Thread by @TillyBridges

Welcome to #TransTuesday! Today we’re talking about a little thing I’m going to call COMPLETE TRANS HEALTHCARE, or more pointedly, THE LACK THEREOF.

This was brought about by this image I shared yesterday, which you may have seen and thought HA that’s funny for I obvs do not have a cervix.

But the thing is, while this is funny, it’s not necessarily harmless as it’s a symptom of larger issues that are actually a problem for trans folks. Before proceeding you should check out this previous post about my experience with our healthcare system.

https://twitter.com/TillyBridges/status/1425149833388593154

I will remind you that through all of this, that message in the image, and my entire transition, and the medical procedure in the thread above, I have been with the same health insurance and provider. I’ve been with them for a long time pre-transition too. For about a decade.

These folks have all kinds of things in place for trans healthcare. Psychologists, endocrinologists, people on staff who can and do perform gender confirmation surgeries (both top and bottom), facial surgeries, even my voice therapy.

They have my entire medical history, and again have been the only people seeing me for a decade. And they still sent me a reminder to get an exam for a body part that I do not possess.

As was evidenced in my thread linked above, despite providing all of these trans services they are completely at a loss as to how to handle trans people.

And I will point out that though my name and gender is legally changed and I gave a driver’s license to prove it, none of that has yet been updated with my healthcare provider due administrative issues I’m not getting into here.

Point being in their system I’m listed under my old male deadname, and it says right in the file I’m a transgender woman. AND YET THEY WANT TO EXAMINE MY NON-EXISTENT CERVIX.

So let’s look at the bigger picture it’s indicative of. Because if this can happen, you’ve got to wonder if they’re going to remember that, uh, I’m still going to need prostate exams?

All trans women will, even if they get the full “bottom surgery,” as the prostate isn’t usually removed. This is a thing they should (and I would presume, do) know, and yet they seem to be entirely unprepared to deal with this.

At least urologists perform prostate exams, and people of all genders see them for a variety of reasons. So it wouldn’t be weird for me to be sitting there.

But spare a moment to think of trans men who DO need cervical exams and cervical cancer screenings, and other OBGYN care. They may not even get notified, and if they do, when they go in the cis women present are going to see a man.

A man in the waiting room, a man being called in, a man walking around inside the office and going into an exam room. And I imagine that could be extremely uncomfortable for trans men, when being associated with things for women is likely a very dysphoric experience.

But what choice do they have? They need this medical care, it’s important stuff, but they have to go through something that’s awful for them, just to get that care. Because there’s no places that specialize in JUST trans medical care.

Or if there are, they’re so few and sparse that they certainly aren’t available to most people. I live in Los Angeles and don’t even know of any. There probably aren’t enough of us to make it “financially viable."

But frankly it’s putting a lot of trans people at risk. We need (and deserve) the same care cis people get, and yet the entire system is just stymied by our existence at every turn.

Are they going to remember I need mammograms now? Or when I need to go in for my first one? It’s going to be on me to contact my doctors and remind them I have breasts now and so that will be kind of important.

But I also have a prostate and checking THAT is important! This would weirdly make more sense, in a horrible kind of way, if they weren’t set up at all for trans care.

If they didn’t provide any at all, that would be discriminatory bullshit, but at least it would make sense that they don’t know how to deal with us on an administrative level.

But if you’re going to offer trans services (and you SHOULD, every provider and insurance should!), you have to go ALL THE WAY.

And this isn’t just paranoid speculation on my part, I know trans people this has happened to. I hoped it wouldn’t happen to me, but then I got that notice it was time for my cervical cancer screening and it feels like it’s already starting.

It’s not just hormones and surgeries. Not even just mental health and voice therapy and electrolysis. We have other needs that cis people don’t (and some they they do!). It’s YOUR JOB to know that and to take care of us.

In a world that discriminates against us at every turn, where trans people often lose family, friends, jobs, and housing just for coming out as who they really are, where our governments routinely try to legislate us out of existence, we can’t even trust our doctors

And I wish they didn’t put it on us to have to keep reminding them of who we are. We shouldn’t have to constantly say HEY I’M TRANS AND I NEED THIS CARE. It shouldn’t be on us. And it shouldn’t be awful to go through.

Tilly Bridges, end transmission.