transdocfail

Charring Cross Gender Identity Clinic: Caution

My first appointment at the Gender Identity Clinic in London was with Dr James Barrett in April 2012 (a little over a year ago).

Useful context: I am autistic, asexual, aromantic, I am becoming more and more settled in my sense of self. I am in receipt of DLA and ESA. I have been aware that I am agender since 2011. I have consistently wanted chest reconstruction since I found out it was possible for transgender individuals on the NHS.

I’ve just received the letter he sent to my GP following my appointment; I can see why they took more than 6 months in sending it to me.

  • He starts by referring to me as “this” (ie: it), and then switches to “she”. (I told him that people close to me call me “they”, but if he doesn’t like that he can just use my name.)
  • He refers to my gender identity as “gender identity problems”, “uncertain”, and “a disturbance of gender identity”.
  • He judges that I “would probably attract a diagnosis as a schizoid personality”. He fails to mention my seeking an autism diagnosis, which we discussed in some detail.
  • He told me that I probably wouldn’t be eligible for treatment, “because lots of women call themselves bisexual in their 20s and by their 40s they’ve got married and say they’re straight.”
  • He told me that I would lose my benefits and have to get volunteer work to stay on jobseeker’s allowance. This has not happened, but he frightened me by saying it, and it was entirely inappropriate because the appointment was about my gender and not my disability. He then says in the letter to my GP that this would be a good thing, because it would give me a chance to see whether or not I can “sustain” a nonbinary gender identity outside of social situations. (Ie: he clearly thinks that this is a whimsical phase and I am just pretending to have no gender, as if I would give up when it got difficult.)
  • He implies that I will change my mind about wanting kids, and refers to the “ticking biological clock”.

He has passed judgement on aspects of my health in which he is not specialist. He has consistently misgendered me and calls me “it”. He frightened me by promising that I would have my little financial support withdrawn. He implies that my gender is something I am trying out, rather than something I am.

He might not be this way with other patients, and I don’t wish to discredit him. I am too tired to make a formal complaint; I have explained to another doctor at the clinic that I don’t want to see him again. But this seems to me like something that it’s important to share. I’d like to add that my treatment by other doctors at the same clinic has been extremely good and very helpful, and I would recommend seeing them if you have gender stuff going on and have the option of a referral.

Cassian Lodge

Edit: I have since found out that he’d written a chapter called “Third Sex” about third gender people back in 2007; it seems he’d already decided he knew all about people like me.

Has your doctor ever laughed in your face during an appointment? Denied that your condition exists? Or simply told you that you’re too ugly to merit treatment?

Outrageous? Yes, but also, pretty much par for the course if you happen to be trans. You must expect a world of abuse and humiliation to attend even the simplest of interactions with the medical profession, whether trans-related or not. As for making a complaint, few will risk it: most are cowed into silence by the tacit threat that rocking the boat could lead to a termination of their desperately needed treatment.

Of course, there’s little new to this. Wherever there is power imbalance between patients and professionals who control access to resource, there is a risk of an unhealthy relationship developing. From benign paternalism to outright bullying and belittlement, the pattern is repeated time and time again – with women, disabled people and those with mental illness frequently on the receiving end.

This tumblr was created so that folks can anonymously submit to TransDocFail and be posted via twitter - where transgender folks can discuss their bad experiences with doctors, general practitioners, and others during their transitioning journeys.

ACTUP.ORG Article: As the #transdocfail hashtag showed, many trans people are afraid of their doctors

On twitter, follow the hashtag #transdocfail to read the terrible stories.

Trigger warning: posts may include misgendering, cissexism, transmisogyny, sexual assault, discrimination, etc.

quick reminder that not all parents are supportive or caring some just yell at you for years about not having health insurance and don’t offer assistance when you’re broke chronically underemployed and just got denied disability and medical assistance some say they are supportive but can’t be bothered to remember your name or the name of the doctors they took you to as a kid to pump you full of all the wrong chemicals and surgery you did not ask for some parents fight for their kids and listen to them when they say they are being beaten and molested at school and in relationships but that’s not everybody’s experience I just want you to think about that for a very long time and know that if your folks are there for you you’re very lucky please to not rub it in my face today, thanks

URGENT APPEAL FOR DR CURTIS

As many of you know, London doctor, Dr Curtis, a trans doctor who treats trans people, has been at the centre of a huge NHS-sparked witch hunt against him. They have used my medical documents with my forced consent to twist my words and history of his care of me, whilst continuing to hurt and bar trans people, especially non binary people from life saving treatment.

