Trigger warning for transphobia, medical abuse, ableism, and discrimination.
Hey y’all, it’s been a while, and for that I’m truly sorry. I’ve been trying to work up the courage to create this post for… Well, over a month, but it’s been a real ride. To be honest, I’m not fully healed from this experience, and I’m not sure when (if ever) I will be, but I think it needs to be shared. I’ve also felt guilty leaving this blog abandoned when I’m sure there were at least a few people out there who were interested in seeing more about my non-standard transition.
So, to preface, this post isn’t really going to contain much in the way of updates on the effects of my HRT. If that’s all you’re here for (zero judgement, that’s literally what the blog is for), feel free to stay tuned for the next post, where I’ll return to documenting my transition progression. This post is going to detail a pretty traumatic run-in with transphobia and ableism in the US healthcare system, so if you don’t want that out on your mental plate then please take care of yourself and exit the post now.
On to the real meat of the story.
For those who don’t know, I’m diagnosed with autism (formerly referred to as “asperger’s”, which is a term that’s largely fallen out of favor). Also, I have been in a year-long battle with the Great Gods of Private Health Insurance to get top surgery, which has taken a truly massive toll on my mental health. I live in a state where it is literally illegal to be denied coverage for gender affirming healthcare, and I had more than the necessary documentation of gender dysphoria to qualify, so I thought that I was a shoe-in. I expected to be officially flat-chested by New Year’s Day 2022. To my surprise, however, my claim was denied, and I have spent months upon months trying to navigate a system that is extremely determined to not be navigated.
**A very special shout-out here to TransFamily Support Services, a true blessing for the trans community. Their insurance experts have been absolutely the only reason I’ve gotten as far as I have in this appeals process, and I’ve never had to pay a dime (other than what I have been able to donate of my own freewill). If you ever find yourself with some spare cash, I couldn’t recommend donating to them enough, and if you’re ever stuck trying to access trans-related healthcare in the US, please reach out to them. I honestly don’t know where I’d be without the good people who work there.
Well, by the end of March I was in a very dark place, as the fight against the powers that be was showing no signs of letting up. Not all trans people experience dysphoria, but personally I’m quite crippled by it, particularly surround my breasts. Combined with my sensory issues making binding (or really wearing any sort of undergarments for my chest) pretty ridiculously miserable, existing in my current body can be a bit of a nightmare at times. I found it much easier to cope with when the thought of top surgery was on the horizon, but as I continued to run into roadblocks on my journey there I started to lose hope that I’d ever find relief. So, one afternoon after another round of bad news on the insurance front, I had a bit of a mental breakdown, and things proceeded to get much, much worse.
I was involuntarily committed to a psychiatric hospital because of an autistic meltdown- which, if you are autistic yourself, you may recognize as truly the greatest fear that many of us have. I lost the ability to communicate, and despite my partner’s best efforts to explain autism to the medical personnel at the hospital, I was strapped to a stretcher and escorted away by armed policemen. As my partner watched helplessly, he begged them to be sure to take me to a hospital that was autism-friendly. He frantically tried to explain what that entailed, but was reassured that he had nothing to worry about, that everyone there was perfectly capable of treating a patient with autism. (Spoiler: That was a lie)
As I was rolled away, I watched the nurses pointing and laughing at me, as they had been since I had come in. My partner had tried to block their view of me, but they insisted they needed to keep me in constant observation, so we were forced to overhear their jokes and laughter about the way I rocked, the way I tried to speak, and the way I cried. I knew then that I was in much more trouble than I had originally thought.
When I arrived at the psychiatric hospital, I was still incapable of proper communication. I was so terrified and dissociated that I was hardly aware of my surroundings. I do remember sitting in a small room at a desk though, and a piece of paper being slid to me for me to sign. It stated that they had the right to physically restrain me whenever deemed necessary by staff. Physical restraints have been known to result in injury or death for many autistic people, but are still allowed to be practiced by staff members with minimal experience. It dawned on me in that moment that there was a possibility I wouldn’t leave this place alive.
Many of my memories of the next few days are extremely fuzzy, cutting in and out, as I was in such a constant state of terror and overstimulation that my brain could not process where I was. Despite the promises of the staff at the previous hospital, this was not an autism-friendly place. The fluorescent lights buzzed loudly overhead, everything was glaringly bright and constant streams of noise (yelling, talking, arguing, slamming, machines beeping) hammered at me. I was not allowed to close my door, and I didn’t even have a door to the bathroom in my room. My ear defenders, my number one line of defense against sensory overwhelm, were forcibly removed from me- I tried to resist two attempts to seize them, but then they brought in an armed security guard and I had no choice but to hand them over.
I was naked (truly, fully naked) except for the thin gown I was given in the ER and some trans tape left adhered to my chest from the day before. During the night, someone (a nurse I believe) visited me several times trying to force me to remove the tape. She even resorted to pulling up my gown while I was asleep in bed to try to pry it off. I’m not sure what I said or how I was able to get her to leave me alone, but eventually the effort was dropped and I was left to sleep.
