Weird experience in urgent care today

[aleon515]

This pretty much never has happened as they usually are low grade for awhile but woke up with a really bad UTI this morning. So I did some chores and then went over to urgent care.

Mostly so they wouldn't call me by my given name I filled all the stuff out told them I wanted to be called Jay and I have gotten pretty comfortable saying I am trans. So that part wasn't weird. Sat in the waiting room and got called Jay and no one looked up or anything. So finally I get called in and this woman bops in and says "Have you had your surgeries yet?" And I was just floored. So I asked the doctor why they would ask this and she went on something or other about how since this involved the genital region (yeah but NOT genitals) and later I was wondering how exactly this would be treated differently in a post-surgical ftm?! I mean they didn't even push on my belly and I got put in a ENT type room. So weird. 

Kind of an unpleasant feeling that this was done for idle curiosity or something.


--Jay

[Adam (birkin)]

They may have been concerned that it was a post-surgical complication. Catheters can cause UTIs, and they're often a different bacterial strain than one that you'd get, say, from day-to-day causes. For a lot of reasons. If it was possibly a post-surgical complication that would affect which antibiotic they chose as a first line of treatment.

[Ayden]

Males and females have different groin regions. They could have been worried about post op complications. I wouldn't worry too much. Biology will always play a role in medical care.

[aleon515]

Thanks guys, I hadn't thought about those things, and don't know if they did either actually.  Made me feel better about it. Made me wonder if they needed one of those Trans 101 that the trans center does.
I tend to like to assume the best, so maybe they were just kind of awkward about how they asked this.
As I said they weren't disrespectful or anything and were excellent on the name thing.

--Jay

[Elspeth]

Thanks guys, I hadn't thought about those things, and don't know if they did either actually.  Made me feel better about it. Made me wonder if they needed one of those Trans 101 that the trans center does.
I tend to like to assume the best, so maybe they were just kind of awkward about how they asked this.
As I said they weren't disrespectful or anything and were excellent on the name thing.

It's rare that health care workers have much time for idle curiosity. Best to assume they are asking for a particular reason like one of those already mentioned, and, if you are concerned (which is a good thing) to ask them about why they are asking a particular question, starting from the assumption that they have a medically relevant reason, and that you just want to know what that reason is in order to understand how their question is relevant, and to be sure you are giving them any details or information in sufficient depth to be sure the practical medical concerns are being addressed properly and with all the relevant history and physical questions answered that might be relevant.

Even if you suspect something else may be going on, even if you have non-verbal cues that it is happening, bringing the focus back to medical and diagnostic relevance gives them the opportunity to re-evaluate their own practices so maybe they will handle things with more sensitivity the next time around. 

It would probably be a good practice for HCWs to do more of this explaining, but often they do tend to cut to the chase and not offer much detail about why they are probing in a particular direction unless the patient asks "why are you asking that? How is that relevant?" Assume unless proven otherwise that they are just trying to save time, and never feel pressured not to ask about why something is being asked, especially if it seems odd.  Curiosity could save your life some day.

[aleon515]

Yeah I realize health care workers don't have time for idle curiosity but the way this was done was so clumsy-- literally bopping in and saying "have you had all the surgeries yet". (Seems like they didn't know too much given I am someone who is not passing at all-- wouldn't that come first?) Maybe the only trans person they know they saw in awhile. Anyway I was literally speechless, that doesn't happen much.

I think if it had come from the doctor and had been in the context of an exam it wouldn't have been so clumsy.


--Jay

[spacerace]

If you want to avoid this in the future, only disclose to the doctor, while you are in the examination room.

The correct name being important aside, if you want to avoid weirdness - just don't tell anyone. look forward to the day it is legally changed. It is your business, random urgent care admin staff  that have you fill out paperwork don't actually need to know about your body - that's for the doctor and the nurses.

When you tell everyone that you're trans on first interaction, it can get awkward quickly.  We get really wrapped up in trans stuff because it dominates our lives, but most people have no idea about what it is means to transgender, and when you throw that out there first thing, it will define the way they interact with you and you get scenarios like what happened with your visit.

Now, if you want to put yourself out there and educate as you move through life - that is different, and I applaud you. But you can't expect people to get it and handle it correctly right away.  Even medical staff - especially primary care doctors in an urgent care center that may have never worked with a trans person at all, so when you make a big deal out of being trans right away, so will they.

