The Last Straw

Trigger warning: suicide


Well, I’ve finally worked up to it. I’m going to rant about the Last Straw doctor’s visit.

Those close to me have already heard this story, and hashing it out in a support group setting really allowed me to realize just how much this event had impacted me. For weeks I’ve been dismissing it as just another ‘no’ in a long series of ‘no’ responses from the medical field. Just the norm, just what everyone has to go through, right?

But no, this was devastating. This broke me for a good while before I put myself back together again.

A bit of history, I am on Medicaid. This means I call a Medicaid hotline to see if any doctors are currently taking Medicaid patients. Most of the time there aren’t any. And I get it, why have a poor Medicaid patient take up a slot which could be more profitable. The healthcare system is incredibly profit driven. Without money to flash, I’m not going to get optimal care. That’s just reality.

So I call, there are two, one in each of the major medical systems in this city. I make appointments with both and both are a six month wait before the initial appointment. That’s difficult enough already.

The first visit with this doctor immediately had me take my shirt off for a breast exam, because I am biologically female. It raised a red flag for me, and it made me feel incredibly uncomfortable. However, that is just his policy. And I do have breast tissue which should be regularly checked, that is just good common sense, but he handled it very badly without any respect for my preferred gender identity.

I presented immediately with my two primary concerns, my chronic pain and my desire for testosterone. He decided to focus on getting me healthy first, prescribed me a medication which has worked for me in the past, and sent me on my way without another word about the hormone replacement therapy.

Next appointment six months later. I was an idiot who wore xis binder for far too long and cracked some ribs. Not only that, but wearing the binder so frequently had caused some changes in my breasts that concerned me, and I actually asked for a breast exam this time.

With the help of the medication he had prescribed, I could function for several hours a week again, so I had implemented a healthier regimen of light activity; including yoga, water exercise, light walking, and weight resistance training. However, I was frustrated because I was not seeing many gains despite what I thought was a serious amount of work and dedication. He dismissed those concerns by excusing that whatever time I had spent completely non-functional (four years) would take at least half the time to return to prior functioning (two years) and six months was not adequate time to see change.

Perhaps true, but I thought I had well demonstrated that I was on the path to managing my chronic pain and we could now focus on testosterone. He insisted that I stick to what I was doing, be patient, and he would see me in six months.

This was also the visit where he clarified what name I was wanting to be called, even if they had to use my birth name on the charting, they could make note of it. I told him NilLynn. Nil. Lynn. He looked so confused and called me Dillon at least three times. Then asked me why I hadn’t chosen an easier name. I would probably get more support if I helped other people out and used a name that was more familiar. So much anger packed into here I just don’t have time or room for it all right now.

Six months later, in January of 2016, I was just about done with him stringing me along. I was going to either fish or cut bait, as the saying goes. I’m no spring chicken anymore; wasting time is not something I want to do. Not only had I stuck to my daily yoga and walking, but I had made consistent gains on the weight training and was going to the gym at least five times a week. I was mobile, I barely needed my cane anymore, and I was up to eight to twelve hours a week of good functioning.

The nurse seemed confused as to why I insisted on being called ‘sir’ and the use of he/him pronouns (because xe/xim, my actual preferred pronouns are ‘too weird’ for most people just yet). I explained that I was a transgender male.

No joke, she looked at my chest, and I have no shame in saying that I have fantastic breasts, and stated, “Oh, so you’ve had ‘the surgery’ already.”

I was not sure if I wanted to laugh at how ridiculous that was, or cry because this person was on my health care team, or just be proud because she thought my breasts were so great they had to be fake. It was a weird moment.

Then there were questions about my sexual activity, naturally, but the nurse prodded a little too hard into the area of why my partner had died. It upset me. Even after four months of grief therapy, I was still grieving. Two months later, I’m still grieving. It is not a wham bam and done process. This was a raw, emotional issue for me. Still, she pressed, and left me in the room crying.

By the time the doctor arrived, I was terribly uncomfortable about the surgery remark, oddly flattered, and extremely upset over losing Raiyne. I don’t blame him for asking about my mental health care. But I explained to him that I attend several support groups, I have a therapist, I am trained as a therapist, and I have grief counseling. I have my mental care well in hand. It’s sort of my thing, it’s what I do. Yes, sometimes it is difficult for a mental health practitioner to see their own suffering, but I had thought I was doing damn well.

He looked at me and said that he wanted me to get a therapist and work on my mental health. As if he had not even heard me that I was already seeing a therapist and a counselor.

He flat out stated that being transgender is a mental health condition and I was too focused on it, that it was not any concern of his and he did not believe that it impacted my physical health.

I have rarely felt so dismissed, so pushed aside, so unheard.

I asked, feebly, just once more, about testosterone. It would help me by managing my debilitating period pains, help me regain functioning through my gym progress, and just living authentically would reduce stress. He said no, he would not treat me.

I said we were done. I left the office crying, I checked out at the front desk, crying, and said I was never going to return. It was humiliating standing there with the secretary sympathizing and asking if I wanted to speak to an office manager. I didn’t have it in me. I went down to my car and just sat there and cried.

It took everything I had not to put my car in gear and drive forward into the street in front of me. I called five suicide hotlines, none of which picked up. I sat there for over an hour, just willing myself to sit through it, to tolerate it, to just wait.

Now, I was suicidal for several days following Raiyne’s death, and that scared me. I love life, I want to live, and these suicidal ideations scare the crap out of me each time they happen. I reach out for help because I know these things aren’t me. This time I reached out and no one was there. The doctor responsible for caring for me, someone who took an oath to do no harm, had torn me down and treated me like a second-class person. And this was after years of getting the same from half a dozen other doctors.

This was crushing, and only now do I see just how low it had brought me, both emotionally and physically. Without my medication, the pain and muscle spasms are so much worse. I haven’t been to the gym in two months because why? To work my ass off for little gain? I can do all these things I’ve been doing for two years and people at large don’t see me as male.

But I don’t want to go back there. I spent four years immobile in bed and just miserable. I can’t go back there. I need to live as my authentic self. Raiyne and everyone else in our community who has lost their lives is behind me, and I’m still here, I have to go forward.