Susan's Place Transgender Resources

I posted a similar thread last year, my dates are now confirmed.

I have been asked by an Occupational Medicine conference as a plenary speaker to explain the problems trans*gender people have in the workplace.

In particular how should company medics treat us, what they should be aware off and how do they respond to us properly.

I have to admit I was dismissive. You treat me like you treat any woman. A Transman is treated like any other man. What's the question? Are you dumb?

They came back with 'Well we thought most transwomen worked in the sex trade'. " We have just realised they don't"

Oh yes guys I'm a Prof of Medicine, ye I could call it the sex trade :laugh:

What are transmen? They asked!

Jeez. This is Australia, one of the most accepting countries in the world for gender diverse people and you don't know transmen exist?

Enough.

So I want stories, events in your life at work of how you have been treated by company medics. What have been the problems, what has been totally dumb, what has been tragic, and what has been hilarious.

What have you needed and the problems you have faced.

I'm working from a scenario of a trans*person at a remote mining site. How do we deal with communal showers?  How do we explain our medical records.

All and anything is grist to my mill.

So let your stories flow. This is a positive opportunity, let us take it to let them know.

Cindy

I don't have to deal with company medics where I work, never even had to have a physical when I started, not sure if I can be of help...?

You've probably heard this story before.

My principal said they were going, within the next day or two, to send a letter outing me to the entire community. This had been cleared with the school system lawyer.

I had a frantic afternoon trying to get union help. Finally the union lawyer talked to the school system lawyer who said he had not OKed anything of the sort. I think they were hoping I'd be naive enough to agree.

Second story: I asked the benefits liaison for our insurance company whether I will have trouble getting coverage for both male and female medical needs. E.g. prostate screening AND breast cancer screening. She made a few calls. No one knew. Said she would get back to me. This was 4 months ago. I'm still waiting.

Im training to be a radiographer (rad tech i think you call them in the US) when we are in the hospital we basically learn by doing and just have a qualified member of staff around to oversee what we are doing. I had learnt all about the theory of abdominal xrays including that any females of childbearing age must legally be asked if they are pregnant.

I get a card for a request for a patient who will be my first ever one .. check the name.. check the clinical indication for the exam, check its signed etc etc. Call the patient in, introduce myself - she introduces herself back, I ask her to confirm her date of birth, address etc.. Then say "I'm sorry but due to your age I do have to ask if there is any chance you could be pregnant at all".....

Patient stares at me then bursts into tears... internally i'm freaking out thinking omg what have i done/said im so gunna fail this assessment if i make my first patient cry haha... grab some tissues for her.. when the crying eventually stops she starts laughing and says "hunny thank you for that"... I'm completely confused at this point... she must see/sense this confusion and says "I guess you didn't check the box where it says sex on the card".. I look and it says Sex:M ... I'm sure i must have seen it previously but thought nothing of it when i called the patient by her obviously female name and saw a woman in female clothing and just a woman in front of me..  so i said to her "oh i think they made a mistake there" she says "only mistake was the way i was born but thank you ... you have made my day.. you are the first person here who has taken me for face value rather than what it says on that piece of paper"...

I'm retired so this isn't specifically a workplace event but may be useful.
I had an appointment to see the dermatologist at the local veteran's hospital to have some barnacles frozen off, having spent entirely too much time in the sun during my youth. I was early into transition at the time and was greeted by a young male intern, since I had some spots on my back and legs I had to strip to my sexy powder blue briefs. He starred at me incredulously and blurted out, "You have gynocomastia!" I already had some cute minnie boobs well on their way. I flatly said, yeah I'm transexual! Suddenly he grabbed the top of my panties and peered inside. It happened so quickly that it caught me completely off guard. I told him he was out of line and that we were done, I got dressed quickly and left and later complained to the department head and have never seen him again since.

I recently had a physio want to see how  my arms worked with my shoulder joints and needed no clothing in the way. I wasn't wearing a bra and was presenting as male.  I just told him and he immediately apologized.  I guess this goes to the impact on trans folk at various stages of transition.  Some health service providers are good with the surprise, others perhaps not so much.

I have had a GP offer to refer me to a surgeon for breast tissue removal - never seemed to occur to him to check the alternative with me and the whole approach was very "Aussie Blokey".   I voted with my feet. I also think this is why in Melbourne, trans folk try to get their health services at 2  GP practices recognised for their services to the LGBTI community.  For other services this isn't possible and it can be a bit stressful managing the process.

Physio and osteo are where I would be most impacted from an occupational health perspective. I now expect to have to manage disclosure as part of the deal.

