And I could not care less.
Yesterday, I went to my GP and got my testosterone injection administered. It’s an intramuscular injection generally administered to my backside, where the fattier, softer flesh makes the intramuscular penetration of the needle less painful, and also gives it space to settle in the flesh and slowly be assimilated into my endocrine system over time.
Every 12 weeks — 3 months — I get this injection administered. I have been on it for about five years.
Prior to that, I was on Testogel, a topical form of testosterone where you slather a very strong-smelling slime over your shoulders every day and sit uncomfortably, waiting for it to dry, before you can put your shirt on, and trying not to sweat in the meantime.
The nurse at my local GP has been administering this T-shot for about a year.
Previously, I had been prescribed an oestrogen cream to help with the symptoms of vaginal atrophy — when you have a vulva and vagina and you, for whatever reason, have low oestrogen and progesterone, the mucous membranes that make up the inside of your vagina and your labia minora become thinner and produce less lubricant. It can make it harder to produce enough lubricant whilst having sex, make you more prone to tearing, and contribute to muscular pain and discomfort.
As you might have surmised from how I described the Testogel, this cream was Bad for me. It was very texturally unpleasant and awkward to administer with a little syringe, and I despised it.
So I made a mistake. I said, hey, can you guys give me a suppository version of the same cream?
The receptionist seemed surprised by how comfortable I was talking about my vagina in the waiting room, but hey. Such is life.
I receive a phone call the following morning at a few minutes past nine.
With delight, the receptionist informs me, “We’ve made a referral to the gender dysphoria clinic for you!”
And I say, “Well, you shouldn’t have done that. Why did you do that?”
And she goes, “Oh.”
“I don’t need to speak to a gender dysphoria specialist. This is for a vaginal suppository. It’s the same thing you’d give to a cisgender woman experiencing vaginal atrophy after experiencing menopause — it has nothing to do with being transgender.”
“Oh. Well. Erm. The doctor just doesn’t feel comfortable prescribing you hormones without you talking to a specialist.”
“What about the hormones you already give me?”
“… What?”
“I was literally there yesterday getting my T-shot administered. You’ve been giving me my testosterone for a year. Is the doctor suddenly going to take me off a medication I’ve been on for eight years? Is he comfortable putting me at severe health risk for no reason?”
“Oh, er, well, I’m sure, um, I don’t — I’m just a secretary, I don’t, um, I don’t know about… I’m sure he wouldn’t… But I can’t guarantee that — “
I was pissed. I made it very clear I was pissed and that I felt this was a waste of time and resources.
I know exactly what happened. Because many doctors don’t actually know anything about much of the medicine they administer unless it comes up on a Google search, they immediately react to base assumptions like “transgender” (or “woman” or “disabled” or “Black”) and attribute any issue you’re having to that.
My doctor looked at the fact that I’m on testosterone, then saw that I’d asked for oestrogen. Aaaaah!!! That’s so confusing and weird! I must be confused about my gender identity! You can’t just mess with all this stuff and brew it all together!
The fact that I’ve been given a cream-form of the same medication in the past is irrelevant. The fact that what I’ve requested is a LOCALISED form of HRT, which will not impact my broader endocrine system, is irrelevant — he doesn’t know that. The fact that again, the same exact thing can be given to cisgender women, is irrelevant.
He doesn’t know how any of these medications work. Hormones + transgender = ooh scary!!!!
When you have any sort of chronic health condition — which my transgenderism will be until someone makes an implant for my T —
you end up having to learn how a lot of these medications work and how they work together. You have to actually pay attention.
And then you have to manage healthcare practitioners who are acting based on bias and assumptions rather than actual healthcare comprehension.
And then, infuriatingly, after all this, I was put in the position of having to say, “Look, I’m sorry, I know you don’t know anything about this, and I’m very clearly aggravated, but it feels like I’m being targeted for poor medical care simply because I am transgender, and that my health is being put at risk at random.”
Which is what’s happening.
But when your doctor tries to do malpractice on you because he’s anxious about the fact that you’re transgender, you’re not allowed to get angry and upset about it, because that makes you scary and intimidating and a Bad Patient. It might make you worthy of even more punishment, or being struck off.
So that ruined my day.
I now have to go to the endocrinologist, and hopefully, I’ll be able to say, “I’ve literally been on T for eight years. Do not fuck with me. I do not need a fucking assessment. I do not need to prove for a second time to some stranger that I’m transgender. Just give me the suppository to make my dick work better and fuck off.”
And the endo will just give me the suppository, and my doctor will go back to giving my testosterone every three months,
and I won’t have to ruin anybody’s life or publicly embarrass my GP surgery into treating me like a human being.
It’s so frustrating to have to constantly think about what damage control I’m going to have to do to just be given the basic medication I require to live my life and that I’ve already been on for the better part of a decade.
The thing about the fact that it feels like this whole thing has put my general life at risk is that it feels like a punishment for caring about my vaginal health and wanting to be able to have comfortable, good sex — and that makes me a bad transgender person.
Cis people don’t want to think about trans men having sex or being sexual beings. That’s gross and scary and weird and uncomfortable.
Doctors don’t want a patient advocating for their own sexual health or being empowered and knowledgeable about the ins and outs of their own healthcare, let alone contradicting them just because they very clearly not only don’t know how my healthcare works, but because they can’t be bothered to learn.
Cis people don’t really want trans people to exist, because the concept of trans people disrupts the things they would like to believe about “biological sex” and how it contributes to the roles they choose for each other and pressure one another into.
If they’re okay with trans people existing, they only want trans people to exist in perfect theory.
They “grieve” over the cisgender children they “lose” when they transition to their correct gender. They don’t want kids and teenagers to be given puberty blockers, but they also don’t want them to get the right hormones — and now even as an adult, I’m constantly put in the position of having to be worried about my T getting stopped at any moment in case a doctor has Feelings about having a transgender patient.
Because it’s too scary and too hard to actually do any research about my medication.
They want our healthcare to go to nebulous “specialists” who, frankly, know more about diabetes and menopause — which is what most endocrinologists study! — than they do about being trans.
Cisgender people are often very fixated on the idea and the narrative that transgender people live in fear and anxiety and self-loathing because we’re so cursed by our bodies and our lives.
But
almost every negative experience I have is to do with a cisgender person choosing to make my life difficult rather than any internal issue I have with my actual life or body or gender. It’s cis people using slurs or making places inaccessible, refusing to learn or be educated on any subject, and trying to push any kind of transgender person out of their lives, their facilities, their society.
And so yeah,
I’m bad representation.
I’m openly gay and fruity, and I wear sexy fun clothes, and I write erotica and I talk openly about sexual health and resources, and I’m open about being transgender. I’m not ashamed of my sexuality or my gender — or my disability and chronic illness, which I’m also open about, God forbid!
And who cares?
I could be the absolute perfect example of transgenderism — invisible, meek, silent — and I would be treated with the exact same level of disrespect and ignorance. I would just feel like it was genuinely my fault for existing instead of theirs for treating me poorly.
At the very least I can complain loudly where other people can see and hear me, and it can make other trans people feel better about advocating for themselves and telling cis people and cis-focused systems to fuck right off.
And I can create bad representation proudly in my own fiction work —
trans people who are criminals and assholes and sluts and freaks and actual monsters, who are off-putting and autistic and disabled and weird — and let people enjoy that as well.
