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Hello! I have been visiting my doctor lately, for over a year. I just recently had an appointment with her on upping the dosage of my meds. (Prozac) I got to thinking, should I tell her that I am transgender? Can she deny me medical help if I tell her? Is it pointless?
The doctor I visit is in the Northeast Arkansas area if that is any indication.
I am just wanting to make a step forward in my transition, and although she may not know how to help, I don't necessarily want to miss an opportunity of her knowing of some resources...
Quote from: Vincent Johnson on July 21, 2017, 05:16:25 PM
{Mods, if this isn't in the right area, please move it}
Hello! I have been visiting my doctor lately, for over a year. I just recently had an appointment with her on upping the dosage of my meds. (Prozac) I got to thinking, should I tell her that I am transgender? Can she deny me medical help if I tell her? Is it pointless?
The doctor I visit is in the Northeast Arkansas area if that is any indication.
I am just wanting to make a step forward in my transition, and although she may not know how to help, I don't necessarily want to miss an opportunity of her knowing of some resources...
It is not likely that she can deny you treatment for being trans. However, some states have some barbaric laws about that kind of thing, so you should check the situation in your state regarding non-discrimination.
Assuming she operates with civilized standards, it would be to your advantage to tell her. She can help you find therapists, endocrinologists, or other professionals that you will need if you decide to transition. She will also need to know about any hormone prescriptions you get in order to ensure there are no conflicts with other meds that you may need.
I found a Dr. to handle just the transition stuff. Because he is like an hour and a half away, I kept my doctor in town for routine stuff like colds, shots, regular Dr. stuff. When I updated my med list I decided to tell them about the Estradiol, Progesterone and Spiro. The Dr. (a young female) asked why I was taking them I told her I was Trans. Her entire demeanor toward me changed from jovial to distant and cold. I told her about the other doctor far away and asked if she would be interested in taking over my transition, she could not say NO fast enough.
I have not been back to her nor her clinic, which is large and well respected in this region. What is interesting is that the clinic this Dr. works for has previously been sued and lost for refusing to treat TS people.
I decided to use the far away Dr. for everything and use local walk in clinics when I get sick.
I would tell her so she could help you to find other therapists, and other kinds of doctors. And so that you and your doctor is on the same page for everything.
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I thought it would be unethical for a doctor to deny treatment to anybody who requires it. WTF is the world coming to?
Hi Vincent!
May I ask if you are on HRT or perhaps you are seeing a different doctor? I think it is important to acknowledge the doctor about your transition. If you are on HRT and the doctor doesn't know, she might be concerned about your lab result (blood work). If you are on HRT, I think it is a good way to go to the same pharmacy because they have your full medical record.
In terms of your concern being denied for the access of care, I think it is illegal to do so because healthcare professionals are obligated to take care of patients who are in need.
Jinnie
Often being transgender causes depression and people find they can reduce or eliminate antidepressants when they go on hormones because they feel better. Yes I know that Prozac is used to treat other condition but some of those might also improve as you treat your gender dysphoria. The doctors should know what is going on with the rest of your life to better determine the amount of Prozac you should be taking.
@JinnieY I am not on HRT. I only visit that main doctor I go to for almost everything. I haven't gotten on HRT because I am not sure about Missouri and Arkansas's laws on going on HRT for FtMs.
@Dena I am not sure about Missouri and Arkansas's laws on going on HRT for FtMs. I am taking Prozac for social phobia and seasonal depression, and my dosage has just recently been raised because my seasonal depression has kicked in. I am scared to bring it up to her, as she might try to deny medical treatment all together and I feel that I won't have another doctor to go to.
Quote from: JinnieY on July 21, 2017, 09:11:21 PM
In terms of your concern being denied for the access of care, I think it is illegal to do so because healthcare professionals are obligated to take care of patients who are in need.
You would think but sadly, no.*
*It happened to me.
Quote from: 2Wendy2 on July 21, 2017, 06:12:05 PM
I found a Dr. to handle just the transition stuff. Because he is like an hour and a half away, I kept my doctor in town for routine stuff like colds, shots, regular Dr. stuff. When I updated my med list I decided to tell them about the Estradiol, Progesterone and Spiro. The Dr. (a young female) asked why I was taking them I told her I was Trans. Her entire demeanor toward me changed from jovial to distant and cold. I told her about the other doctor far away and asked if she would be interested in taking over my transition, she could not say NO fast enough.
