Friday, December 08, 2006

Doctor's Orders

Just got a voicemail from Dr. Vavasis (whom I still think of as "my doctor" even though I haven't had an appointment with him since lo these nearly 8 months ago when I first started T) at Callen-Lorde, saying that he received a phone call from a woman working for my union. She wanted to discuss with him my surgery, in order to assess whether or not to grant me my short-term disability benefits for the time that I was out of work during my chest surgery. Apparently, though, she used my old name (guess my union still hasn't caught up its old paperwork, since I've corrected it in all the various departments).

Anyway, he left me a message saying that he wants to talk to me before calling her back, so that he knows my boundaries, and what he can and can't and should and should discuss with her, etc. A very pro-active, thoughtful and respectful thing for him to do, and I'm very glad that he did it. I feel duly empowered.

The trouble is, I'm not sure what to tell him.

I've got an inclination to ask him to say whatever it is he thinks will get me my 300 bucks from the union. Trouble with that strategy is that I've really got no idea what exactly would be the most effective strategy.

One way would be to pretend I'm female, and that I needed to have a "reduction" done for some sort of medical reason- backpain and history of breast cancer are the two most common ones used. That would be pretty much fraudulent on every count, though, since I'm not female, had no back pain due to my breasts (unless you count from hunching/binding to hide them), and have no history of cancer (thankfully).

I could also try to present it as thought I'm a non-trans male with "excess" breast tissue that needed to be removed...gynecomastia, I think, is the usual term. Which is more accurate in some ways, since I basically did feel that I had excess breast tissue that wasn't appropriate for me as a male, and so I had it removed.

But there's also the fact that I'm pretty sure Dr. Brownstein filled in the form with "transgenderism" as the reason for my surgery. I'm not certain, though, since I foolishly had him fill it out and send it right back to the Union, rather than through me so I could see what he put.

That right there might have doomed me, since most health insurances as a matter of course routeinely deny anything that's associated with Gender Identity Disorder or Transgenderism or any such diagnosis. Which is frustrating, if you think about it, seeing as how insurance companies (and other authority figures) often require a diagnosis in order to grant any sort of validity, but then turn right around and exclude anyone with those diagnoses from insurance coverage or non-discrimination policies like the ADA.

So, what to do, assuming that the union knows that I'm trans? (which, well, duh. not just Dr. B's form, but also the fact that I changed my name from Emmalyn Cassandra to Elliott John, and also the fact that my original membership form says F but all my stuff now says M, etc- and a note on that, now...sometimes I wonder if maybe it wouldn't have been easier to lie more on some of my forms when I was often being read as male but before I had the ID to back myself up. I often wasn't asked for ID or, even when the telltale F was presented, it was often overlooked. sure, I would've been perjuring myself, but really, it would just have been preemptively telling the truth. and it might've saved me some trouble now.)

I think there's two approaches we can take- there's what I think of as the Classic Transsexual Model, such as it, talk about how it's Medically Necessary For Transsexuals To Have Chest Surgery, and how I was in Intense Emotional Distress, and this is a Necessary Step in the Harry Benjamin Standards of Care, and I had to do this for my own good. so I could be Normal.

which, while it has elements of truth in it (I do feel more normal now than I have in a long time), is also a fucked-up narrative that I feel a little icky for taking part in and perpetuating. I don't know that I was in intense emotional distress (though this might just be my penchant for downplaying my own troubles talking), and I certainly don't believe that it's necessary for all trans folks to have surgery and/or follow the SOC in order to be respected and believed and validated in their selves and identities. And I think it's dangerous to perpetuate that model, and why it may be dangerous to have trans health regulated by the insurance industry...we may end up with slight victories (insurance coverage!) at perhaps great cost (only if you fit the appropriate rubric!). Such as the policy in NYC about changing one's birth certificate...the Board of Health (bastards!) voted down the recommendations to allow less rigid guidelines about what's necessary before issuing a new birth certificate, so as it stands, trans bodies (our own physical bodies) are being regulated by the state- no new birth certificate unless you've drastically, expensively, and who-knows-how-successfully modified your genitals, according to THEIR notion of what's necessary in order to be a transperson. Not even what's necessary to be just a "man" or a "woman" but still, because they won't issue an entirely new document but rather an 'amended' document, a "transsexual" as defined by the state. Urk.

But, back to me and my union.

You can see why I'm wary about participating in/perpetuating these "medically necessary" notions, but at the same time... I do believe that this chest surgery was a medically necessary procedure for me, as part of my own personal medical transition. I really needed to have surgery in order to feel whole (ironic! scars signify not absence or loss but gain of self!), and I believe that surgery costs themselves should've been covered, as well as time out of work.

I'm not fighting on the surgery itself front (oh I wish, though!) but I am going to fight this fight about time off of work.

Sooo....I think I'm going to ask Dr. V to say that I'm a ftm transman under his care, that he's supervising my transition, that chest surgery was a medically necessary part of my transition. If they need to know if it was causing me pain/distress, then yes, it was.

I hope this works. I'm tired of fighting. Though I better not be, since I'm sure this ain't my last fight.

I'm wondering if this is going to affect my chances/opportunities to have a hysterectomy one of these days. Hopefully not. Not that I'm sure I want to have a hysto, but it seems like probably an inevitability, given everything I've heard about PCOS and endometriosis and the effects of long term T on one's bits, and the ever-diminishing likelihood that I'll ever be able to use those bits for anything ever again, so why not get rid of 'em?

It seems so long ago, though it was only August- I'm straining now to remember details, like the day of, getting back to the hotel still wearing the anti-clotting stockings, and trying to stay awake through a Project Runway marathon. And my new blue pajamas that I wore for days! and the flowers that Rochelle sent me the day after surgery. (see left for picture proof, with bonus hotel room background)

And how I was hunching over for a few days afterwards, keeping one hand on my chest, semi-convinced that things would just...fall off, if I straightened up or took my hand off my sternum. Though now I think maybe it's just that the binder was a little loose, and would slip, and make me worry. (as evidenced to the right, with bonus cable car in the background- yay, San Fran!)

And the first peek that I got at my chest, back in Portland, holding the binder away from my chest, and my worried feelings about looking...well...ravaged. Bruised/taped/scabby. It was a bit scary that first night I saw it, honestly. I didn't want to admit it for the world, of course, because being scared sounds like regret and not for one second ever have I regretted this. But I was for a while worried and scared and wondering "what did I just do to myself?" when I couldn't life my arms and everything was sore and swollen and different.

It seemed like it'd take forever to get better, but now, barely four months later (four months nearly to the day, actually), I feel fine and fantastic- fit as a fiddle and ready for love!

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