Anyone had an experience of being rejected or asked WTF is a trans*person by a medic when getting medical treatment?

A couple years ago I raised being transgender with my GP at the time and he immediately confessed he knew nothing about it and therefore wasn't the right carer for me.  We didn't discuss it further since I already knew where to go.  Even at a very high level, he knew nothing at all but at least was honest enough to acknowledge that without judgement.

Quote from: Cindy on March 26, 2014, 01:16:30 AM
Anyone had an experience of being rejected or asked WTF is a trans*person by a medic when getting medical treatment?

Yup. I have a recurrent medical condition which could be alleviated by a simple operation. Despite explaining the situation in detail to the doctor in question and explaining how my condition makes life difficult and painful for me as a gay man, he refused to treat me because "we don't perform this procedure on women" (note: this is not a gender-specific or sex-specific procedure). His attitude was extremely stand-offish from the moment I disclosed my trans status to him, and he wouldn't accept that I'm not a woman.

I have also found that I get 'forgotten' for routine tests. I needed regular breast checks due to a family history of early-onset breast cancer, and I need regular cervical smears due to having a damaged cervix... but as soon as I changed my details with my GP, I was simply dropped off both lists without any notice. I've had to fight tooth & nail to get the care I need. Of course, just talking to the Reception staff about a sex-specific test that doesn't match your presenting gender can be a triggering and challenging event in itself, especially in front of a busy waiting room.

And with the cervical smears, they give me a very triggering form to fill out in advance, where every question is worded as "Woman's name', 'Woman's age', 'Woman's address'" etc. Why can't they just write 'Name, Age and Address' or even 'Patient's name' etc.? Why do they need to specify the presumed gender of the patient on the form?

Other than that, my doctors and nurses have been pretty much exemplary.

I find this unbelievably horrible to ask.

To be honest I cannot get close to how to understand this, I beg forgiveness.

Can a transman describe what it is like to have urogenital examination.

I can do the breast stuff, people looking at my thing.

Careful don't get triggered

Honest experience please.

OK, I'm happy(!) to answer this. For science!  :)

It's effing soul-destroying. Especially since the procedure is almost always performed by a woman, or in the presence of a woman.

[Trigger Alert!!! Description of urogenital examination]

If the person conducting the exam is a woman, they always address you and interact with you as if you were female. For me, this is probably the most difficult thing: the social aspect of the nature of the test. There's a camaraderie between women (one that I know many transwomen long for and hopefully enjoy when they experience it) that is completely inappropriate and very triggering for most transguys, who just want to get the job done as quickly as possible and get the heck out of there. It's kind-of like using the toilets: women might want to stand around and discuss their shared experience; but guys don't want to look at or talk to anyone and just want to get out quickly.

Having to spread your legs and accept a bodily invasion from a stranger, but especially a woman whose whole attitude is one of "don't worry dear, I know exactly what it feels like because I'm exactly the same as you are and all of us women have to go through this!!!1!" is very triggering and distressing. They just want to talk about it and empathise with you, thinking that this will put you at ease - but in many cases, this is the worst possible thing you could do with a transguy in this situation.

I like to think of the bits between my legs as being out of sight and out of mind. I'm ok with using them sexually under the right circumstances and with the right person, but they're definitely not for public consumption and I'm not happy with having to show them to anyone I'm not intimate with. I certainly don't want to think about them or talk about them with a woman who thinks we have a shared experience.

So... they insert the speculum and you can feel it dilate a body part that you'd probably prefer not to be aware of, and then they do whatever exam they're going to do. Once they're done they release the speculum and you might be left bleeding for a couple of hours afterwards, particularly with a cervical smear. Of course, they talk to you all the way through it, trying to empathise with what you're going through... but they do it from a female perspective, with absolutely no sensitivity to how emasculating it is for a man to have to think about his vagina, let alone allow some stranger to probe around in it.

When the test is done, they offer you a sanitary towel so that it can take care of the light bleeding that we'll suffer for an hour or two after the exam. Of course, most transguys will have painful memories associated with the use of sanitary products, but they are given to us without consideration for how we might feel about them.

For me, it's very difficult to have a smear test without feeling that the person doing the examination in some way presumes me to be a woman. I had my first smear at age 19 and I've hated every single one since then.

[End trigger]

So my advice to medics offering urogenital exams to transguys is: we don't want to think about it or talk about it; we just want to get the job done as quickly as possible. You're examining a body part, not my 'womanhood'; please treat it as if you were examining my arm or leg. And if you routinely offer sanitary towels afterwards, please don't talk about it. Just leave one near us and let us choose whether we want to use it.