See what we are saying by following the #transdocfail tag on Twitter- thousands of voices are speaking out and more and forced into silence in order to get meagre treatment, under a barrage of cissexism from doctors.

THIS IS TO INFORM YOU THAT UK GROUP GIRES IS COLLECTING SUPPORT LETTERS. They are coming to the aid of Curtis and need your letters and emails to back up the proof that he is a positive force in the world of UK trans treatment.

Please email them on: info@gires.org.uk for more information and ask for Bernard Reed who is the one orchestrating this.

I could go on for pages about the problems faced by trans* people accessing treatment, but at the core are two main problems. The first is the fact that gender is seen always and exclusively as a binary. It is assumed that if you were assigned male at birth and are not male, that in asking for any form of treatment you are asking the medical staff to make you as close to their idea of cis female as possible. For some people that’s what they need, but for others their gender identity doesn’t resemble what their doctors think of as correct, and the pressure that can be laid on them to conform to what is expected can be immense, and treatment that they need to eliminate their dysphoria can be denied because, for example, a trans woman would like to have a pixie cut, yet their doctor believes that all women should have long hair in order to present as properly female. There are a significant number of people who feel that their gender doesn’t fit neatly into either male or female, and would like medical help to change their presentation to more accurately fit their gender. At the moment, it seems that the only option available for these people is to lie, as if they tell their doctors the truth, it may be taken as evidence that they are not serious about transitioning, and they could forever lose the chance to access the medical care they need to cure their dysphoria.

The second problem is that so much of the process seems to serve the sole purpose of stopping you from making ‘a hideous mistake’. The process is lengthened by multiple appointments with psychiatrists and therapists whose role is to assess the mental health and sanity of those seeking treatment. Tweets yesterday on the @TransDocFailAno account and the #transdocfail hashtag made it clear that, for many medical professionals, depression and other mental health problems were considered to be barriers to treatment that in some cases were used as excuses to delay treatment for dysphoria, and in other cases only the dysphoria was treated and other mental health problems ignored. Mental health issues blocking treatment for dysphoria is dangerous when dysphoria creates those mental health issues, and depression is immensely common in trans* people.
—  Charlie Hallam, “As the #transdocfail hashtag showed, many trans people are afraid of their doctors - Trans patients should not have to please medical staff before they can access treatment, writes Charlie Hallam.
fuck you

to all the people who abused me to try to teach me how to protect myself from future abuse

to all the people who tried to change me instead of ever trying to understand me

to all the people whose comfort was apparently worth so much more than mine

to all the people who stood by and said nothing

to all the people who stopped talking to me

to the closet you beat me into

for taking 25 years from me

for making me feel less than

for kicking me where i’ve just had surgery

for not listening when i tell you how people are treating me

for sedating me and destroying my endocrine system instead of trying to help

for being ashamed of me because of what you think other people will say or think

for teaching me that trust, support, care, nurturing and acceptance are not things i deserve

for leaving me out in the cold when you can see me shivering and you see me doing everything i can and you know it’s not enough but you just keep walking

i am approaching the end of my rope. i cannot do this by myself. i have reached out to everyone i can think of and i am not getting the things i need. i am in constant pain and i know exactly what will make it better and not knowing how i’m going to get there is killing me. how am i supposed to keep on pretending everything is ok when it’s not?

i am falling apart and it’s nothing new and i have no safety net and i am used to tightropes but it is hard to balance all these things at once. i work as much as i can and i try to sell my music and i made a paypal donate button and i’m thinking about putting together a benefit but this does not seem like a realistic way of meeting my needs.

after all of the traumatic experiences i’ve had with family, doctors, therapists, and all other stripes of authority figures it’s incredibly difficult to ask for help. making myself vulnerable feels like opening myself up and inviting more abuse. i asked the bank for a loan and they laughed at me. i told my doctor about the pain and she shrugged, there’s no palliative treatment without the money to pay for it.

somehow i’m supposed to transcend all of this? i want so badly to believe that it is possible. that it gets better. that there is community and support and that i make it to the other side. i wrote a bunch of songs about it and i thought they would take me there and i’ve made it so far and survived so many odds that it feels like i am living on borrowed time. when i stopped taking the meds that were keeping me zombie-like at age 16 my doctor told me i had a one in five chance of living past 20. it’s been a decade and i am still alive.

but i need help.

where is help

Unpleasant disability-related nonbinary experience

So yesterday I was not very functional socially and I was pretty tired, but I had an appointment booked for a pre-operative assessment for tubal ligation (sterilisation). I had my casual-worky PA with me, just to help me get there and back safely. I also worked out in the last few days that it’s possible I might be able to have a hysterectomy on medical grounds, and then I wouldn’t have to wait 3 years for the gender identity clinic to say it’s alright. I went to the pre-op anyway, because it was very short notice to cancel and because the nurse might be able to help me.

