Unavoidable

I have a real problem with coincidences. There are so many moments in my life where I want to announce to the universe, “OK you don’t have to lay it on so THICK, back off.”

Last Friday morning was one such moment. I was at work. A gay boy I work with was talking about his genderqueer friend, female, who just a little over two months ago was raped. He was saying they are transitioning to using “he” and identifying as  a guy, and he thinks their emotional instability over the years was because of this fundamental mismatch with not being seen as male.

He says this, and I look down at my hands. I don’t talk about transition stuff in my day to day life. Because I’ve only had one person who didn’t experience dysphoria actually listen to what I was saying. The people who haven’t experienced dysphoria think they are hearing me, and then they say a bunch of condescending bullshit. This is why I don’t hang out with people who identify as trans allies. When someone says they are “committed to social justice” I have to immediately get away from them- I’ve just had to be the Person They Help too many times to be around that story.

Then a trans woman walks into the restaurant . And I’m like, ok universe, you’re laying it on thick, but whatever you want. I’ll have all these feelings about my own dysphoria, and my trauma, and my own regrets, and I’ll manage to have these feelings without laying my shit on this stranger.

So then that same co-worker says, “I love that woman.” And I don’t give a reaction, because ok, maybe you know her and love her, or maybe you love her because she’s trans and you love trans people and that’s a weird trip you’re on. So he repeats himself, “I love that woman. She came in here on last week, and got totally wasted. Then she went to my boyfriend’s bar and my boyfriend texted me about a trans woman drinking the same stuff she was drinking here and I was like, it’s totally the same woman! He had to cut her off because she kept touching one of the waitresses over and over.”

I thought, universe, I need you to back off here. I need you to back off and give me space.

Here’s what I wanted to say to my co-worker:

What’s funny about someone needing to get that drunk? What’s funny about someone acting like they get to touch their waitress’ body anyway they want to? What’s healthy about someone who just got raped making these decisions now? Who are you helping? Whose well-being are you invested in? Because it looks like you just like it when people put on an interesting show for you, regardless of what it does to their well-being.

What I said instead to my coworker was, “I have strong feelings in response to hearing about your friend deciding to transition because I very much regret having taken testosterone and I think most of the people who take it don’t understand they are signing up for a lifetime of needing doctor’s appointments every six months.”

He said, “What do you mean?”

I said, “If you consistently take testosterone eventually you have to decide what to do with your uterus, because the testosterone fucks with it and things can happen like your cervix closing up. So they recommend you get a hysterectomy within 5 years of beginning testosterone. Once you get a hysterectomy you have to get to the doctor every six months because your body will not start making its own hormones if your testosterone supply runs out.”

He said, “Oh, I didn’t know that.”

Now, I am not a doctor, and perhaps my understanding of when and why a hysterectomy becomes necessary is flawed.  I am just someone who was on testosterone and then worked at a clinic that dispensed a lot of testosterone. While I was at that clinic we had a person walk in who did not have an appointment, but needed testosterone that day because their supply was out. They had had a hysterectomy and so it was now a medical emergency that they were out of testosterone. You can’t just walk into that clinic and get an appointment that same day. That person was in their early twenties.

I have really, really tried to not talk about my time at that clinic. Mostly because I am afraid of breaching patient confidentiality. But I have never gotten over all the bad outcomes I saw at that clinic. And when that person came in, and it was a medical emergency, and they were in their early twenties, I put it together that most people can’t understand what they’re signing up for as far as being dependent on doctors if they haven’t been dependent on doctors before. If access to doctor’s appointments hasn’t been the thing you structure your life around before transition, how do you understand that is part of the choice you are making? That means you choose where you live based on getting to a doctor who has seen a trans person who has had a hysterectomy before. It means you stay put once you’re in a work situation in which you can get to such a doctor.

I didn’t understand this when I began testosterone. I didn’t fully get it till I worked at the clinic and saw all these young people in various states of crisis. Young people on disability because of the crushing social anxiety associated with being read as trans. Young people who needed revisions from surgeries they weren’t happy with. People who now needed to dilate daily but were too poor to afford lube to dilate with. Lots and lots of people on lots and lots of drugs.

Generally  health professionals who make their living from trans health chalk up these high rates of anxiety, depression, suicidality, and drug use to a transphobic society. That’s one way to explain it, and there’s probably a lot of truth to it. But what I also saw was professionals sidestepping the moral question of how informed the consent can be when the circumstances the hormones create are incomprehensible until you are in the circumstances.

Once at that clinic we were sitting around the lunch table and one person asked if there were studies of what happened to people who were supposed to have gone through menopause, but had been on a consistent course of testosterone so menopause couldn’t happen. One of the providers replied, “No, there’s definitely not a study about that.”

We don’t know what happens to a human body in that situation. There are no studies. About the situation I believed was best for me. About the situation my therapists and doctors agreed was best for me. About the situation that every day another person chooses to put themselves in.

Do you understand there are no studies of what generally happens to the body in this situation?

Do you understand how bad the anxiety can get?

Are you prepared to find ways to deal with that anxiety that aren’t drug and alcohol abuse, disordered eating, cutting yourself or lashing out at people?

Do you understand you’ll have to be grateful for truly shitty jobs- shitty pay, shitty bosses, and you can’t leave because getting hired at jobs will become exceptionally difficult?

Do you understand your emotional responses will change and you will have to re-learn how to manage emotions?

Do you understand the limits on how the appearance of your body can change through hormones and surgery?

Do you understand your sexual orientation can change?

Do you understand, if you are triggered by men saying woman-hating things, you are creating a public persona that will make them exponentially more likely to share woman-hating thoughts with you?

Do you understand how unavoidable the people who fetishize you for your dysphoria will become?

I really, truly work everyday at minding my own business and not universalizing my experiences to other people with dysphoria.  I don’t know what my moral duty is here, but from what I have seen the current informed consent/cheerleading paradigm that holds sway is bad for people. I wonder how long these healthcare providers can be in denial about the bad outcomes they see daily.

Also, how long are dysphoric people going to accept terrible life circumstances as their share? How long before we decide martyrdom is not that best use of our lives? How long before we demand studies of the long term effects of the substances that are supposed to be our salvation? How long before we reject the “help” offered by people on savior ego trips and start studying ourselves and what actually makes us stronger and more effective in the world? How long before we are done with being condescended to and experimented on?

That moment is coming, I just want to know how long.