorry you had to go through. I would try to get a second opp.  FYI. I would off cry as well.

much lv sis 

[Betty K]

Thank you @Lexi C, I felt a bit the same afterwards: “Who does she think she is?” But it’s hard to trust your feelings when people seem so nice and confident in their jobs. I mean, I already have imposter syndrome anyway: I hear other trans women talk about how certain they are that they need to transition, but I’m not certain about anything at all! I don’t need someone not believing in me; I need guidance to make up my own mind. Anyway thanks again x

[Betty K]

3 hours ago, DonkeySocks said:

Maybe she's not the right fit for your journey.

 

 

It’s hard because there are so few options here. I have another appointment in 8 weeks. I think I will tell her then how she made me feel this time, and if she apologises and we move on then all good. Meanwhile I really need to find the right counsellor; I think that will be the most important thing in the short term. 

[Maddee]

Betty I relate!

I was turned down for for any services by the only surgeon offering GCS in my state.  Based on a ten minute phone call.  I asked honest questions and she was impatient.  Maybe their patients have common sense and tell the Dr only what's necessary to check the boxes.  Your question about stopping get makes real sense to me. 

My question was... what happens if someone becomes seriously disabled and cannot dislate themselves...

 

We are all different in our ability to navigate the maze.

 

I don't fit the box and neither do you girl.  But we are the box.  Stay open and things will fit you.

[Maddee]

*Stopping HRT*

Not stopping "get"

Genius spell-correct

[Betty K]

Hey @Maddee, thanks so much for your comment. It makes me feel like less of an imposter to know this has happened to others too. A 10-minute phone call! That is crazy! But I think you're right: I think next time I'll just make sure the boxes are ticked, rather than expecting any doctor to help me make a decision.

 

2 hours ago, Maddee said:

I don't fit the box and neither do you girl.  But we are the box.  Stay open and things will fit you.

 

That sounds like very good advice.

 

x B

[Kiera]

4 hours ago, Betty K said:

 

 

It’s hard because there are so few options here. I have another appointment in 8 weeks.

 

@Betty K why are you stressing over this? Dr Powers does "tele-visits" and also informed consent, won't ask a thousand questions and will set you up with preliminary labwork instead. Do you have a local "Labquest" although I think they'll use whatever you 'ave available.

The only catch is there's a waitlist and he will charge you $300 cash annually upfront (which I suspect is used to cover people paying cash or not paying co-pays/deductables?)

They accept payments through paypal and you can email any questions to Amanda Thomas @ [email protected] regarding: "Waitlist Submission". She's very friendly and helpful . . .

 

LET US KNOW WHAT HAPPENS!

 

Cheers Kiera

 

 

[DeeDee]

Hi @Betty K I had a similar feeling after talking to the psychologist that where I am gets to decide if I can go on HRT or not earlier this week, I hate sharing personal details with strangers that dont care at the best of times but felt like she was jumping all over the place and focusing on the wrong things (like my marriage breakup and my sex life) rather than letting me explain my own life story, at one point she also mentioned something to do with socially transitioning for a year before starting hrt - which is not a requirement - and I missed the next 5 mins of conversation because of it so I felt very frustrated. I have calmed down and am just going to let her finish asking her questions but emphasise that she is not the first person I have talked to about my dysphoria. I specifically said I was there because I want to start HRT and it could be that in itself made me defensive, but she won't stop me becoming who I am and neither should your doctor. HRT helps with the redecorating but it doesn't stop you being who you are.

[Betty K]

Hi @Kiera, I will look into Dr Powers but I suspect it mightn't work so easily for me coming from Australia? Scripts written in the US might not work here, and it'd be prohibitively expensive to have drugs posted from the US. But who knows, maybe you're right. Also I actually would like to be in close touch with whichever doctor I end up with, since I am actually very nervous about HRT (as I am about any drugs and/or surgeries). I was hoping this doctor and clinic would be supportive. Thank you for the info though, I will certainly look into it.

[Betty K]

Hey @DeeDee, that's funny, the last psychologist I had did exactly the same thing: she focussed in on my marriage break-up and kept downplaying my assertions about being transgender. "Gender fluid maybe," she said. It was a bad experience too, so I am now looking for a new psychologist. Also the doctor said a similar thing about social transitioning. She didn't exactly say a year, but she pressured me about it and told me that "some trans women never take hormones". It was so frustrating because I really just wanted advice about options. I feel alone. I need help. I don't need to be measured up against some ideal of trans-ness and found wanting.

[DeeDee]

1 hour ago, Betty K said:

I don't need to be measured up against some ideal of trans-ness and found wanting.

Ultimately this is the biggest problem with the old gatekeeping model, even with the changes the systems are not always caught up and we end up feeling like the defendant in a court case, don't give up and just be yourself and be confident in who you are and why you are there. They will pick up on that confidence. x

[Kiera]

"Trans-ness" is a total misnomer, doesn't really exist, and have seen this on "forums" a thousand times before -> one must resolve "self-doubt" other "life issues" first! Whether indeed "girl or not" is really quite SIMPLE, is based on a criteria that's been around since day one, at that's "overall social success" - be it "as male" or "female" - and, of course, the younger one starts the better!

[Betty K]

Thanks @DeeDee, that's good advice. And "defendant in a court case" is exactly right!

 

@Kiera I agree: I don't believe in trans-ness either. The only question for me is am I going to decide to do this thing or aren't I. I can decide either way. I can live as a man or a woman. There are no doubt good and bad sides to both options. But as to resolving self-doubt and life issues, I don't know if I ever really will! I mean, I sure hope so, but I don't wanna be unrealistic.