I have not been back to her nor her clinic, which is large and well respected in this region. What is interesting is that the clinic this Dr. works for has previously been sued and lost for refusing to treat TS people.
I decided to use the far away Dr. for everything and use local walk in clinics when I get sick.
Hi Wendy!
I'm sorry about this totally unacceptable attitude of your general practitioner. As a physician myself, I feel ashamed to have her as a colleague. Physicians are supposed to be objective, scientific, compassionate... their purpose is to promote health, relieve suffering, cure diseases... I can only see ignorance and/or personal reasons (prejudice) for her attitude, both incompatible with an ethical practice of our profession. A shame, really... I wish you the best of lucks in finding the good physician you deserve.
Hugs, Sarah
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Thank you so much Sarah! Although it is not the most convenient situation it is working out by using my transition Dr. who is a GP (Primary Care) Dr. for most everything and the walkin for when I get sickly.
Just because someone is a doctor doesn't mean they can't be just as ignorant as anyone else when it comes to trans people. I see a gyn for my hrt but I needed to find a new GP after mine moved to another city. The first one I went to was transphobic. I hadn't mentioned I was trans because I didn't want to start with that. After he started looking through my medication list he asked about the large doses of spiro and estrogen. So I told him I was trans. He asked how long I had been on hrt and I told him 2 years. Then he said that meant I had started it at 17 and he asked me if I had been buying hrt medications from the internet since a 17 year old needed parental consent. I told him I had had parental consent when I started and he started going on about that was awful and it could qualify as child abuse and what was wrong with my parents, blah blah. Then he said if I stayed on hrt a lot of the changes to my body would be irreversible and to stop now. Then he actually told me to just go ahead and be gay! So I totally just got up and left. This wasn't an old guy either. He was about my dad's age. (37-40). The next Dr I went to is a young female. She couldn't have been nicer. She even told me that if something happened with my gyn she would fill my hrt medications until I found a new one. I don't think it matters if a Dr is younger or older, male or female. Its just like luck of the draw. Drs are just people and some of them are transphobic dicks.
Julia
Quote from: Julia1996 on July 22, 2017, 07:25:01 AM
Just because someone is a doctor doesn't mean they can't be just as ignorant as anyone else when it comes to trans people. I see a gyn for my hrt but I needed to find a new GP after mine moved to another city. The first one I went to was transphobic. I hadn't mentioned I was trans because I didn't want to start with that. After he started looking through my medication list he asked about the large doses of spiro and estrogen. So I told him I was trans. He asked how long I had been on hrt and I told him 2 years. Then he said that meant I had started it at 17 and he asked me if I had been buying hrt medications from the internet since a 17 year old needed parental consent. I told him I had had parental consent when I started and he started going on about that was awful and it could qualify as child abuse and what was wrong with my parents, blah blah. Then he said if I stayed on hrt a lot of the changes to my body would be irreversible and to stop now. Then he actually told me to just go ahead and be gay! So I totally just got up and left. This wasn't an old guy either. He was about my dad's age. (37-40). The next Dr I went to is a young female. She couldn't have been nicer. She even told me that if something happened with my gyn she would fill my hrt medications until I found a new one. I don't think it matters if a Dr is younger or older, male or female. Its just like luck of the draw. Drs are just people and some of them are transphobic dicks.
Julia
Omg, Julia! [emoji33] I wasn't aware of so much transphobia among doctors! I mean, yeah, in the general population this doesn't really surprise me, but doctors are NOT supposed to let their personal convictions interfere with how they treat their patients. This is wrong on so many levels... It's unethical, it's unscientific, it's cruel... I get it when a doctor who declines helping you on grounds that she has no experience with HRT in trans*, but at least tries to redirect you to a colleague who knows. But the case you describe is repulsive. I'm really sorry for this and truly happy that you've found a GP who is trans-understanding. Hugs, Sarah
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Quote from: Julia1996 link=topic=226256.msg2005200#msg2005200 date=
I don't think it matters if a Dr is younger or older, male or female. Its just like luck of the draw. Drs are just people and some of them are transphobic dicks.
