Posts Tagged ‘health’

Question MarkA reader writes: “I’m in high school (Junior), but am very open about my gender identity (cross dress, bind, etc). At this point there isn’t a whole lot I can do about hormonal treatment or surgery. So instead I try to do what I can, at my age. I bind, as mentioned, and use a commercially available binder.

“It has been fine, but lately I’ve gotten a lot of pain, difficulty breathing, and nasty bruising on my rib-cage. I wear it too often as it is (about 12 to 14 hours a day, nearly every day), so I know the best thing to do would be to just stop wearing it so much.

“Unfortunately, this is a problem for me as my gender dysphoria has also gotten much more severe as of late (and includes thoughts of self-harm and things we don’t need to get into). It’s a difficult trade-off for me to consider – wear it less and hopefully not end up with a serious injury in the hospital and cause my dysphoria to be that much worse (which, when paired with my depression, anxiety, and raging teenage hormones can be a serious and kind of terrifying problem), or continue doing what I can to suppress (no pun intended) my dysphoria and likely end up in the hospital.

“My mother doesn’t take my depression or dysphoria seriously (it took her witnessing one of my most violent panic attacks to convince her to let me see the school therapist), so advice from her doesn’t help (especially when she doesn’t offer any).

“So that’s problem one. My other problem, which is much less serious, is standing to pee. I really would love to be able to stand to take a pee, but the price of commercially available STP devices that also function as packers is insane! Not to mention the harnesses! The cheapest set I found would still set me back by $50 that I do not have (a lot of money for a jobless teen who’s worried about affording college, a car, gas for that eventual car, animals, etc). Do you have any ideas in this regard?”

Last question first – have you tried a coffee can lid? I never got the hang of it, but a lot of guys use a plastic coffee can lid with the edge or lip part cut off so that it’s just a flat circle. Then they roll it into a kind of tube and pee through it. You can also buy a sheet of thin plastic at the hardware store and cut a coffee-lid-sized circle out of it. It’s explained here on TransGuys.com, along with other suggestions, tips, and links for the Stand to Pee situation. (more…)


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Question MarkWe have two letters below regarding testosterone – first, from someone who can’t take it, and next, from someone who doesn’t want to. I hope readers will chime in with their suggestions and personal experiences.

A reader writes: “Though I have had top surgery, no doctor will prescribe me T because of my health problems, and I cannot find it through other channels. Add that to crippling bottom dysphoria, being five feet tall, and being universally misgendered, I am not a happy guy.

“I have a fantastic long-term boyfriend, a queer cis guy who sees me as I really am, but my own angst is magnified by the way the rest of the world treats us. Either I am treated as his ‘little lady,’ with waiters handing him the check when I give my credit card, gay men saying I’m a fag hag, being called a butch dyke, or being offered ‘makeovers’ to ‘look like the pretty girl stuck under the boy costume’ (oh, the irony).

“My boyfriend and I try to explain endlessly about me being a trans guy, and we get met with reactions ranging from puzzlement (‘I know a trans guy who really looks like a guy, but you don’t, and I can only think of you as a butch girl’) to laughter (‘You’re joking’) to hostility (‘You’re a crazy bitch and he’s a closeted fag’). I wish I could let all this misgendering go, because obviously our explanations aren’t making it better, but I just can’t.

“So, my question is twofold. Firstly, when I came out in 1999, we needed therapist letters (which I had for my surgery) to get treatment. Now, there are informed consent clinics to give you hormones even without letters, but they do require blood tests. Do you think in the future they will waive this requirement, too, or at least let people like me get hormones if we sign an affidavit indemnifying them from liability? There is no guarantee that hormones will worsen my physical issues, but my gender angst has gotten worse over the last 15 years to the point where I don’t know how much longer I can stand it.

“Secondly, do you have any tips to make going out in the public eye easier for the constantly misgendered trans man and his boyfriend, who himself is tired and hurt by the way his love for me, and also his own identity and motivations, are misconstrued? Am I being delusional in the first place to expect anyone to respect my gender identity when, despite my teenage goatee, big muscles, low voice, flat chest, and boyish style/haircut, I am still very short and not on T?”

In response to your first question, I think it is unlikely that even informed consent clinics will change their policy on blood tests, because there is just too much liability involved. Even if you sign a paper releasing them from all responsibility, that might not hold up in court. We have become a lawsuit-happy country.

