many of us who are trans women live in a unique double-bind when it comes to basic medical care: this question on intake paperwork, which has a completely benign intent but ends up leading to the very bad decision: do you lie, or do you tell the truth and probably deal with problematic behavior?
i know why it has to be asked of womankind generally: it’s critical to know if someone is or isn’t pregnant before giving them medication for the condition they present with. it’s a bad idea to give a number of meds to a pregnant woman, or, god forbid, send her for x-rays. it’s not designed to block medical care for trans women, but the end result ends up being that it does, and there needs to be a better way to handle it because in many situations disclosure really isn’t necessary and the danger to our health, person, and dignity is really unacceptable.
i’m sick of lying to appease people, especially people who should know better, and medical professionals, from the office staff to doctors, really ought to know better by now. i know all the excuses, from Anne Lawrence to “we’re not familiar with…that, somebody else deals with that” to the reality that someone will either freak out and start yelling or alternately you get treated like a freak, asked improper questions, and probably misgendered by someone who would never have thought twice about you if you hadn’t said anything. it’s a bad scene because even if the doctor might be cool, a nurse or an office staffer might not; similarly, a nurse might be totally okay with it but the doctor themselves can’t discern you from Anne Lawrence and the results are expectedly horrible.
there is no special medical procedure involved in treating a trans person when they present with a sinus infection or a rash that would somehow differ from how you’d treat a cis person in the same situation. no matter how you try to throw in variables, there’s no magic difference between our bodies. yes, there can be a few minor differences, but estradiol does not somehow have a magic pull over the snot in your sinuses which causes your disease or disorder to be different.
i often end up getting much sicker because of this dichotomy. i live in a city where there are fairly few “trans-friendly” medical professionals (or at least there are fairly few who anyone will speak of publicly) and they generally focus on being dispensers of hormones and thus gatekeep your fitness for being seen by their practice that way, which is pretty much bullshit but such is life. for some reason, nobody has bothered to figure out the radical idea that a trans person (locally, specifically a trans woman, as there are a number of medical access options for trans guys that we don’t have) might need routine medical care, so it becomes a nasty waiting game: try to fake it without medical care, but have an established point where once you’re so sick, you go to the urgent care and forge your answers to this question (five days ago, haven’t had procreative sex since…you’re welcome), and then hate yourself for the next week and hope you don’t do anything stupid to yourself out of the self-loathing over lying, but at least the pneumonia won’t kill you, this time.
i’m not saying medicine shouldn’t ask this question…what i am saying is that you should probably have an option for “yes, i’m sure i’m not pregnant” while we’re at it. it would be helpful for cis women who don’t bleed, and most cis women don’t really want to talk about their menstrual cycle with some random doctor of the day who knows nothing about their body and cycle anyways, since, really, everyone’s so different and medicine really believes 28 days is normal, 28 days is absolute, and 28 days…well, guess what? it’s not, and it’s never been. it’s an average, a number which is designed to represent fictitious Average Fertile Cis Woman in her average stress-free life with her average (white) Toyota Camry who lives in Averageville, U.S.A. if you see a doctor for a while, they might get to figuring that out, but when it’s some random dude at the urgent care (and why are all the local urgent care doctors male, anyways?), it’s useless for a thousand reasons.
medicine, alas, is not a beast that is likely to embrace change. it’s stayed painfully white, cis, hetero, and male for a very long time, and this reality is much of what keeps it so hostile to trans people generally and trans women in specific. i do not know how and why doctors form their opinion of trans women; i am quite aware that we’ve had our share of trans women who were doctors and behaved rather problematically in public, but it’s not like Joe Blow at the local urgent care knows any of these people, and besides, even if he did, one bad apple doesn’t mean we’re all like that, yet no matter what, medicine sticks rabidly to its fears and the worst-case scenario when it comes to trans people, especially when it comes to trans women. somehow, at the end of the day, i think that’s my real problem: i can do all these things in life and yet i can’t manage to convince some random doctor that i am good enough to be treated like an actual human…i can’t convince them that i am any different from, well, Anne Lawrence.
…and you know what? that’s why this really sucks. we’re still considered freaks by medicine unless there’s some clear way to profit off of us, and then we’re good enough as long as we know our place, but don’t expect to be allowed luxuries like basic medical care or treatment for chronic conditions, because that’s just asking too much.