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“So I’m a nonbinary trans man and I’m starting college next year. At college I want to start going by my preferred name and pronouns, maybe presenting a bit more masculine, etc. BUT. I’m confused on one thing… Should I tell people I’m trans when I meet them? Like, I don’t want to like, have to explain what being trans is or stuff right when I meet people, especially since I have trouble with social anxiety already. But I’m worried they might assume I’m a girl if I don’t explain.”

-Question submitted by Anonymous

Liam Lowery Says:

Hi there, Anonymous. As a non-binary trans man who started going by my preferred name and pronouns in college, I’m glad you reached out with this question. The fact that you’re reaching out at all indicates you have your stuff far more together than I did as an incoming freshman, but I will tell you the top three things I wish I had known when I started undergrad.

The first and most important thing I can tell you is to let people pleasantly surprise you.

When I rolled into my all-girls dorm and met my lady roommate, I stutteringly told her I was trans Actually, I may have said, “I’m a dude, kind of like inside?” I braced for impact, assuming she would ask to change rooms. Instead, she said “cool” and asked me if I wanted to order pizza. Don’t discount that you can get lucky.

What’s more, all the women in my dorm who I feared would shun me were friendly and generally disinterested in my gender identity. That’s because from the first week on, we had papers to write, philosophy texts to read, passages in Russian to translate (maybe that was just me). On top of that, people were hooking up, fighting, and going to Taco Night at the cafeteria. Which is to say that once you are in school and dealing with the day-to-day, it will likely not be as challenging as it seems in the abstract.

My advice is to practice your script for when you meet people initially. Maybe you want to say you’re non-binary, maybe you just want to say your name and preferred pronouns. It will probably change, but the important thing is that you set boundaries for your everyday interactions and introductions that are comfortable for you. Once you do this a few times, you will get used to it and feel out how much you want to say and when.

Now, to the second big thing I wish I’d realized sooner. There is a major pitfall to be wary of, especially as a trans person: you will feel pressure to do the unpaid work of educating people when there are others who are tasked with that responsibility. Try not to fall into this role.

Early in my time in undergrad, when I did happen upon some poor unfortunate soul who had no clue what gender identity was and had never heard the word trans before, I would talk with them at length about gender identity and why it mattered. I had at least thirty of these conversations in my first month of school, I kid you not. It left me feeling burnt out and unsatisfied.

Here is the thing, Anonymous: you are at school to learn, just like everyone else. And hopefully, have a blast and make a lot of friends. But you are not there to be anyone’s personal gender identity educator, even if you happen to be an expert in the subject area.

Looking back, I realize that those people who had burning questions about what gender pronouns are should have just googled it. I mean, give me a break here—gender pronouns are what they sound like!

Asking me those simplistic questions just because they knew I was trans was disrespectful of my time. If nobody is paying you to do that educational work and there are a lot of great resources available to people who want to be allies, you do not need to be that resource. Stepping into that role instills an expectation that trans people exist to educate cis people. If you want to get involved on your campus, advocate for your school to include a transgender 101 training at orientation so that all students will get some info on trans identities—that would reach more people than a one-on-one chat with you.

The other important pitfall to side-step is one I never realized until I was done with school, and it might be even more important than the whole “you are not everyone’s gender professor” thing.

My RA didn’t really get it when I told her it was important that she take the sign with my given name off the door. Instead of complaining to the building manager, I ripped it off and put up on that said Liam in big, honking block letters. I did that, more or less, all through college: I would email professors at the beginning of the semester and ask them to change my name on their class rosters. Usually they would, sometimes they wouldn’t. I would get called by my given name in class, be embarrassed, and stop participating. Or if I felt brave that day, I would clear my throat and say, “Actually, I’m Liam.”

Those moments were far from personal triumphs. What I should have realized is that there were salaried staff members at my university tasked with helping students—including me—deal with administrative issues. By making my problems and myself invisible, I was giving them a free pass not to engage with the issues transgender students often face at colleges.

Look for opportunities to lessen your load so you can take full advantage of being a college student. For instance, contact a dean at your school and ask them to inform professors about your preferred name. Let people do their jobs for you, and by extension you will show them how to do it for other trans students.

There you go, Anonymous—those are the things I wish I knew when I started school that have remained relevant (at times, too relevant) since graduating. Good luck at college, and remember: you’re there to learn and occasionally have fun!