Julia
I think statistically your chances are better with younger generation (but by younger I mean 20sh, not 40sh) and I found female generally better accept mtf than male (for a female, it's probably a subconscious validation that the fair sex is better and mtf is no longer perceived as a male, an aggressor and a potential partner; for a male it might be a subconscious threat).
I am somewhat in the same boat, talking about formally starting HRT with the VA as well as a private clinic. I have had a woman GP for my healthcare even before I knew I was trans and she was great and I didn't mind seeing her even though my trans wasn't an issue. She gave prostate exams and never once hurt me, the male GP I had before her hurt me several times giving that exam and has left me feeling very ill at ease about the prospect of a male GP for exams or especially this trans issue. Well, fast forward and I've had to own this for a while now and as uneasy as I was about the male doctor I was to see about HRT, turns out that as soon as he entered the room he announced he was gay and that he knew what a lot of the issues I was facing were about and I should put my mind at ease, he was there to help in any way he could. I was equally nervous about my dealings with the VA, but it turns out they were equally nervous about me! I'm in the Hill Country in Texas and it seems I'm the first self proclaimed trans person that they've had and a bit of a celebrity :-). They were asking all sort of questions about how should they address me and what did I want to be called and were all worried about some sort of perceived etiquette with the newly acquired trans person. In the end I was assuring them that I only wanted to be looked at like anyone else and no special handling was required and that Toni works with a Y or an I. I ended talking with a big, self proclaimed biker looking nurse who it turns out couldn't have been nicer. He said he had LBGT friends who he valued as good friends and nothing else mattered to him. So there you have a couple of pleasant outcomes in spite of our apprehension and the fact is that sooner or later you'll have to own this. Tell the truth and don't be sheepish about who you are. Give your caretakers the same opportunity you would ask of others and if you're not happy, be your own advocate and say no thanks and find someone else.
In my case it was an entire Medicaid clinic that has a staff of 18 doctors and twice as many nurse practitioners. They are all complicit in a conspiracy to deny transgender health care while taking federal dollars. All because the founder was a member of the clergy or a prominent religion. It's really stunning when one gets bit in the rear end by "religious freedom" in 2017.
Quote from: Janes Groove on July 22, 2017, 03:00:51 PM
In my case it was an entire Medicaid clinic that has a staff of 18 doctors and twice as many nurse practitioners. They are all complicit in a conspiracy to deny transgender health care while taking federal dollars. All because the founder was a member of the clergy or a prominent religion. It's really stunning when one gets bit in the rear end by "religious freedom" in 2017.
I didn't realize that Colorado was so conservative as a state. Colorado Springs yes, as one goes north, it changes.
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With the exception of a few countries where it is illegal to be transgender, I think it's best to tell a doctor without hesitation. This is information they need to correctly handle your health care. Dena brought up a great specific example. If you postpone the conversation you run the risk of accidentally not getting good health care through no fault of the doctor.
If this particular doctor is in the wrong profession you need to know as soon as possible. I think Julia did the right thing to immediately leave. Wendy I am glad you switched clinics. Jane, sorry to hear you encountered an entire clinic full of people who are not interested in your health - I cannot call them professionals. In an extreme case I would be taking a short break in the lobby on my way out the door to write down exactly what was said.
Vincent, if you don't have any other doctors in your area this sounds more difficult. Or if this is a case where you're seeing a shared family doctor and other family members might ask questions if you request a different doctor. You need to make a decision based on the long term health requirements of most important person, and that is you.
My general practitioner is near retirement age with several decades' experience. He has taught at a top medical school but I am his first transgender patient. Within the first 5 minutes I told him I am transgender (I am not full time yet). He told me he doesn't have any experience with transgender patients - I admire his honesty - and he seems sincerely interested. He plans to cover everything he normally would, and check with my endocrinologist (same clinic) for trans-specific topics.
Perhaps you could call your local LGBT center and see if there are LGBT friendly physicians in your area. Also, if there is a trans group in your area you could go to group and ask where the others go for HRT. You may want to call planned parenthood in your area. That particular center may not provide HRT but they may know of sympathetic physicians.
I would definitely tell your current physician. In rural areas and areas in the bible belt there may be some more probability of a doctor that is uncomfortable treating a trans patient. I am in Philadelphia and there are doctors that will not treat a trans patient or treat them differently after they find out they are trans. There are also many many more good physicians that are perfectly fine working with a trans patient.
