Thursday, October 04, 2007

of UTIs and authenticity

I had an experience at the doctor's office today that's left me a bit nonplussed; I suppose I'll need to get used to explaining myself, when I move out of NYC and away from my very knowledgeable, respectful doctor. I was startled today because I did go to Callen-Lorde, which is the LGBT center- I guess it's too much to ask for that even the medical professionals at an LGBT health center be totally professional and knowledgeable around trans issues.

I had to make a last minute appointment this morning, having developed my first ever (wicked uncomfortable!) UTI. My usual doctor isn't in on Thursdays, so I got sent upstairs to see whichever PA had a free appointment. Anyway, it was a fairly routine trans patient/clueless doctor situation:

I explained to him my suspicions of having a UTI, that I'd never had one but that Google and all of my friends had diagnosed me. He started asking about symptoms and behaviors on my part, and right about when he started asking me about what my penis looked like is when I realized that he didn't know my trans status. I'd discovered, in my assiduous Googling of symptoms, that UTIs are much more common in female-configured folks. I'd guess that most folks who are assumed to be female are pretty readily assumed to have one of those pesky UTIs, but that male presenting folks are questioned more thoroughly to rule out other possibilities, since it's not so common to have a UTI. Or maybe this guy always asks these questions.

In any event, I thought it prudent to enlighten him as to my actual genital configuration, and interrupted with "Um, I don't know if it says anything on my chart, but I'm trans."

He stopped, and quickly ran through the not unfamiliar puzzled-shocked-embarrassed-nervous cycle of facial expressions. I've seen it before, especially on gay men (which, unless my gaydar betrays me, he was). I could almost hear his train of thought: You're a tranny? Why the sideburns? Why no makeup, high heels, skir....oh. OH! You're really a girl! I mean, shit, you used to be a girl and now you're a boi. I mean, a boy. But you looked like a real guy when I was talking to you. Actually, I thought you were sort of cute. Wait, was I just attracted to someone with a vagina? Shit, I hope I don't offend you when I open my mouth and say this first thing that comes to my mind.

Which in his case was a nervous little laugh and "Oh! Well, look...uh, that is...I don't want to offend's very good! Um, that's a compliment!"

There was a pause, during which I couldn't help but feel a little sorry for him, and be a little charmed because he was clearly trying to give a positive response. Of course, I would have preferred a non-response. I think the appropriate response for a medical professional is to say "Okay, thanks for informing me." And from there, proceed to be matter-of-fact while taking my trans status into account, asking relevant follow-up questions if necessary. ("Have you had [bottom] surgery?" would be relevant in this case; it wouldn't be if I were in to complain about a cold.)

Instead, I just said "Okay, well, besides the BURNING that I mentioned to you, everything else looks and feels normal." and sort of sidestepped the questions of what my genitals are like and how to respond to his 'compliment.' Things went smoothly from there- he ran a test, I got my prescription for antibiotics (thankfully), and there was a handshake and a smiling "Nice to meet you!" and that was that.

It wasn't til I was walking back to the subway that I had time to think about his response and how it was upsetting or not. Clearly, it wasn't the matter-of-fact response that I consider ideal when I disclose- to anyone, but particularly to a professional. That response, though, can only come from someone who is educated and familiar with trans people and transsexuality. Clearly, he is not in such a place. He's still coming from a personal paradigm of "transsexuals are really X who want to be Y" and while he may have gotten enough sensitivity training to be able to rein in that impulse and be mostly polite about transfolks, he's still used to being able to "spot 'em."

He's not used to his paradigm being disturbed: transsexuals aren't really real to him. I came in and he perceived and believed in me as a man. When I revealed to him that I'm a transsexual man, he had some cognitive dissonance that the "real guy" he saw in front of him was actually part of a group that he doesn't view as real; that is, transmen aren't really men.

That was apparent in his nervous/unthinking reaction: "'s very good!"

What was he trying to say? "You look good?" There was a hint of that, but what is he saying is good? That 'it' is my guise, my front, my masculinity. The boyness which I put on to cover my original/real girlness is working! Heck, it fooled him! But now he's not fooled anymore. Now he knows the truth.

So there's the painful rub, because now he does know a truth about me that he didn't know previously. But what's the truth that he thinks he knows? The painfulness for me isn't coming from his knowing that I'm trans, but rather his using that knowledge to downgrade my authenticity. In a different context, if he were coming from a different perspective, I wouldn't take any offense at his reaction. After all, he's congratulating me on my constructed masculinity, which I did in fact mindfully construct, arduously, painfully, expensively. His masculinity is constructed too, of course, but he doesn't see that, and that's where his judgement is rooted. His lack of awareness around the construction of his maleness is the privilege that contributes to his condescension, which fuels my defensiveness, and that's why I'm offended.

His left-handed compliment would be no shame if it weren't a window onto what can legitimately, if a bit dramatically, be called his transphobia. Thus I am offended by him, and have the right to feel frustrated and burdened by this interaction. It's not an uncommon interaction for me or any other trans person, and it's rather a depressing one coming as it did from someone at Callen Lorde- someone ostensibly belonging to my community, someone who ought to know better.

And he does know better than a lot of folks- his reaction, while not perfect, wasn't all that bad. Which is why I'm not too offended. I can see through his compliment to the insult beneath it, but it's a half step up at least from straight out insult.

This is a larger parable about being 'out' as trans or not, I suppose. Outting oneself is most productive when it's met by open minds, but those minds have to be opened first. One line of thinking goes that those minds will only be opened by repeated exposure to trans folks- that is, some of us have to be the shock troops throwing our dignity down like capes over mud so that Trans Awareness can move majestically forward. In this interaction, I disrupted his paradigm- maybe next time, he won't be shocked when the man in from of him discloses a transsexual history. I agree that visibility can be a really powerful consciousness raiser.

But there's got to be a better way. Trans advocacy and education can and must occur in other ways, so that we trans folks can stop constantly shouldering the many small stinging burdens of these interactions. Eventually, hopefully, it'll level out and disclosure won't sting anymore because I'll be seen and understood for who I am, not the pile of unknown baggage that's assigned to trans folks these days. But there have got to be better ways of getting there.


As an aside, I can't decide to be pleased or annoyed that, clearly, Callen Lorde hasn't stamped TRANNY in red ink on my chart. On the one hand, I'm glad that they're trying to respect my privacy, allow me to disclose at my own preference, etc. On the other hand, medically is one of the ways in which my being trans is quite often justifiably relevant information. I certainly consider my transness to be in large part a medical condition/situation. It wouldn't be the worst thing in the world to have that in my chart, so that medical folks can have some idea of what my body is like. Certainly at Callen Lorde where, or so I thought, those folks would probably have a reasonably accurate idea. I guess the ideal world would be one in which 'transsexual' (or whatever terminology suited me best) would be included on my chart...but that chart would then be seen by medical professionals who had all be trained and educated around trans issues, so that they could respond with the calm professionalism that I deserve.

1 comment:

T Mav said...

UTIs: had them all the time as a tot, they are AWFUL. (it does seem bizarre that your med file doesn't mention trans status -- i wonder if that's standard practice?) sidenote: i came out to my bro today and probably mentioned you a dozen times. i was super impressed with the whole shindig, i've been dreading it a long time and he took it exceptionally well. hey anyway, i'm going to be visiting some folks in the city this month -- we should hang out.