Written in the Waiting Room

Marlene says:

Today I took a little extra care deciding what to wear before leaving the house. I didn’t have a date and I didn’t have a job interview. I had an appointment with an urologist.

My regular physician referred me to the urologist for an orchiectomy. That means having my testicles removed. This is something important for my long-term health, as a way of reducing the amount of estrogen I have to take every day. My testicles haven’t been doing much for the past fifteen years, but they do still produce enough testosterone that I take testosterone blockers and more estrogen than I would without them. There are no long-term studies on non-operative trans women, but it is presumed that lowering these dosages is healthier.

Why did I worry about what to wear? Because I have to. The level and the kind of care I get are influenced by how my doctor perceives me. If I appear as a respectable, reasonably attractive woman, I am treated better than if I appear to be the queerest gender-nonconforming thing on the planet. I don’t look like that much these days, but there was a time when I did.

For a very long time, I didn’t look like the artsy but otherwise nondescript woman I am now. Sometimes that was by choice, often it was not. The morning of a day when I see a new doctor throws me back to a place I haven’t been for a long time. I’m as unsure of myself as I was the day I first wore the right clothes to meet with an endocrinologist.

Lately, dealing with doctors, especially new ones with power over me, is harder. A few years ago, I put down the emotional armor that protected me from such things. I thought I didn’t need it anymore. The rest of my life has been better for that, but days like today are harder than they once were.

I don’t know how much or little my appearance will affect my care, because I haven’t met this doctor yet. I do know it will make a difference. It always does.

In describing my afternoon plans to a friend, I explained that I was going to try to convince someone I probably won’t like or trust to agree to perform one of the most traumatically intimate acts on me I can think of. Actually, I’m queasy at the prospect of having to cajole someone I hate into cutting me open.

It’s hard to be enthusiastic about being here, despite the fact that it is the necessary step towards something I want and need. It would be bad enough if I simply had to go through the procedure. I don’t like doctors. I hate that so much of my basic existence is medicalized. On top of that, I will have to fight with my insurance company to just maybe pay for it. On top of that, I will feel guilty for complaining when I am incredibly lucky to have insurance at all, let alone insurance that even might cover this. How dare I, even for a second, think that this should be no big deal?

After all these years, you’d think I wouldn’t still be able to forget, but I do. I still need this bitter reminder once in a while. Without these reminders, I might mistake myself for a real person. Putting on the “right” clothes in the morning is a reminder. It’s a reminder of my place.

3 thoughts on “Written in the Waiting Room

  1. I’ve been thinking about this post and what it means to make what’s in it public.

    Trans people are too often reduced to their genitals and are often expected to tell the world about their genitals. The story of a life is subsumed by surgical details. People focus on the process of “transformation” so as to reinforce that the trans person’s gender is constructed and artificial.

    My intention certainly was not to tell that story. I hoped to shed light on one of the things we do not talk about, problematic relationships with people who are supposed to be caring for us.

    1. Marlene, I just wanted to say how much I appreciated this post. I didn’t feel like it was about your genitals at all, but about your process, and the hard parts, along with a shadowing of why the hard parts are worth it.

  2. I think this post will resonate with almost anybody who has had a lot of dealings with doctors in this medical system. It certainly did with me. When I go to see a new doctor for the first time, I always think about what to wear to make the impression that will get me what I want. In one case I gave some serious thought to picking the right book to read in the waiting room — one that would signal “intelligent, sophisticated adult” (I ended up with A.S. Byatt’s “Matisse Stories”).

    One guy on my old diabetes mailing list used to talk about the importance of finding a compliant doctor.

    I don’t mean to bash doctors in general, because I’ve had some very good ones (as well as some very, very bad ones). But it is painful, frustrating, and shocking to be told, directly or indirectly, that what you know about yourself and your body, including what it’s like to live it every day, is second-rate information — or simply irrelevant.

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