She did help - sort of. She offered to call and ask about an appointment with my gynaecologist. While she was on the phone she referred to me as a young lady and called me “she” the entire time. When she got off the phone she told me that she had made an appointment for me on [day] at 9:20am. I immediately said “I can’t do that” and she got a cross face on. I explained that I can’t do anything before midday, and (as she already knew) I was autistic and needed a PA to help me get to and from appointments, so any appointment had to be okay with my PA too.

This is where it gets weird. I said that before we go any further she needed to know that I’m transgender (which I had already mentioned pre-phone call in passing), and not to call me a lady or “she”. She immediately got really snippy and said yes, she had read my notes thoroughly before I came in. I pointed out that she called me young lady on the phone and said “she” repeatedly on the phone. She called it a slip-of-the-tongue. Ummmmm?

Anyway, then I called in my PA, and she proceeded to make another phone call to rearrange the first appointment, again at no point pausing to check whether the date and time she’d arranged for me was alright with me or my PA. If it hadn’t been okay, she would’ve had to make another phone call. Why didn’t she just ask us while she was arranging? If she knew I was transgender, why did she wilfully misgender me while I was right there?

She then started discussing my health and the risks of various procedures, with my PA, and pretty much acted like I was a bystander. WHAT EVEN.

I know, I know. But it’s annoying.

Please stop pushing things onto me that I don't want

I really hate it when doctors, councillors and other trans people treat me as if not wanting genital surgery is something I’ll “grow out of”. I don’t appreciate people who are supposedly experts on trans issues trying to tell me what they think I should get out of my transition. Surely gender specialists of all people should be capable of recognising that gender identity is not just limited to those who have penes and vaginas, and those who want penes and vaginas.

I’ve said many times before that HRT is all I’ve ever wanted, and I’m happy to stop there. This seems to always be completely dismissed by my doctors and councillors though, as I’m often criticized for not looking at the bigger picture and preparing for any future surgeries.

This is actually quite worrying, because if medical specialists are incapable of understanding that genital surgery isn’t a requirement of being trans, then I could easily have my current treatments withdrawn on the basis that I’m “not really trans”.

I can understand that a lot of people get genital surgery, so I can understand why it would be initially assumed. However, I shouldn’t have to find myself questioned or ignored for not being part of the majority. More importantly, I shouldn’t have to find myself being pushed into body-altering treatments that I don’t want simply because people can’t understand that I’m content where I am.

Keep on waiting for the world to change

Its been almost two years since I started HRT and while it has made a big difference it does not change or replace my need for reconstructive surgery. I thought for sure I’d have a date by now, or insurance or medical assistance or social services but that’s not how it’s worked out. Despite slow movement in the right direction on federal and local levels I have had to accept the fact that just because I’ve watched friends and family get the medical care that they need, that it is not my experience and never has been. I have a lot of PTSD from doctors offices and this ordeal with getting denied everything repeatedly has only made it worse. How do you make peace with unacceptable circumatances? I’m not strong enough to do this on my own. I’m not able to support myself enough to even meet my basic needs how am I ever supposed to be able to go the distance, value myself enough to get the things I need. I keep telling myself that I will do whatever it takes to see myself in the mirror and I’ve been trying it just doesn’t feel like it will ever be enough, to make my dreams realistic, permanent.

I’ve really grown to resent gender identity clinics over the years. After being pretty much ignored for years while I badly needed them, and now essentially being talked over while being expected to go through a bunch of shit that clearly isn’t necessary for me now, I’d really rather just not bother.

If I were actually capable of funding my HRT prescriptions outside of the NHS (which I really am fucking myself over trying to pay for), I wouldn’t even bother getting involved with a GID clinic at this point… The most irritating part about it all is that a prescription is literally the only thing I want from them. Everything else is something I’ve either already dealt with, or am not interested in, so I’d really rather just come in, pick up what I need and not have to ever come back, rather than go through 6 fucking months of therapy when it’s already clear from both my visit and from the letter that my GP wrote to your clinic, that I’ve already been diagnosed, had sperm banked (although the status of said sperm is incredibly dubious), ran an official name change, been referred to 4 gender clinics, started HRT on medical record, and done most of this 3 fucking years ago!

