So you know that big, important hormone consultation I had today? You know, the one I booked four months ago and fought for and sacrificed for in order to ensure I got an experienced female doctor who was actually accepting patients? Long story short, in walks a male. He stares at me, I stare at him, and after a moment he says, "Hi there. I don't know if you were expecting a man or a woman." I was just about to tell him that he had the wrong room, when he introduced himself as the new nurse practitioner under Dr. Kass. Not only was this his first week at Fenway and as a nurse practitioner (today was Tuesday, people), but I was also the very first transperson he was ever dealing with. And that was that. He was very sweet and concerned about doing things "right," but he was not what I had signed up for. Instead of my experienced female doctor who I had fought so hard to get, I instead got tossed an inexperienced male nurse practitioner, not only without consent, but without forewarning. If I had opted for this, I could've been on T at least a month ago. That gets my goat like you wouldn't believe.
Not only did nobody ask me, but nobody told me. Not even during the confirmation call from the day before. I'm incredibly insulted that, once again, I'm so easily disposable; all of my best efforts are being tossed away carelessly by the flick of a faceless person's wrist. The American Dream isn't real, people; we minoritized identities usually realize this first. It doesn't matter how hard you try, that isn't what gets you anywhere. What does is the rare mercy of normative people, which can be taken back just as easily. Good luck. I went in today after all of my hard work and fighting, with every last scrap of preparation, and look what happened to me. Yet again. You know, one of the definitions of insanity is repeatedly going into familiar circumstances and expecting a different result.
I'm so goddamn sick of being a guinea pig. I've been that virtually everywhere I've gone since coming out, particularly in medical spaces. I moved to Boston thinking I'd get a break. I truly believed that, going to Fenway today, I could finally relax with the comfort that somebody highly knowledgeable and experienced was looking after me. I no longer would have to carry most of the burden myself and take the brunt of "accidents." But instead, I once again got screwed over. I again am the zoo animal, reduced to a living instrument, and any learning mistakes will be warred out on my body. Let's think about this, shall we? Would anybody stand for receiving cancer treatment from somebody with no experience in doing so (and they ask you what the normal treatments are)? Or consent to a surgery by somebody who's never done it before? Keep in mind that you were waiting four months on the indication that you were getting somebody else entirely, only to have a stranger walk in and say otherwise.
I want to be explicit that I'm not mad at this man, nor do I think he did a bad job today...for his first time. I'm rather mad at the situation and the way Fenway itself has treated me once again. I'm appreciative that he admits when he doesn't know something, and yet am concerned that, well, he doesn't know said things. Whenever we'd be going over basic stuff like T effects, whenever he'd say, "Wow, I didn't know that!" in wonderment, I'd try so hard to not have a pained expression on my face. But it was eating away at me. This is the person that's supposed to oversee what is perhaps the biggest pivot in both my life and health for the rest of my existence. I deserve appropriate care, particularly since that's what I signed on, sacrificed, and fought for. I was unjustly blindsided at the last minute. And I'm pissed.
I do feel justified, however, already in being angry with Dr. Kass. Originally I was getting angry that I wasn't seeing her at all during my long appointment (after all, once again, she's the one I had made an appointment for and had been confirmed as such just the day before), and yet her single appearance made me even angrier. She knocked on the door about thirty minutes in, enters, and says to him, "Oh, you're still here, are you?" Not really even waiting for an answer (and I don't think he even managed to give one in time), she turned back around and left, never to be seen again. First off, this appointment was scheduled for forty minutes, thankyouverymuch. Second, she not once acknowledged me, looked at me like a human (she may have glanced at me once, only to quickly look away and pretend I didn't exist), introduced herself to me, or anything else that would consequent a doctor worth their salt. I didn't even know who she was until the nurse practitioner must have read the look on my face and said, "Oh, that was Dr. Kass." And I had heard six-degree good reviews about this woman! What. The. Hell.
Oh, and the whole thing took over two hours. They said it'd take forty minutes. But, you know, apparently they need to test for every goddamn thing on the planet, ask you every medical question known to man, and attempt to examine every inch of you (that was a fun tussle; I nearly got my threat on until he backed off) because HRT is oh-so-horrible and -serious. (If it's so serious, why did they stick me with an inexperienced person without a care?) Not to mention that the guy admitted to being new to this and taking things slow so he could "learn along with me." What is the meaning of "specialist" again and why am I seeing medical practitioners at all if this is the situation? I hate to say I'm beginning to sympathize with transfolk that go through the black market.
I'm upset and upset that I'm upset. This was supposed to be a happy day for me, albeit a little anxiety-ridden. And my well-deserved and hard-earned happiness was unfairly and unjustly tainted. That truly bothers me, particularly since I've had a horrible history with Western medicine in the past and had to specifically swallow my pride to return to Fenway after they treated me like crap in the summer. So why am I so upset that I can't sleep? This was not what I was out for today. Maybe so excited that I can't sleep, but not upset.
To all my transitioning trans readers out there: I know this is incredibly easier said than done due to virtually no other options, and I may as well be a hypocrite in this regard because I simply can't go on in my current state, but please try to find somewhere else to go for your health than Fenway. My two big experiences have shown that they're a complete crock in at least the trans department; they don't really care about you in the long run. They're taking full advantage of their quickly-growing monopoly on trans health care in Boston. I currently am undecided what I'll do. I plan to contact the nurse practitioner tomorrow and, with as much respect as I can muster, lay out my frustrations and concerns over him caring for me. Maybe he'll actually say something that'll make me feel better.
I have no autonomy here, which was my absolute biggest fear about starting transition. It's times like these that I unfairly get mad at myself for not only being trans, but being as dysphoric as I am. All I want is a break. I want to lay my head in somebody's lap, have them stroke my head, and say, "It's okay. You've worked hard. Let us take care of you for a while. You've done well."
So I have a pretty big decision to make: do I go ahead with this care and subject myself to potentially major health risks, or do I wait perhaps another year before going on T when somebody else becomes available, which in its own way creates potentially major health risks?
I'm going to try and end this post with the (potential) positives of today's appointment. For starters, I've already secured my first T shot appointment for January 3rd. The irony here is that, because he has virtually no patients yet, that day was wide open and I could choose any time I wanted. Also, he told me a few times throughout our session that, again because he has virtually no other patients, that he has and will spend so much more time with me. (e.g. Two hour consultation today instead of forty minutes.) However, I'm skeptical as to this extra attention; is it for my own benefit, for me to be his learning tool, or somehow both? Also, I get the feeling that I'll be getting special attention, whether I warrant it or not, because I am and will always be his first trans patient. Within an hour of me leaving the office, he called me on my cell with a few-minute-long message correcting and clarifying some assumptions and mistakes he had made regarding the protocol at Fenway. He gave me his number, encouraging me to call him for any reason. This was very nice and personable of him, but again...the fundamental nature of the call...
He's already proven to me that he's trying, committed, truthful, and empathetic. But if that's all he can offer, I hate to say that's not good enough. Not in such a massive medical situation such as this. But at the same time, after my quick witness of Dr. Kass, I don't think I want a damn thing to do with her in the end, either. I want to believe so hard that this is all a blessing in disguise, but the potential and realistic threats to my future health logically contradict me.
And yet, what other options do I have? There are no other doctors I can go to now, especially after the hooplah of signing on with Dr. Kass (frustrated much?) and life without T hit the end of its tolerability months ago. All I can do is swallow what little dignity I have left, subject myself to objectification and possession, and pray that my body survives it.