White Coat Hyperstressing

A few weeks ago I had an appointment with a dermatologist about a shiny bump I had on my face (which turned out to be nothing to be concerned about). However, since I’m in my 40s and have very pale skin, the doctor suggested I come back in a few weeks for a full body check. I suppose this is a smart thing to do, but now it’s causing me a ridiculous amount of stress, as most doctor’s appointments tend to freak me out for various reasons, a lot of them having to do with the whole trans thing.

This anxiety is exacerbated even more because the procedure I’m going in for requires me to strip down, and, since I have been on hormones for almost ten years now, my body is a mishmash of two different sexes. 

Now all of this could turn out to be totally fine, and with the visibility and empathy that trans people have been getting lately, and with the fact that this office is in the heart of downtown Philadelphia (a very LGBT-friendly city), many of my fears should be allayed. Yet they still exist.

And these fears still exist even after writing all my medications (hormones included) on the patient information form I filled out during my initial visit. I also even had a conversation with the dermatologist and another doctor about some minor scarring that has appeared on my face (probably) due to the extensive hours that I’ve had a needle repeatedly stuck in my face during my electrolysis treatments. 

When I told the doctors that I was having electrolysis, they asked if I was just getting ingrown hairs and other similar problems addressed, or if I was having my whole face cleared. I answered that I was getting all of the hair removed from my face, and that was pretty much that. The conversation may have paused for a second, but then they jumped right back into what could be done to treat the scarring, and even talked about how their office offers laser hair removal (though that doesn't work for me due to my blonde hair).

I should have just told them that I was trans then and there, and that probably would have helped me either feel more at ease with my upcoming appointment… or realize that I should cancel it altogether (as I wish I could've with some of the other AWFUL doctor's appointments that I've had in the past). But that ship has most certainly sailed.

So, what I described above would make many people think that everything would be fine, and that I should just go down and not worry about it and get checked out. But I also want to go because I was MUCH heavier than I am now, and I have just AWFUL stretch marks under my arms that trail onto my back and chest. So I’m hoping that something could be done about this, as sleeveless things are SUPER comfortable to wear and also make me look a lot more feminine, but I would have issues with going out in public like that because (among other reasons) it looks like someone dug in and scraped a rake down my armpits.

All of this being said, I’m STILL thinking about cancelling this appointment, because this is how heavily the whole situation is weighing on me. And because the scarring I’m looking to have addressed is where it is (primarily talking about my chest here), I’m just SO filled with agita about it. I keep thinking about what I would have on during this exam, and how things would play out, and it just makes me nauseous with how much it’s making my head spin.

On top of ALL of this, I’m just INCREDIBLY annoyed that I feel this way, and that I’m thinking about being a complete coward and cancelling this appointment. This leads me into beating myself up for ALL of the fear that has rooted itself deeply into my psyche, not just with this doctor’s visit, but with the entire trans issue.

This very minor situation is making me realize more and more that I am utterly immobilized by fear, and me being trans is at the core of it. After all this time, and all the progress that I have made, and all the effort I put into trying to be okay with myself and who I am, I still can’t fucking bring myself to do it…and it’s killing me. 

And the fact of the matter is, what many friends have told me about the trans thing is more than likely true: “No one cares about this as much as you do. NO. ONE. Most people give absolutely no shits about it.” So why the fuck do I care so much? Why am I so mired in this horrible position and why do I keep doing subconscious things to keep me pinned where I’m at? How do I get past this fear? 

Well, I think I can start by realizing that people are who people are and they feel what they feel (even if it's open contempt toward me), and accept that fact and be who I need to be regardless of that fact. People being who they are should have ZERO impact on me being me. Other people should have no impact on me EMBRACING who I am, and not just grinning and bearing it. This is a lesson that I desperately must incorporate into my life, because even in spite of all of this, I’m STILL thinking about cancelling, and I have about two days to decide to do so. 

If anyone has any suggestions for how to get past fear, please let me know. In the meantime, however, I wish all the best to you, always.

What If?