[Rena-san]

I got a funny hospital experience that shows the blatant ignorance of most people to trans issues, even those who hold medical certificates, degrees, whatever.

So I went to get my blood drawn for my endo. I had to use the male name because I had just gotten it changed and the insurance didn't update it yet. Anyway, the lady comes out, calls the male name, I stand up, she looks at me funny and I have to explain it to her. I go back there and tell them I have a tendency to black out. So she calls an assistant. They open with, "We've never had someone like you before, do we mind if we ask a couple questions?" I'm like no problem, go ahead.

(Here I would interject that my weak point, the thing that causes me the most sadness, is that I will never be a fertile female with a cycle and the ability to menstruate.)

First question out of their mouths, mind you they must have some medical background, "So will you ever be able to have periods like us?"

Yeah...

[aleon515]

If you want to avoid this in the future, only disclose to the doctor, while you are in the examination room.

The correct name being important aside, if you want to avoid weirdness - just don't tell anyone. look forward to the day it is legally changed. It is your business, random urgent care admin staff  that have you fill out paperwork don't actually need to know about your body - that's for the doctor and the nurses.

When you tell everyone that you're trans on first interaction, it can get awkward quickly.  We get really wrapped up in trans stuff because it dominates our lives, but most people have no idea about what it is means to transgender, and when you throw that out there first thing, it will define the way they interact with you and you get scenarios like what happened with your visit.

Now, if you want to put yourself out there and educate as you move through life - that is different, and I applaud you. But you can't expect people to get it and handle it correctly right away.  Even medical staff - especially primary care doctors in an urgent care center that may have never worked with a trans person at all, so when you make a big deal out of being trans right away, so will they.

Well there is a problem with doctor's office in that my medical records might have to stay F. The reason is my age and I don't know that I want to get a hysto, given that. So if I have the parts, it is going to be very hard to take care of them with the F not there.
If you don't say why, they don't think it's that important. I have been there before and that was exactly the case.

I'm afraid I am going to get this kind of thing a lot. I don't plan to be stealth and I do plan to be open. I may complain about it, and thought it was weird and still do, but I am actually a bit proud of myself in a certain way. I want to be an advocate and I think it has to start with me. Now I wish I had handled it all better. But it just surprised the heck out of me.

(BTW, the person who asked me WAS a medical personnel. I believe a nurse.)

I don't think it quite matches "hippolover". Yikes.


--Jay

[Elspeth]

I got a funny hospital experience that shows the blatant ignorance of most people to trans issues, even those who hold medical certificates, degrees, whatever....

...First question out of their mouths, mind you they must have some medical background, "So will you ever be able to have periods like us?"

It is so important to remember that most HCWs are hugely ignorant, not just about trans issues but about any condition that is uncommon. It's part if the logic behind sub-specialization, that no one is able to become expert at every possible condition and often their ignorance outside their basic areas of competence can be profound. 

(Close example: My ex is a leader in her sub-specialty.  She is hugely ignorant on many trans issues, even though she married one, and has an FTM son.  It's still not an area that she has invested the time to become informed on in many, many respects... she knows the basic medical aspects, is not as ignorant as those in your example, but still, in conversations I can usually count on her to come up with one or two glaringly wrong assumptions that are based on her own prejudices and inferences rather than any kind of research or experience).

I allowed an off-hand comment from a psych nurse to affect me for far too long.  When Celexa pushed me into mania I was admitted to a psych ward for about a week on a locked ward, and another week or two in an open ward. The main duty nurse on the locked ward took it upon herself to lecture me about the bad outcomes she'd seen for transwomen, presumably because she imagined (she had been informed of my transness during admission to some degree) -- but I really don't know what she imagined or knew -- since I was already aware of the risks. And over time I realized that her experience had to be hugely skewed, since she would only have seen those who wound up in her ward for some reason. I was there because of a prescription drug that should never have been given to me in the first place, I haven't had another manic episode since then, either while on or off the meds meant to stabilize my moods.

I suppose it's really just my problem that I allow off-hand remarks to sometimes hang out in my head for far longer than they should... it's not that I ever accepted what she said at face value, but I've spent far too much time trying to reinterpret and qualify what for her was probably an off-hand remark that, for all I know, she may have regretted saying right after she said it?

My point is, it's unwise to imagine that, even when their remarks are not blatantly stupid, that HCWs statements should not be treated with every bit as much skepticism as the remarks of some unqualified relative or those of some stranger you meet on the street.  It's not imprudent to question nearly everything.