Apathy can be tackled by education
by Kira Wertz
Community Issues Columnist
In the beginning of my transition, I was very naive about the process. I thought I’d see a counselor a couple times and be on my way to hormone town. It gives me a chuckle to think how ignorant I was at that point.
Those I met early on in support group gave me the 411 on working around the standards of care. The advice was appreciated. But despite my motivation to expedite my transition, I chose to follow the guidelines so that I could at least go about my transition as safely as possible. In truth, that decision was made out of respect for my wife.
After probably a dozen or more counseling sessions I began to see how essential it was to have someone to discuss the emotions I was dealing with but also the intricacies of day to day life. I now see the benefit of the standards.
I know many people who self-actualize need to begin the process as soon as possible. For me, I think at least having HRT [hormone replacement therapy] started at the onset of counseling could have been a big benefit. Whether it’s common knowledge or not, estrogen has a calming effect which certainly could have quelled my frustrations early on.
In researching HRT I’d become aware of the process of informed consent. This is a situation where a trans person having self-educated on the pros and cons of HRT will visit a clinic, be given an assessment of sanity and given prescriptions necessary to begin transition. Unfortunately, informed consent clinics are lacking in Oklahoma City and, in my opinion, they are lacking nationwide.
Trans people seeking HRT in the past have been known to be humiliated by doctors that try to play God by ascribing arbitrary rules to what it takes to be trans. The most common form of discrimination seems to relate to mode of dress. A ridiculous metric if ever there was one, a person transitioning from male to female might not want to change that aspect of themselves until they’ve grown softer features. Or they might never even want to dress feminine.
A person transitioning from female to male might not want to assume a style change until physical changes make that presentation more applicable. It goes back to tired clichés regarding what it means to be trans.
When visiting trans forums, I am often overwhelmed by the panicked comments left by those so desperate to begin their transition that they begin to get very blunt about their suicidal feelings. This can sometimes be an indirect result of medical gatekeeping otherwise known as the WPATH standards of care. Before I continue, let me stress that this is not a condemnation of that process but merely a call for an alternative option.
This notion of gatekeeping is really the one I find the most troubling. To know that any one person can determine the course of your life is emotionally damaging. If someone needing to transition has suicidal ideations and knows they need to start HRT, then a practitioner who chooses to gatekeep instead of offering informed consent could make them morally culpable in that patient’s death.
It is with this idea in mind that I advocate for the dissemination of informed consent doctors and clinics to propagate locally and nationally. You have great potential to positively impact those who have suffered with dysphoria. These people may be unable to survive six months of counseling or may be unable to pay for six months of counseling. From a mental health standpoint, it would be a violation of a Hippocratic oath to stop an informed patient from taking this active role in their life.
Having seen the benefits of the WPATH process, I must still concede that informed consent should be an option that’s available to all. It is my hope that these standards will change to better address patients who are ready to begin transition without third party permission.
The day I never see someone post a suicidal thought relating to the difficulties in acquiring hormone treatments will be a red-letter day for the entire transgender community.
Gayly editors do not necessarily agree with some of the writer’s thoughts in this column.
Copyright The Gayly – November 14, 2017 @ 9:20 a.m. CST.