***
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“hi, how do you handle being intersex when you go to the doctor? my primary care doctor knows that I’m intersex, but I never know if I should talk about it if I have to go to the school nurse, the ER, or see a specialist. do I have to tell them? does it matter if I don’t? thx”

-Question submitted by Anonymous

Claudia Astorino Says:

Awww, booooo, Anonymous—having to go to the doctor’s is never fun, but having additional needs on top of your medical needs isn’t always intuitive to navigate. When I’ve chosen to disclose aspects of my body that aren’t normative for women—or even to say that I’m intersex—I’ve had results that range from really positive to really awful (like, eat the whole pint of Ben & Jerry’s awful #chubbyhubbyforevs). Based on these various experiences, I’ve created a few rules for myself that tend to end up making my visits a bit more pleasant.

1) I only disclose information about my body that is (I think is likely to be) medically necessary. So like, if I have a sore throat and go to the doctor’s, it’s probbbbbbably highly unlikely that my XY chromosomes are the reason I’m hacking up a lung. If the reason I’m getting medical care CLEARLY has nothing to do with my being intersex, I don’t mention it.

Now, I’ve put “I think is likely to be” in this rule as a reminder that if I think that my being intersex might be relevant to my medical care, then it may be worth bringing up to my doctor.  For instance, if my doctor may say something to the effect of, “Well, [health concern] is highly uncommon in women,” I may say, “Well, that may still be worth exploring since I’m not a biologically typical female. I’m an intersex person, and my form of intersex is complete androgen insensitivity. Is [health concern] likely to impact me?”

2) If doctors ask questions about my body that are medically relevant, I answer them (although I don’t have to give them all the details). I had an appendicitis scare, and the doctors performed an MRI of my lower abdomen to see if my appendix was inflamed. After doing this, one of the ER nurses said that she’d observed that I didn’t have a uterus, and asked me why.  I said, “I was born without a uterus.” In similar instances, I might follow up with, “I didn’t have a hysterectomy or other procedure you might want to be aware of.” These medical professionals are likely making sure that they’re ruling out any possible reasons why I may be having a set of symptoms, and answering these questions helps them to do that. However, I’m not obligated to provide further details. Read on, intrepid Anonymous!

3) If doctors ask questions about my body that are NOT medically relevant, I’m not obligated to answer. So. The thing is, doctors are people. And we people are living at a time in history where intersex people aren’t highly visible or well-understood. Many people don’t know what it means to be an intersex person, and sometimes these people wear white coats and stethoscopes and hold medical degrees. Sometimes, it is clear that medical professionals are asking questions about your body that aren’t medically relevant, and you might feel really uncomfortable with this. Well, Anonymous, I’m here to say it loud and clear: YOU DON’T HAVE TO ANSWER THOSE QUESTIONS, AT ALL, EVER

Let’s go back to that appendicitis scare I had. After I stated that I was born without a uterus the attending nurse asked me, “Um, why is that?” Hopefully, this nurse was trying to ask me if there was other medically relevant information she should know about. In response to situations like this, it’s perfectly acceptable to say, “That isn’t medically relevant in this case,” and state that I haven’t had a hysterectomy or other procedure they might want to know about, as suggested above. Another way to respond to questions like this is by asking another question: “Is that medically relevant?” or “Can you tell me how that’s medically relevant?” and wait for a response.

What doctors need to know is information that is medically relevant. That I’m intersex and my form of intersex is complete androgen insensitivity and I have XY chromosomes and I was born with testes and blah blah blurgh blah is usually not medically relevant information. Under those circumstances, I don’t need to report this info. If I feel comfortable providing this information, I can choose to do so, but I’m not required to.

Occasionally, you may have an encounter that makes it clear that doctors are asking questions about your body out of curiosity, and that’s not appropriate or okay. You are visiting them to stop hacking up your lungs or prevent appendageddon—not to teach them about intersex people.

Let me tell you a story.  Several years ago, after I moved to NYC, I went to try and find a doctor to serve as my primary care physician. During my first appointment with a physician we shall refer to only as Dr. Doodoopoobutt, I was asked why I took a daily estrogen pill. Since Dr. DDPB was going to be my GP, I came out to them as intersex, and told them my form of intersex. Dr. DDPB responded by asking a series of inappropriate questions, including, “So, um, do you have a penis? Oh. *pause* So you have a vagina, then? Uh, what do you and don’t you have?” Later, when I was lying on the exam table, I was terrified that Dr. DDPB was going to try to insist I should pull down my pants so they could inspect my genitals.

