Still angry
Jul 14th, 2008 by Rebecca
I’ve been sitting on this post, not knowing quite what to say, ever since returning from Melbourne. Reading (belatedly) a great post from cripchick tonight compelled me to finish it.
As a trans woman, so much of my life, and my own history, has and is defined by the influence the medical establishment has over that life. I am forced to rely on cis-appointed experts on whose say the medical treatments that have allowed me to get this far are dealt out. The policies, biases, ethics and powers of my doctors have had an enormous influence on my life ever since I was fifteen; for the last seven years. They determined that I couldn’t be seen by a doctor for the first three; that I was too young and too butch to be prescribed hormones for the next two, and that I had to prove my own sanity before being granted to the right to surgery, and thus a body that fits with my own self, for the last two.
I’ve not had a pleasant history with my particular doctors, the Monash Gender Dysphoria Clinic in Melbourne. Neither, for that matter, has anyone I’ve ever known under the age of thirty, with the exception of a trans couple who themselves have heard so many horror stories that they’re highly aware of how much in the minority they’ve been. I’ve had a treatment that has been profoundly influenced by both the sexism and homophobia of the doctors concerned, and their belief in 70s-era transphobic stereotypes, such as that trans youth are inherently suspect and should be delayed until they’re older. This is an environment in which patient respect and autonomy are things that other people do.
Last Wednesday, I went to see the Monash doctors for the first time in six months, and to my great surprise, was told that I was being referred for surgery after four years of ‘therapy’. The 18-month “trial” period assigned by Monash policy had finished, but I was not optimistic; many of those I’ve known over the years have been jerked around over the lot longer, and on my last appointment, I’d been harangued about my level of outness and queerness, and had to debunk some bizarre assumptions the shrink had made about my relationship with my parents based upon the sole fact that my mother had made the appointment. This time, however, I found that I was in luck - although I was left under little doubt as to why. Nonetheless, upon leaving, I was again nagged to participate in their research project, two years to the month after I first declined consent, and nine months after the lead psych attempted to blackmail me into participation.
Having left that appointment, I was at first overwhelmed with relief - in that finally, this stage of my transition is coming to an end, and in that sense, I can start to get on with my life. After a couple of days, though, I found that I was as angry as ever; that, perhaps, they’re finally going to stop interfering with my life did in no way change that I want to stop them having the chance to do this to anyone else. It had been made pretty clear to me in that appointment that my gender-normativity, my decision to go ’stealth’ and my ability to pass as not just cis but as straight had all counted in my favour. I have made the decisions that I’ve made because I’ve personally felt that they’ve been right for me, not because some bastard doctor decided it was best for people like me, and I greatly fucking resent having people in the medical profession trying to influence those decisions, or trying to push others into taking my course. And in a very real way, in my case, they already have influenced that life; I’m a very different person than I was seven years ago. These people have substantially influenced the course of my life, and they had absolutely no right to do so.
I’m relieved, yes, that this last stage of this particular battle is over, but I’m very much still angry. This system, which assigns cis medical professionals such enormous power over the direction of our lives, is a system that is morally broken. It’s at it’s worst, as it is here, when you have Bastard People adding sexist, homophobic and ableist (I’m fucking thankful I never had to deal with them on the latter, but I’ve heard some particularly nasty horror stories) biases into the mix, and adding a general contempt for professional ethics on top of that; don’t you know that trans people don’t need respect, autonomy, or the basic protection assigned by the rules medical practitioners are supposed to abide by. Yet there is something very wrong with a system that assigns such power that this can happen, and not only happen, but continue unabated and unscrutinised. These are decisions which, within reason, need to be decided by trans people themselves, and not by a practioner deciding how best that person fits whatever arbitrary guidelines they made up this year, or in response to the last lawsuit.
This is a system that needs to change. While I am in many ways getting reluctant to publicly engage on trans issues, this is one cause on which I will always be up for a fight. This system needs to end, and these people need to be brought down. My body should be my own; no one else should ever have that sort of power over it.
