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"I’m a young (20) transman who is still mostly not out. I haven’t transitioned, etc. Well it’s about time I go to the girly doctor, because biologically I’m a girl. But the thought of going gives me incredible amounts of anxiety. I freak out just thinking about it. I don’t think I can go. Also, if I did go, I don’t think I can be honest with the doctor about being trans. Any advice would be great."

- Question submitted by Anonymous and answered by Liam Lowery as part of Everyone Is Gay: Second Opinions.

Liam Says:

First of all, props on planning to go to the doctor. Going to the doctor is so so so SO important! And it is so easy to let that get away from you because of everyday things like work or school or watching Netflix, let alone when going to the doctor means considering coming out (or not) to a healthcare professional and steeling yourself for all the negatives that can come of out that interaction. So good job, you health-nut! You are doing something very hard and important, but it is worth it.

Second, I take it from your questions that by “girly parts” you mean your internal reproductive organs—such as a uterus, ovaries, fallopian tubes, etc., as opposed to external reproductive organs like testes and penises. I also have those internal organs, but I don’t consider them girly parts. And my care provider isn’t a “girly doctor,” she’s just a garden-variety gynecologist. Here, this great piece by Dean Spade about gendering body parts is helpful. Because honestly (and this is a bit of a mind-f’er, the first time you hear it) there is nothing about any organ that is inherently girly or dudeish. Those categories (along with the idea that, somehow, reproductive organs “make” you one gender or another) is cissexist, and has been put in place without transfolks and intersex people in mind. Now, if we all operated using Dean Spade’s preferred language, there would still be room to say things like “Most women are cisgender, therefore most women have internal reproductive organs” but it would leave that all-important room to acknowledge that there are men walking around with uteruses, women with testes, and many people with a combination thereof, and that our gender identities are in no way determined by or determinative of our reproductive organs. Basically your junk and/or reproductive organs do not make you “biologically” anything.

Next, you need to find a healthcare provider. Remember, please, that finding a healthcare provider is a process, not a quick fix. When you go to your first appointment, treat it like an interview—is the office clean? Do you like the staff? This is a place you will likely come at least once a year, so you want to be comfortable and feel like you are getting your needs taken care of.

As to your relationship with your care provider, it is not my business whether/when you come out to anyone, but I would advocate for coming out to your healthcare provider (as long as you feel safe doing so) as early in the relationship as possible to derive the benefits being out can give you. I know this can be awkward and nerve-wracking, but it is worth it. For instance, since I am trans and have internal reproductive organs, I need to get those suckers checked out. I am on testosterone, so I need certain tests other people may not need. Moreover, a healthcare provider needs all the relevant information they can get to provide you with good care, and you need to feel safe and comfortable asking questions. I remember asking my pediatrician, who often called me “little lady” though I have never been either of those things, if it would be safe for my “friend” to procure injectable testosterone. She was like “Uhhhh no… that would not be a good idea.” I never brought anything up again, I just stopped going to the doctor for two years until I decided I wanted to get on testosterone and pretty much HAD to see a doctor, which I always thought would be a nightmare.

My point is this: to be comfortable and receive holistic care from a doctor, AND to make sure it’s not a terrible, harmful mis-gendering experience for you (that will make you not want to go again) it makes sense to be out to your healthcare provider. And now that I am out with all my healthcare providers (including my dentist, who is super gender-affirming) I love going to see them!

Full disclosure here: I live in New York, and there are heaps of LGBTQ friendly healthcare providers here, especially when compared to other areas of the country I’ve lived in. I can take a train half an hour and get a physical at a trans* clinic, and I know I’m spoiled. But regardless of where you live, I’d recommend asking other LGBTQ folks if they like their healthcare providers, and searching online using the GLMA “Find a Provider” search tool.

Now, I know what you might be thinking: That’s all great Mr. City Slicker, but I don’t live in a city and there’s no trans* clinic near me. But I still need a doctor. What am I supposed to do, tell my doctor what language to use for my junk? They’re the doctor, I’m just some schmuck! Well, my friend, print this column and that Dean Spade article out, and bring them to your appointment! Remember, there’s no Gender Identity 101 in med school—often doctors learn from their patients. So as long as you feel safe, come out to your healthcare provider, and see how it goes.

WARNING: sometimes it will go badly—they won’t get it, or they won’t care. But often, doctors care about their patients enough to at least try and respect their patients’ culture and identities.

If the healthcare provider is a jerk, just peace out. Seriously. Just stand up, say “I don’t really appreciate your disrespectful bedside manner, you are not the doctor for me,” and leave.

Make sure to treat yourself to a can of ginger ale in the waiting room, and try a new doctor next week until you find one who works for you. Keep trying new clinics and offices until you find one that works for you, you’re worth it. Remember: all it takes is one good provider to give you the care you need, the way you need it.

Good luck, and take good care!


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One thought on “Dealing with Doctors and Gender Identity

  1. Oh geeze, going to the gyno sucks. Even being cisgender, I get anxious, nervous, and basically just miserable about going. I am impressed that you’re planning on going, I’m behind on my appointments and my girlfriend is as well, but it’s nerve wracking even for us to find a new doctor we’re comfortable with. If it helps, think of it as a phsyical, a dentist appointment, an oil change (lol), something necessary that helps keep everything healthy and running smoothly. Good luck!

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