Today, if this situation had happened, I would have the confidence to say, “Those questions aren’t medically relevant. Can we move on?” or perhaps to say, “Those questions are medically irrelevant and they’re insensitive. I’m going to leave now,” and walk out the door and buy a hot chocolate and sit on a bench in Central Park and watch the squirrels stealing soft pretzels right out of the garbage cans, because eff that noise you know? But at the time, I didn’t know these options were open to me. Dear Anonymous, know that if any medical professional acts in a manner that’s inappropriate or disrespectful, you don’t have to sit in that plastic patient’s chair and try to deal. You are fully within your right to let them know it’s not okay, to leave, to go get that hot chocolate.

4) If doctors ask questions about my body that are NOT medically relevant, I reserve the right to lie about it.

Yep, you read that correctly, Anonymous. Real talk:  I may choose not to be truthful in answering questions about my body related to my intersex if I know it’s not medically relevant—and especially if I don’t feel comfortable with a particular healthcare provider. I have mixed feelings about this—I want to be clear about the fact that, in general, I don’t advocate lying to health care providers, and that coming out to medical professionals can be a positive experience. That being said, you are not required to come out. It can be painful when clinicians are less-than-sensitive about my body after coming out to them as intersex. I’ve dealt with a lot of damaging words and procedures from various doctors at multiple medical facilities during my childhood and adolescence—I value myself and my emotional health too much to put myself in a similar position again as an adult.

In what situations might one lie? There are often standard questions you’re asked to fill out on medical forms or asked by clinicians that you can’t answer truthfully without coming out and having a conversation about it afterward. For example, I’ve never gotten my period, but I’ve never had a medical appointment where I didn’t have to report when my last period was.  Although I tell doctors now, “I don’t get my period,” or “I have amenorrhea,” and go from there, I used to simply lie about it when I was younger because I didn’t know that, “I don’t get my period,” was actually an acceptable answer. My go-to was, “The first of the month,” and then sit there white-knuckling it because I was nervous they knew somehow I wasn’t fessing up.

Finally, I am fortunate that I have never felt truly unsafe when visiting medical facilities as an LGBTQIA individual. However, this is not always the case for LGBTQIA patients. If I felt that my safety was at issue by disclosing my intersex, I would not hesitate to lie to protect myself, and leave the facility if I was able to. Remember, you can always find a new doctor. Keeping yourself safe—even if you have to lie—is okay. #safetyfirst #always

Well, Anonymous, I hope that this helps you out! Before appointments, I’d recommend spending a few minutes thinking about what information you’re comfortable disclosing and how much—it will make you feel more comfortable during the appointment and feel empowered that you’re taking control of the conversation about your body (which is not what most of us have experienced being medicalized as kids).

Fingers and toes crossed that your next appointment goes great! <3

***

Claudia Astorino is an intersex activist living in NYC.  Claudia serves as Associate Director of Organization Intersex International’s USA chapter (OII-USA), coordinates the Annual Intersex Awareness Day (IAD) events in NYC, and writes for Full-Frontal Activism: Intersex and Awesome (her personal blog) and Autostraddle. Help support our contributors here on Patreon!

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"I Do Not Need Gender"

An essay by Tyler Ford

As a child, there were two things I wished for every night before falling asleep: braces (I was strangely obsessed with orthodontia) and different genitals. I didn’t have much of an understanding of gender, but I knew the word “girl” fit as uncomfortably as the skirts I refused to wear. From the age of three, I was insisting that my body was not my own and not what I wanted. What was “down there” felt wrong to me in ways that I could not articulate, but I knew that there were people out there with different genitals from the ones I had, and I thought I might want those. Everyone called me a tomboy; I settled only because “boy” made up half of the word.

Yet as I grew older, I longed to experience girlhood. I wanted to fit in, I wanted to have a normal teenage life like I saw in movies, and I wanted to be seen and to be validated by my peers. Most of all, I wanted to grow up to be a woman because I loved the women in my life, and I wanted to identify with them. My desire to exist as a boy and my inability to feel like a girl pulled me in one direction, and my desire to ground myself in what others called “reality” – seemingly the only path to normalcy, pulled me in the opposite direction. At times, I felt like saltwater taffy – a really shitty flavor of the sort – being stretched until I could no longer recognize myself.

Most of my life has been spent swinging back and forth on a pendulum, trying to figure out which side – boy or girl – I would inevitably make my home. I spent years desperate to feel any sense of stability, to feel any sort of permanent allegiance to one of those two genders, to feel like I belonged anywhere at all. I’d spend one year in bras and miniskirts and the next injecting myself with 200mg of testosterone weekly. I could alter my body, wear different clothes, change my mannerisms and my speech, and none of it could change my confused heart, which would vibrate out of control every time I tried to hold my gender still and teach it to behave. Throughout my life (and constantly now), people have read me as in-between male and female. I am not in-between anything but the confines of the Western gender binary.