I go to a LGBT center that specializes in Trans, LGB and people with HIV and AIDS. They have a PCP center, mental health, pharmacy, HIV wall in testing, a food bank and clothing bank and group. It is in Philly and it is Mazzoni. I love going there.
@Rachel Lynn I sadly do not know of any local LGBT centers or any trans specific groups in my area. There aren't even any therapists that work with trans people within 2 hours of me. At least, not that I know of, and that makes my mother rather sad as she is wanting to find a trans-friendly therapist for me.
@Kendra The only family I really associate with or care about is my mother and my siblings. All of which are aware that I am transgender and are actually working on finding help for me. That is partially why I was asking if I should tell my doctor. As of currently, there aren't many doctors in my area, but she definitely isn't the only doctor out there. If this helps any, she is located near a major college campus that has transgender students enrolled and students from all over the country and even abroad. So maybe me telling her I'm transgender won't be too much of a shock?
Quote from: Gertrude on July 22, 2017, 03:08:06 PM
I didn't realize that Colorado was so conservative as a state. Colorado Springs yes, as one goes north, it changes.
It's not but there is one medicaid clinic in Denver that is. All of the other medicaid clinics offer transgender services, but this one is associated with a particular religion. I was just unfortunate enough to be going there when I started to transition. So I just walked down the street and went to an informed consent Planned Parenthood clinic. Since then I've switched to Denver Health and they are great. I have no complaints.
It starts getting conservative when you go north too. Or east. Or west.
Except Boulder of course.
Vincent - in that case, if I was in your situation I would definitely tell my doctor.
If your local college has transgender students it's possible a student organization there might know more. Every college I went to had a student union building or center, paper bulletin boards with meeting notices. If you inquire, they might not ask if you're a student there - for this sort of extracurricular meeting you might be able to just show up. Just an idea.
You should most definitely tell your doctors that you are trans, and make sure they all work together as well!
When I first started taking T nearly 10 months ago, I knew that it would make my body create more red blood cells, which would raise my already high blood pressure, for which I take meds for. I was ready for it, so when I started having headaches, dizzy spells and palpitations, I made an appointment with my PCP, to who I had come out as trans to a few months prior. She gave me an EKG, and it showed cardiac changes. [emoji44]
She immediately called my pharmacy and issued a higher dose of one of my blood pressure medications and had her nurse walk me across the hall to a cardiac clinic (which I hadn't even noticed was there before.)
They made appointments for stress tests, heart echo and whatnot on the spot. I also made sure that my new cardiac doctor knew I was trans. I'm his first trans patient. My PCP has at least three trans patients, but I'm her first FtM.
After being checked out completely, I was medically cleared. My higher dose meds are now working beautifully, and my blood pressure and heart are back to being background issues. Let me tell you, this past April and May were the scariest months I've had in a long time!
My endo, PCP and new cardiac doctors all co-ordinate my blood tests (I ask what tests they need me to have done), and I keep them all in the loop whenever I see them.
Sure this was an extreme case, but it hopefully shows you what could happen if your doctors are unaware of your transgender status.
Good luck!
Ryuichi
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hi
well im in the uk so we have diiferent rules that cover the whole country,they cant denigh u medical treatment. as far as telling,well it depends on ur doctor really.some just arnt interested and some are great. mine is great.he talks straight,understands the problems,wont let me rush into anything and answeres my questions no matter how silly or crude or embarasing.actually we got to the point embarrassment has dissapeared. like he said hes there to give medical and mental help,to him its no problem.
I'm struggling with this question myself right now. My primary care physician is ten minutes from home, but my therapist and endo are in a clinic that specializes in trans care and are 1:20 away. I just had my first blood tests from the endo, and a lot of them duplicated the tests done by my local doctor. I'd love to get them coordinated, but I'm in the middle of a very conservative area, and am not confident of a positive outcome if I tell my local clinic I'm trans. My endo would be happy to take over my primary care, but I really don't want to drive that far (and pay all the tolls) for some sniffles.
Complicating matters is the local clinic has one or two MDs, with nurse practitioners working under them. That's not a problem generally - my absolute favorite caregivers in the past have been NPs. The problem here is I never know which one I'll be seeing. I want to develop a one-on-one relationship with my doctor. I'm usually surprised by who walks in during my appointments.
