Severe pain in my 17-year-old son's abdomen took us to the ER last week. It's one of those situations that everyone dreads, but if you're transgender, there can be an added level of anxiety when the medical professionals you are dealing with aren't current on trans health care. Such was the case for us, beginning at the reception desk.
"Name and date of birth?" the harried man asks 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'd been in this particular ER years ago, and that information had remained in their database.
"Samuel?" he asks in a perplexed tone.
I hold my breath as flashbacks of other occurrences of this very scenario begin playing in my head. It's happened at the orthodontist's office, at school, at the bank, at the library, at the community center -- basically at any institution, organization or business that has Sam's birth name, Samantha, in the computer system from the years 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. In this instance, a white lie 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, and certainly easier than outing him not only to this person but 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, 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 that 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 seems premature given her young age, ushers us into a small, sterile room to take Sam's vitals and discuss his symptoms. Protocol dictates that she also determine what current medications he is on, if any, 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, so I explain, "Sam is transgender."
"Ohhh," she replies, unfazed, which actually makes me feel better, because I assume she is familiar with the term. However, that assumption is quickly thwarted by her next query. Gazing at her computer screen in search of an appropriate code for this piece of information, she asks, "Would that be the same thing as... transsexualism?"
In awe of her ability to simultaneously elongate and slaughter the word, I say, "Sure," trying to put an end to this line of questioning as quickly as possible, for Sam.
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, so I answer for him again, saying, "Double mastectomy."
George glances at me, looking slightly perturbed, and says, "I'm not asking about your medical history, ma'am. I'm asking if your son has had any surgeries." Now, at this point, most people might be horrified, but we learned a long time ago that being able to laugh is a trait that will get you a lot further in these types of situations. 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 that George obviously thinks I have had a double mastectomy, the ER doctor announces his arrival by sliding the privacy curtain aside. I assume that 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 that Sam is transgender comes up. 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 be able to laugh at this question too if it weren't so humiliating. There is no bigotry or malice in the question, but that doesn't make it any less difficult to hear. Deep down, we know that the doctor's intentions are good, but his bedside manner leaves much to be desired. Knowing that this question hurts Sam's psyche just as much as the physical pain searing through his stomach, I jump in to provide a quick "Transgender 101" on his anatomy and medical history.
Following emergency surgery to remove Sam's appendix, we face another educational moment when the night nurse hands Sam a portable plastic urinal. Staring at the container, Sam looks like he might start to cry, so I assure the nurse that I will help him to the bathroom. Once he is situated, I rejoin the nurse in the room and ask if she knows that Sam is transgender. She is just a year out of nursing school, and her immaturity shows as she releases a nervous giggle and says, "Yes, but I didn't know if that meant he had--." Implementing a crude form of sign language, she waves her hand in front of her crotch to finish the sentence.
We entered parts unknown that night, 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 that trans patients receive the same respect and level of care as everyone else.
To learn more about health care facilities throughout our nation that have adopted policies for LGBT equity and inclusion, check out the Human Rights Campaign's annual "Healthcare Equality Index."