For the most part, I like to completely ignore the fact that my body exists at all. I am a walking brain; I am a galaxy of stars; I am unable to be contained in and defined by something so limiting. My pronouns (they/them) are both a rallying cry against being gendered without my consent, and a way in which I embrace both everything I am and everything I am not. I do not need to fit into or belong to an identity to exist, to survive, to make other people comfortable. I need space and I need freedom; I need compassion and I need kindness; I need openness and I need understanding; I need my own love. I do not need gender.

***
Crowned one of the best social media stars of 2015 by MTV, Tyler Ford is a 25-year-old NYC-based agender writer, speaker, consultant, and personality. They are a contributor for Rookie and MTV, where they often write about their experiences as a queer transgender person. Their work can also be found in the GuardianPoetry Magazine, and V Magazine

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"I’m trans, and I’ve avoided going to any doctor for a long time. I have no idea how to find someone who will understand and make me feel safe. How do I find a trans inclusive doctor?? And what should I ask once I’m there to make sure they’re actually accepting?"

-Question submitted by Anonymous

Riley Johnson Says:

Congrats on seeking care after some time away! I have had this tendency for avoidance a time or two myself. Accessing care and being consistently on top of one’s health can be a challenge for trans folks. In 2011, the National Transgender Discrimination Survey found that 28% of respondents postponed medical care due to discrimination and 48% postponed because they couldn’t afford it. So we are definitely not alone, unfortunately. There is definitely help on the horizon though.

RAD Remedy is a community-driven, nonprofit organization that created the first review and referral site for trans, gender non-conforming, intersex, and queer health. The Referral Aggregator Database (RAD) is live in open beta and has approximately 3,000 providers with more being added daily. RAD Remedy aims to make it possible for folks to find great doctors nationwide and know precisely what to expect when accessing care. Providers come to RAD in one of three ways – through an intensive questionnaire about their practice and expertise, through referrals from community organizations, and through the reviews of folks like us who have seen the provider. I would encourage you to check the database first, and if you have trouble finding what you need, drop RAD Remedy a line and we’ll work with you to find a good solution. [I can be reached at riley@radremedy.org.]

Next, I’d like to talk briefly about strategies for getting care safely and knowing the questions you can ask to find a welcoming and knowledgeable provider. I think it’s important to be real and say that we as trans folks need to meet providers where they’re at. Looking for a provider who is an expert and has many trans clients is great, but it can be unrealistic at times depending on your location. More often you will find a provider who is interested in serving trans clients but hasn’t done so yet. TransLine operates a medical consultation service to help those providers, and RAD Remedy works with providers to improve their practices, forms, and processes to make them more welcoming.

It’s also important to note that what I consider acceptable in a provider may not be what you might. Gather all of the information you can and make the best choice for your situation. Before you make your choice, I find it’s helpful to sit down with yourself and identify the following:

Must Haves: [an example from my list: providers must use my right name.]
It Would Be Nice: [an example from my list: I would prefer that a provider has experience with trans clients but I’m willing to work with one who hasn’t done so yet.]
Dealbreakers: [an example from my list: messing up my medications, being hostile or fatphobic, etc.]

Some key questions you can ask the provider (or ask the front desk person to ask the provider personally) to ascertain whether or not a provider is trans-affirming:

1. I am a transgender man (trans woman, nonbinary person, etc.) in need of primary care/gynecological care/etc. Will this be a problem?
2. Does the provider have experience with trans clients?
3. Have the provider and clinic staff been trained about trans issues?

Here are some best practices for providers serving trans clients (and ways patients like us can subtly see whether a provider is affirming):

*Do the intake forms have a spot for preferred name and/or pronoun?
*Does the office location have gender neutral or single stall restrooms?
*Does the office art reflect the clientele? If there are pictures, are the people in them diverse in age, race, etc?
*Does the office have magazine subscriptions for LGBTQ publications?
*Does the office have an efficient and transparent means of providing feedback or complaints if needed?

Here are some key general strategies for getting the most out of your time with your provider and feeling safe while you do it:

*Use the buddy system. Other than in some domestic violence screenings, you’re allowed to have a friend or loved one in with you for office visits and exams. You can insist that they come in with you to the exam room.
*Know the questions you’d like answered or the medical issues you’re having. Some folks find it helpful to jot down a short list so they’ve got a plan for the visit. Try to keep your list short and prioritized, since you often won’t have a lot of time with the provider.
* If you are concerned about information being listed “on the record”, discuss the issue with your provider. Providers will usually tell you the sort of information they feel compelled to record and what can be discussed “off the record”.
*Take notes when in with the provider (or have your buddy do it). It can be hard to remember what gets said in a visit – particularly if you’re nervous.

