Logistics

I recently got back on ADHD meds. I’m fucking thrilled about it. I’ve been off of them for three years, and the lesson from those three years is I need ADHD meds.

I got on them the first time I was in grad school. I found a psychiatrist who specialized in ADHD and mood disorders. The morning of my appointment, I had to call them and tell them I’d be late because 1) the doctor’s office was not downtown as I thought but in a far east suburb 2) I had lost my wallet the night before in the street in front of my friend’s house but luckily his neighbor had picked it up so I needed to get the wallet first and 3) I especially needed to get the wallet first because my car had no gas in it.

They told me I should come regardless of how late I was.

That first appointment my psychiatrist said to me, “Wow, you’re living alone?” My psychiatrist is a funny guy. My most recent appointment he talked to me about my heart chakra and we talked about how unnerving and distressing the homeless situation in San Francisco is.

I pay out of pocket to see him. I’ve only ever had charity care insurance and when you see those doctors they do not want to give you adhd meds or give you a referral to a psychiatrist. If you do get through to see a psychiatrist in a charity care scenario, they’ve been seeing people in extreme crisis all day, and if they see someone with my white lady face they are just kinda like, you’re fine, here’s some fluoxetine, work harder.

When I was a patient at the informed consent clinic in SF where I would eventually work, they were willing to give me a scrip for adhd meds, but only a month at a time, which makes sense since people party with adhd meds. So I had to have a social worker appointment at that clinic every month to get a refill. Only problem with that is that clinic canceled appointments on patients all the time. So I never actually saw a social worker because the clinic canceled appointments on me three months in a row.

Well, I saw the social worker immediately after I got my testosterone scrip. It was a crazy experience. She started talking at me about the mission of the clinic and didn’t stop talking at me for 15 minutes straight. Finally I interrupted her and said I’d like to have therapy appointments at the clinic. She said they had a waitlist that took people months to get off of. (Later, when I worked at the clinic, I saw how totally meaningless it was to put someone on the waitlist. People were on that list for half a year. That clinic does not have the mental health staff to serve the number of transitioning patients it does.) I asked if I could get in on one of their support groups. She put me on that waitlist. I would get a phone call about it 3 months later. I asked if she had a therapy referral in the East Bay. She told me to google the Pacific Center.

You can get a 3 month supply of testosterone right away. After a 3 month check-up you can get 6 month refills as long as you go get your blood tested every 6 months. You don’t need to check in with a social worker. You don’t need to be in therapy. I guess it’s because people don’t party with testosterone? Although people constantly were trying to buy the testosterone off of me. Like, when I knew I was going to detransition and had no one around me who knew that was a thing, and had found a nationwide list-serve but it turned out they had shut that down, I posted on craigslist looking for support. I got some emails saying I was “fascinating,” I got a guy describing his dick, and I got an offer to buy my testosterone. I never sold it. I have some moral hangup about selling drugs, even if I’m going to end up throwing them away. I’m risk-averse that way.

Off of ADHD meds I am a fine, if frazzled waitress. I am a totally ineffective anything else. I could do the receptionist job without ADHD meds because that job was people yelling at me, so I always had something urgent making a big mess right in front of my face to address. So there’s an income level I’m trapped in if my ADHD isn’t treated. And there’s a stress level I’m trapped at too. Off of ADHD meds I’m trapped in jobs where people are ordering me around.

On ADHD meds I am so calm. It is almost eerie. It’s unnerving to be without the frantic anxiety I’m used to. In a lot of ways I think of that frantic anxiety as me. So it’s like, oh wow, is this still me, this person just doing stuff instead of worrying about what it is she should be doing?

My family thinks ADHD is a made up thing. Most people do. Honestly people love a day-dreamy, frazzled waitress. They don’t care so much about the mistakes you make as long as they get to laugh at you. Other people feel totally ok about me being trapped at that income level.

I don’t have health insurance right now. I applied through the obamacare website, then they said with my income I qualified for my state’s medicaid. Then I applied for my state’s medicaid, then they asked for my last 4 paychecks, then I took them to the children and family service’s office, got a receipt, the whole deal. Then a week later they sent me a notice saying I’d been denied for not providing them with requested information. So now I have to go back down to the office, bring those paystubs and now my tax return, and cajole them into helping me appeal or helping me file a new application. I can’t file a new application online because it says I’ve already filed one.

What sucks is that as a poor person you have to be much stronger at logistics than as a person with money. Because if an organization or agency considers you to be part of a population they are “serving” they do not believe your time has any value. They believe it’s a great use of your time to make you come down to their office and wait for hours, and do that a couple of times. If you took off of work to make it to an appointment with their social worker, and they cancel the appointment, well you’ll just have to take off of work again, what’s the big deal? What, a waitress had to take off of work? Who cares?

Who cares if you stay a waitress forever? Who cares if you can’t see a therapist? Who cares if your whole working life will be being ordered around by people who think it’s ok to yell at you? Who cares what happens to you at all?

You know, the fact is no one cares. Your life is such a little tragedy, so un-dramatic, a nearly silent waste of potential, they really don’t care. Just keep  smiling and acting like you like it and this is all you ever were meant to do, and it’s better for everyone. Just die slowly. While you’re dying, if you want to switch your pronouns, well then that’s something someone can get angry on your behalf for. That’s a righteous cause. Your boss can scream at you all day long but she’s a good person so she’ll use your preferred pronoun while she does it.

Once I got a phone call at that clinic from a trans woman who was saying she wasn’t ever coming back to the clinic. She said, “I’m going back home. Being a client at your clinic and at the shelter I’m at has been the most disrespectful experience I’ve ever had. I’m going back home and I’m giving this up.”

I said, “Well I wish every staff member could hear you say that because they need to.” She didn’t want to file a complaint. She just wanted out. I’m glad she got out. I hope she’s doing ok.

 

 

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