Content note: Potentially triggering, TMI discussion of depression, anxiety, self-harm, sex, and being trans]
Earlier today, I wrote a [TW] series of tweets on what my past dysphoria’s been like the past few years. You should read it if that’s your sort of thing.
I’d been meaning to write this into a bad-ass essay, but it was easier to just write a series of tweets when I hadn’t quite woken up from my nightmares.
My point is that OH MY GOD thinks are so bad for me, or for all trans people ever. But I did want to get across the point of what it’s been like for me to fight with dysphoria these past few years. Dysphoria is clearly dynamic, in my case, it’s gotten worse over time, as I’ve been out for 10 years, but still haven’t had SRS and need to shave my face daily. Based on conversations with folks over the years, this is fairly typical, but don’t feel bad if it’s not you. Yay you!
Anyhow, I’m tired of dealing with medical professionals that “don’t know what to do” or “don’t have the expertise to deal with this” or “want to play it safe” by not giving me any care. For me, the status quo is incredibly damaging.
And I don’t want to hear any more about the potential horrors of “but I’ll use the ladies room!” (I’ve used the ladies room for 8 or 9 years, everyone).
Cis people need to frame medical care for trans people in terms of the impact on trans people, full stop. And in my case, the lack of adequate care is has seriously impacted my well-being.
Dysphoria isn’t “being sort of sad” that I can’t “lose 5 pounds” or “look prettier” or “be a dolphin.” It’s traumatic. It’s five-year-old me asking my grandmother when I’ll get rid of my cock (like, is it a baby tooth that’ll fall off?). It’s things profoundly not making sense. It’s being unable to comprehend my own body, because it’s too damn traumatic.
I’m not living with dysphoria. I’m trying to survive it. That’s my measure of most things these days– whether or not I got through them without hurting myself. I’m an old hand on this. I have lots of tricks, and lots of hope of making it through the worst of this. But I might not. A lot of women like me don’t.
That’s what I want to talk about. Not OMG BATHROOMS. Or BUT BIOLOGY (I have a Ph.D. in Biology, and the lot of you can stuff it). I want to talk about how to get me, and those like me (now and in future generations) help so that we can survive the dysphoria, and go on to live lifes that are connected to the world around us.
[Content note: This post contains some major-league triggery stuff about depression and self-harm. Also, there’s transphobia. There’s always transphobia, lolsob]
Yesterday I wrote a piece about why I don’t like “love your body” campaigns. When I wrote it, I made a deliberate decision to omit any of my issues with self-harm. I’ve been thinking about that a lot.
First off, I think it’s inappropriate to start talking about self-harm at the same time that I’ve got widget up raising money for my medical bills. The whole “give me money or I’ll cut myself” thing is manipulative as hell.
Just to be clear that I’m not being passive-aggressive, I’ve long since decided that if I ever find myself insinuating that self harm is eminent, I’m absolutely stopping raising funds prior to doing so. It’s just not cool to put folks in that position, full stop.
And you know, since friends and family are likely reading, let me just say that I’m having a fairly decent week, all things considered. I’m an old hand at managing my depression. I’ve got a great support network. This being trans* shit ain’t fun (nor is mental illness). If it was, all the kids these days would be doing it.
As much as I like to ground my writing in my experiences, I’m not really here to talk about me as much as I am why I’m usually careful to not publicly talk about self harm.
If you’re trans* (or intimately involved in a trans* community), you’ve probably already noticed this: we’re constantly talking amongst ourselves about self-harm.
Read more…
Over the past few weeks, I’ve had a glut of opportunities to consider the ways in which society privileges cis bodies. More specifically, I’ve been reflected on how society privileges cis people’s medical needs.
A few years back, I was at the radiology department of a local hospital, because it was the third Sunday of the month and I played roller derby. (Seriously. Let’s hear it for the rad techs.) Anyhow, I’m about to get my chest or head or whatever x-rayed or scanned to make sure that everything is of the appropriate size and relative location, and I’m talking to the tech.
According to my driver’s license and my chart, I’m a woman, so I have to answer the usual questions, because if I’m pregnant and playing roller derby, it would be totally inappropriate to expose the fetus (or fetuses!) to radiation.
Now, there’s two basic ways a provider can approach that question. Read more…
Star-Tribune, Minneapolis “UnitedHealth to Buy Brazil’s Amil for $4.9 billion”
“Brazil has emerged as a consistently growing and evolving market for private sector health benefits and services. Its growing economy, emerging middle class and progressive policies toward managed care make it a high potential growth market,” said Stephen Hemsley, UnitedHealth Group’s president and CEO. “Combining Amil, the clear market leader serving an under-penetrated market of nearly 200 million people, with UnitedHealth Group’s experiences and capabilities developed over the last three decades is the most compelling growth and value creation opportunity we have seen in years.”
Dow Jones has just added UnitedHealth to the Dow Jones 500. In the 2010 fiscal year, the insurer had profits of $4.63 billion.
The other week I was looking at my medicine drawer. Certainly, I’m quite privileged in that I’ve had not one, but two different insurance plans in the past year.
I’m not posting this to play Drug Olympics (certainly not on a weekday). What gave me pause was that all these bottles represent just five prescriptions– three anti-depressants (go team!), estradiol, and a testosterone blocker.
It took me close to a year to find a doctor that would prescribe me hormones. Eventually, I decided to drive to Chicago (150 miles away) to get my script. When I moved to Upstate New York, it also took me a while to get settled in with a new doctor.