I was worried enough about it all that I started looking around for younger women doctors, thinking, as noted above, that they may be more accepting. I went to two offices and asked if I could get just five minutes for a private meet and greet with the doctor to see if they would be ok with it. In the first, the receptionist said sure, we'll set up an appointment on the computer, have a seat. She then wandered around the office, yakking with coworkers, getting coffee, etc. After 20 minutes I walked out. The place was kind of shabby, so I wasn't excited about it anyway.
The next office seemed neat and clean, and the receptionist was friendly, but would not set up any kind of appointment unless I initiated a records transfer from my current doctor. I wasn't going to do that until I knew this new doctor was willing to take me on. So I walked out of there, too.
Note that none of these people knew why I wanted to talk with the doctor, and I was presenting as my male self, so at that point trans issues didn't enter into it. I guess the docs around here just aren't hungry enough.
My labs follow up with my primary doc is next Monday. I'm leaning toward telling whoever I end up seeing, and letting the chips fall where they may. The further I go into transition, the more courage I've been able to muster, and it's my health that's at stake. Of course, I can talk big now, but I may turn to jelly when the time comes.
Any advice is appreciated...
Stephanie
Quote from: Steph2.0 on August 22, 2017, 09:25:55 AMI'm leaning toward telling whoever I end up seeing, and letting the chips fall where they may.
That sounds like a good plan, Steph. Chances are they'll be fine, in which case you avoid the hassle of looking for a new doctor. If they aren't, well, then you'll know.
I told my family doctor a few months prior to living full time. I was nervous as heck thinking she'd maybe not want to be my family doctor. When I told her, and that I was hesitant, she said that was silly.
Then in early 2015, six months after my GCS, I asked for a physical. When she saw Dr. Brassard work, first thing she said was: Incredible!
She was blown away how good my vag looked.
She says I'm still her only trans patient who's had surgery.
Quote from: NJOttawa on August 22, 2017, 10:54:53 AM
I told my family doctor a few months prior to living full time. I was nervous as heck thinking she'd maybe not want to be my family doctor. When I told her, and that I was hesitant, she said that was silly.
Being originally from a border state, I love just about everything about Canada except the weather. There are always exceptions, but generally speaking they're just a much kinder people. I'm not surprised your doctor was completely professional.
Now that I live in Conservative Central, I tend to worry. Maybe too much. We'll see.
Steph
Quote from: Steph2.0 on August 22, 2017, 01:12:48 PM
Being originally from a border state, I love just about everything about Canada except the weather. There are always exceptions, but generally speaking they're just a much kinder people. I'm not surprised your doctor was completely professional.
Now that I live in Conservative Central, I tend to worry. Maybe too much. We'll see.
Steph
While Canada is far from perfect, I'm fortunate to live where there are less obstacles for trans folks. Surgeries are covered by most provinces, transgender folks have no fear being ejected from the military, little in the way of hate crimes that have been reported.
Lol about the cold. Anything above 70F, I'm cranky and irritable. Ask my hubby
Quote from: NJOttawa on August 22, 2017, 02:55:53 PM
Lol about the cold. Anything above 70F, I'm cranky and irritable. Ask my hubby
Almost the opposite here. Ask my wife!
Where I grew up we learned a little Canadian history. I particularly appreciated the way the country was named, by drawing three Scrabble tiles out of a bag.
"C, ay!"
"N, ay!"
"D, ay!"
Alternate facts from your Southern neighbors. [emoji16]
Steph
I am going to switch doctors as the one I went to is conservative. I looked up lgbt in my insurance site and found a practice that treats lgbt as a specialty. It's 15 miles versus 2.5, but I will live with that.
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I think you should, as they should know about anything that can affect your health. But then, I'm not a doctor and I don't play one on TV. ;)
I can't imagine not telling my hairdresser I am transgender and I mentioned this fact within the first few minutes of meeting her. She was super accepting, we have become good friends since then - but if she had seemed too uncomfortable or insisted on the wrong gender of hair cut I would have bailed on the spot. It's my hair. I am sure you already know where I am going with this.
A qualified health care professional needs to know in order to give you the best care. If they can't handle the fact you are transgender they are in the wrong field. If someone has a chip on their shoulder I wouldn't trust them to treat a common cold. I expect in future generations, any health care professional that gives a patient a hard time for being transgender should lose their medical certification.
