Susan's Place Transgender Resources

I'm going to be doing some cultural competency training for my work about how to talk to trans* individuals. What will make things complex is we do hiv & std testing as well as sex counseling. While I feel very good about my knowledge of word choice and how things should be asked, I wanted to get everyones opinion on how you would want someone to ask you questions about your sex habits without being offensive.

Personally I'm someone who goes very clinical when talking about myself because it helps me to stay detached. I do understand that is not the way for everyone though. This is an extremely uncomfortable topic that can be triggering for a lot of us.

Lastly assume since you would be getting tested, that you are sexually active.

I could give my opinion if I knew what answers were needed.

I don't know it seems to me what's the difference either way your asking someone to be on the bottom the question is illogical if being on the bottom your going to get std so your saying that it's all right for at least someone to be on the bottom.

I am not sure I would want anyone asking me anything about my sex habits; If I have a question that is one thing, but I am not sure there is any wording that could make me comfortable with other people asking me questions about what I do in the bedroom.

Why does a place that does testing need to know anything about the state of my genitals or the sex I am having? If I need information, isn't that what those pamphlets are for, so that I can get information without being probed for it?

I really hope that your first recommendation is to stop not using condoms.

Also they shouldn't be telling people what position they should be in while having sex whether trans or not. 

Quote from: Alexis Paige on March 08, 2014, 01:57:22 AM
They need to know about the state of your genitals, what sort of sex you are having, and what you are doing to protect yourself from std's and HIV.

The questions are more problematic for trans* men than women, but the advice they give can be bad. They do a lot of work with gay and bi men, so they don't all get that some of that advice is not going to work.

An example would be, if a gay man doesn't use condoms they advise him to be the top even if he says he is normally the receptive partner. I fully intend to tell them to not ask a trans* woman to become the penetrative partner if she says she isn't, no matter what her condom use is. I know for me that due to my personal feelings about my genitals and the way things will probably go after awhile on hrt, that would not be a possibility and I would be offended to be asked to do that by a sex counselor.

Honestly, I feel very comfortable with explaining any issues that are there and why for trans* women. It is more for trans* men that I'm worried about. I just figured that I would ask here as well as in the ftm section in case anyone wanted to give their opinion.

I don't mean to sound like I'm asking an unreasonable question but who are the they you refer to in the beginning of your post.

and as another curious question why would you suggest that the person not wearing a condom be on top. To be honest I find your questions highly problematic. I think given the nature of these questions I think it would be only fair to all concerned to name the group your asking these questions for. and also you've suggested by you question this is a clinical setting , but your post in the ftm section suggest it 's for some corporation out side of a medical setting. sorry for my questions . I'm probably way too skeptical sorry if I come across this way. I really don't want to stand in the way of someone trying to help.

Quote from: stephaniec on March 08, 2014, 12:34:01 PM
and as another curious question why would you suggest that the person not wearing a condom be on top. To be honest I find your questions highly problematic.

Because the risk of transmission of some STD/STI like HIV are lower for the "top" than they are for the "bottom". Which is pretty much the equivalent of saying that it is safer to drive drunk at 60 MPH than it is to drive drunk at 100 MPH. Both are incredibly dangerous, but one slightly less so.

Quote from: allisonsteph on March 08, 2014, 02:00:14 PM
Because the risk of transmission of some STD/STI like HIV are lower for the "top" than they are for the "bottom". Which is pretty much the equivalent of saying that it is safer to drive drunk at 60 MPH than it is to drive drunk at 100 MPH. Both are incredibly dangerous, but one slightly less so.

so the problem is like being half pregnant

appreciate the answer

Quote from: Alexis Paige on March 07, 2014, 08:43:11 PM
I'm going to be doing some cultural competency training for my work about how to talk to trans* individuals. What will make things complex is we do hiv & std testing as well as sex counseling. While I feel very good about my knowledge of word choice and how things should be asked, I wanted to get everyones opinion on how you would want someone to ask you questions about your sex habits without being offensive.

Personally I'm someone who goes very clinical when talking about myself because it helps me to stay detached. I do understand that is not the way for everyone though. This is an extremely uncomfortable topic that can be triggering for a lot of us.

