A Privileged Position

TW: medical treatment for non-gender-binary and trans people, privilege

 

Side note: rumour has it that one no longer needs to provide ID to get codeine, at least until it goes script-only. Small wins are good, right?

 

So all this medical stuff I’m going through lately, and specifically how people seem unable to see ‘me’ in all this, has made me think about how i fit into the whole thing and how trans* and non-binary people get care. My position is that because i am afab (assigned female at birth), and since that’s generally how people assume when they see me, even if i do my makeup and bind and layer specifically for passing (especially now), i don’t really get put in the position of having to ‘convince’ anyone i was afab for things that is necessary for.

And, it is, unfortunately necessary. Because medical experimentation and treatment outlines and pretty much everything is designated male or female, it’s something that sticks with someone even if they surgically transition and live entirely as their preferred gender identity. (It’s very embarrassing to have to approach FtM relatives, for example, to ask if they had endometriosis, just fyi.) So, because i was afab and because i don’t want to permanently alter how i look, i don’t get the ‘but i was afab so you do need to give me a pap smear’ things.

What i also don’t get is valid and appropriate care for things which should not be gendered but are. Half of my heart is enlarged and i have a family history of heart disease (the rocks fall everyone dies kind of history). Because i don’t present male enough, it isn’t being taken seriously. Nobody knows why my heart is enlarged. Nobody thinks it’s worth looking into, no matter how much noise i make over it. Heart disease is a male illness; the warning signs and treatments are all designed for and tested exclusively on men. The fact that my heart isn’t working how it should, because i do not present male, is not important. The fact that i get dizzy if i move too fast, that my right shoulder doesn’t work, that i get chest pains for no reason – these mean nothing.

Well, i am told that the chest pains are just anxiety, because i have a mental health diagnosis, but then if that was the case it wouldn’t happen exclusively when i’m either sitting doing nothing and being very calm, or in the middle of the most strenuous physical activity i can not fail at doing.

 

Because i present female (even when i don’t mean to), doctors treat me as the stereotypical female. Since i have a mental health diagnosis from when i presented as a female under thirty… every physical thing gets written off as stress. i don’t get second opinions. i don’t get the right scans – just the cheapest. i had an echocardiogram after six months of saying ‘this isn’t right’. The cardiologist sent back a report saying it wasn’t concerning. My family history wasn’t passed on to him. i’m sure my file sits next to my dad’s in their file room, but confidentiality means even if someone noticed, they couldn’t use that as a reason to suspect a connection. Another doctor asked why i hadn’t had an ECG or a stress test, until he saw the report. Then, well…

Because people who present female and still count as ‘young’ are still ‘hysterical’ and ‘its just stress’.

 

And this is before the gynaecologist, where suddenly i’m not dysphoric enough to have a procedure i asked for for medical reasons, and i’m meant to wait until i’m older “in case”.

 

My point is, i think, that having any kind of non-binary or trans identity not only blocks people from accessing care due to the attitudes and assumptions of physicians, but even without those, we can never escape our birth identity. It still defines us, for them. We can’t avoid their boxes and the traits that go with them. Some of us have privilege that matches enough to get what we need; some of us do not. Some of us have to apply labels we don’t identify with to get what we need; some of us do not. Some of us can fight for what we need; some of us can’t.

It’s not us that need to change.

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