I ended up being listed as Queer and Genderqueer in Callen-Lorde’s computers (with no preferred pronouns). Callen-Lorde is NYC’s LGBT health clinic. You make an appointment, fill out the forms, talk to a nurse, get your blood drawn, wait two weeks for the results, and if everything is good, you can get a prescription for cross-gender hormones. Normally I’m pretty speedy filling out forms. I’d already put down my sex assigned at birth (F) and the sex on my insurance (F), but I was flummoxed by these two questions:
If the questions were fill-in-the-blanks I would have answered Sexual Orientation: butch (attracted to femme women) and Gender Identity: trans. Instead, I held the pen in the air and just stared at the questions. Confused. Lots of choices, but none of them are mine.
Sometimes I say I am gay, but I know Callen-Lorde is asking whether I am attracted to men. I’m not, I just dress like one. I generally don’t use the word lesbian to describe myself, I use butch, but that isn’t on the list. I am definitely not bisexual. I think of myself as queer, but more on the gender side than for my sexuality. I do not identify as straight. I hesitate at checking off “Something Else” because there is no place to write in “butch”. “Decline to Answer” seems cantankerous. I think I should be able to answer this question more easily, but sexuality is quirky.
I do what they tell you to do on multiple choice exams (leave blank what you can’t answer and come back to it later if you have time) and I skip to Gender Identity. I figure I can work backwards to Sexual Orientation once I pick out a Gender Identity. The choice is between TransMale/Transman, Genderqueer/Nonconforming, and Something Else. I identify as transmasculine, but not as a transman (or trans man) because it implies identifying as a man, which I don’t do. I fit Genderqueer (although I think non-binary fits better) and I am definitely Nonconforming. But I think of myself as trans. Trans is not on the menu.
I pick Genderqueer/Nonconforming for my Gender Identity, and then check off Queer for my Sexual Orientation. It is not exact, but it is consistent. At least I didn’t end up choosing Lesbian and TransMale/Transman. I should have picked Something Else and Something Else, and scribbled in the margins. The internal debate throws me off-balance and makes me doubt myself.
The good news is that now I am officially a client. I have a primary care physician, had my basic blood work done, got a referral for a colonoscopy, and had a physical exam. The bad news is that I have high cholesterol (total is 282, LDL is 164).
Shyvon, the Nurse Practitioner who examined me, was pleasant and gentle. She did a manual chest exam and a pelvic exam. It was the least unpleasant pelvic exam I’ve ever had, but it still hurt. It left me shaken and unsteady. We talked about my cholesterol while I pretended I was fine. I didn’t re-start the conversation we had at my intake about possibly going on low-dose testosterone. The timing was off. I’ll get another chance.
While Shyvon talked to me about changing my diet, my brain was racing ahead. I thought “I’m not going to take a Statin. I don’t want to put Lipitor or any other drugs in my bloodstream.” There is a part of me that feels the same way about testosterone. There is another part of me that recognizes that it is an entirely different situation.
Notes: “What the Ruby Rose Obsession Misses About Gender Fluid Lives” by Micah (of Neutrois Nonsense) touches upon the issues of having a gender that is not easily recognized or ticked off on forms. The post “On Sex/Gender Checkboxes” from The Intersex Roadshow discusses the problems of multiple choice forms for sex/gender, and the need for fill-in-the-blank options. Both are good reads if you hate filling out forms.
A Boy and Her Dog 
Those cholesterol numbers, while high for the “normal” range, are not terrible. My overall cholesterol runs around 300 and my triglycerides, specifically, are just under 500 – and that is *with* dietary strictures, exercise, and a triglyceride-targeted medication (NOT a statin) called fenofibrate. My issues are genetic, but due to my high testosterone levels, my cholesterol is off the charts.
I am not one to give unsolicited advice, so please don’t consider the following as such. I’m just sharing:
I cut my dairy intake to 3 servings a day, and by “serving” I mean, a single slice of cheese on a sandwich is a serving. It has helped.
I take supplements. Cider vinegar tablets are considered by many doctors to be folk remedy / voodoo medicine, but I have had consistently lower numbers when I’ve taken it. I take 250 mg daily.
I also take vegetarian omega 3’s (Udo’s oil), vitamins D3 and B12, and glucosamine. The glucosamine is actually to ease the arthritic pains in my lower back, but when the body is in pain, cholesterol levels spike. (My migraines are also an issue, thus.) Dramatic weight loss can also cause a spike.
Reducing sugars can help, which is a stumbling block for me. I do not have a sweet tooth, but I am a carb-loader. So pastas, breads, etc are something I have to watch out for.
And niacin can help raise your “good” cholesterol, but I had a really bad experience when I tried taking it. *shudder* I have tried to add some niacin-rich foods to my diet, but it’s been a bit slow going.
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Now, I have a question if I may… 🙂
You mentioned your referral for a colonoscopy. Is that a general-health / 50,000-mile-check-up thing, or a pre-hormone thing? I’m just curious where it fits in terms of prerequisites for any medical/procedural transition choices you make are concerned.
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This was my first check up since 1999 – I’ve had doc-in-the-box pre-surgical checks, but not a real physical. I’ve procrastinated getting the baseline age 50 colonoscopy, and that is why they referred me out for it. To their credit, they treated me like a normal adult coming into a health clinic, and did all the stuff they would do for someone who appears to be in good health, but hasn’t had any tests in 15 years.
I work with a bunch of guys (now mostly younger than me) who are all on various heart medications because they eat fast food or mega-meat every day for breakfast, lunch, and dinner. I don’t want to end up like them.
