Susan's Place Transgender Resources

Howdy peeps.  I'd like to describe a recent experience with a new doctor and get some opinions on whether his behavior was weird or I'm just being paranoid.

I'm FTM, had chest surgery almost 10 years ago, and been on T since 2001.  Very passable.  I have no medical problems.  I have had no lower surgery.  I just moved to a new state that's not exactly known for its liberalism and needed to secure a new prescription pronto.  The move wiped be out financially (luckily I moved to start a job that will pay okay).  In the past I've had excellent doctors who were experienced with transfolks, but now I just needed to find a scrip as quickly and cheaply as possible. 

I ended up making two calls related to scheduling an appointment, speaking first with the receptionist and then with the nurse.  One said the visits costs "$65 and up" and the other "$60-150."  I said I wanted to avoid labwork and each woman told me I'd have to talk to the doctor. 

When I went to my appointment, the friendly receptionist wanted to talk ->-bleeped-<- but I didn't go out of my way to indulge her.  She asked me if I'd had lower surgery (well, she did this weird whisper thing and waved her hand over her abdomen with her eyebrows raised) and I asked if she was trying to ask if I was legally male.  I believe I'd checked male on the form I'd already handed her.  I explained that surgical status was not the same as legal status, and this truly might have been the first time she'd heard that.  (I've been legally male for years.)

When the nurse took me to the exam room, everything was normal until she casually asked why I'd had a mastectomy.  "Did they find a lump?"  I explained that no, I'm a transsexual and the surgery was part of transition.  For a moment she froze, as though stunned, then asked if I'd had lower surgery.  I think she said "full surgery" while waving her hand over her abdomen.

The doctor was a little old man who asked a few questions (he seemed surprised that I self-inject T) before asking me to take off my shirt, adding "if you feel comfortable."  My shirt was tucked in and I assumed he just want to listen to my lungs.  I was dressed for work and removed my dress shirt, sitting in my t-shirt and slacks.  Maybe he'd wanted me to remove the t-shirt, too - which would have been fine, but a doctor has never asked me to do that.  He took my blood pressure and told me to lay back.  He lifted up my shirt and listened to my lungs or heart or whatever doctors do.

Then he started pressing his hands into my chest.  Over my scars (thanks Dr. Brownstein!), and I think with his hands over my nipples (I wasn't looking and my chest is still a bit numb and the whole thing happened pretty quickly.  I was also focused on making the doctor understand that there was no cause for expensive tests).  The doctor seemed fascinated.  It was quick but uncomfortable, and then he moved his hands to my abdomen and pressed (doctors have definitely done that to me).  He didn't seem as fascinated by that part.

Then the exam was over and he told me that he didn't think I needed labwork if my last test was around Halloween and everything was fine (it was, though he never asked to actually see the labwork).  He wrote me a prescription with three refills (which will last almost a year and a half) and told me to come for labwork in about six months.  He shook my hand and added that I can come to him for any medical concerns (I had assumed this was an option.  He's a doctor).

I made an appointment with the receptionist for September.  She called the doctor (I assume) to ask what to charge, and it only came to $45.  No one mentioned why the charge was lower than I'd been quoted.  I wasn't going to complain about it. 

After leaving, I thought about the chest exam (or whatever that was).  No doctor has ever done that before, or asked to.  My scars are thick, so if he wanted confirmation that I'm a ->-bleeped-<-, he achieved that visually when he applied his stethoscope.  Was he checking for breast cancer?  Is that a normal part of a guy's physical that I have somehow never experienced?  He didn't test my reflexes or look at my eyes or throat.  I don't want to be the paranoid ->-bleeped-<-, but I suspect that the only reason the doctor put his hands on my chest was to satisfy his curiosity about an FTM post-op chest.

What do you think?  Am I being overly suspicious?  Was this totally normal?

I'm not sure, maybe he assumed they left some breast tissue behind during top surgery (since he's ignorant on that front it seems) and was trying to do an exam?  I'm not sure if they do those for cis men, but I know that cis men can get breast cancer so I would assume they check. 

You don't mention the state, but on the off chance you moved to Alabama, you can message me and I can help you find doctors here that won't cause a problem.

Testosterone is contraindicated for males who have breast cancer, so maybe that had something to do with it. He could have assumed you were at higher risk.

I had a physicians assistant who used to perform the yearly lower checkup when I still had the parts.  Part-and-parcel of that was having a breast exam, which she did when I still had the things, and again after they were removed (I forgot to mention that I'd had top surgery, so she got a surprise, LOL).  She then went ahead with the exam after asking me if it was OK, saying that it wasn't likely that I had 'breast' cancer, but that it can still happen in men, so might as well check since I was already there.  Nothing awkward or 'too curious' about it, though she did comment that the surgeon did a very complete job of removal.

And now I'm trying to remember the last physical that I had...  That was with a male doctor who did not know me, after I was entirely passable... and I do not believe he did a 'breast' or 'chest' exam.  He did do the turn-your-head-and-cough groin exam, though.

I'm gonna guess that what he did was just a checkup for cancer.

We were taught in school (nursing) that men should do self chest/breast exams monthly as well.  I don't think the public is taught that though and I'm 100% many (most) HCPs don't do them for men.  It's still possible for men to get breast cancer, so it's a good thing that he checked just in case.  However, it's kind of odd how he went about it.  I mean, it makes a little sense knowing that he probably hasn't examined a trans guy's chest before and was curious.  But still, the whole fascination bit would disturb me a little.

What really bothers me (which may or may not bother you) is the receptionist asking if you've had lower surgery.  It's not her business, she's not a health care provider.  The nurse and the doctor should ask as part of the routine, "have you had any previous surgeries?" but not the office assistant.  At least the visit didn't cost as much and you don't have to do blood work for a while.  :)

Thanks folks.  Follow up questions:

- Assuming this was a cancer check, do you think it was appropriate regarding what I came in for?  He didn't check my reflexes, my throat, or my eyes - and doctors have done those things to me quite frequently.  He also concluded the appointment right after the more thorough chest check, then the relatively quicker abdomen check, and told me he'd write me a scrip.  I'm not fishing for an answer, but because I've never had this experience before (including with rather thorough doctors who have insisted on labwork and have asked appropriate gyno-type questions), and because his face was closer and his hands slower when he was touching my chest than when he was touching my abs, I want to know if a breast exam was normal for what I came in for, or if it was just an excuse to satisfy trans curiosity.  I haven't had a hysto but the doctor didn't ask about maintenance for all that junk. 
- MTFs, do you remember any such experiences prior to transition?
- If you were me, would you try another doctor?

I used to look like a boy and I went to the doctor for many years looking like that and I have never had a chest exam like that. Check the lungs under the shirt front and back, done.

breast reduction can cause problems with cysts and blocked ducts etc so maybe he was just very thorough and checking for these as it's highly likely he has women with post-op breast problems.

no GP ever checked any of my  male bits but I did have a boob xray.