[Jani]

Betty I'm sorry to read of your experience, but as I know you will, you can explain yourself at your next meeting.  Be brief so not to dwell on the point and just tell her your question about side effects was just your normal view of covering all the bases no matter how remote they may be.  Then move on to your next point of discussion.  I think you'll do fine.

 

Jani

[Delcina B]

Breathe Betty! You are brave! You've taken another step forward exploring the femme in you. I've yet to seek a therapist though it is likely what I will have to at some point. Take heart in her saying she's not abandoning you.

 

While I don't know the doctor's mind, the situation reminds me of a Colonel I served under. When a young Lieutenant had an idea & tried to bring it up in the morning meeting he would invite them to see him at 5 pm after the duty day was done. If they were sincerely desirous to seek his approval they would show up, if only half heartedly committed they wouldn't. Maybe she is testing you to see if you are seriously committed to HRS.

 

I believe in fate, so the way I see it you've been granted 8 weeks to do whatever you were meant to do. It might seem like an eternity at the moment, but I believe it will pass quickly.

 

Hugs!

Delcina

[Betty K]

Hi @Jani and thank you, I'm sure you are right. I actually did already explain what I'd meant by my question, once she let me get a word in edgewise, but my feelings go beyond the practical question of whether or not this doctor will eventually sign off on HRT. I felt hurt by her insensitivity. I didn't think the interrogation was necessary, especially since the doctor is not a psychologist and I thought ultimately it's the psychologist who assesses whether I'm "genuinely" transgender or not. I just resent the whole gatekeeping component, I guess. And it's a shame, because I went into it hoping maybe the doctor could help me in my decision, but all she did was alienate me.

[Betty K]

6 hours ago, Delcina B said:

While I don't know the doctor's mind, the situation reminds me of a Colonel I served under.

 

That was exactly my thought too Delcina, but it seemed cruel and unnecessary for the doctor to treat me like that. Still, if she wanted to test my resolve then it worked: I went away far more determined to follow this course than I had been beforehand.

 

6 hours ago, Delcina B said:

I believe in fate, so the way I see it you've been granted 8 weeks to do whatever you were meant to do. It might seem like an eternity at the moment, but I believe it will pass quickly.

 

You're right, 8 weeks does seem a long time. I'm so sick of waiting! I waited about 6 weeks to meet my first gender therapist who I didn't like. Then another 2 weeks to meet my current social worker, who I like and is supportive but I now find out is not a clinical psychologist so I'll still need to find someone else! But I'm beginning to realise this entire journey may have to wait. I was almost ready to leap, consequences be damned, about a month ago. But practical concerns are beginning to take over.

 

I highly recommend finding a therapist, but I'm sure everyone's told you that here.

 

x thanks Delcina

[Delcina B]

I've read in the forums here & I paraphrase, the gender decision is ours alone to determine, the therapist or doctor's role is more an affirmation. This aligns with what I've read so far in My New Gender Workbook, & oh dear, in reading my thoughts & feelings are topsy turvy! It has me looking at gender in a new light, some what overwhelmed in thinking of my gender identity as fluid along a spectrum between my femme & masculine. 

 

Thanks! I'm pretty sure therapy is in my future. 

[Betty K]

Well that's exactly what I didn't get from this doctor: affirmation. It hurts more because on her website she says she is "passionate about supporting transgender people on their journey", so I guess I just don't fit her definition of transgender. Obviously I shouldn't care what she thinks. Obviously she doesn't know me better than I know me. But when you are confused and isolated to begin with every bit of negative affirmation hurts.

 

I'm reassured to hear what you say about My Gender Workbook. I too believe my gender identity is fluid. I actually feel that people like this doctor have, to some extent, believed a fairytale -- the fairytale that one day we just "know our true selves" and everything falls into place. Maybe that happens for some people but I don't think it will happen for me. The nearest thing I can hope for is to make an informed decision based on closely monitoring and not denying my movements along the gender spectrum.

 

It's funny that the mainstream notion of what it means to be transgender is still so binary. Have I realised I am "really" a woman? Certainly not -- it's way more complex than that. I have realised I am deeply unsatisfied with being a man and bubbling over with excitement about the idea of being a woman. Isn't that enough to at least justify my asking some questions about transitioning? I would have thought so.

[Delcina B]

2 hours ago, Betty K said:

 

It's funny that the mainstream notion of what it means to be transgender is still so binary. Have I realised I am "really" a woman? Certainly not -- it's way more complex than that. I have realised I am deeply unsatisfied with being a man and bubbling over with excitement about the idea of being a woman. Isn't that enough to at least justify my asking some questions about transitioning? I would have thought so.

 

Betty,

Ditto, jinx, amen, any or all the above. I am at the same point on my gender journey. I think until recent I was of the binary transgender mindset either all in one way or the other, but not today.

 

From what I've read on clinical diagnosis of gender dysphoria they have 6 conditions where they look for at least 2 to be manifested by adults for at least a 6 month period, as well as clinically significant distress or impairment. Not sure this will help ease the frustration, but it's been said,"well informed is well armed." It was a short but informative article, I'll see if I can find the link.

 

Hugs!

Delcina

[Betty K]

Hey Dulcina, that's great to hear that you feel the same.

 

Yes please do send the link. But you know, that is another thing that irks me, this focus on distress or impairment. My doctor said that too: she said she sees transgender clients who have suffered their whole lives over being the wrong gender, as if I hadn't suffered enough! I told her I have suffered, I'm just not sure the primary cause was my gender. But why should suffering be a prerequisite for transitioning anyway? What if I haven't suffered as much as many trans women but I simply feel that my life would be better if I transitioned? Shouldn't that be enough?