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Monday, February 7, 2011

Moon over Parma

"There are many black cows, but they all make white milk"
-Pennsylvania Dutch saying I learned on the greyhound to Cleveland

Hello friends. I made a new video, it's all edited but I need to render it overnight... gotta love HD video. I know many folks can't watch the videos, I prefer that method because I tend to write like I talk, and much of the inflections and feeling is lost in text, but I also love to write and the written word has great power, so here it goes.

I had set up the appointment because my Kaiser healthcare isn't available in NY, the closest available doctor was in Cleveland Ohio. I set-up a new Kaiser number for Ohio, set up an appointment with a M.D. and made travel plans. I didn't have background on my doctor other than a simple fact sheet that Kaiser provides, and wasn't able to open any lines of communication between me and her before the appointment. I mentioned I was transgender to the appointment setter, and she assured me that the best thing to do was to just go in and go from there. I asked if there was a specialist, and she said no, but the doctor would be able to work with me once I got there, and that the doctors are willing to see any kind of patient. I wasn't sure if transgender care (from bloodtests to SRS) was covered by Kaiser, but I could use a check-up regardless of if it ultimately ended in hormones/transitional care.

Upon arriving about 2 hours early, I was brought into the exam room about 15 minutes after my appointment time and waited over an hour due to some issues with my Doctor messing up her password too many times and having to talk to the tech help desk. In accordance to NY state law, I could legally record the conversation for my own private purposes without her consent, so I did, it was never brought up through this entire experience, I just wanted to document this step more efficiently. When she finally came in, she alluded to being in the wrong room, largely due to my legal name still being a masculine one. I assured her she was in the right room. I told her I go by Riley, which she ignored throughout the appointment.  She asked me what medication I was taking, I then spent the next five minutes explaining the purpose and effects of Estrogen and Spironolactone. She asked me basic questions, and then "what my issues were" I told her I was healthy but seeing her for a general check-up and bloodtests, as well to discuss where I was going with my transition. She  asked me about "transgender meaning you have male or female genitalia?" and the lump in my throat grew twice the size, I told her I was physically and operationally male. 

At this point she started her diatribe about how she didn't have any experience in this, and that . At this point I said I was aware that this might be the case, but was hoping to be referred to another doctor that did have experience. At this point she said she'd talk to the endocrinologist and see what, if anything, the endo could do. When I mentioned the Harry Benjamin standards of care, she cut me off with dismissal and "I can't help you and I'm perfectly happy to tell you that". She ran through some personal questions, including whether or not I got periods, in which I had to reassure her that I had male genitalia. She did a quick physical through my layers of clothing, said "I was an unsual situation" and "a challenge" then walked out the room, closed the door and went into her office to use the phone. I could hear the office chatter and her on the phone, she was speaking loudly and my Itouch could pick up quite a bit of the conversation, I could hear all of it quite clearly, as I'm sure everyone in the waiting room and nurse staff could as well.  She started with the conversation with "I have a strange situation here" and used words like "apparently" and "supposedly" in reference to my healthcare situation, which was entirely valid and paid for. The worst of it all is she used my full legal name in the same breath as the word transgender, giving up my personal information to a office full of strangers. At the point at which I can only assume that the endocrinologist told her that she didn't do transgender care, she quickly agreed, "I thought so" and hung up. 

Upon returning to the room she again told me that she can't help me, and that the endo said "there's been  other issues like this". I asked her if that meant that this office wouldn't have anything to do with a transpatient, and she said "that's correct". She then mentioned there was an individual at Cleveland Metro who works with transgender patients and "was terribly sorry she couldn't help me, but she just can't" and walked out of the room, this is the last time I spoke with her. An intake nurse walked in and spoke with me about the standard blood tests that I could take, but I had a strong desire to just get out of the building/city/state. I mentioned the loudness of my Doctors phone call, she said I was a customer and I had the right to complain. She was sympathetic, said "it's even worse if you can hear it" and "she said that to your face?" Then, with a smile, she re-iterated something she had said when I first came into the office, that my doctor was "old-school", whatever the fuck that means.

As a side note, I'm not trying to paint the picture that this doctor as a monster, I'm just telling you what happened. She was confronted by something new and strange, and people react poorly in those situations, these are the failings of an unenlightened culture. Back to the story, on my discharge papers there was an allusion to my medication being declined, and the nurse said the pharmacy had just called and asked if it was to be filled, and that it wouldn't be. I'm not sure exactly, but I had further refills on my hormones and it seems as if they were preemptively declined by my doctor, cutting my several months of hormones left down to what I had on hand, 2 weeks of estrogen and spiro. At this point I decided it was best to just leave this whole situation behind me, and on walking out I was greeted with stares and sheepish smiles, as if they knew something they weren't supposed to. 

I walked out of the building, got on the phone with planned parenthood in California and found out the doctor who had signed my original prescriptions had moved on from that office, and that I would need to physically come in to renew my prescriptions. I stayed tough, trudged to the snow to my hour long RTA ride from Parma back to downtown Cleveland. I filled a large McDonalds cup full of cheap wine and hopped onto the Lakefront Lines bus back to NY, a 4 hour red-eye trip of contemplation and feeling like shit. I shared my libations with a mohawked kid from Detroit who sat next to me, he was happy to have a friendly girl to talk to while he was on his way to the city, he was making the trip to bury his father. We talked about our favorite music and movies the whole time and took turns playing Dead Space on my Itouch. I met my friends at the bus stop in NY, big hugs, went home, got into my PJ's, hugged my teddy bear and cried myself to sleep.

And here I am. The girl you see in the videos, the smiley, pleasant young woman, that's really me. I have a temper, sure, but I don't show my cards, not ever. I internalized all this, and will use this experience to work towards a better future. I wanted to call my doctor a hick and ignorant and all sorts of things, but I kept my cool, I did everything I could and took the experience with me, the one who raises their voice to a yell is always the loser in any situation. I walked away with my pride intact, one of the few things I have left. I've got a wealth of options ahead of me, but I'll save that for my next post... rest assured, I will continue taking the hormones I have and get more before I run out. I've always been able to come up with whatever I need and this time will be no different, nothing will stand in my way. I started this post with a quote that I don't quite understand, but i'm going to end it with something that makes much more sense to me.

I feel like talking but don't preach
I'm all right
God don't make no junk
So you see
I'm all right
There's nothing wrong with me

-the halo benders

5 comments:

Brady said...

The minute you said Kaiser, I knew what I was going to read. I wouldn't use that type of medical coverage for anything, and I have no special circumstances to deal with.

I'm sorry you had that experience. Hopefully you can find employment with a nice PPO plan that has a large amount of options to choose from one day.

Anonymous said...

You seem to recognize that the doctors fear was only a reaction to something being introduced to her that is different. GOOD FOR YOU. Keep your head clear and dont let people's judgments get to you.

Unknown said...

Hey... I know Denver is kind of far but here's the link to my doctor.

http://www.mountainviewfamilymedicine.com/

Her name is Dr Anna Wegleitner. She's one of the only doctors in Denver that deals with transgendered patients, and she's amazing. Aside from the receptionist, the visit went amazingly.

The only problem is that they might not accept your insurance. I've been paying out of pocket for all of my treatment. Its just another option for you.

Unknown said...

Oh yeah! another option.

http://www.wpath.org/

:)

Kvetinka said...

Hi Riley,

Maybe it is time for legal name change. Afer name change you also have to inform all insurances and get new documents. That is the only protection in conservative environments like you experienced.

Kvetinka