There are two types of people in the world: There are those who believe unequivocally that what they think is true and never question anything once they come to a conclusion about it, and there are those who are open to the fact that they are human beings, and sometimes human beings can make mistakes—not just mistakes like they said the wrong thing to someone, or they backed into a telephone pole while trying to parallel park, or they tripped over a curb and embarrassingly spilled themselves all over the sidewalk in front of a herd of ritzy and annoying onlookers, but mistakes in how their thoughts, views, and opinions were constructed.

If you're one of the people who fall into the former group and you think you make exactly zero mistakes, please stop reading now and seek therapy, because you're obviously grappling with an astounding amount of delusion and you have FAR more important things to do than waste time reading my stupid website.


Okay, now that to those never-wrong fools have been addressed and are out of the way, let's move on.


Since this blog is about what it's like to be trans, I am now going to bring that into the conversation.

There are a ton of people in the world who don't understand what transsexuality is, or they fear it, or they're revulsed by it, or they have <insert terrible reaction here> to it.

Sure there are a bunch of people who "get it" as much as anybody can who's not actually dealing with these feelings, and these people are wonderfully understanding and supportive (to say the least). As awesome as these people are, and as thankful for them as trans people are, this post really isn't written for them; but they can feel free to stick around and read on. Maybe I'll even amaze everyone by saying something funny, or interesting, or insightful. I mean, you certainly wouldn't want to miss that, would you? 

Annnnyway...

This particular post is specifically addressed to those who either don't understand transsexualism or have an adverse reaction to it. To those people I ask a simple question: "What If?"

What if, much like people are born intersexed (or as hermaphrodites as people might say) and have biological characteristics of both sexes, some people are born with the body of one sex, but the brain of another? Put away your skepticism just for the moment and simply ponder the thought: What if this were true? I mean, do you know with 100% certainty that it couldn't be possible? Do you just want to believe that it couldn't be true because it's easier to process and deal with if it's not? Seriously, WHAT IF this were true?

Could you imagine the amount of suffering that these people would go through, not only because of the condition itself, but because of how society sees and treats them?

What if people were born like that—born, in essence, to suffer and wage a lifelong war against their own biology solely because they just happened to be made differently? What if people were sickened and revulsed by these people who were born with and struggling with an issue that they did nothing to bring upon themselves?

Couldn't it be possible that this could be true? Can you really, undeniably prove that it's not? Perhaps more importantly, how would you treat these people if they did exist?


Well, I'm telling you flat out that we do, and that every "what if" question I asked above is what I and many other people are struggling with on a daily basis. And please believe me when I say this is true because we have spent more time thinking about, examining, and questioning this situation from every. possible. angle. than all of the other people in the world combined, so we're kind of experts here... and this is without even getting into all of the medical corroboration that backs up what trans people like myself feel.

For who only knows what reason, a switch got flicked in the womb and we developed this condition. Would you treat anyone else with a congenital condition like this as badly? Would you be sickened and revulsed by someone with autism, or someone with a heart defect, or someone born with diabetes? Is it right to ostracize these people and treat them badly because they were born with a condition that makes them different? Is it right to deny them the care they need to get healthy? I mean, wouldn't you want these people to have the best life they could possibly have because they're dealing with something that most of us are lucky enough to NOT have to contend with?

So this is up to you. What if people are born transgendered? What if that meant that they're going to be internally tortured their whole life, especially so if they can't even get treatment for their condition because insurance companies can get away with not covering it due to the fact that most people don't care about it or are staunchly against it for some reason? Do you want these people to continue to be marginalized and suffer even more than they have to, or do you want to help them, because we as good human beings are supposed to care for each other, love one another, and help those less fortunate than us to get something out of life?

Again... what if all of this was true? How would you personally deal with the situation then? Would you hate or would you love people who were born with a condition that caused them to suffer? I can only hope that most people would come down on the side of love.

All the best to you.

Cover Me

Living without healthcare is a VERY dicey proposition. There’s not a one of us who would willingly want to do that, and if we were living without coverage, I’m sure it would be super-high on our priority list to get something in place with utmost haste.

But what happens if your chronic ailment isn’t covered by insurance? Well, essentially, that’s the same as not having coverage.