Lastly assume since you would be getting tested, that you are sexually active.

What exactly is the purpose of gathering this information?

Is it attempt to gather statistical information? Is it an attempt to get a snapshot of a subset of the community?

How the data being gathered is going to be used has a direct impact on how it should be asked/collected.

That being said I have been tested at both a Gender clinic and an HIV/AIDS clinic. Both gathered their information in a similar manner. They asked how I identified and who I had sex with, and gave several (20 or so) different gender options including no gender. Not one of the questions asked how I have sex. I wouldn't mind giving that information in certain circumstances but it's doubtful that someone could create an intake form that is all encompassing enough.

     

I still have a concern about telling someone it's safer to be on top , so basically one lives the other dies for the sake of statistical gain.

@Alexis Paige:
Thank you for the clarification, so long as the questions are not required for testing my mind is at ease. All I know that in such circumstances there is no way I would divulge that sort of information. I value my privacy and learning facts about safe sex isn't difficult to do in the privacy of my own home and my own computer.

so is this similar to the Howard Brown clinic in chicago

As a Paramedic the topping idea is not good advice at all. No matter who is where the love must be gloved or transmission is almost guaranteed. If I have a viral free patient no matter how I inject them with a dirty needle guess what, not a good outcome for the patient. Sorry if this offends, but I have 28 years on the job and have dealt with a lot of people who tried so called "good advice" and became infected. The only good advice to give is protection for both or face the consequences of the decision not to use it. :)

Quote from: Alexis Paige on March 08, 2014, 03:59:24 PM
It is the organizations belief that judging people for their life choices that they don't want to change will just make them stop being tested and lead to more people who are spreading disease and not being treated until it is to late.

I am so sorry if you thought for a moment I was judging anyone. I would never do that at all. I was just trying to say there is NO safe way to have unprotected sex. To tell people or suggest that there is an alternative besides condoms is plain wrong and medical malpractice. This is not judgment this is medical fact. I have gotten to know too many people through my career that were told there are safer ways to have unprotected sex and eventually I had to watch them die all the while listening to them say "We were told so and so way was safe". Sometimes tough love is called for to save lives. To give topping information out is a great way to expose yourself to a lawsuit, plain and simple. There is a difference between collecting statistical data and giving dubious information. I would have no problem with giving data for statistics in a clinical setting to answer your original post question. This is because I know the data will be used for trends and future prevention protocols, just vet the advice before giving it out. :)

I don't know it seems some what unethical to disregard the safety of the bottom person for the statistical  advantage  of the top person . It doesn't sound like making too much common sense. Especially your talking about either party may or my not have std/HIV

Quote from: Alexis Paige on March 08, 2014, 06:21:45 PM
If, as a different example, someone is in an open relationship and sleeping with several people a month and says they don't like condoms so they rarely use them, maybe they will compromise and use them with the random hook ups they have outside of the relationship.

Really? Not likely in the least. This is just something we will have to agree to disagree on. They will never compromise and continue to spread STDs and HIV no matter if they are positive on viral load or not. Testing is great for statistical purposes and to track spread/transmission, nothing more. In the end it comes down to more Federal dollars and grants for "research" and does nothing to stop the issue. I have no issue with you as a person and am glad you are passionate in your work. Good luck in the future. :)

well, I wish you well too, anything that helps stop the epidemic is good . From the news reports another generation is headed for disaster so what ever helps is good.

I may be wrong,  but it seems to me that this clinical organization is trying to base its help on the trans people's actual sexual activity, rather than what some one assumes their sexual practices are.   If this is the case, as a trans woman, I would not be adverse to answering these questions, if my name was not attached to my answers.    I know form my social science major back in the 1960s that when makes up a questionnaire on a particular population of individuals it was best to gather information from this population to develop a questionnaire that was relevant to that population.

  Are organizations which are concerned about healthcare for the trans community going to base this healthcare upon uniformed assumptions, or are they going to gather this information from individuals within the trans community and base this healthcare on our actual problems.   