Lastly, know that you have the right to access health care without experiencing discrimination. Earlier this year, a federal court in Minnesota issued a preliminary ruling that discrimination against an individual because of his gender identity is prohibited under Section 1557 of the Affordable Care Act. For more information on how to file a complaint with the Department of Health and Human Services (usually after a provider-based complaint has failed or if things are particularly egregious), check out their website.

***

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“I grew up in a Muslim household. I’ve recently come to terms with being trans, and while I want to stay connected to my faith, I’m not sure how to reconcile my identity as a trans person with my identity as a Muslim.”

-Question submitted by Anonymous

Mahdia Lynn Says:

Mash’allah! What a blessing, to be Muslim and trans. Islam is such a beautiful and dynamic faith. And! Trans people are friggin’ awesome. Being a TRANS MUSLIM!? This is awesome. You are awesome. Yes.

It’s not all sunshine and roses, of course. Holding on to your faith while being “different” can be a real struggle—and being trans is a pretty big “different” to deal with. The highly normative, gender segregated culture that is so common can make navigating Muslim spaces a minefield of gender feels. And while a lot of people in the community are more accommodating and accepting of trans people than you’d think, it’s often the bigots who yell the loudest.

That doesn’t mean Islam as a whole is unaccepting of transgender people. In fact, multiple well-respected scholars have ruled in favor of transgender people’s rights (like the Grand Mufti Muhammad Sayyid Tantawy of Al-Azhar, the oldest Islamic university in the world, who ruled in favor of modern transgender pioneer Sally Mursi in 1992) and many governments have followed suit (like when the Islamic Republic of Pakistan provided a “third gender” option on legal documentation in 2009 or how the Islamic Republic of Iran provides financial and legal support for its citizens undergoing transition ever since 1987). While the language we use to describe ourselves may change over time, gender variant people have existed since well before the time of the Prophet Muhammad(SAW) and Islam is a dynamic and diverse faith that makes room for all its followers—cis and trans alike.

Here are some strategies that have worked for Muslims like us: A lot of people choose to avoid the masjid* during the early stages of transition. Some start visiting a new mosque, making it easier to use the washroom without being clocked from that one nosy aunt who’s known you from birth. Still a great number of people—trans and cis—have begun creating our own spaces out of exhaustion and frustration with the heteronormativity of it all. LGBTQ friendly, gender-equal, and trans affirming Muslim space is becoming more and more accessible every day—if you’re near any kind of major city (or even some less-than-major ones), chances are there’s a family of queer & trans Muslims meeting up for coffee or having a potluck this Friday. If you can’t find a real-world community quite yet, the el-Tawhid Unity Mosque in Toronto Skypes its jummah services every Friday.

One of the many blessings of my life is that I have a great deal of transgender Muslim family to help field questions like this. Sitting back with such lovely friends last week I asked, “If you could give advice to a Muslim just coming to terms with being trans, what would you say?” It sparked a great conversation—inspiring and engaging, much like most of the conversations I have with such family—but it was what my gender-nonspecific-sibling Fatima said which sums everything up better than I ever could:

“Allah(SWT) doesn’t make mistakes and as such you are not a mistake. Your knowing in yourself is leagues more honest and mature, with wisdom and intelligence, than the things society says/thinks/enforces. Trust in yourself and Allah and make room for the process to learn yourself even though it may be long and confusing and sometimes painful.”

Our faith does not belong to the bigots. Whatever happens and wherever your path leads, there is family to have your back and provide support. The way society divides and stresses it can seem like there’s nobody else on the planet like you. But we’re here. Getting by in our own quiet ways, living out Islam as best we can.

~

A glossary for some Muslim-y jargon used here:

– “Mash’allah” is a phrase that means something like “Allah has willed it,” used to express gratitude or happiness at a person or happening.

– “masjid” is another name for a mosque, or Islamic community center.

– After the name of the Prophet Muhammad, out of respect Muslims often use the acronym “S.A.W.”, a shortening of the salawat, which translates to something like “may Allah grant peace and honor upon him and his family.” Similarly, after the name of God we can use the acronym “s.w.t.” which translates to “Glory to God, the Exalted.”

– FUN FACT! The world “Allah” is just a literal Arabic translation of “God”—the same one Christians, Jews, and Baha’i pray to, to name a few faiths in the diverse dynamic family of monotheistic religions.

***

Click through to read more about Mahdia and our other contributors!

Also check out our resource list specifically for LGBTQ Muslim youth, curated as a part of Longest Days, Sacred Nights!

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