Dodging Gender-specific questions...

From my past blog entries, I've written about my current hormone intake. I am currently on 200mg/day of spirolactone and 10mg/week of estradiol. I take spirolactone daily, and I go to the nurses clinic every Friday... because it is more convenient for me, albeit some of you may argue otherwise if you have work or other weekday commitments. It was difficult when I was going to school and working at the same time, but now my flexible schedule allows me to go to the nurse's clinic, which I prefer... because when I self-injected, I doubted myself, whether or not I was doing it right. Also, it is free... so I'd rather go to a professional than do it wrong while paying at least $60/month. For now it is the best option; however, it is a hassle when I am constantly bombarded with questions that are gender-specific and my responses may reveal my gender at birth. In this situation, I have a choice between: to trust that the nurse is culturally competent or to dodge the questions and re-direct her to what is most relevant to my health.

Last Friday, I went to my usual visit to the nurse's clinic. The front desk reps and nurses know me pretty well by now, well maybe not a friendly-acquaintance-kind-of-know... but, they do recognize me every time I come in. My experience has been the same every time, but this Friday is particularly different because I was triggered to write about my experience in dealing with medical providers and the realizing the need to train culturally competent (sensitive to gender non-conforming identities) providers. I am forced to write about the repetitive questions that are ultimately insensitive to my feelings about the issue.

Like I said, I've gone through this every time I go to the nurse's clinic. I dodge the questions. Recently, I learned that pap smears are for older women or women who are sexually active. Additionally, the HPV vaccine is common in women... and both HPV and pap smears are preventative of cervical cancer. Obviously, I do not have a vagina, yet, but HPV can also affect men... however, it may not have similar effects. I may be lying to the medical professional, but I have discovered that telling them what I learned.... "I am young and I am not sexually active" excuses me from taking scheduling a pap smear exam. Of course, they tell me that they are required to ask me for procedure purposes. So, every... every Friday, I prepare myself. I think of a line to dodge the question, and sometimes go off on tangent when the nurse is trying to make a conversation. In the past, I have used... "I will schedule it when I have the time," "I already had it done at another organization," or now my go to is... "I heard that I do not need it because of my age and I am not sexually active." I dodge the questions because they are not relevant to me, and I do not need to reveal my unwanted gender identity with providers that I am not permanently attached with.

I understand that it is a routine procedure to ask about an overdue pap smear or suggested HPV vaccine for recommended for my age group. I understand that the nurses are just doing their job, and they are only asking for my health and well-being... I commend them for that. In fact, I've gotten used to the questions that I've come up of several ways to dodge them. To some extent, I feel like I became numb... not flinching whenever someone asks me why I am taking spirolactone or estrogen, I don't feel like I am being read (or my transgender identity has been revealed). While there is a patient confidentiality clause, I do not think that it is necessary to tell them about my medical records... In fact, I am pretty sure that they already have access to them, but it is easier to ask than read a long record of medical notes etc. I understand that they are only trying to make a conversation to make the minutes go by quickly, but please be mindful that I do not need to tell you anything unless it is relevant or unless I want to. For now, I am re-directing the conversations... Last Friday, when the nurse asked me why I am taking estradiol... I immediately started telling her that the needle didn't hurt as much as last week's and I commented her on her gentle hands. For as long as possible, I would like to keep my secret a secret... and continue my weekly encounter with the nurses without making it awkward or weird.

My interactions with medical providers increased my knowledge about the medications I am taking. For example, I learned that spirolactone is used to treat heart, liver, and/or kidney disease from a pharmacist who asked me why I am taking spirolactone at a young age. I am often asked that, and why I am taking estrogen. Last Friday, my nursed asked why I am using estrogen, I stood quiet. She further investigated by asking if I am using it to increase sexual appetite, to prevent menstruation, or to strengthen bones and prevent bone loss. I take my nurse clinic visits as very informational, because I learn something everyday... I hope that someday, I can be brave enough to share myself with them... so they can learn not to ask gender-specific questions, because it made me uncomfortable... and noone deserves to feel that way in a medical environment.

I have scheduled my next appointment with my awesome endocrinologist. I am going to ask him about my weight gain, and hopefully he can suggest things to lower my BMI. Also, I will be asking him about signing the DMV form to change my gender marker... hopefully by May, my 24th bday, I will have it changed. I also scheduled my 2nd Psychiatry appointment, and I am excited. I will write about it soon!




xoxo,

Jas