Orihime asked me to post about this in the forum.
On Monday of last week, the Duke Medical School Gay-Straight Alliance club held a trans healthcare panel. The audience was about 40 future doctors, nurses, PTs, etc. I was one of the four panelists. Although I never directly read what I post below, I covered all the points. The format was changed between the confirmation e-mail I was sent a week before, which was that we'd be introduced by the moderator (hence the Introduction sentence referring to me in the third person) and were asked to prepare a remarks for 5-10 minutes then it would be audience questions. Instead, I did an off-the-cuff introduction that encompassed most of the points, and the rest were covered in response to audience questions. Though I anomymized it here, my current employer is a software company that is well known as one of the best places in the US to work.
Additionally, I'm currently working with an acquaintance for an article about myself, as an example of a transgender individual, which will appear in the newsletter of the NC Psychological Association.
Quote
Introduction: Agent_J is a thirty-something Scranton, Pennsylvania, native who, with her wife, moved to North Carolina in 2008 and currently resides in Durham.
When I told my wife that I needed to write a self-introduction, she, ever so humble, suggested, "Hi, I'm Agent_J; a trans lesbian biker babe with a really hot wife."
The reality is I am that and more. To give you terms quickly, I am a feminist. I am a survivor of child abuse, endured while growing up on the dairy farm my father ran. I am a depression survivor. I am a trans woman and lesbian, though I also use the terms "gay woman" and "queer." I am asexual; the combination of those might seem confusing, but it's actually pretty simple - I want relationships with women but do not want sexual relationships at all.
I am polyamorous, and in a monogamous relationship. This means that, though I would like relationships with others, I do not have them, out of respect for the rules of the relationship I am in.
My wife, WindRider, and I met in 1996 while working on a helpdesk for a small software company in eastern Pennsylvania, and married in the fall of 1999. We still celebrate the anniversary of our first date; we just had to when it fell on April 1st.
Of my transition she has said, "I see again the person I married."
I am an IT professional, who has spent 15 years working for universities. I transitioned at work 2 years ago, while working for --PUBLIC UNIVERSITY--. 6 months later I was recruited by --SOFTWARE COMPANY-- for a mid-level position of System Administrator. My experience at --SOFTWARE COMPANY--, having been hired simply as this woman named Agent_J and without the history of my transition being known in my workplace, has been both frustrating and fantastic. I have experienced sexism in that mostly male segment of the IT field. I had to work far harder than my later-hired male colleagues to have general acceptance of my skill. Since proving myself capable with challenging projects, colleagues have remarked that they hope I am assigned to their project due to my reputation as a professional who is composed and tenacious in the face of even the most challenging projects. My management has been good, taking steps last summer, when I was interviewing with Google, to make staying a little more attractive. I was rated "distinguished" in my annual review, the highest performance rating, and a promotion to Senior System Administrator is pending. I have been recognized for my mentoring of junior administrators. My position and income definitely puts me in the upper few percent of trans* people.
I have lost contact with most of my family as a consequence of my transition. My parents are the only relatives, immediate or extended, with whom I have any contact today, and we negotiate space to prevent conflicts that would interfere with their relationship with my estranged relatives. I do not wish them to lose the grandparent-grandchild relationships even as I mourn the loss of the relationships with my niece and nephew - I have not seen them in over two years.
I realize the focus of this panel is medical and mental health experiences. I began my remarks as I have for a reason - a serious problem in trans healthcare is pathologization. This is not my first attempt to transition. I tried in 1994, at the age of 19, and abandoned the effort a few years later, having met fierce resistance from providers in that region of Pennsylvania; resistance which was clearly aimed at having me committed for being trans.
For many of my appointments, particularly from when I began this attempt to transition, in September, 2008, until last May, my experience of treatment was extremely dehumanizing, as though to those physicians and therapists I was a collection of charts and lab results first, and a human being a very distant second. I was subject to interrogation of my gender expression, and the classic double-bind for trans women - my manner of dress was not feminine enough because I did not wear skirts and heels to the appointments, or too feminine and over-the-top once I did, even though what I wore was my work clothes. That I ride motorcycles was unacceptable. Like so many trans people, I fit binary and stereotypical definitions of gender, woman, and femininity in some ways, and very much do not in others.
During that time I had great difficulty accessing appropriate hormone treatment, which is to say treatment that would feminize my body. This problem persisted across two endocrinologists. I learned where to acquire HRT without a prescription and availed myself of that option, mostly to avoid running out when, due to a heavily overbooked physician, my prescriptions ran out before the next appointment and extensions were refused. During this time I began to deal with depression that included desires for self-injury and suicide ideation, for which I am in therapy and receiving medical treatment today. I felt unable to seek treatment for a time for fear that doing so would derail my transition.
In May of last year I found a provider at Planned Parenthood who operates on Informed Consent. I remember that first appointment – a 4 page form documenting the risks and possible effects of Estrogen therapy - and having to stifle a laugh when I read passages such as, "estrogen therapy may cause me to develop breasts." I had to restrain myself from glancing at my chest and remarking, "yeah, got them."
I left that appointment in tears of joy, as it was the most empowered I felt about my own medical transition; the most agency I felt I had over my own body. I was given the right to say that this is what I want, rather than having that right in the hands of therapists and doctors.
Hormone treatments had, and continue to have, an incredible emotional impact for me. I describe my pre-transition emotional state as an endlessly cloudy, overcast, and chilly day. On HRT, I experienced the pleasant warmth of a sunny day for the first time, and so many wonderful, new experiences awaited. This is how I truly know that I can never go back to my state before my transition.
The biggest problem I have experienced in medical settings that is not specific to transition treatment is appropriate use of pronouns once my trans status is known to the personnel. I have encountered doctors and nurses who were flawless with my pronouns until that moment, only then to become inconsistent. Additionally, I had much difficulty with timely access to treatment. Even my first surgery letter was delayed by 3 months, and I will never forget –a local therapist-- stepping in to offer me a Plan B that would prevent the possibility of having to have my transition drawn out further.
In my case, the access problems were always with transition treatment, but many have suffered problems with access unrelated to transition. A thought that goes through my mind every time I ride my motorcycle is, "if I wreck, will medical personnel leave me to die because of my body?"
Today, I am finding my way through a life that is filled with far more potential than I could have imagined prior to transition. The near future includes closure of this chapter of my life. At this time, 7 weeks from now, I will be reporting to a hospital in Montreal in preparation for sex reassignment surgery the next day.
