Severe pain in my 17 year-old son’s abdomen brought us to the ER last week. One of those situations everyone dreads, but if you are transgender there can be an added level of anxiety when the medical professionals you are dealing with aren’t current on trans healthcare. Such was the case for us, beginning at the reception desk.
“Name and date-of-birth,” the harried man says through what looks to be bulletproof glass.
Providing the information requested, I nervously wait for what is coming next. Predictably his brow begins to furrow as he stares at his computer. Without looking I know what is causing the confusion. On his screen is Sam’s pre-transition female name because we had been in this particular ER years ago and that information remained in their database.
“Samuel?” he asks in a perplexed tone.
I hold my breath as flashbacks of this same scenario begin playing in my head…at the orthodontist, school, bank, library, community center — basically any institution, organization or business that had Sam’s birth name, Samantha, in their computer system before it was legally changed to Samuel.
My first instinct is to lie if he asks whether Sam has a twin sister named Samantha, which is usually the conclusion people reach to explain why they have an obviously male bodied person in front of them but a female name listed in their database with the same address and birthdate. A white lie in this instance seems justifiable and easier than telling a total stranger that Sam is transgender, then waiting for the uncomfortable silence that ensues as the person processes what I have said — outing him to not only this person, but also to the people in line behind us, who usually then begin to stare and whisper. It’s happened too many times to count and today I would give anything to avoid the situation.
He continues to study Sam, then his computer screen, and then Sam again. As if admitting defeat, he shrugs his shoulders, pounds out what seems to be a novel on his keyboard and tells us to take a seat. I breathe a sigh of relief knowing this could have easily gone the other way, as it has so often in the past.
Next up is the triage nurse. A woman wearing white orthopedic shoes, which seem premature given her young age, who ushers us into a small sterile room to take Sam’s vitals and discuss his symptoms. Protocol dictates that she also determines what, if any, current medications he is on, which we openly share.
“Testosterone?” she repeats in the form of a question. “Why are you taking that?”
Sam’s tired eyes anxiously dart in my direction, signaling that he would like me to answer this question on his behalf and so I explain, “Sam is transgender.”
“Ohhhhhh,” she replies unfazed, which actually makes me feel better because I assume she is familiar with the term. That assumption, however, is quickly thwarted by her next query. Gazing at her computer screen searching for an appropriate code for this piece of information she asks, “Would that be the same thing as t-r-a-n-s-s- e-x-u-a-l-i-s-m?
In awe of her ability to simultaneously elongate and slaughter the word, I say, “Sure,” trying to put an end to this line of questions for Sam as quickly as possible.
As if on cue, George, the burly ER nurse assigned to Sam appears, his mere presence saving us from the awkwardness of the moment. A regular Superman in scrubs, George shows us to an ER bay and immediately goes about his usual routine. Getting Sam settled on a hospital bed he gently asks, “Have you ever had any surgeries buddy?”
Sam’s eyes fixate on me, the telepathy between us stronger than ever, and so I answer for him by saying, “Double Mastectomy.”
George glances at me looking slightly perturbed and says, “I’m not asking about your medical history mam, I’m asking if your son has had any surgeries.” Now most people at this point might be horrified, but we learned a long time ago that being able to laugh is a trait that will get you a lot farther in these types of situations. And so I let out a little chuckle and say, “Yes, I know, I am answering for him. Sam is transgender.”
Just as I am making a mental note to purchase a better bra given the fact George obviously thinks I have had a double mastectomy, the ER doctor announces his arrival by sliding the privacy curtain aside. I assume someone along the way must have brought him up-to-speed, but unfortunately I am wrong. The doctor begins to examine Sam’s abdomen during which time the fact comes up that Sam is transgender. With that revelation, he quickly removes his hands from Sam’s body, as if he has received an electric shock. Looking completely surprised, he admits out loud, “I’m not up-to-speed on those issues – do you still get a period?”
We might have been able to laugh at this question too if it wasn’t so humiliating. There was no bigotry or maliciousness in the question, but that didn’t make it any less difficult to hear. Deep down we knew the doctor’s intentions were good, but his bedside manner left much to be desired. Knowing this question hurt Sam’s psyche just as much as the physical pain searing through his stomach, I jumped in to provide a quick Transgender 101 overview on his anatomy and medical history.
Following emergency surgery to remove his appendix, we faced another educational moment when the night nurse handed Sam a portable plastic urinal. Staring at the container I thought Sam might start to cry and so I assured her I would help him to the bathroom. Once he was situated I rejoined her in the room and asked if she knew Sam was transgender. Just a year out of nursing school, her immaturity showed as she released a nervous giggle and said, “Yes, but I didn’t know if that meant he had…” Implementing a rudimentary form of sign language, she waved her hand in front of her crotch to finish her sentence.
We entered parts unknown that night when we checked into the ER, and to our surprise, some of Sam’s medical staff were along for the ride. While Sam had someone who could advocate for him and speak on his behalf, many transgender people do not, which makes them even more vulnerable when seeking medical attention. We share this experience not to shame, but to shed light on the fact that education and training are still greatly needed to ensure trans patients receive the same respect and level of care as everyone else.
Post note: To learn more about healthcare facilities throughout our nation that have adopted policies for LGBT equity and inclusion, check out the Human Rights Campaign’s annual Healthcare Equality Index.