Midwest Man

Due to relocating three times since beginning hormone replacement therapy, I have had three primary care physicians. The first was a gynecologist at a university hospital who took me on at the beginning and then became the school’s go-to transgender doctor. The second was a family doctor near my hometown. And the third is a transgender-specializing doctor in the city I moved to recently. With those three doctors, out of 7 years of HRT, I will say there was a BIG difference between the family doctor and the two who specialized with transgender care. And I can even see the difference between the third (with experience in the field) and the first (new to the field). The differences included things like their choice of vocabulary, their perspective on the costs and benefits of HRT, and their understanding of the minutae of how HRT works in the body, such as how blood levels fluctuate, different ways to inject, etc.

I hope this psalm of David consoles you the way it has consoled me.

LORD, you have probed me, you know me:

you know when I sit and stand;

you understand my thoughts from afar.

You sift through my travels and my rest;

with all my ways you are familiar.

Even before a word is on my tongue,

LORD, you know it all.

Behind and before you encircle me

and rest your hand upon me.

Such knowledge is too wonderful for me,

far too lofty for me to reach.

Where can I go from your spirit?

From your presence, where can I flee?

If I ascend to the heavens, you are there;

if I lie down in Sheol, there you are.

If I take the wings of dawn

and dwell beyond the sea,

Even there your hand guides me,

your right hand holds me fast.

If I say, “Surely darkness shall hide me,

and night shall be my light”—

Darkness is not dark for you,

and night shines as the day.

Darkness and light are but one.

You formed my inmost being;

you knit me in my mother’s womb.

I praise you, because I am wonderfully made;

wonderful are your works!

My very self you know.

My bones are not hidden from you,

When I was being made in secret,

fashioned in the depths of the earth.*

Your eyes saw me unformed;

in your book all are written down;

my days were shaped, before one came to be.

How precious to me are your designs, O God;

how vast the sum of them!

Were I to count them, they would outnumber the sands;

Northwestern University’s Institute for Sexual & Gender Minority Health is doing a survey. You should do the survey. More participants means more successful research.

Here is what they say about the survey:

“This survey will ask about your everyday experiences as an LGBTQ person.

“Your answers are completely anonymous; we will not ask any questions about your name or identifying information, and answers will not be linked to any information about who you are.

“Your participation in this study is completely voluntary and you can stop at any time.

This study by IMPACT is approved 5/31/2017 through 1/30/2018. It is seeking LGBTQ participants. The initial survey takes less than five minutes.

The last time I tried to give blood I passed out after the fingerprick. No lie. That’s how strong my fear of needles was. This happened during high school. One group or another was always hosting blood drives, and I finally found the strength to sign up in spite of my reservations. After I failed, I felt ashamed. I knew it was not my fault and I did not hold myself accountable, but I regretted not being able to contribute and I resented the weakness.

When I moved after college, I got a new doctor. I have to have a doctor to authorize testosterone prescriptions, and my old one was not going to blindly authorize refills from another state.

I had a few to choose from, but I picked Betty, who has the right medical focus and has seen other members of my family. Betty does not see me the way I do. During our first conversation she told me that I am female. On one hand, I get it. I am XX, I do not have male gonads, etc. On the other hand, I sensed that although she respected me and my wishes, she did not buy into my intuitive maleness. What really caught my attention was when I got papers (I forget what for) that had my diagnosis written on them:

transvestic fetishism

Hold on. So I have a fetish related to putting on the other sex’s clothes? I was really perturbed by this language, but I let it slide. I have my meds. I do not have to see the doctor again for a long time. If that is how Betty has to think about me to prescribe what I want to treat my physical disorder, so be it. What is comes down to, honestly, it pride. Acknowledging that allowed me to move on.

           In the last few months I have heard from two, independent sources (one a medical student and one a medical professional) that scrubbing the skin with an alcohol swab for a few seconds before performing an injection does not get rid of “all the harmful bacteria.” The reasoning is that alcohol needs ten minutes to sterilize a surface (don’t believe me?). That means ten minutes of wet alcohol contact time. Considering how fast that stuff evaporates, ten minutes would be hard to get just from swabbing.             The Irish Nurses and Midwives Organisation has a pretty neutral article available discussing the supporting and dissenting opinions on the subject. It’s short, so you should read it yourself. There is solid evidence and logic for either practice.