I'm going through this debate right now as well, but seemingly a bit earlier on in the process (that I might be/probably am trans, but not ready to declare outright and really set wheels in motion). I'm currently trying to figure out something therapy related to really get started, but the situation here is just awful. (Coastal Georgia, which is super unpredictable on this sort of thing because you have a crazy mix of cliche deep south and a California beach town vibe going on simultaneously.) So In another thread inquiring into the therapy issue, Gertrude gave me a link to the GLMA provider search--and lo and behold there was exactly one name that came up for my area: my current GP who I was hours away from an appointment with (to get some generic propecia, so actually playing into this very thing :x). Sounds like a good thing, get the GP in on the ground floor and use him as a way to get recommendations for therapists that might be known locally but going under the radar or whatever. So a good sign, but unfortunately, despite the GLMA search result declaring him LGBT friendly it's still not that simple (is it ever?) for a few personal reasons I won't go into here for brevity, but mostly because I am not 100% sure I trust this clinic from a pure quality perspective (also unfortunately my only option in town, trans issues or otherwise). So leading up to the appointment I began a fierce debate on bringing it up with my GP that shot my anxiety so high when they took my blood pressure it raised some serious concern until they retook it after I calmed down a little. After the nurse left, the debate continued and I think I might have very well have been on the verge of going with just saying something... annnnnnd he walks in with a probably 24 year old medical student that looks like he is the villain in a movie about wall street corruption(that sort of overly attractive, a little bit *too* clean look). So there went that course of action. (Of course he asked if it was okay the med student sat in, but I am one of the least assertive people out there and offered a completely false overenthusiastic "sure, no problem!")
This has been a ton of fun so far.
Quote from: Kendra on August 24, 2017, 12:58:14 PM
A qualified health care professional needs to know in order to give you the best care. If they can't handle the fact you are transgender they are in the wrong field. If someone has a chip on their shoulder I wouldn't trust them to treat a common cold. I expect in future generations, any health care professional that gives a patient a hard time for being transgender should lose their medical certification.
Yup, what you said! That's as it should be, but considering where I am, smack in the middle of Redneck Central, I'll be planning for the worst and hoping for the best. All of my interactions with people so far have been in safe spaces or known-LGBT-friendly areas, and with people I know I can trust. Despite my earlier jitters, I was fairly confident in a positive, or at least neutral outcome.
I've already decided that I'll be telling the doc, but this will be the first time where I really have no idea how it's going to turn out. And it's not just the doc that needs to be completely professional. There's a whole office of nurses, assistants, accountants, etc. who need to understand what HIPAA means. (For those outside the US, that's the act that ensures the privacy of health information, among other things.)
I was originally nervous about it, but I'm ever so slowly growing a thicker skin. I'm to the point now where I'll be demanding professionalism. If you see a mushroom cloud over central Florida on Monday morning, you'll know we had a problem.
Details Monday afternoon!
Steph
Quote from: Steph2.0 on August 24, 2017, 01:51:12 PM
considering where I am, smack in the middle of Redneck Central, I'll be planning for the worst and hoping for the best.
I've already decided that I'll be telling the doc, but this will be the first time where I really have no idea how it's going to turn out. And it's not just the doc that needs to be completely professional. There's a whole office of nurses, assistants, accountants, etc. who need to understand what HIPAA means.
Details Monday afternoon!
As promised, here's my report:
The world really is changing. The doc had absolutely no issues with it. I deliberately used terms like dysphoria and HRT, and he knew exactly what I was talking about. He made smart observations and asked intelligent questions. He knew the kind of prejudice we can be subject to, and assured me I'd get none of that from him. He even asked me for my recommendation for specialists so he could have them on file if other patients asked where to go for help. He made the suggestion before I did that we just keep it between ourselves for now and not put it - or the prescriptions for E, Spiro, and Finasteride - in the clinic records. And he offered to coordinate with my endo on blood tests so we don't double up.
My therapist keeps telling me that on the "Bad Outcome" scale of 1 to 10, take the level you're expecting and dial it back by 4. I'm still waiting for the first really bad reaction. I know it's coming some time. There's no avoiding it, but hopefully the good will outweigh the bad. So far so good.
Steph
Stephanie that's excellent news!