We sue tobacco companies (and win), even though we choose to smoke. We sue McDonald’s (and win), even though we choose to eat junk food. So even though it is obvious that we are making our own choices, we can still assign blame and win in court. Doctors and clinics are aware of this. Even when a person’s blood tests come out fine, that person still has to sign something saying that he/she/ze understands the risks of hormones. If medical risks are obvious, as determined by blood tests, regardless of what you’ve signed, medical malpractice might be an issue. (more…)

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Question MarkA reader writes: “My first close contact with a transgender individual was following a car wreck where the victim was later discovered to be transgender.

“Besides taking care of the patient’s physical/medical needs during transport, which, following a trauma, always includes exposing the majority of the body to examine for bruising, swelling, etc., I learned a lot about all the additional issues this person had going on. Things got a little complicated pretty fast.

“Fortunately, I was the only paramedic in the back, so was able to eventually establish how the lady wanted to be referred to, her new name, and the other issues involved, including being homeless at that time. I was able to become an advocate for her (with the other personnel).

“It takes a lot of courage for some transgender folks to discuss things with a perfect stranger, especially when in a serious medical situation. However, it would have made things much faster for the secondary care issues, and protecting the modesty of the patient even more, if the patient had given me just a little warning initially.

“Perhaps this could be a discussion on your blog sometime.”

I’m glad that you were able to have this discussion with this individual during this time of crisis. In many cases, people are not able to speak up at all about their situation or their needs – they might be unconscious or injured to the point where communication is impossible. Or they just might be too traumatized or in too much pain to communicate much.

This is a tough one, because I know that medical personnel need as much information as possible about a patient, particularly in an emergency, so that they know the proper ways to treat that patient – and even, as you say, to protect that patient’s modesty or privacy.

And even in an emergency situation – actually, especially in an emergency situation – using the correct name and pronouns with a trans person is extremely important. It’s scary enough to be in that type of situation without experiencing any kind of prejudice or misgendering. It’s also very comforting to have an advocate, so thank you.

But sometimes, even when a person has the capability of speaking up, that person might not feel comfortable disclosing a lot of information – or might not even think about it. Here are some reasons why a trans person might not disclose personal information about his/her/hir body in an emergency situation: (more…)

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Question MarkA reader writes: “I am a woman who recently started dating a man who was assigned female at birth and transitioned several years ago, a fact that he shared when we began talking about having sex.

“As part of my usual pre-sex discussion, I asked him about getting tested for HIV and other STIs, and he said that he has had very negative experiences with health care providers and was not willing to get tested.

“He said that since he has not engaged in risky behavior since he was tested several years ago, he could not possibly have HIV, and that he can’t transmit any fluid-based STIs to me anyway since he can’t ejaculate. (There are of course skin-to-skin STIs, but those are more difficult to test for).

“I know the likelihood of getting a fluid-based STI from him performing oral sex on me is very low, but I would still like him to get tested. From his vantage point, because of the very low risk factor, I am making an unreasonable request. From my vantage point, getting tested is something that responsible adults do to take care of themselves and their partners.

“However, I know that it is difficult for me to fully understand his resistance to medical settings, and the last thing I want to do is traumatize him or pressure him to do something that has a negative impact and have him end up resenting me. He appears to identify very strongly as male and not as trans, and I don’t think he would be open to going to an LGBT clinic, as he has felt marginalized by the queer community in the past.”

I completely understand his discomfort with medical providers. Many trans people feel this way, and many do not get regular health care, even if they can afford it, because of their concern about how they might be treated or their trauma because of how they have been treated in the past.

And not all STIs can be diagnosed with a simple blood test. Some require examination, a urine test, or cells taken from the genital area, which can be very unpleasant for anyone, but particularly for trans people. So I do not fault him for this at all. (more…)

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Question MarkI’m getting a little backed up again, and this week is my “holiday” week, so I put some short questions together with some short answers. For my many question-writers, thank you for your patience. I’m getting there!

I am also working on trying to make the blog a little easier to navigate (I hope) by adding some specific categories so that readers can more easily find old information and posts that might apply to their circumstances. I am trying to redo my Categories, and it’s taking some time, so again, thanks for your patience.

