Ode to the Bravest People I Know

It takes guts to show up for your medical appointment and meet a new provider about whom you know nothing. Perhaps this one will stay longer than the last three primary care providers you have been assigned. Perhaps this provider will use your correct name and pronouns and will not deadname or misgender you. Perhaps this PCP will not dwell on the fact that you are trans when gender identity is irrelevant to your chief complaint. Perhaps you will not be asked the dates of your last menstrual period when you were born without a uterus. Or, perhaps support staff will think twice before asking about menses, as the word “menstrual” triggers dysphoric feelings, and you have had breakthrough bleeding when you’ve been unable to obtain a testosterone prescription.

It takes guts to ask your new PCP to prescribe your gender-affirming hormonal therapy, which allows you to live as yourself, rather than within a body that is wrong and a source of loathing. And it takes guts to learn that your PCP needs to refer you elsewhere because they do not know how to prescribe these hormones. Apparently, the medical system did not teach that gender-affirming care IS health care.

It takes guts to voice your questions about non-heterosexual sex. About topping or bottoming. Human acts that societal elites declared illegal and psychiatrists deemed pathological. As if such decrees could overrule instinct, love and desire.

It takes guts to be visible. To be a tall person with a deep voice and shadow of a beard, wearing the cute bra beneath the patterned dress and a scrunchie pulling back your flowing, long hair. All of which makes you feel alive and joyful. It takes guts to be a petit, curvy person with a bound chest under your flannel shirt, cracking voice and fuzz just starting to appear above your lips. The fuzz and voice changes that make you hopeful about seeing friends again.

It takes guts to utter the question that names the elephant in the room: will politicians make gender-affirming care illegal? And it takes guts to breathe through the pause as you wait for your provider’s response.

It takes way less guts to show up as an ally, a prescriber, a listener, a believer, and an open-hearted human. And it takes way less guts to apologize for past wrongs perpetrated by the medical system, and working to do better.

Pam Adelstein
Newton, Massachusetts