Basically, I’m paranoid (or justifiably anxious) about losing access to my medication. Maybe I won’t be able to find a doctor to write a prescription. Maybe my insurance company will decide to stop paying for my hormones. Perhaps there’ll be conscience clauses.
I subconsciously hoard pills. As soon I’m eligible to refill an order, if I can afford it, I do it (hooray for tax returns!). Over time, that can lead to quite a surplus. I hold on to old pill bottles just in case I ever need to prove to a pharmacist that back in ought-eight such-and-such doctor wrote a certain prescription. I’m not sure what sort of situation would lead me to desperately whip out a four-year-old prescription bottle. I guess it’s best to be prepared.
Every day I hear of more and more laws that chip away at bodily autonomy. The less privileged the person, the higher the likelihood of finding oneself without healthcare. I’m worried that in one of the most affluent nations on Earth, hoarding and scarcity will increasing define our experience with medicine.
Four months after deciding to move back to the Midwest, things are finally taking shape. Our house is mostly unpacked, I’m somewhat used to my job, and our daughter has a grown up bed, courtesy of an IKEA road trip. Plus, it’s a bazillion degrees and sunny out, and we live well inland. Things are looking up.
[Me 1, IKEA Ø]
For those of you wondering about the fundraiser, it’s still very much on. The tally is at the same place it was in December. It’s not that there aren’t plenty of folks making monthly donations (thank you!), but that I add the full value of subscriptions to the tally at the time they’re made.
On of the hardest things about quitting my gig with New York State was losing health insurance for surgery. As I’ve said before, this was kind of a tease, given that I don’t know of any surgeons that accept insurance.
Given the low rates at which many insurance companies reimburse providers and the massive number of folks desperate for surgery, I don’t necessarily blame surgeons for being cautious with their finances.
In any case, I no longer have Blue Cross covering my hospital expenses, which means the cost (to me) of surgery is back in the much more typical range of $20-$25k (plus travel, pre-operative care, and unpaid time off work). Still, I stand by my decision to leave the academy (I’m sure I’ll be writing plenty about that at Shakesville or my other blog).
I’m cautiously optimistic that my new career in IT (coupled with the improving economy) will eventually make it possible for me to pay off past loans for medical expenses, or even save on my own. In the meantime, that’s the reason for the new goal on the right.
Needless to say, I’m pretty blown away that I’ve been able to raise what I already have. I wasn’t really expecting to raise the full amount I need (let alone doing so while taking an extended break), so I’ll see how it goes.
I think I’m previously on record as really, really not being a fan of the Human Rights Campaign. I’m also not a fan of their Corporate Equality Index (CEI). It’s not that I have a problem with all corporations– I’m starting a job with one in a few weeks. It’s just that it’s going to take a lot more than acceptable policies on LGBT equality to give me a boner about Dow Chemical.
Despite both of these facts, the latest CEI contains some good news.
The number of companies (out of 636 surveyed) that provide insurance coverage for trans* people’s medical care has more than doubled in the past year, to just under a third.
Unlike previous years, HRC’s criterion was fairly realistic. Here’s what it took to get the 10 points (out of 100 overall) for trans* medical coverage, companies needed to…
extend to transgender individuals [the following benefits] including… services related to transgender transition (e.g., medically necessary services related to sex reassignment):
* Short term medical leave
* Mental health benefits
* Pharmaceutical coverage (e.g., for hormone replacement therapies)
* Coverage for medical visits or laboratory services
* Coverage for reconstructive surgical procedures related to sex reassignment
* Coverage of routine, chronic, or urgent non-transition services (e.g., for a transgender individual based on their sex or gender. For example, prostate exams for women with a transgender history and pelvic/gynaecological exams for men with a transgender history must be covered.)
*Plan language ensuring “adequacy of network” or access to specialists should extend to transition-related care (including provisions for travel or other expense reimbursements)
The dollar maximums on this area of coverage must meet or exceed $75,000. [Emphasis original]
I’m skeptical of HRC, but that strikes me as a pretty fair criterion. Read more…
NPR:
Deb Barth is raking leaves for Lesley Jones. But Barth isn’t earning money for her yardwork, at least not in physical currency. She’s earning “time dollars” — for every two hours she spends doing odd jobs, she’ll earn a free visit with her doctor.
Let’s see, figure $150 for an hour-long doctor’s visit (without insurance), $15000 for a cunt (with insurance), so that’s 100 hours of yardwork at $75 per hour, 45 minutes to mow a small lawn, which works out to 130(ish) lawns. That seems doable.
Bloomberg Businessweek:
The nation’s third-largest health insurance company is the latest to leave the individual policy market in Indiana in another sign of diminishing competition to benefit consumers who purchase policies through a state insurance exchange under the federal health care overhaul.
However, [Deputy Insurance Commissioner Robyn] Crosson, in her letter [announcing the news to the Centers for Medicaid and Medicare Services], said Aetna was leaving the Indiana individual market over a rule in the federal health care overhaul that insurers essentially must dedicate 80 percent of the premiums they collect to medical care. Anything less than 80 percent would be paid as rebates to policyholders the following year.
Crosson said Aetna and four other insurers — Pekin, American Community Mutual, Cigna, and Guardian Life — cited the 80 percent rule, known formally as the medical loss ratio, as their reasons for leaving the individual market in Indiana over the past year.
Leave it to for-profit corporations to decide that profit is more important than helping people. Who could have possibly predicted this?