As I’ve stated in the past, there seems to be more and more evidence that people are born trans. Something happens in the womb, wires get crossed, and someone like me gets born.

Now you can look to the majority of the posts that I’ve placed on this site to see the amount of mental carnage that this bestows on someone. I don’t want to get too sidetracked with covering that ground again, so let me just say that it’s hellish.

The RECOMMENDED treatment for people such as myself is cross-gender therapy, which consists of hormones and other cosmetic procedures designed to get your body in line with your head. However, the costs of these treatments are well beyond the point of being called “substantial” and pretty much crash through the threshold of “egregiously obscene”.

Electrolysis, for instance, costs anywhere from 70 to 100 dollars per hour and it takes anywhere from 100 to 400 hours to clear an average face of hair. I’m already 200 hours in and I still have so much hair left on my face that I can’t even really think about the outlay of time and money that waits for me, because it seriously makes me want to die. I’m at least going to need another 200 hours of getting a hot needle jammed into my face over and over again. After a two-year break that I had to take from this delightful process so that I didn’t bankrupt myself, I finally just started electrolysis again at a cost of 85 per hour. So, you know, that’s about seventeen THOUSAND dollars I have to come up with right there, and that’s not counting the money that I spent on the 200+ hours that I already endured.

On top of this, many male-to-female trans peeps require some kind of facial surgery in order to live in the role that they feel they belong. These surgeries, at their most basic, can run anywhere from 10 to 30,000 dollars. And sex reassignment surgery (which is the “big” surgery that most people think about) costs in and around 20 grand. This cost is even higher for female-to-male trans folks (I’ve read in the $50,000 range), and they would have the added cost of removing their breasts, which also carries quite the price tag (I’ve seen this vary from anywhere between $7,000 to $20,000).

The money needed to deal with this condition that I was born with, and a condition that has wreaked tremendous havoc on my life, easily floats somewhere around $100,000… all of which I would have to pay for myself with absolutely NO help from health insurance.

ALL I want out of life at this point, is to get through this. To get through the whole process of transitioning and be done with it, so I can stop thinking about it and just live my life for once. That’s it. Just PLEASE get this monkey off of my back. I’m INCREDIBLY tired of dealing with it and having my entire world on hold because of it. I’m almost 40, and until I get this sorted out it’s near impossible to build a relationship, or to feel truly secure in any career, or just to settle in and enjoy life. 40% of trans people attempt to KILL THEMSELVES. It’s not hard to see why when you have this much stacked against you.

Many health plans now cover mental health, and they allow so many visits to a therapist within a given year, so there is SOME value that these faceless corporations place on their clients’ mental well being. But I, and many, MANY other people, have this unrelenting mental agony, and the RECOMMENDED treatment for this is NOT covered by most of the health plans in this country. More and more people employed by LGBT-friendly companies are getting some of these costs covered, but there are still a staggering amount of people who are struggling to deal with all of the trans bullshit while trying to scrimp and save enough for one of these NECESSARY surgeries, AND, at the same time, trying to scrape together enough money for yet another hour of electrolysis, or for hormones, or for a host of other things.

As I said, ALL I want out of my life at this point is to get past this and be done with it and live my life. And, though it’s taken me a hella-long time to get my head in the right place to do this, I’m so, so, SO ready for it to happen. But while I do okay when it comes to making a living, I have nowhere NEAR enough money to complete this process, or even to take another big step towards that goal. If I did, my life would be AMAZINGLY better. I’m not saying all of my problems would be solved, but a really big problem would be, which would give me more patience and more mental energy to focus on any of the other issues that life hits us all with on a daily basis.

My point in writing this is to say that being trans and dealing with it is my MAJOR health issue. It’s what I desperately need treatment for, because it’s slowly destroying me. For the sake of thousands and thousands of people, trans-related procedures need to start being covered by health care providers. They NEED to be. If it was, my life, and the lives of SO many others, would drastically change for the better in an instant.

Let me repeat that…  

Thousands of lives would change for the better in. an. INSTANT.