Also, it really pisses me off that I never seem to be able to say that I don’t care about any type of surgery to a specialist. The last time I mentioned this, I just ended up getting a description of the lead-up and recovery process for genital surgery, which I don’t remember asking for, and really only served to even further put me off something I already didn’t want… Also, every therapist, doctor or specialist I’ve ever mentioned this to (Except my GP, curiously enough), has ALWAYS given me the exact same response: “Well you could change your mind later.” Well yes, and I’ll be sure to let you know if the idea of hacking apart a functional part of my body that I have no ill feeling toward becomes suddenly appealing to me - after all, it really seems like the kind of thing that people would be on the fence about. But even with that aside, surely the option to do so isn’t going to go away, so I don’t understand why this sort of thing is even worth mentioning. If I really do later decide that I’d rather have my penis on the inside, then we can just talk about all the details then, while I’m interested.

There really is something wrong when my GP, someone who has no prior experience in gender-related issues, serves my needs far better than every single clinic I’ve ever seen, even though a lot of his solutions are compromised options, since he’s pushing against a system that’s extremely reluctant to facilitate my treatment outside of a clinic.

This post wasn’t even meant to be a rant, but I got angrier as I wrote it…

Cissexistneurotypicalistclinicfail

I will run out of estrogen this week. The endo won’t renew the prescription without a new appointment. The clinic screwed up my last appointment. I went through hours of pain on the bus and in the waiting room to find out they had cancelled my appointment while I was waiting there for my appointment. I don’t have the mental energy to try again, and will have even less energy when my estrogen runs out. I can’t deal with the hours of pain and I can’t be sure that they won’t cancel my appointment again.

If we as trans people had better access to health care, this wouldn’t be so hard.

If we as autistic people had better access to health care and public accommodations, this wouldn’t be so hard.

If you consider yourself a cis or neurotypical ally, ask yourself and us how innaccessible such things are, and ask yourself and us what you can do to change things.

Omfg I hate doctors sooooooo much

I swear this happens ‘every’ fucking time…. no matter how many times they do it or how specifically I ask.

I’m like “hey made an appointment for a blood test to make sure estrogen/progesterone is in normal female ranges and that spiro is blocking testosterone to normal female ranges too.”

Doctor: “okay draw blood and come back in a week~”

*comes back in a week*

Doctor: “blah blah blah bloodwork about a bunch of things I don’t care about”

Me: “soooo yeah. Am I in good ranges for hormone levels?”

Doctor: “hmmmmm.. what?”

Me: “you know, whats my estrogen/etc levels at?”

Doctor: “Oh… you see we have to specifically check for that!! And I didn’t! I just did a normal blood test!”

Me: “….but that’s what I 'specifically’ asked you to do….”

Doctor: “….”

Me: “….”

Doctor: “well come back in two months when I have an appointment available again and we’ll do that!!!”

And…. omg… this happens with every doctor I’ve had. And it happens multiple times in a row to the point where after four years on hormones I still dont know if I’m taking the correct dosage because doctors refuse to give me any info or take necessary steps in helping out.

Really just hate them…

it doesn't get better it just keeps getting worse

I am so frustrated about not getting health care or medical assistance about how I have been unable to set surgery dates or even afford to keep working on my face its like no matter how important these things are to my transition I’m not allowed to have them I’m just stuck with scars and pain and unwanted secondary sex characteristics from when they forcibly transitioned me as a kid and its just like. ugh. how was THAT ok but now THIS is too much to ask. I am not allowed to heal or recover or get what I need because it is unacceptable. But the medicalized erasure of my deviant body and psychological erasure of my queer adolescence was business as usual. I am in so much pain and being told NO a thousand times is only making it worse. It has destroyed me to a point where I cannot even take care of or support myself I am a train wreck of stigma and culturally approved sanctioning I am not supposed to exist but I’m not allowed to get what I need so I can shut up about it I’m not allowed to be hopeless or suicidal I’m not supposed to exist

I feel like I'm being ignored

Hey doctors, it’s only been over 2 months since you were supposed to give me the anti-androgens that were meant to come with the rest of my treatment.

I’m not getting any better over here; Actually, I get worse the longer you leave this…

#transdocfail

mx-magpie said: Yeah damn right, you deserve respect. My GP did a similar thing with a letter I needed. They constantly and purposefully misgendered me and very un-subtley implied that my gender was my invention/delusion. Basically UK GP’s are shit with trans* people.

Oh no, that is so awful. :( There’s going to be a letter of complaint about my GP’s conduct, for sure. I feel like I can’t just let her treat me like this and have me just sit back and take it. But as you probably know yourself, it’s just so stressful. We shouldn’t have to deal with this crap.