Think about one of the major misassumptions of the cis gendered people about trans people is that they changed their gender from sexual identity to another.   When the fact is that,  from my own experience, is that I was born a female, but I was labelled as a male because of the sexual characteristics of my body, and thus I was raised and socialized as a male.   Therefore, my transitioning is actually me stripping myself of this false male gender identity and my male socialization,  then living and developing my life as my female self and discovering who I am as a female, and as a female, how what my personal interactions with others are going to be.    When I walk into a clothing store and look at the wide variety of women's apparel,  what are my styles?  What are my likes and dislikes in textures of cloth, colors, fashions,  sensuality, that I like and that works for my physical features.   Then look at all of that makeup, what's me, and what do I like?   

Then now I am a woman, how am I going to be accepted, and how will I respond to people treating me as a woman.      Then there are my sexual relationships,  what will I experience when I am being treated as a woman, as apposed when people assumed I was a male.   I know on Facebook and the AARP social website, that when I posted my picture, as you see it here,  there were men who, immediately came on to me as a woman.     It's like they thought that,  here's a woman that I can spin into my masculine orbit with charm and overly evolved male ego.     Some of this may have been sexual, and some of it,  just men gathering their admiring harem to stroke their male ego, and admire their education. 

Now, I personally stated in both cases, that I was transgender, and most of my resentment came from my emotional response of,  "Who do they think, I am?   They don't even know me!!!!!  How can they make the assumptions that I would even want to get to know them, let alone become their admiring bitch.  Just because a man has a penis, that doesn't mean, that automatically, want to have anything to do with it!!"   Before I want to be considered as a part of a man's hero circle, I want to get to know him, and him me.

Well this goes to healthcare professionals, also.    I want them to know about how I live my life as a trans woman, before they make decisions about my needs as a trans woman.   I deliberately used the word,  "trans" because I am somewhere in the spectrum of transgender and trans sexual.   

So, while it is understandable, that, it may be uncomfortable for me and many other trans individuals to answer personal questions about our sexual practices and lives,   I don't what them just to assume that I am a gay male cross dresser, which I am not.   I am a woman.   Nothing wrong with anyone being a cross dresser or the being a gay male cross dresser,  or a bi sexual male crossdresser.    And as far as my sexual practices, I don't know if I am a lesbian or bisexual, never having any sexual interactions with males.   I can have imaginary sexual interactions with males and feel that I am ok with it.   However, in my actual everyday life,  I have never been near any male that I am sexually attracted to.   

When I am in a relationship, I am intensely loyal to it, even when over time I do not know what that relationship really is.   I am currently in a twelve year relationship.    I am also extremely private about my personal sexual practices.   I have never bragged or made up stories about any kind of personal sexual conquests.   I have always been uncomfortable about this, even when others are spewing theirs to all within ear shot.

However,  if healthcare professionals are going to make assumptions about my lifestyle I want them to be based upon the facts.   I used to donate plasma.   I have never had a sexual relationship with another person of my legally assigned gender.   Just because I wore finger nail polish one of the people working at the plasma center became uncomfortable about me and pressed me,  when I finally told her,  I was a trans woman, my days of giving plasma were over even though I had been donating for months, and they had tested my blood for HIV a multitude of times and found nothing.

I don't think that I was rejected for having sex with my cis female partner who was also giving plasma at the same time that I was.   I would have understood that my rejection because I was in a lesbian relationship with her.   However, my driver's licence still listed me as male.     

They judged me on prejudged and not on fact.   I know that it is illegal for individuals who had had same sex sexual relationships to sell or donate blood products.   But legally in Florida, I had not.

I guess each one of us will probably decide for ourselves when healthcare individuals get too personal about our sexual lives and just tell them to mind their own businesses.

This is kind of a conundrum,  tell them to mind their own business, and them have them base our healthcare on ignorance,  or tell them about our personal lives and over time they will base our healthcare on the healthcare realities of all trans individuals of whatever orientations.

Sooner or later, I feel, that the Affordable Care Act will be changed to insist that all health care polices have to provide for trans peoples healthcare needs including surgery if desired.   I would hope that this healthcare will be based upon our real needs and not ignorance.