On a trans-mission

About three years ago I slipped and fell while getting dressed for bed. I bruised my hip pretty badly, so the next morning I went to see my doctor. She smiled and shook her head critically. “High heels again?” she asked.

“No,” I replied. “I was taking off my pantyhose.”

“You see?” she said, smiling. “Being a woman is dangerous”

I nodded. Being a transgender woman is dangerous, I said to myself.

A couple years before that, shortly after I came out to her, I developed a rash. After the doctor’s usual questions, she paused, looked at my chart and said “You changed make-up brands?”

She learned well, although it was clear when I first came out to her that she didn’t have a clue (most medical people don’t), so a few days later I brought her some pertinent literature. We had a short chat about gender identity, sexual orientation, and the impact one’s LGBT status can have on his or her health issues.

Some of it may seem trivial, but sometimes it’s the trivial that trips us up. When I ask my transgender brothers and sisters if their doctor is aware of their transgender status, many reply that it’s “none of his (or her) business.”

But it is. Or if it’s not, it should be.

Medical professionals need to know about our health issues and, for now, it’s up to us to teach them. If yours isn’t receptive to learning, it’s time to find a new provider. In order to best secure your health, your doctor needs to know you are trans, and he or she needs to know what that entails and be able to discuss it intelligently and objectively. Such medical issues potentially include:

  • Sexual reassignment surgery (SRS)
  • Cosmetic surgery
  • Electrolysis. This common procedure can come with unanticipated health issues, like a histamine response, congestion of superficial capillaries, scars, and bumpy skin; most of those clear up over time, but sometimes medical treatment is necessary.
  • Hormones. Many in the trans community purchase hormones without a prescription and take them without medical supervision, but there’s no good research on the effect they have on those born in the other gender. Potential side effects include blood clotting, strokes and anemia.
  • STDs & HIV. Transwomen are at higher risk of HIV and many are on the ‘down low.’ Medical professionals need to be discrete and respectful, especially toward those who ‘work the streets’ as the only way to obtain money for hormones and/or surgery.
  • Breast Augmentation. Some transwomen resort to the black market so are at higher risk of post-operative infections.
  • Post-op Treatment. Because they are now their true gender transpeople may avoid preventive procedures like prostrate screening and pap smears.

Insurance plans routinely deny insurance coverage for SRS and other procedures; a patient who declares transgender status can be denied coverage for ailments and injuries associated with it. A transman was denied coverage for an injury sustained during a local soccer match because he was considered a female who was playing on a man’s team

In order for transfolk to improve their quality of life through better access to healthcare, issues such as those above make it critical that we are open and honest with our medical professionals. And it is equally important for them to become educated and to be open to and understanding of transpatients.

As for my pantyhose accident? Well, my doctor was smart enough to leave that part off the record.

For more information, see:

Right to Dignity (Barriers to healthcare for transgenders)

The State of Transgender Healthcare

TransHealth website



Also from Bobbi Williams:

When All Else Fails, Put a Guy in a Dress



Dr. Bobbi Williams is an author, teacher, lecturer, and consultant. Comments may be sent to her at bobbi@bobbiw.net 

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