And while these surgeries and the like may seem cosmetic, they are not. They are the RECOMMENDED treatment for someone in my position. I DREAM of having the cash to complete this process. If the treatment for my major health problem was covered by health insurance, however, I wouldn’t need the ungodly amount of money required, and I could address all of this and move on with my life in a mere couple years, rather than the glacier-like pace that I’ve been forced to take, which should get me to my goal, hopefully, by the time I’m 80. You know, if I can make it that far.

I hope you’re faring much better than me when it comes to your health care. If you’re not, I send you nothing but love and the hope that things improve for you as quickly as possible.     

*For additional reading click here.

Part III: The Lovely

Now's the time for the much-delayed conclusion to my "The Good, the Bad... and the Lovely" posts. If you remember, these were about three different experiences I had dealing with health care professionals while being trans. As I said, this is the third part, meaning it's time for...

The Lovely

It's the summer of 2006, and I'm driving in the direction of my mother's house. She's on the phone and I'm telling her that I have to go to the emergency room because I'm having chest pains and feeling dizzy and just in a bit of a daze. It's the middle of the week and it's around midnight.

She's telling me that I should go to one of the ERs in the neighborhood, because the wait will be much less there than if we go into downtown Philadelphia. At the time, she knew I was trans, but she didn't know that I was on hormones (i.e. doing anything about it), though I had been for just over a year. That being the case, I wanted to avoid these neighborhood hospitals and go someplace that promised to be a bit more accepting of my situation. I insisted that we go into town – to the hospital that was affiliated with the LGBT center that I was getting treatment at. Now I don't know what would have happened at another hospital, but in hindsight I feel safe in saying that going to the hospital I wanted to was very much the right choice.

After we'd gone through all the waiting, they finally take me back into an exam room. A nurse was there and he said that they wanted to do an EKG on me to check my heart. I was nervous to begin with, and getting this test done made it even more nerve wracking, because, like I said, I had been on hormones for over a year, and that being the case, I was starting to get some noticeable breast tissue. Still, the test occurred and nothing was said by anyone in the room as far as anything being abnormal about my appearance, though the nurse did tell me that there was something slightly irregular on the test. Of course, I got a bit worried about this.

I realized at that time that I had to let the nurse know what was going on with me and what hormones I was taking, just in case I was having some kind of reaction. Since my mother was sitting right there, however, and I figured that this was NOT the way to let her find out what was going on, I waited until she left and went back out to the waiting area. I then began to jitteringly tell the nurse that I was trans, and that I've been or hormones for a year, and that I waited to tell him this privately because my mom didn't know.

He immediately put any and all of my concerns to rest, saying something along the lines of: "Don't worry about this at all. I'm gay myself and we deal with people in your situation all the time. Don't worry about any of this stuff, it's all fine." And he smiled and he was super-supportive, and it was simply amazing.

After this conversation, I was sent back out to the waiting area. There I found my mother. We went outside to get some air and that's where I told her that I was on hormones, and that I'm telling her this now because they found something a little odd with my EKG, and they also said that there may be a chance that the hormones were part of the abnormality. Since my mother was at the ER with me, I figured she should know this.

My revelation, however, was met with her tears. That sucked. That was a bad, bad part of the evening. To try to comfort her in some way... in any way... I told her that I mentioned all of this to the nurse, what he said about everything, and in doing so, I told her what was the most important lesson that I learned that night...

There are going to be people who will be fervently against me and what I'm doing. It's just the way it is. Either they have a problem with it from a religious standpoint, a societal standpoint, through lack of understanding, or just out and out fear of the different. I get that people are going to be like this, because the news is inundated with stories of this kind of hatred and intolerance. What we often fail to see, however, is that there are people who will IMMEDIATELY jump to your aid just BECAUSE you're in this position. You get support from literally out of nowhere, just like I did by the nurse who was treating me who just happened to be gay himself.

I stayed in the ER overnight that night, and underwent a litany of test. I remember around 6 in the morning the nurse who was treating me earlier, and who I hadn't seen since the EKG, came into the little cube that my bed was set up in and said that he just wanted to check on me before his shift ended. He squeezed my hand for a second or two and told me, "Don't worry, sweetie, everything's going to be okay." Then he asked if I needed anything before I sincerely thanked him and he left.