Hope this helps.

Sometimes I can say thank you.

Sometimes I weep and say thank you.

Sometimes I weep.

Thank you.

I shall use this.

Hugs my brother

Cindy

QuoteOnce they're done they release the speculum and you might be left bleeding for a couple of hours afterwards, particularly with a cervical smear.

Is this different from a pap smear? I don't think I've ever bled from an exam down there. That sounds horrifying!

Quote from: Cindy on March 26, 2014, 01:16:30 AM
Anyone had an experience of being rejected or asked WTF is a trans*person by a medic when getting medical treatment?

As I said earlier, I get my medical stuff handled at the local Veteran's administration hospital. Each clinic and department has access to my full medical history and background and has me listed as Male-Female Transexual on the computer screen. Once when I was sent for a chest X-ray I noticed there were two young male technicians present. Normally I can strip down to my undershirt, but they insisted that I remove it and then made a big deal of ensuring that I was properly pressed against the screen...We know what that was about don't we? Meh!

The nurse practitioner I had seen earlier couldn't figure out why I had a drip, and after taking samples on slides and loading me up with antibiotic injections assuming I had some kind of VD though I had told her that I had always thought that one had to engage in sexual situations to get that, she found out otherwise and sent me an appointment to the Urology clinic. I was greeted by a rather imposing African American medic who asked me why I was on estrogen. I told him that I am trans and he blew up at me, I can't remember the words, but he was loud and vitriolic. I calmly told him that I had noticed a sign over the doorway as I entered the department about respecting diversity and then pointed out that I hadn't made a big deal over how black he is and asked him if he thought it should perhaps go both ways. (Point taken!) Btw- the drip was my prostate drying out and shrinking from the effects of feminizing HRT, it was forcing small amounts of residual seminal fluid out.

Quote from: Cindy on March 25, 2014, 05:36:06 AM
They came back with 'Well we thought most transwomen worked in the sex trade'. " We have just realised they don't"

Oh yes guys I'm a Prof of Medicine, ye I could call it the sex trade :laugh:

What are transmen? They asked!

Jeez. This is Australia, one of the most accepting countries in the world for gender diverse people and you don't know transmen exist?

REALLY ???? Are you serious? Sex trade... That's just (Place angry expression here). WOW! I can't believe people are this shallow and narrow minded. That just burns my soon to be pretty little ass. LOL

Quote from: Shantel on March 25, 2014, 09:26:12 AM
I'm retired so this isn't specifically a workplace event but may be useful.
I had an appointment to see the dermatologist at the local veteran's hospital to have some barnacles frozen off, having spent entirely too much time in the sun during my youth. I was early into transition at the time and was greeted by a young male intern, since I had some spots on my back and legs I had to strip to my sexy powder blue briefs. He starred at me incredulously and blurted out, "You have gynocomastia!" I already had some cute minnie boobs well on their way. I flatly said, yeah I'm transexual! Suddenly he grabbed the top of my panties and peered inside. It happened so quickly that it caught me completely off guard. I told him he was out of line and that we were done, I got dressed quickly and left and later complained to the department head and have never seen him again since.

The intern seemed to have no idea what his actions mean to the patient. He was too much professional

He is like a guy in the gas station yesterday. In gas stations here, workers are poor and not educated well. I asked to fill up the gas tank of my car. Standing out side of the window, he peered at me, and said like "When I heard your voice, I thought you were a man. Now, you look like a woman. Are you a man or woman?" I stared at him, and then turned my head, just ignoring him. Fortunately, he shut up his mouth, and no longer talked. At least, he seemed to grasp what he is talking, and what is his duty there.

barbie~~

Quote from: FA on March 26, 2014, 08:57:48 AM
Is this different from a pap smear? I don't think I've ever bled from an exam down there. That sounds horrifying!

'Pap smear' and 'cervical smear' are the same thing. ;)

But yeah, I bleed almost every time. It's pretty common with the smear test.

Here in my country (S. Korea), most people have heard about transgender (actually, transsexual), and I have never experienced an embarrassing moment in any hospital. Nurses took care of me. In a dermatologist's office, I said them that I prefer my daughter's name as my patient name. Then, they always used my daughter's name when calling me. In a psychiatrist office, the nurse kindly guided me to the internal department by walking next to me, as I wore 4-inch heels. A most important rule in hospital of my country is that medics and nurses never make their patients upset. If patients are upset, they always apologize. To my eyes, they sometimes apologize too much and needlessly, as the patients are actually at fault. Thus, those medics and nurses usually get a lot of stress while treating their patients.

