Dear healthcare provider

In two weeks, on both December 1 and 2, I will have the privilege of visiting Indianapolis’s branch of Indiana University, to speak with students in their dental school. The professor recognizes that LGBTQ folks might or do have special needs and concerns, and that these prospective dentists would be well-served to be informed. I am most grateful for this.

Here are the things I have in mind so far, most of which I have experienced in both positive and negative ways. As Gina, I have been in the following places which I put under the general heading “care giver’s office.”

The places I have been

General practitioner in private practice
Endocrinologist at IU Health
Sex Reassignment Surgery surgeon at IU Health
Two plastic surgeons in private practice
Optometrist in partnered practice
Ophthalmologist in partnered practice
Dentists in family practice
Endodontist in family practice
Electrologist in private practice
Four therapists, in both private and partnered practices

These offices have varied widely. At IU Health, the doctors are in large office buildings. My regular dentist is the only occupant in the building. My electrologist’s office is connected to her home, in a residential neighborhood.

I park in parking garages, on city streets, in small and large parking lots, and in a residential driveway. While any of these care givers probably have little or no control over a patient/client’s parking, it would be good for them to be aware that leaving and returning to a vehicle can be a challenge for some trans folks. Sadly, some of these areas can be danger spots, where a person might be accosted.

First impressions

Entering an office, it is important for receptionists and others to react to us, and treat us, as any patient. I am pleased to report that I cannot recall a single office person making wide eyes at the sight of me, so I have been able to approach them with confidence. Sadly, not all trans folks are able to report the same, at times feeling under a spotlight for the reactions they have received.

We long for the same smiling faces, friendly good mornings, and what-may-I-do-for-yous that every patient/client desires. When we receive those, we get off to a good start in that environment.

The name game

Many are in transition who have not had their name legally changed. It can be very hard for us to tell you our legal name. For some, whose lives have been filled with great angst, even trauma, their birth name is dead to them, unspoken by them to anyone. Yet, if it remains their legal name they have to use it for official purposes.

They will ask you to record and use their preferred name. It is vital that you have a system in place to include a person’s preferred name. At IU Health, where I began going before I had my name legally changed, they had a place in their computer system for my preferred name, which showed up on each form so that I was always called Gina. At some other offices, they did not have this option, and wrote in my preferred name on any form that would be seen by aides and nurses and doctors.

Sometimes, their system worked. Sometimes, it did not. When it did not, I suffered for it.

In one of the larger offices, with perhaps a dozen folks in the waiting room, the person calling for me rang out with “Greg Eilers?” Rising and walking to a male name, when I clearly was presenting as a female, was no fun. As soon as we were out of the lobby, I corrected the situation. In both cases, “Gina” had been handwritten above my printed name, but the person did not see it. In other words, that office’s system doesn’t work and I paid for it.

Thankfully, I don’t feel stabs as deeply as some. I have in mind a couple of trans acquaintances who are not so blessed, who are shy and timid, who, if this happened to them, might hesitate making a future appointment in that place.

He, she, and they

Pronouns. Pronouns. Pronouns.

Pronouns. Pronouns. Pronouns.

Guess what my next topic is? Pronouns. Pronouns. Pronouns.

Please, never assume our pronoun. Some of us will assume you should know it, by how we present. Others of us might not desire the pronoun which you would automatically use. Be aware that more and more opt for “they/them” over a feminine or masculine indicator.

Pronoun usage is problematic for many, perhaps most, trans persons. Here are three examples of wrong pronoun usage which I have experienced:

1. In an office, where trans women are not uncommon, a nurse referred to me as “he.” I noticed that she caught herself—the uncomfortable pause before she continued—but she did not correct herself or tell me she was sorry.
2. I am referred to as “he” very naturally. My voice, I am told, is the problem. Depending on the situation, I gently correct. At my regular dentist, everyone has been very attentive to this and are doing a good job of getting the pronoun right. The dentist, specifically, was messing up. He has worked hard at getting it right and, because I’ve been there so much this autumn (!) he has had ample opportunity. He is good-natured and will say, “Did you hear that I got your pronoun right?!” and I appreciate his friendly manner with me.
3. I have listened to a number of doctors and others use “Gina” only to immediately use “he.” It is unfathomable to me, but they don’t seem to get the disconnect between female name and masculine pronoun. At the grocery store, where many now know and use my name, the messed up pronoun doesn’t surprise me. In an office with professional people who are trained to work with patients/clients, my expectation is higher.

We hear every wrong pronoun. Each one hurts. Suffering gender dysphoria is terrible. Transitioning is challenging. The more we hear wrong pronouns, the more they stab us. Conversely, the more we hear correct pronouns, the more we rejoice. Indeed, at our trans group meetings folks love telling their stories of being correctly gendered, always speaking with beaming smiles.

Blending, passing, and fitting in

Many of us don’t blend in with the sex with which we identify. Look at me—not even close! Oh, that I were five inches shorter, shaped like a female, and way prettier!

When every person, at every stop in a physician’s office—from reception to assistants to nurses to doctors to billing—looks at us and treats us as the typical patient, no matter how we look or are dressed, it makes a world of difference. (This is true for every person, right?)

It is not uncommon for a trans person to feel like he or she or they are under a microscope. I’ve seen some stares and heard some giggles when out in public, and I always feel them in a negative way, and some of them have hurt. I should never hear them at a healthcare provider.

The more we are treated like regular folks—and we so want to feel like and be regular folks—the more self-confidence we will have. Setbacks can come swiftly and be severe. The last place a trans person—any person—should have a setback is in the office of her or his or their doctor, dentist, or other place where they are supposed to receiving healing, not hurting.

Rx for prescriptions

When we have to give a list of the medications we take, we can feel sensitive discussing our hormone replacement therapy (HRT) prescriptions. I was on HRT before making public that I had gender dysphoria, using HRT to hopefully calm my brain, and it did. Preparing for toe surgery, I was asked meds I take. When I named the HRT ones—especially the estrogen—the nurse reacted, “What are those for?” I don’t know if she were supposed to ask that, or if it were a knee-jerk reaction. Thankfully, I had prepared for it and was able to answer, “Those might seem odd, but they work in me like depression medication.” It really was true, but who thinks of HRT that way? Thankfully, the nurse immediately moved on.

We understand that you have to inquire about what meds we take. When we name one or two that seem odd, please be professional, even if you are required to ask for what the medicine has been prescribed. You don’t like being in an embarrassing spot; do your best not to put us in one.

We are on our way

I am pleased to report that healthcare professionals have been my allies, not only those I see as a patient/client but also my friends who are nurses and work in offices. I would like to think that the suffering they witness, and the reasons they went into health care, are behind their treating trans folks well. I hope so. I hope all trans folks are able to report the same.

When each step in the process with our healthcare provides goes well, we experience what everyone desires, that our good health is their concern, that we are respected, and that we can be optimistic about future visits to these offices and, by extension, when we need to engage new providers we can begin on a hopeful note.