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.