It had been made pretty clear to me in that appointment that my gender-normativity, my decision to go ’stealth’ and my ability to pass as not just cis but as straight had all counted in my favour.
oh, add it to the ever-growing list of why monash fails like the failingist thing ever.
however! congratulations on the good news!
i can understand enough to get a peek into what a nightmare that must be for you. and i agree…nobody should.
by the way. i’ve moved my blog (sidebar link). its not where at /elmachete (i put the new one in the URL field here)
be well.
Congrats on the surgery.
You’re spot on about how fucked up the medical establishment is.
Congrats, Rebecca. I heart this post a lot.
Yeah, that’s awesome about surgery
I think I’ve gotten off comparatively easily, maybe cos Perth doesn’t have a clinic?
One thing that was made very clear to me, though, was that third gender or genderqueerness was not going to be tolerated. I don’t identify that way, but was still like, hmm.
That’s interesting (and fucked, obviously) what you said about butchness, since one of the things that a friend of mine said to me before my first meeting with my shrink was “don’t wear a skirt, he’ll think you’re a cross-dresser.” So there’s issues no matter how you present, I think.
Nix, Az and Ryan: Thanks!
Nezua: Thanks for letting me know - I’ve updated the link.
Em: Yeah, I definitely had the opposite situation going: that I continued to come in my usual jeans and t-shirt pre-hormones, when I patently wasn’t going to be able to pass, was being read as “not serious” for a long time. It felt like I was just fucked around for two years until they were like “well, she’s still here, so she must be serious after all”.
It’s much the same with genderqueer here, though: while I’m not the slightest bit genderqueer, it pisses me off to no end that it’s taken as invalidating one’s need for medical treatment. It’s not even scorned as such; they just pretend it doesn’t exist, and look at you silly if it’s even discussed in passing.
And yeah, I think you’ve probably been lucky to avoid the clinic system by geography: I’ve not heard anywhere near the volume of complaints coming out of anywhere else than Monash, and some of my friends who did it independently have had great experiences. If I’d known how bad Monash was back in my teens, I’d have gone that route too. Most of the trans folks in Canberra that I know of have been going to people in Sydney to avoid Monash altogether.
Congrats on your upcoming surgury!
I guess I’m lucky in having a clinic (Mazzoni Center of Philadelphia, PA) that prescribes hormones on informed consent (they just do some medical testing to make sure that you don’t have a physical condition that makes hormone use dangerous, like an f-ed up liver), having a great doctor who operates on the same basis. I’m going the independent route r.e. counseling, and my therapist has been very good. However, I’ve not tried to get the approval letter that I need for surgury, I’ll need a psychiatrist’s approval, and I have zero trust for psychiatrists (my therapist is a psycologist).
The thing that really, really scares me is Real ID, which potentially means losing my driver’s license / ID, which is bad enough. Worse, though, if the gov’t ever decides to fully enforce the gender no-match provisions, I may be permanently unemployed. (Currently, they’re sending out the no-match letters, which is bad enough as people are getting outed and endangered, but the gov’t put on hold — temporarily only — a provision that anybody who’s the subject of a gender no-match or name no-match letter be immediately *fired*, with no chance to appeal.)
That’s absolutely disgraceful.
What happened to the basic human right of self-determination, patients having choice over medical procedures… gah! Where to begin with the utter betrayal, the sheer disregard for basic ethics!
Too many injustices are allowed to be perpetuated.
I’d like to help end this one.
Congrats on both the referral and no longer having to deal with an organisation that sound like they have some serious cultural problems.
*shudders*
So much for “first, do no harm”.
Congratulations on surviving all that heartless bureaucratic bullshit; don’t blame you for still being angry.
I wish every dumbass “but I want to do AWAY with gender! yer just reinforcing blahblee” would actually read this piece. Just…argh. anyway:
Right on, sister.
Good luck with all that medical mess.