One disappointing moment was when I asked some treatment for facial skin enhancement. The female dermatologist commented like "You will not need it so much because you are a man." After that, I always wore skirts and heels when visiting her office. Nowadays she treats me very well, because I become a valuable customer. She also discounts the price of treatments for me very well.

barbie~~

Quote from: Cindy on March 26, 2014, 08:43:03 AM
Thank you.

I shall use this.

Hugs my brother

Cindy

Thanks Cindy. It means a lot to me to know that some anonymous trans*person down the line might have a better experience because of your efforts, and that I may have made some small contribution towards that.

Quote from: barbie on March 26, 2014, 09:57:59 AM
A most important rule in hospital of my country is that medics and nurses never make their patients upset. If patients are upset, they always apologize.

That sounds wonderful! I wish things were as civilised here in the UK. Most medics here are excellent and will treat you with professional detachment, but there are some bad individuals who relish an opportunity to be able to say 'no' to a patient.

They are not all horror stories.  I've found a wonderful MD here.  This is her practice's form that they have everyone fill out.  Notice the top lines.

ADULT HEALTH HISTORY QUESTIONNAIRE
Today's Date: _______
Patient Name: __________________________ Date of Birth____________ Gender: M__ F___
For transgender patients: MTF ____ FTM ____
Does your insurance have you listed as male or female in their records? Male __ Female __
Medication Allergies (drug name and type of reaction):
__________________________________ _______________________________________
__________________________________ _______________________________________
Non-medication allergies (ex. Bees, wasps, seafood, peanuts and type of reaction):
___________________________________________________________________________
Chronic Medications: (Include doses and how many times per day are taken)
__________________________________ _______________________________________
__________________________________ _______________________________________
__________________________________ _______________________________________
__________________________________ _______________________________________
Over-the-counter medications (nonprescription), vitamins or supplements taken regularly:
___________________________________________________________________________
___________________________________________________________________________
Communication
Do you have any vision/hearing or mobility problems? Y N
Do you speak and understand English? Y N If not, what is your primary language? _____________
Personal Medical and Surgical History
Have YOU had any of these health problems? (Explain in space provided)
Heart Y N __________________________________________________
Hypertension Y N __________________________________________________
High
Cholesterol Y N __________________________________________________
Strokes/TIAs Y N __________________________________________________
Headaches Y N __________________________________________________
Neurologic (other) Y N __________________________________________________
Lung problems Y N __________________________________________________
Cancer Y N __________________________________________________
Diabetes Y N __________________________________________________
Thyroid Y N __________________________________________________
Stomach/colon Y N __________________________________________________
Kidney/bladder Y N __________________________________________________
Prostate Y N __________________________________________________
Menstrual Y N __________________________________________________
Arthritis Y N _____________________________________

Well I think my employer knows I am trans, but it is hard to say. I still have my birth name because I have not changed it yet.  So "legally" I am still female.  My employer has all that information. The place I work at is a pretty small place, so the Manager deals with a lot of paper work and we have all the people that do payroll and such in the same building as us. So they see my birth name quite a lot. That being said, no one has questioned it, not even my Manager (the head honcho of the whole place). They see me as a guy and treat me like one.  I have been on T for a year now by the way. Still pre-op. 

No one has ever asked me questions about it. I am not sure because they legit do not know or they do not care. You see my birth name is "Alejandra" and everyone here sees me as a guy. They may think that my name is just simply spelled wrong and it is meant to be "Alejandro" or that is just how I spell "Alejandro" with an "a".

When I first started working here, our pay checks displayed our names, obviously. One day my supervisor handed me my paycheck and said that my name was spelled wrong on the check so he was going to let my Manager know that it is spelled wrong etc. I was hesitant to tell him that that is the way that is spelled, but I told him before he sent it in. I just told him that it is spelled that way and that I have been meaning to fix it. He was confused, but just said okay. He never questioned me about it.

One of the other supervisors, alternate between calling me "Alejandro" and "Alejandra" Which bothers me to no end, but I feel like he does not know the difference? Seeing as it is a Spanish name, and he knows nothing of Spanish except for perhaps "Gracias" which means "Thank you". So I am not sure because they are completely oblivious, do not care, or rather not question it. Nonetheless, he still refers to me as male.

It makes me nervous, because I am not sure how they would react. I mean more my co-workers since we sort of grown fond of each other. As for management, the worse they could do is fire me. Which would be very discriminatory and would be rather inconvenient, but there are other jobs out there. Either way I would prefer not to get fired, I like my job.