I showed up in that on-time-early way they ask you to show up to the doctor’s office. 15 minutes before my appointment, waiting for forms that I will only begin to complete before a nurse, 5 minutes before my appointment, calls my name: “Daniel.”
Since showing up, I’ve been called twice. Before giving me the chunky clipboard, which advertised a medication I can only recall sounding like “Acetone,” the receptionist called me over to her drive thru naming window: “Daniel? Dan?” Now the nurse motions me towards the door with her long, professionally pink jazzed nails. “Daniel?” Both times I have responded to any name in proximity to my own because I am remarkably compliant in the face of institutions like taxes, medicine, and school. When it’s all over and done, I will run my mouth and remember the experiences I couldn’t let myself have in the moment. In the moment, I am more than a little afraid of the loneliness and scorn that comes with calling official documents liars.
No one asked me on the phone about my gender, but my sex is marked at the top of my medical forms before I arrive. I seem “M” to them.
I follow the nurse into the holy of holies of the medical temple. I ask if I need to remove my shoes before stepping on the scales of ?, but the nurse tells me that my shoes look light enough that they won’t change the outcome. I think she wants to tell me that my shoes are dirty. They are. Keeping teal shoes clean in a desert is a real challenge. Some numbers bubble from her sticked lips and I am ushered into an adjacent exam room. Sitting in a chair next to the computer station, I try to remember who of my genetic peers is dying or who has died of what and when so the predictolator can simmer up a medical future for me. It’s hard to believe that the diseases of people who hate you can be a threat. Is this how Ronald Reagan felt?
No, I’m beautiful. He couldn’t possibly have known this feeling.
“Sir.” She calls me “sir” once and I figure it’s an accident. Maybe she meant to say another word and got a burp and the bubble disrupted the control of her arytenoids over her vocal folds and so the word that came out was a failure of phonation. A meaningless wobble of pressure. The pressure becomes less meaningless when repeated the second and third times. I feel clammy and worried. When she asks if I have any medical conditions, I tell her about everything except my depression and anxiety because, at this juncture, I feel too vulnerable.
Doctors and nurses are people, too, which means they are not outside of the system that beats on my body every day. When you tell me, through careless design or defaults, that I am not safe, then I am not safe and that is as real to me as the blood pressure cuff inflating on my arm and I hate the feeling of my pulse in the joint of my arm and so I’m doing whatever I can to distract
my mind is now like six radios, turned full blast to different stations. Polka, Mariachi, Classic Rock, Classic Hip-Hop, Classic Al, that station that sometimes plays C+C Music Factory and I sing along in the car and realize I still don’t know all the words to “Gonna Make You Sweat.” What is wrong with me? I try to focus on commercial voices with unoffending tones and hope that my anxiety won’t tattle on me. 106/80. I seem calm like I seem “M.” The nurse leaves and I begin to fill out the stack of paperwork resting on my lap. I check off more boxes for diseases in genetic proximity, problems I’ve had. A box asks if I’m sexually active and with what
I say “what” because the options were “Male” and “Female” and those aren’t people. They’re refrigerator drawers, like “high humidity” and “low humidity,” “orange” or “lettuce.” Do you do it with oranges or lettuces? I pick a produce and try to move on but across the rest of the page smears the implication of checking that box, calling fleshy, full people an orange or a lettuce with two pen swipes. Even Regis Philbin lets you phone a friend, but this doctor’s appointment leaves insufficient time to call anyone and ask, “Dearest, for the purposes of a survey with unknown and ominous weight, are you an orange or a lettuce?” As a shiny magenta radish, a dirt-caked beet, a craggy and crooked horseradish, I can’t ignore what I’m being asked to do and it brings me sadness.
But sadness at the doctor’s is for bad news and good insurance, and I’m okay and poor so I should just be glad with what the Good Obama gave me. I finish the paperwork and stare at the wall decor. A poster for a Paris art exhibition, a painting of flowers, drawings by the doctor’s children. I quietly over-pronounce the French words to myself, wondering how badly my French has rusted since leaving Montréal. Before I left my car, before I found out I was “M,” I was hopeful about this appointment. I’d found the practice in a list of trans-knowledgeable doctors. I’m now sitting in a hardback chair, staring at mass-produced posters, under the ever-reflected glare of florescent bulbs on off-white walls. How low is the bar set for doctors that this qualifies as an encounter with a “knowledgeable” physician and their staff? How low have my trans sibilings set the bar so that this experience might be recommended?