I eat pretty healthy. I can cut down on the dairy a little, and on some of the white carbs, and up my soluble fibers, and see what happens. Shyvon recommended Omega 3’s, and I might try the Udo’s oil (last time I took Omega 3’s I burped up mackerel all day – and although I like oily fish for dinner I wasn’t too crazy about the burps).
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You might like a vegan Omega 3 supplement like Ovega-3. They’re derived from algae. If you take them right before you eat, you’re less likely to get seaweed burps.
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Gotcha. That makes sense.
Udo’s is available in capsules or liquid form; I use the capsules and have found it easiest to take them at night before I go to bed, as they can be a bit hard on my stomach sometimes.
I’ve been a vegetarian for several years now, but I debate with myself about re-introducing fish/seafood to my diet in order to help my cholesterol numbers. Chewing flesh again is the thing I can’t really wrap my head around, so for now it’s a moot point. I know that in the overall scheme of things, it’s better to get my nutrients directly from a food source when possible. I’m just not ready yet (if ever) to take that step.
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Forms like this turn me into a complete mess. In the end, I feel that I have had to lie.
Last winter, I switched to get insurance through the healthcare exchage. Some of the questions had me in fits. The whole experience upset me for days.
Just add a pelvic exam to make sure there is no chance of recovery.
I understand the quirkiness of identity and orientation. It cannot be contained by checkboxes.
About 10 years ago, I got my cholesterol down from above 300 to below 200. Something in me clicked, and I was able to get all of the saturated fat and sugar out of my diet. It took a long time for my numbers to go down though.
In the last few years, my numbers have crept up steadily. I can’t find the discipline that I had then to avoid ice cream, pizza and such.
Good luck on the start of hormones!
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I’m used to feeling out of place when I fill out forms in “straight” environments, but I didn’t realize it was going to be differently awkward in an LGBT clinic that takes the T very seriously.
I hope it is just for statistics and funding and that no one really looks at it. When I screw up my courage again I may call for an appointment for hormones, or I may just let it slide for a while longer.
It occurred to me that I had my blood drawn right after a three week vacation during which I ate a lot of stuff I don’t normally eat – but I am going to cut some stuff out and take Omega 3’s – and see if that brings it down. I hate being middle aged.
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I agree with you when you said you didn’t want to introduce any mess into your body. I kid you not I looked towards the route of natural transition for a second because I was very skeptical of the shots. The side effects in the long term is something I worry about but the changes on the t have been so positive for me. I’ll deal with all that later. Right now just stay in a positive mindset and good luck on your journey.
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Thanks. I’m in a place where T is a choice, not a life and death necessity – top surgery took the edge off of my dysphoria – and I’m not uncomfortable with how my body looks to me. It is too bad that T is the only drug/supplement that works magic – but the alternatives are to make the best with what I’ve got or go on T.
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I went to Dr. Weiss 3 years ago. I definitely poke my chest out more so top surgery did it wonders but it left me more dysphoric about my bottom half.
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I went to Dr. Weiss in December. It is interesting what brings out dysphoria. I went to Weight Watchers to drop my weight down from 175 to 140 (I’m 5’4) and as I lost weight my breasts either became or seemed more “out there” and my dysphoria increased as I lost weight. Top surgery was the best thing I ever did for myself.
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Woah have you ever posted of your weight loss? I would like to hear how you did it. I am an avid workout junkie myself now as you can see here
Are you in NYC?
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I wrote a couple of times about the psychological issues of losing weight, not the nuts and bolts of it. I’ve also written a little about the gym (I only manage to work out twice a week). The two pieces about losing weight are https://aboyandherdog.com/2013/02/06/the-elephant-in-the-closet/
and
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Thanks for listing. I will be reading.
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Oh Jaime, I love you. I could, once again and still, totally relate. I was so stymied by the forms I broke out in a cold sweat. I made an X. Crossed it out. Chose another. Scribbled over that. Worried that they were going to think I was psychotic. I finally asked if I could just decide at each visit what my preferences were for THAT visit. They said yes. Glad to be sharing the journey with you.
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I am very impressed that you asked a question about not having to put down a finite identity, and that you might change how you identify. I am so hung up on wanting it to look like I know who I am and what I am doing – that I am unable to ask for help/guidance on stuff like that. I am waiting to take T until I have it all figured out – until I have answered all my own questions – it is absurd. But at least we both got to the clinic, even if we left empty handed.
Glad to be sharing the journey with you too.
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The forms could easily fit more people. When you recognise that there are more genders than two the whole thing about orientation gets a bit messy. Why not just ask what gender you are attracted to? M, F, Bi, Whatever. Or same, opposite, other. Straight and gay requires you to be male or female. And when it comes to gender, why not mark your gender on a line with extra boxes for agender, bigender and trigender? Something so complex could be quite easily on a form if the one making it gave it some thought.
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They also didn’t have anything for people who identify as asexual or pansexual. It would have been better to just fill in the blanks, but computers and data processors don’t like open ended questions, they like multiple choice. And the choices are endless.
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Congrats for going in to the doctors and taking care of your health. I’m surprised you had to have a pelvic exam considering you had a hysterectomy years ago. Don’t sweat the colonoscopy. The prep is the worst part. As for the forms I’ve never had the pleasure of your dilemma as all of my doctors are still stuck in the binary and never ask about my orientation. I understand your frustration but at the same time I think it’s awesome that they’re taking the T seriously, as you said, and trying to be inclusive. Obviously there’s a lot of room for improvement and maybe with some feedback from enough people that can get better. Also, for the cholesterol, a combination of fish oil (or equivalent) and CoQ10 seems to be the standard for helping to lower the bad stuff. There is burpless fish oil out there that is much easier on your stomach.
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