I was not given clothing or my prescribed medication. I know now that my partners (my husband and my girlfriend) had brought me an entire suitcase of approved items to wear and have with me, but they were withheld from me without reason given. Eventually, halfway through the day, someone took pity on me and put a second gown on me backwards so that my bare bottom was no longer exposed to everyone in the ward, but that was the first and only act of kindness I was shown that day.
When I enquired about my testosterone, I was told I was not allowed to have it. My partners had brought my bottle from home, the hospital had it, but they said they would not give it to me. I called my partners to tell them what was happening, and a nurse tried to take the phone from me, saying loudly “we’re never going to let you have that stuff in here, they can’t help you”.
A social worker came to me to take my history, and he put my partners on the phone to help communicate (since, again, I am hardly capable of speech at this point). The man proceeds to give me a lecture about how unhealthy it is for me, a “biological female”, to be taking hormones, and that I need to stop immediately. He started questioning me about what surgeries I was planning on having, and what I was going to do “down there”. When my partner began speaking about me and referred to me as “they/them”, the social worker told him that since “they” is a plural pronoun, he had no choice but to assume that I had “multiple personalities”. He went on to refer to my preferred name as a separate person living in my brain, and my birth name as the “real” me. My partner tried to educate him about the use of singular they, but the man continued to threaten that I would need to stay longer for further evaluation if he did not stop using “plural” pronouns for me.
My partners, bless their souls, were fighting tooth and nail to get me released. I was in a stupor, completely shut down and unable to speak normally or communicate my needs. I have a condition that requires me to drink a lot of fluids (I’m prescribed 64oz of electrolyte drinks a day), but I was never offered any water and wasn’t able to ask for it. On day 2 I found a water cooler in the corner of one of the day rooms, but by that point I was incredibly dizzy and dehydrated, so the little plastic cups didn’t offer me much relief. Still naked but for two hospital gowns, I cried to myself in my room, only to be visited by a nurse who told me that I would never be released if I couldn’t learn to regulate my emotions better.
Finally, the staff realized that they were in trouble when the floor manager learned that my partners were recording all of their conversations with them (legally, as they had been informed they were being recorded). Suddenly, the tune changed drastically. I was given a few items of clothing from the suitcase my partners had brought, and my testosterone was given to me as well. None of my other medications were dispensed, but at least I had my HRT finally.
Then, without warning, I was discharged. I had not even been there for the 72-hour hold that was supposedly legally required, that was the entire reason I had been brought to this place. Within an hour of the floor manager learning that he and his staff were being held accountable for their actions, and that my partners knew exactly what I was being denied and how I was being treated, I was escorted out the door and left on the curb with the suitcase of items I had never been given.
Looking back at the notes from my stay, I’ve found all sorts of wonderful gems of transphobia. “28-year-old female patient who has been trying to transition into a male” may be my favorite, but there are plenty of other good ones. There are also interesting tidbits such as the part that states that my risk for injury to myself or others is quite literally non-existent (a zero on their standardized assessment scale), but that continued hospitalization to protect myself and others was the recommended course of treatment. There was also an interesting fascination and disbelief with the fact that my partners actually wanted me, an autistic person, to be released back to their custody, and not kept out of their hair in this hell-hole of an institution in perpetuity.
All in all, it was one of the most horrific things I’ve had to go through. It took a few days for me to really start feeling like myself again, and once I did the reality of what had happened dawned on me and I found myself unable to sleep for a good 48 hours. My illusion of safety has been shattered. The illusion of being respected as a person by medical professionals has been shattered. I have been facing continuous health issues, but since this nightmare I struggle immensely with trusting any doctor with my care. Now that I know it is entirely possible for me to be physically restrained, dragged in an ambulance to a prison posing as a healthcare center, and left naked in a room without water to be told why being transgender is merely a delusion and why I do not have a right to my own freedom… Why would I ever go to a hospital again? I think I would quite literally rather die than experience that again.
So… I’m sorry for the downer everybody, but I think it’s important for people to know that things absolutely happen in this country. And with the way current legislation is going, it may get worse before it ever gets better. Be careful out there. It’s a really horrible burden to have to live in fear, even of the people we are supposed to be able to trust the most, but it’s a reality that needs to be acknowledged for our own safety. While I hope with every ounce of my being that no one reading this ever has to go through anything remotely similar, please remember this story and protect yourself around people who have the power to control your destiny. I don’t want to be alarmist, and I don’t want to give anyone the impression that there is no hope and no good to living as your authentic self. Just please, show love for yourself and be aware of danger when you need to be. Surround yourself with good people. Research explicitly trans-friendly medical care in your area, know where your safe places are, take advantage of trans-specific resources to help you when needed. There may be forces out there that aren’t on our side, but we also have a community that fights hard for its own.
I’ll be back again soon with more info and updates about my nonbinary transition. I apologize again for the temporary derailment of that mission, but I hope that I can continue to provide resources and representation now that I’ve made it to the other side of this hurdle. Until next time: stay safe, because you are absolutely loved.