Warning: this article contains graphic content that may be triggering or unsuitable for certain audiences.
The suspicious gazes of the women around me are disconcerting. I shift in my uncomfortable waiting room chair and fixate on the TV screen propped up in the corner of the ceiling. I tap my feet. The unwitting nurse calls my birth name and my face flushes red as I shuffle past a woman eyeing me over the edge of her Martha Stewart Living magazine. Gynecology appointments are never a fun experience, but they’re even more nerve-wracking when you’re a 16-year-old boy.
The nurse hands me a white paper dress and allows me a private moment to put it on. It irritates my skin, abrasive against my bare nipples, and crinkles with every slight movement I make. I sit on the examination table with my hands in my lap and wait. The doctor comes in and greets me by my birth name. I dare to correct her.
“My name is Ashton,” I say.
She looks down at the file in her hand. “Ashton? Did the nurse get it wrong?”
“No,” I reply, “That’s just my legal name. I’m trans.”
The smile on her lips falls into a tight line, each wrinkle like an army solider following a strict general. “You mean you want to be a boy?”
“No, I am one.”
“But you don’t have a penis.” She glances down at the file again. “That’s why you’re here.”
Up until that point, I was certain that doctors always had my best interests in mind. I believed that their education made them free from prejudice and bias. I didn’t think I had anything to fear. And I didn’t— until I began my transition in spring 2014.
As the doctor examines my breasts with cold, freshly-washed hands, she asks me, “Do you want to get your breasts removed?”
I answer honestly. “Yes, eventually.”
She scoffs. “You don’t really want that. Listen, every woman wants to get her breasts chopped off in her life, but they all get over it. You’ll regret it if you do.”
“I’m not a woman, though,” I argue, but my voice is shaky under the interrogative fluorescent light.
“But you don’t have a penis,” she says.
She moves on to ask me about my health history, and I hope she’s done with the comments that make my stomach churn. The questions veer toward my sexual habits.
“What is your form of birth control?”
“None,” I say. “I don’t have sex with men.”
“So, you’re gay,” she concludes, making a note on my file.
Nausea builds in my throat like a chunk of food too big to swallow. “I said I don’t have sex with men.”
She sighs and adjusts her reading glasses. “In any case, that means we don’t have to test you for gonorrhea or chlamydia or anything.”
The appointment progresses. My legs are spread wide on the examination table and the paper dress barely covers my naked knees. The doctor inspects my genitals with a scrutinizing eye.
“Did you know that if you go on testosterone,” she remarks, “your clitoris will swell and grow into a penis?”
This is entirely wrong, and I know it is. I say yes anyway.
“I just can’t imagine why you would want that…,” she mumbles, trailing off.
She remains silent until the very end, shortly before leaving me to put my clothes back on.
“You’ll never be able to have children if you go on testosterone, you know,” the doctor says. “Would you really want to disappoint your mother like that?”
I never returned to that doctor, and I certainly never will. I am lucky to live in a city where I have a selection of who provides my medical care, but many others are not so fortunate. A transgender individual in rural Nebraska will have only one doctor nearby; if that doctor is unfriendly or plainly uninformed, the individual in question will have no choice but to forgo medical attention altogether.
Viewing transgender healthcare as a specialized field is uneconomical at best, and dangerous at worst. To put “transgender” as a separate medical specialization is to collect all the individual medical needs a transgender person may have into one umbrella of care that’s handled by one kind of doctor. This specialization of transgender needs indirectly leaves out the possibility that a transgender person may need a dietician for treating diabetes, or an orthopedist for arthritis. The more specialized the need, the more difficult it becomes for an individual to find a doctor that will, at the very least, understand what it means to be transgender.
Required, basic education for all medical practitioners would not only broaden each doctor’s scope of knowledge, but increase accessibility to transgender people across the United States. A search for a dietician that specializes in transgender needs would be rendered unnecessary, for accurate and adequate treatment of transgender people would become the expectation; the norm.
Without required education, physicians of all kinds are going without necessary information that could spot prostate cancer in transgender women, or breast cancer in transgender men. Invisible illnesses—sex-specific ones especially—go undiagnosed or misdiagnosed due to a medical practitioner’s basic misunderstanding of a transgender individual’s physical needs. Medications are under-prescribed or over-prescribed. Patients are harassed with unnecessary questions by doctors who were allowed to forgo the most basic knowledge.
Doctors and other medical institutions have already been held accountable for racist pseudoscience and sexist delegitimization of women’s pain by the mainstream media. Let us not leave transgender people out of the discussion.
