Doctor DOESN’T Know Best
By Jude Samson
Do not take them for granted because they are well-versed in many of the ailments of our body, but don’t put your entire faith in them at the same time as they are only human and the body we inhabit is still a mystery. Sometimes you need to be your own advocate and take your own healthcare into your own hands. Sometimes that means helping the doctor to learn or guiding them along.
“IF YOU’VE STARTED YOUR TRANSITION IN THE LAST 2 YEARS OR LATER, ODDS ARE YOU’VE ENCOUNTERED AN AMAZING AMOUNT OF CLOSED DOORS WITHIN THE MEDICAL FIELD.”
If you’ve started your transition in the last 2 years or later, odds are you’ve encountered an amazing amount of closed doors within the medical field. Have you tried to find a primary care physician that can assist you with common colds, vaccinations, or any other number of “common” things every other cis person experiences without any issues, but are told that the doctor won’t accept you as a patient because “trans care is beyond the scope of their practice?” What? I have the flu, I’m not asking you to handle anything regarding my transition. Have you tried to find a doctor that WILL help you with your transition and get shut down everywhere you turn?
This last year especially has brought the massive issue of lacking health care and providers to light. Now more and more practices are trying to catch up and meet our needs, but it’s still an area of “unknown” for many physicians and their staff. This is where we have to step in and be armed with the best possible knowledge and that will often times come from scouring the Internet, but also in speaking with others who are a step ahead in their transition. This also means not attacking those who impart their hard-earned knowledge through the school of trial and error because it isn’t the answer you like or because you feel that the information you received from a doctor is automatically the right and true (and only) path. The backbiting and in-fighting that has erupted among those who are beginning their transition against those who have already started or who are well along their journey is astounding. While you don’t have to adhere to anything someone else says, you should at least appreciate that someone is sharing knowledge with you that could save you time and pain. At the very least, appreciate that the person sharing the knowledge likely earned that information by traveling through a system that is far less friendly than it is today and likely had to fight far harder than you to gain that information. It’s not to say that those further along are any better or deserve any more than the next person, but when you’re piggy-backing off of the changes others set in motion a little common courtesy and appreciation goes a long way.
“TAPPING INTO RESOURCES OF OTHER TRANS PEOPLE IS TRULY AN AMAZING GIFT THAT CAN SAVE YOU A LOT OF TIME AND MONEY AND WRONG-TURNS.”
That being said, tapping into resources of other trans people is truly an amazing gift that can save you a lot of time and money and wrong-turns. The important matter is, if you’re forewarned, you’re forearmed and that means being able to find the best medical provider for all of your needs. Now centers, clinics and offices that “specialize” in trans-care are popping up all over the place, which is great news for us, but it’s important to remember this is still new ground for most of these physicians and staffers and to not take things as tried-and-true medical expertise. Why? Because the medical field specific to handling trans-care and transition related needs is too new for there to be any “tried and true” methods. Furthermore, despite almost every other drug and treatment out there – transitional related drugs (estrogen, blockers, testosterone, etc.), timeframes and effects are so incredibly different from person to person. There is no way a doctor can say “this is how it will/should/is to be” because it truly is such an individualized treatment process.
Too often have I heard of guys posting on forums concerned about this effect or how much their dose is or feeling like they only have one option for how to administer the HRT and a million other concerns. These concerns are that their doctors are not able to answer or may even give wrong information. Because that person assumed the doctor knew best, they wound up with a slew of issues as a result. It’s a careful balance of not imposing your personal wishes and needs on the doctor by insisting on doing things a certain way because you think it will expedite things. It is also in understanding that sometimes you do have to impose your will on the doctor in order to get what you actually need from them. One of the best pieces of advice anyone can give is that you do not have to sell your soul to any one doctor. While it is extremely hard to find physicians who will accept trans clients, especially those for transition-related care, it is sometimes better to wait until you can find that second opinion than to jump in with both feet with the wrong person.
“BE PREPARED TO READ A LOT OF CONFLICTING DATA BECAUSE THE “SCIENCE” AND THE “MEDICINE” IS STILL SO NEW EVEN THOUGH WE’VE ALL BEEN AROUND FOR SO VERY LONG.”
As a disclaimer – while I fully encourage online research it’s important to utilize reputable resources. Typically news sites like to add hype and will often misunderstand the medicine behind the facts. See if they have citations available and go to the sources directly. A doctor’s personal website also does not constitute an end-all-be-all resource. While they can provide a great deal of information they are also, essentially, a business attempting to bring you into their door. Seek out medical journals, learn the names of the pioneers and forerunners relating to trans-health and read their articles. Be prepared to read a lot of conflicting data because the “science” and the “medicine” is still so new even though we’ve all been around for so very long. Also remember that the process is different for each and every person. John Smith and John Doe could be the same age, race, and general physical shape. They could both take the same dose of the same medication administered the same way and each experience completely different results at completely different time frames.
In the end – you know your body. Your body will talk to you, so it’s important to listen to what it’s saying. Many people learn to “just know” or “just feel” when their hormones are off. Don’t feel pressured into one doctor, don’t feel discouraged if your changes aren’t happening as soon as someone else’s and don’t bully your doctors. There is a lot that goes into HRT as far as how it impacts your actual physiology and that’s where it’s important to have a good relationship with your physician. Present information to your doctor, talk about the science behind it, be willing to educate them and be willing to learn from them in turn. Some doctors may feel “threatened” by a patient giving them information but it seems many doctors today are opening themselves up to learning and listening so that they can be better prepared to handle the needs of every one of their patients, cis and trans alike.