So... not only do you get support from out of nowhere, but you also get support like this. You get support that will take people out of their way to make sure that you're okay. You get support in that people will look out for you. And I think that in this case it comes from an almost kind of kinship that people across the LGBT spectrum share with one another. There's a lot of looking out for one another, or so I've seen.

Additionally, there are people who aren't in this group who are just kind, caring, and supremely understanding people. They seem to truly comprehend two things about what I'm going through:

1) This is NOT something I chose.
2) It's DAMN tough to deal with.

And once people get these two things, it really seems like their heart opens up to you... and in amazing ways. When you hear story after story about trans people getting attacked, or murdered, or being fired from their jobs with no recourse, you tend to get more than a bit dejected. Then someone comes along and bowls you over with an intense act of kindness, and it's truly astounding. It smacks you in the face with hope and shows you just how insanely good people can be to one another. This was the first time I witnessed anything like this when it came to dealing with health care... and it was quite simply lovely.

The Good, the Bad... and the Lovely

One of the trickier things about being trans is that sooner or later you have to actually discuss this personal decision with someone administering to your health care, i.e. a person who may very well be a complete stranger. This may be because it's pertinent to what you're being treated for, or it's just something you need to say due to the obvious physical differences that hormones bring to your world. What follows are three brief stories, which will be written over the course of three different posts, about different reactions to this news by the people who attend to physical health. We'll start with...

The Good

About seven years ago or so, I was deeply embroiled in the whole coming-to-terms phase with all the feelings I was having and what they actually meant. I was seeing a therapist, who, while not knowing much about the topic, was very helpful in getting me to admit to myself that what I was feeling (that I wanted to be a woman) was real, and that it would greatly behoove me to explore my options when it came to this.

I did a lot of reading on the topic of trying to figure out what these feelings actually meant, as this was the point where I was desperately trying to convince myself that I WASN'T trans. A course of action was discussed that seemed to be somewhat doable, as well as something that may indeed help me to better know what it was that I wanted. This was: To go on hormones for about three months or so, just to see how it made me feel. If I felt better and liked what was happening to my body (and to my mental state as well), it would be an indication that this may indeed be the path that I should follow. If I didn't like it, it would be an indication that something else was amiss, and I should start trying to figure out what that issue was. Additionally, all the changes that the hormones would cause in me after a mere three months would be completely reversible if I stopped taking them. So I wouldn't be permanently changed if I decided this wasn't for me. All in all it seemed like a great idea, and I was excited to try it. The issue was - where do I get prescribed hormones?

My therapist thought a great place to start would be with talking to my primary care physician (seems kind of obvious when I thought about it after she suggested it, but at the time, it sort of didn't dawn on me). The only problem I had was actually going in to tell my doctor that I was having these feelings and that I wanted to try hormones, because, at the time, I could barely even admit that to myself, let alone admitting it out loud to someone else. I mean, it took all of my courage to even just admit it to a therapist.

My therapist, however, saw my hesitance and apprehension, so she offered to call my primary and tell her what I was dealing with. She did. Which was super-awesome of her. A few weeks later I found myself in my primary's office, discussing all of this with her. Here's how she started our conversation (though I'm paraphrasing a bit here):

"I spoke with your therapist and she explained everything to me. This is obviously a very difficult personal decision your dealing with, and I'm not here to tell you whether you're right or wrong in what you're doing. That's not my job. My job is to ensure that no matter what you decide to do, you do it smartly, and you remain healthy.

"That being said, I have no experience with this, so I'm hesitant to prescribe you anything, because I wouldn't know what to prescribe. I suggest you talk to a doctor who would better know what to do and how to address this best."

It was then decided that I should go see an endocrinologist, as I read that this was where one should go if they wanted to get hormones and be safe about it. She had the referral written up immediately for an endocrinologist in the area, with more than enough visits to take care of any problems that may arise.

Since then, she has been nothing but understanding, very professional, and extremely helpful. I couldn't have dreamt of anything better. This experience... was nothing but good.

To be continued...

Be well.