Category Archives: Biological Health

Queerness in the Doctor’s Office

From the good old Google Images search

I’m looking to do a more in depth post on queer people’s experiences with doctors. I was wondering if some of you feel comfortable writing something down about experiences – good and bad – that you’ve had with a doctor or nurse and being queer.

I’ll give you a quick example. I was once told when I was getting a pap smear that, since I was only (at the time) sexually active with girls, that I only had to get a pap once every 5 years.

Have you ever been told something like that? Or – have you not seen a doctor because you thought they might not treat you in a comfortable way because of your identity? Have doctors or nurses assumed you were heterosexual or cisgendered? I’d love to hear any and all of your experiences! I’d like to put together a post with experiences from readers and recommendations for doctors and nurses. Feel free to add recommendations for things that would make you more comfortable.

Send your thoughts and experiences to comehitherblog@gmail.com. I promise to keep everything confidential.

The Problem of Gender Identity Disorder

I recently sat down with Jess Guerriero, a genderqueer activist and trans ally with an MA in Gender and Cultural Studies and a candidate for MSW from Simmons College. For her thesis, Jess examined the diagnosis of Gender Identity Disorder in the DSM IV-TR and how the current treatment model does not include folks who identify beyond the gender binary.

Gender Identity Disorder (GID) is the diagnosis currently given to transgender and transexual people. This gives providers a diagnosis they can use for reimbursement from insurance companies. The problem is that GID is very binary based and doesn’t recognize people who do not identify as trans but are gender non-conforming.

The current standards of care for someone who has been diagnosed with GID are that they must meet with a therapist to get a letter in order to get hormones. They must then be on those hormones for 9 months to a year and pass the “real life test” – which is “successfully” living as the opposite gender for one full year before they can get a second letter to approve surgery. There is also a “treatment narrative” that therapists are often looking for – a long standing history of “gender troubles”. For example, “I always knew I was a boy, I liked to play with trucks instead of dolls…” etc. These requirements are becoming a little more fluid, especially here in Massachusetts, but still don’t leave much room for people who may not want to fully transition.

The thing is, there’s really no room for folks who don’t want to play the binary game. While the system works for some, for those who don’t want to fully transition or may not have the narrative that therapists are looking for, providers are not given any kind of system care. The hard thing is that therapists need to be able to get paid for their work. That money needs to either come from out of pocket or from an insurance company, and those insurance companies want a diagnosis. However, being transgender or genderqueer or not fitting on the gender binary is not something that should be diagnosed, much like being gay isn’t something that should be diagnosed.

Before setting out to write her thesis, Jess really hoped that she could create a recommended plan of action. What she found is that there’s no clear fix. The systems are broken – the systems of diagnosis, insurance, and communication between the mental health and medical world. What became clear, though, is that there should not be one uniform treatment path and that the client needs to be involved in creating that path.

So what can professionals do now?

  • Start where the person is. Have them define and describe their gender identity to you.
  • Don’t act as a gate keeper. Be honest about the diagnosis process and allow the client to decide if they would like to use the GID diagnosis for the insurance company. Work within the system, but don’t necessarily follow the system perfectly.
  • Increase communication between the mental health world and the medical world.
  • Increase education on gender identity for yourself and other professionals.
  • Provide services for after any body modification.
  • Pay attention to social policy and advocate for your clients. Help create a world that better includes them.

We’ve got a long way to go, but we’re making small steps. For example, as of yesterday, a huge advancement took place, thanks to the Department of State. In the past, some states required passport applicants to show proof of gender reassignment surgery before they could change the gender on their passport. This is no longer a requirement! The requirement now is to show “certification from an attending medical physician that the applicant has undergone appropriate clinical treatment for gender transition.” This is a step in the right direction. Thanks to the World Professional Association for Transgender Health!

For more information, check out GIDReform.org and World Professional Association for Transgender Health. If you’re interested in reading Jess’s amazing thesis, give me a shout out and I can connect you with her!

Civil Disobedience – or – Fighting for your Wellbeing

Recently, the wonderful Pam’s House Blend had a great summary of the history of civil disobedience in the LGBTQ fight for civil rights. Seems pretty appropriate with Pride – the annual celebration of the Stonewall riots – just around the corner (or technically, started, here in Boston).

Stonewall Riots - Image from http://www.pamshouseblend.com

Some great points that the post offered:

  • Stonewall was a violent and spontaneous act that lasted days.
  • The earliest cases of AIDS were identified in 1981 and yet ACT UP wasn’t formed until 1987 out of disgust for the governments inaction. (Not to say that the folks that were ACT UP didn’t do enough, but it’s so easy to forget exactly just how long it took the government to do anything.)
  • In 2007 the Employee Non-Discrimination Act was killed for the 34th time.

As LGBTQ people, there is so much that we have been denied. From freedom to assemble – fought for at Stonewall; for the government to see us as legitimate people – especially during a health crisis; for marriage; for the protection from being told that you can’t have a job, rent an apartment, use a restroom that feels right for you; serve in the military; and many other things.

Lately, there has been a new uprising of civil disobedience by the folks who call themselves GetEQUAL. They’re the folks who organized the handcuffing of Lt. Dan Choi and other LGBTQ military folks to the White House fence and the ones who interrupted Obama while he was speaking at a fundraiser for Senator Barbara Boxer. Since GetEQUAL became active, I’ve seen some blog posts questioning their tactics and wondering if the time for civil disobedience is over. It can seem like such a 1960s thing. But, GetEQUAL has been effective. It really feels like the turning point is near. And while we’ve been doing a lot of work on the inside of the system, groups like GetEQUAL have been causing a much needed stir. (Also, a shout out to Join the Impact, specifically Join the Impact MA, who are also doing great work. More on them later.)

Do you know what empowerment feels like?

Menstruation Alternatives: Menstrual Cups

You may have heard about the menstruation alternative known as the menstrual cup. As a faithful user for the past 5 years who has turned about 5 other people on to using menstrual cups, I’m a little in love with them. After flipping through some awesome zines on menstrual health in college, and having my eyes opened to the fact that tampons and pads aren’t always made with women’s health in mind, I knew there had to be another option.

And there has been, since around the 1930s. They fell out of favor pretty soon after they were created for disposable forms of menstruation products, but have a large underground following.

Benefits of using a Menstrual Cup

They’re better for you. Allegedly. Through anecdotal evidence, there are definitely people who talk about having problems with bleached tampons and pads: skin irritation, TSS (from tampons that are in for too long), and bacterial infections. However, not a lot of research goes on to test the safety of bleached vs. unbleached products. And while menstrual cups are not currently FDA approved, the FDA isn’t pulling them from shelves either. As we’ve seen in lots of queer and women’s issues, the research isn’t being done to measure how safe pads, tampons, or menstrual cups are for us. However, there have been no reported cases of TSS from menstrual cup use.

One thing that’s for sure, though, is that using a menstrual cup can help you understand your menstrual flow better. By not being able to just ignore your vagina with an applicator or pad, you do have to learn the best way for you to put it in and take it out. Also, some cups, like the DivaCup, come with measurement lines so you can see how much menstrual blood there is at a certain time. I’ve found that I’ve been able to pay more attention to the weird things my cycle does (like stop almost completely on the third day? Weird.) and I feel more in touch with what’s going on down there.

They’re better for the environment because they create much less waste. It’s a little unclear as to how long a menstrual cup should be used for. What I heard originally was 10 years, and I have met people who have had theirs that long. I’m on year 5 and going strong. However, DivaCup has changed their website within the past few years to say that they recommend buying a new cup every year. That’s up to you. Buying one cup per year will still save you money in the long run, though.

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