Trans* healthcare is a tricky beastie.

medicineI’ve had some ups and downs with my health over the course of the past 33 years. Chronic mood disorders have plagued me since I was a child, and I was barely a teen when I first realized my “female” parts hated me–undergoing a unilateral salpingo-oophorectomy at 13 for a potentially dangerous contorted ovarian cyst. I’ve never had a good relationship with my body, even before I recognized I was trans*. Between all the health problems and the pervasive sense of wrongness, it seemed like my body hated me back.

Recently I decided to step up my campaign for a hysterectomy. I was diagnosed with Polycystic Ovarian Syndrome about a year ago following years of unbearable shark weeks that happened without warning and left me at the center of something resembling a murder scene. As a trans* man, I’ve found it humiliating to discuss, deeply triggering for my dysphoria and fundamentally emasculating in a way that merely being in possession of that plumbing wasn’t. The decision to push for uterine removal was difficult; I wasn’t actually out to my healthcare professionals.

This might seem silly, given that I’ve been living out 24/7 for several years now. My highly conservative, fundamental Christian family knows. My kids and ex know. All my friends know. I’m Will, and I’m a guy. My daughters call me ‘Da’. But somehow, when it comes to doctors, it all gets fucked.

We live in a culture that reveres physicians. There’s nothing wrong with that, but it does afford them a level of privilege and respect that few other professions can approach, and it often imbues on those in the white coats a sense of rightness, as if their judgment is the best judgment. That’s part of their job after all: making the tough calls. However, when it comes to something like trans* issues, that sense of rightness and comfort level with making a quick judgment can lead to serious conflicts. Few trans* people can claim they’ve never felt discriminated against in their healthcare.

So I put off telling my internist and my OB/GYN. I didn’t offer any excuses for my appearance–pre-T, I look more like a dyke than I do a man–and they never asked. I wasn’t correcting them when they called me she, though it was painful. I wasn’t saying, “I know it says Elizabeth on the clipboard, but my name is Will.” I just let them assume whatever and went with the flow, knowing it wouldn’t be long before I could leave and not think about them anymore for a while.

The problem with this was that my urgency in desiring a hysterectomy wasn’t understood. I was offered several other, less permanent options for treating the PCOS. Prescriptions, advised weight loss (when do they not recommend that?), and invasive testing followed diagnosis, but my doctor mentioned hysterectomy was the final cure if nothing else worked.

I kind of hoped nothing would, as miserable as I was… How great would it be if I could convince them to just take it out? No more shark week. No more wrongness, at least not in that respect.

Last week–in part due to Clancy’s indefatigable support–I screwed up my courage, took my 14-year-old daughter (and staunch advocate) with me to my OB/GYN exam, and confessed I had gender dysphoria and would really rather just get the hysterectomy if it was all the same to her. She didn’t even blink. She just nodded and said, “Of course. Come back in two days to talk to the surgeon.” That simply, I walked out, made the appointment, and came back to undergo more invasive testing.

They performed a biopsy as a pre-surgery precaution. This afternoon, I got the results of that biopsy–one that wouldn’t have been performed at all if I hadn’t pushed for the hysterectomy as bravely as I could manage.

It turns out I have a condition called endometrial hyperplasia. This means the cells of the uterus are rapidly multiplying out of control. They’re mutating. It’s a condition strongly associated with endometrial cancer. If I hadn’t already booked the earliest possible OR date, they’d have bumped me up. It all has to come out immediately and be sent to a pathologist.

The mind-boggling fact is that trans* men are, for whatever reason, more likely than cis women (straight or lesbian) to develop cancers of the reproductive system. And trans* men are far more likely to die from it, often foregoing gynecological treatment and exams even when they’re available…and also frequently going untreated because bigoted healthcare workers refuse to treat them.

If I weren’t trans*, I wouldn’t have pushed for the surgery and wouldn’t have gotten a painful and traumatic biopsy procedure–just getting the test required I sign paperwork stating I’d been warned how unpleasant it would be ahead of time–and I wouldn’t have known I had a precancerous breeding ground for mutation growing in my belly.

If I weren’t trans*, maybe I wouldn’t have these problems to begin with. But maybe I would. What I do know is that if I hadn’t pushed for the hysterectomy, been honest and brave, and undergone an extremely upsetting procedure to be permitted the surgery, I’d have mutant cells rampaging in parts I don’t need or want until something went horribly wrong…something I might not know about until it was too late.

There’s no clear moral to this story, but it confirms for me once more that living my truth and demanding respect for who I am just as I am is the best choice; there are known risks to living my truth…and terrifying, unknown risks lurking beneath the surface if I don’t hold true to that standard.

3 Comments:

  1. I’m so glad you spoke up. When we post that podcast where we were talking about it too, like… it happened in the time it needed to, of course. But I’m so proud of you for going through with both your truth and that procedure, because we needs us our Thursday/Will! <3

  2. Pingback: Not just Trans*: Why let anyone define you? – Thursday Euclid

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