Here are this week’s questions:

A reader writes: “I’m an FTM transgender person. I’ve already picked out a first and a middle name, and I chose to stick with my last name. The problem is I like the first and middle names that I picked, but I also like the first name given to me at birth. I just can’t seem to find a way to add my birth name in there. I need a bit of help or advice.”

I answered a very similar question recently, so I am going to link to that post, Choosing a Middle Name, because I think it could be helpful. I would also recommend reading the comments. A reader suggested something that I didn’t even think of when I was answering the question, which is that the writer could have two middle names.

If you have a first and middle name picked out that you really like, but your birth name is special to you, use it as another middle name. You can even decide to go by one name in a professional setting and another in a personal setting. So don’t feel limited. Changing your name is an opportunity to have exactly the name that you want, so go for it!

A reader writes: “Do you know anything about the connection (or lack thereof) between testosterone and cancer? And any thoughts on how this might affect one’s decision to go on T?

“My second issue is, I am thinking about going on T to transition from female to male, but I have a really bad needle phobia. If I don’t miraculously overcome it, I won’t transition. The thought of giving myself shots for the rest of my life is too overwhelming. Do you have any advice or know anyone who has been in a similar situation?” (more…)

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Question MarkA reader writes: “I just read this extremely sad news about a transman in Belgium who chose to end his life (legally) after a series of unsatisfactory gender-confirming operations

“I wondered what your take on this news is, more from the perspective of the issues FTM people face than from the question of whether euthanasia should be legal (which is the primary focus of the HuffPost article). Though of course the question of whether euthanasia should have been authorized for this man’s situation is very relevant as well.”

I was also very sad when I first heard about this situation. And even though you said that you weren’t asking about my perspective on euthanasia in general, I’m going to put it out there anyway.

I am a supporter of euthanasia, assisted suicide, or similar arrangements. I believe that people should have as much control over their own lives as is possible, and that includes having control over their own death.

I think if someone is of sound mind, has been made aware of all the other options available, and has determined that death is the best option – not just for the moment, but over the very long haul of eternity – then that person should have the right to pursue the best option.

So based on that, I support what this man, Nathan Verhelst, did. According to everything I’ve read, he was living with unbearable psychological pain. He had to apply for the procedure, go through a waiting period, go through counseling, and so on, before he could die. He made the decision and stuck with it through months of waiting, so I feel as though this was a part of his life that he had the right to control. (more…)

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Question MarkI have two letters with relatively short answers (for me!), so even though they’re not related, I put them together into one post. And here we have them:

A reader writes: “I’m a queer cis femme, and I have a number of close friends who, over the past few years, have come out as trans (FtM). I consider myself a strong ally, and I have had no problem adjusting to their preferred names or pronouns, but there is one issue that I am unsure about.

“In many cases, these friends and I share mutual friends and/or acquaintances who may or may not know of a trans friend’s past. When telling stories about various adventures or experiences with a trans friend who, at the time, did not identify as trans, which pronoun should I use?

“I don’t want to accidentally ‘out’ them to people who don’t know (or don’t need to know) the whole story, but I also want to stay true to my friend and true to the story. If we did something together – let’s say, went camping – then should I say, ‘She and I went camping last summer’ or ‘He and I went camping last summer’?”

The best thing to do, particularly if you are talking about relating stories about this person when he is not present, is to ask the person. You will need to ask each one of your friends, individually and privately, what he prefers if you happen to be talking about him to others when he is not present, particularly when those people don’t know that he has transitioned.

However, as a general rule when talking about a trans person’s past, whether he or she is present or not, the following two things apply:

1. Always use the pronoun that the person currently uses, even if everyone in the room knows that he or she is trans. For example, when referring to a trans man friend, you would say, “He and I went camping last year,” “He and I grew up together,” or “I’ve known him since he was five.” The same rule applies with trans women. You would always use “she,” regardless of the time period you are talking about. If the person uses a pronoun other than “he” or “she,” then use that one.

There’s nothing more aggravating than reading a news story about a trans person and seeing that the writer uses both pronouns to refer to the person, as if the writer’s sole purpose was to confuse the public: “She was a nuclear physicist prior to her transition from female to male, and then he became an astronaut.” Huh? No, he was a nuclear physicist prior to his transition from female to male, and then he became an astronaut. (more…)

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