TW: gender dysphoria, anxiety, ableism, discrimination, mentions of rape/pregnancy, discussion of reproductive organ stuff
I just got home from the gynaecologist. I didn’t make it home before spouting into big ugly tears. I didn’t even make it out of the office, though I fought valiantly to keep them just in my eyes.
Let’s recap the situation:
I am genderfluid (they/them), asexual, and very not interested in having children. I very dearly above pretty much everything else in life, including singing with Sir Russell and not having to ever talk to my mother again, want a hysterectomy-oophorectomy.
I have been pregnant and the experience was hell. My body was not doing things it was meant to, my brain wasn’t mine, I had so much anxiety in my head I couldn’t focus on anything. I remember waking up at 2am and finding all the blood and realising it was over and the most likely father (who had bullied me into an engagement, which predictably ended when the baby did, to my great relief) was very sad, and I just felt so glad it was over I was afraid to say anything. Because this happened, I know I cannot go through it again.
Thing is, because of the other things going on at the time, everyone assumed that this was PTSD. I didn’t get any help for it, and it was just me who knew that this wasn’t a thing that my body was meant to do.
A few years later I was finally deemed old enough to get an Implanon, though to do so I had to acquire a boyfriend in order to ‘justify’ needing it, despite being diagnosed with PCOS at the same time. Six months later, period-free, the migraines started being less evil, and I thought maybe things would be okay.
Then the pain started. My last pap smear hurt for a week. I can’t place anything on my tummy, because any kind of pressure makes me nauseous (naturally, this includes my back brace). And so on. Scans and scans and then the surgery and it only got worse. The surgery/the IUD made it go from sometimes, a couple of days at a time, to all the time.
This is where we are today. I have been saying, over and over, to every medical professional I have seen, that I am in more pain, it isn’t getting better, and been told “nothing’s wrong” or “are you sure it’s not psychosomatic?”. Remember, I have PCOS. I was in pain before the whole job thing. I was in pain in high school. None of this is new, or related to PTSD I didn’t have yet, or…
So this new doctor is the gynaecologist to whom the referral was messed up. Apparently, the psychiatrist has still failed to write to her to explain how he thinks my brain works and that inside my head is an otherwise fully-functioning brain that if I was given access to a keyboard, would be able to demonstrate exactly how much I understand, because 99% of the time I am the smartest person in the room, even when I can only see and hear on one side.
This means that she refuses to do a hysterectomy because she can’t be sure I can provide informed consent because for that there needs to be a discussion. (Never mind that like, every time I go in and see there’s no keyboard for me, I get out my phone and type to her and am perfectly able to you know, communicate with her, just like, in short sentences.)
That’s right I can’t have this one surgery she said she totally understood that I needed and would save me so much anxiety and would mean I wouldn’t be terrified of going to the toilet, because I can’t talk.
That would be discrimination. Like, massively. Obviously. I’m not sure whether I was crying because I thought she got it and she didn’t and I dragged myself there with my migraine and everything because I thought something would finally be done and it wasn’t, or because I was just so stunned that everyone (because, you know, she talked to an expert, who gave her legal advice without being a lawyer) thought this was okay.
I know. You’re asking how this works even though right now I’m having a big argument with a different hospital about the IUD, the crux of which is that I wasn’t able to give informed consent. The problem there is essentially the same. I wasn’t allowed to communicate with them. They didn’t even let me ask for accommodations. I was told that the IUD wouldn’t be inserted, which I said was fine because I didn’t want it, and then they did insert it. The procedure wasn’t clearly explained to me, because they thought I wouldn’t understand it.
If I really couldn’t communicate because I can’t talk, how on earth would I be writing this? (Okay, typing hurts my wrists, quite a lot in fact, and I’m sure there are people who say that these are not very coherent pieces of writing.) But you can understand them. You can ask me questions if you don’t understand something.
I can type to the gynaecologist. She has the impression that because I have the theoretical ability to purchase pimple cream, the fact that I have pimples and my face looks mostly clear (pimples apparently only form on people’s faces) means that the pimples aren’t a big deal. I can’t reach my back to put pimple cream on my back, because the whole part with certain things on my body increasing in size due to the IUD (which will go away eventually, so it’s a good thing? right?) means my back brace doesn’t provide enough support since it’s molded to my old shape. And they bleed. A lot. And then there’s the ones on the front, on which nothing works. I know. I’ve been through this before.
I didn’t even notice they’d gone until they came back; that’s how long it took for them to stop last time.
And while my shape and weight changed virtually overnight from the IUD, they are, of course, slow to change back. I’m not sure they are, that’s how slow.
But the gynaecologist thinks that because the Implanon stopped the periods, it’s good and I should just wait the rest out.
Except I can’t wait it all out again. I can’t.
I can’t look in the mirror. I can’t wear tight clothes. I can’t wear pants, because that means I get a yeast infection, and sometimes that means I don’t go out because I can’t go out looking like that. I used to be able to pass and while the conscious effort of deciding how I would pass every day was maybe annoying, I used to have that choice.
Now I know what it’s like I can’t just wait. Years. That’s what it will take.
Oh, and also, because I’m only thirty one, I might change my mind and want kids. The kids I’ve never wanted and the pregnancy I will kill myself to stop if it happens again. (Because, you know, asexuals can have sex. Apparently this makes me a bad asexual, but I like BDSM. It would be really nice to not be terrified of it.)
Did I mention the ‘expert’ giving advice about the gynaecologist’s legal standing isn’t a lawyer, but a psychiatrist?
I asked if a statutory declaration would help. It does require a witness. And every time I make one, witnesses come out of the woodwork because I’m easy – they always find themselves pleased that they don’t have to explain things and clearly I know what I’m doing (especially,the ones I draft myself, putting all those years of legal education to use.)