Institutions love florescent bulbs, paperwork, and check-box bodies.
The doctor enters. I don’t remember if she looked at me. She didn’t shake my hand or take my paperwork or ask my name or say her name or do much in the way of establishing for sure that she was in the room. Wavy, playful grey hair slips over her shoulders and flip-flop sandals grip between her unpolished toes. The circular stool she sits on is just high enough that her feet angle diagonally towards the ground. Her heels rest on the circular base above the wheels. Her face is narrow and her jaw hangs open as she peers onto the computer screen through no-line bifocals. Fussing with the computer, she makes bits of small talk and asks questions without turning to look at me. I don’t know where to put my eyes and so they fidget, occasionally glancing at my palm-sweat-bedewed paperwork, as though I’d not read and re-read all the words out of boredom already. My muscles are clenched. I regret coming here. I regret taking care of my body today. That’s where we’re at. I regret concerning myself with my own wellness.
We talk about my bout of vertigo, congenital defects, back braces. She fusses with the computer even more, trying to figure out if she has time to do a complete physical. With the thought of being naked and yet wholly misunderstood, I am feeling less and less / more and more detached from this experience. I am a jabbering shell person, replying to human input appropriately with the end goal of escaping. When I escape, it will smell like rosemary outside and I will smile because I am done here and I will search for the rosemary but I won’t find it just like I won’t find a “trans-knowledgeable” physician here.
Is it because I didn’t wear a dress?
By the time my undergarments are off my body, I’ve been asked aloud about oranges and lettuce and I am trying to focus on the good news: I’m well. I say what I think will result in relevant sexual health advice for the future. I am floating above what the doctor is saying to me, directing her to follow the paths that are helpful to me because she cannot find the way. She is not expert because she cannot know me because she cannot ask. I do not know why. I do not like these old coping methods, intentional numbness and detachment, but they feel better than disappointment and sorrow and invisibility. I arrange fabric shapes back on my body and exit the room.
This is how low the bar is set for trans health care. I was never asked if I am trans, never given the opportunity to mention gender, never asked for my preferred name, never asked for my pronouns, never asked about the kind of sexual or reproductive health information I need, never asked how I feel about my body – about myself. I am at a visit about the wellness of my self as a whole being and I was not asked who I am. I remain a box unchecked because I am a box unformed because I exceed the four walls of domesticated bodies. At the doctor’s office, I’m a ghost and I slide into a flesh stereotype they will understand. I am a ghost and beyond your science now.
Doctors, nurses, and other varied medical professionals form part of an institution we can call “health.” With the help of money and prestige and accolades, in varied distributions, they wield a certain kind of authority to tell us about our bodies and the reality of our selves. They tell us if we have a health or not. If our feelings, our aches, are real or not. I once took a medical sociology class and I learned the historical, governmental, and social groundings for the authority of medical science in American culture. Chiropractors, tincture makers, midwives, and other practitioners lost out to a wave of philosophy called ‘science.’ I know where medicine’s power comes from and I know that power is contingent, temporary, always at risk.
But I also know what some doctors and dentists – as representatives of the institute of health – have told me with their treatment: My wellness, my life, is contingent on my willingness to sustain their power via “M”-shaped forms, glaring lights, and adherence to the lettuce/orange binary. If my body, or my understanding of my body, angers them, that anger will be re-directed at my poor, mentally-ill, non-binary body.
All of the forms I am signing remind me that the doctor’s accounts always outweigh my own.
When the doctor doesn’t even ask your name, how do you tell them who you are? When hormones and surgery are not on the table, how do you fit in a discussion of how you see your body – your very self – and how you want to be treated? When you cannot arrive in the full glory of yourself, because your employer asks for low-wattage version of your sumptuousness, how do you signal the deceit of drivers’ licenses and insurance squares? I come to the doctor to take care of me, to find wellness for me, to find wholeness for me.
But when I cannot come to the doctor whole, I cannot leave well.
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