I asked if I should see someone who specialises in gender dysphoria. (You know, one who doesn’t write off ‘I can’t look at myself and I hate my body and the IUD has changed everything and it’s not me and that thing inside me isn’t mine’ as ‘your PTSD is worse for some reason but I don’t understand why’.) “You can talk to the one I talked to so she can tell you the same thing.”
(Never mind the whole other thing of discussing my case with someone else without my consent in so much detail that the other person can give a thorough piece of advice based on ‘can’t talk’ and will know who I am when I go to her. Or the gynaecologist only giving me her email becasuse “email will be more comfortable for you”.) The last gynaecologist, the one who happily sat there and was talking about “well now you’re more fertile! that’s so great, isn’t it!” would have done it if I’d had six months of counselling. Mind you, in neither case an actual referral has been made. And I’m really not sure I want to go to a psychiatrist who’s happy to discriminate based on whether I can talk or not, really.
And here’s the real thing – after all the ‘but Implanon’s working really well for you’ (well der, why do you think I didn’t want to change?) and the recommendations for pimple cream (funny how I already have it and I still have pimples, right?), I managed to go ‘but what about the pain?’. It’s Ovarian Cancer Awareness Month, and every time I see one of the posters I mentally tick off the things – abdominal pain, weight loss, back pain, feeling full after little-to-no-food, bloating, changes in frequency of urination – and wonder why nobody’s checked. I tried to explain, but I wasn’t even allowed to finish a sentence.
Here, however, is the advantage of the psychiatrist’s letter not making it to her.
Apparently, the pain? That I’ve been walking around with for like, nearly a year? It’s probably just an infection. In there.
“Is it tender?” Yes.
“Do you have discharge?” Yes.
“What does it look like?” Like thrush, but thrush medication hasn’t worked.
“Have antibiotics! If those don’t work, come back.” And now I have a script. And maybe it won’t work and maybe she’ll do an actual exam and find something and I’ll get rid of the thing that way.
The problem with going back, is that I have to put up with someone who won’t accommodate my disability but believes I actually identify how I identify, and actually apologised for discriminating against me to my face. I don’t know if that’s a thing I can do, honestly. Like, she has two computers there. Two. Let me type on one! Is one from two better than none? Can I go in next time and be like ‘okay, the psychiatrist still hasn’t told you, he tells everyone to provide me with a keyboard so I can type to you on a screen that’s bigger than four inches square so that I can make full sentences, can you do that?’ and have her do it, because I’ve been resorting to my phone? (I did take in a letter explaining and asking the first time, but I let that go because it was the first time.)
(I should mention, I do have a laptop I can, in theory, take with me to type on, but, um, I can’t carry it. Like, I get in trouble at the supermarket because people put three bottles of Coke in a bag and then I can’t lift it. That caused drama today too, because the self-checkout was closed and I had to go through a regular checkout, and she wouldn’t bag things in the piles I put on the conveyor, and then put the bags where I couldn’t reach them, then ran after me cos I ‘forgot’ a bag, which she dumped on my fragile bag, crushing it. I haven’t decided whether to complain. Or maybe, next time the self checkouts are closed? Anyway. I can’t carry it, and like, that leaves me with my phone. Before I had this phone, I didn’t even have a Word-alike to type in. This is why people ask for accommodations, and when they’re reasonable they aren’t meant to be denied.)
(There was also an incident where the receptionist bumped the EFTPOS terminal so my card came out, and when she put it through again, naturally, the bank flagged it because there were two identical transactions within a minute. I used my other card, and because I had a prescription and my wallet and the appointment and etc etc I didn’t pick my card up. She insisted on handing it to me and wouldn’t let me put it back down, so then my wallet went splash on the floor, didn’t it? Honestly. How rude. Also, you’re not meant to take people’s cards from them anyway, at all, not even to swipe it. The bank doesn’t like that because of the potential for fraud.)
But ‘you can’t talk so you can’t give consent’ is the stupidest, ableist-est reason to deny something, ever.
(The Facebook response to this would be ‘but what about a quadriplegic?’ But really, we have technology, however nascent, to let people with locked-in syndrome communicate. It’s not a thing you can just assume, especially not without an assessment.)
I could, in theory, lodge an equal opportunity claim over this. The problem? They’re slow. Long. And they make people less inclined to cooperate, because they see it as being sued. Usually, people get an apology and a token amount of money, instead of real actual change.
But I sure as hell am not waiting until I’m forty “because then you can’t have kids anyway”. Ten more years of this? Really? That’s in my best interest?
I’m so angry I’ve stopped crying.
The absolute most blood-boiling part of this is that she’s talking about legal issues and legal backing and how much trouble she would get into and I’m a lawyer and I know it’s bullshit. It’s not her job to decide whether I can consent or not, and if she’s not sure she gets to send me for an assessment and then abide by it. The psychiatrist she talked to? Shouldn’t be giving her legal advice.
(I could segue into my legal opinion of the act, but honestly? The issue here, also, is conflating contraception with gender reassignment. Technically, a hysterectomy, as “an act to alter the sexual characteristics of a person” is covered by the Act, but only if it’s for the purpose of reassignment. I’m not looking to transition. The wording is terrible, but hysterectomies for contraception only? Are not covered by the Act. I greatly dislike when people misapply the law because they don’t understand it and then people get hurt as a result. I am asexual and genderfluid and I would like permanent sterilisation in the form I choose. That is all.)
Still angry. I’m going to post this before I start off on some other point and my back decides to lock up because I’ve been sitting too long.