Tuesday, September 7, 2010

Finally.....

...I have a blog. I resisted starting one for years because - well, truthfully, because I was too lazy to write a blog regularly, and didn't think I had anything interesting to say. Now that I have something to say however, I needed somewhere to say it, and here we are! I will write about all kinds of stuff, but for now I want to start with a quick history lesson in my current situation re transition:


I have been on hormones for 2 1/2 years now. I *should* be getting chest surgery and a hysterectomy, but due to the way the system is set up here in Western Australia *grumbles...bloodybuttfucknowherebackwards...*, I am presently pretty much in transition limbo. Granted, I have a fairly unique set of circumstances, but still.... for those of you who are not Australian and not familiar with West Australian policy, those of us who are on low incomes or social security payments for various reasons are at a serious disadvantage when it comes to the cost of transitioning, because Medicare here does not cover any of the expenses. If I had any other medical condition, I would receive free or heavily subsidised treatment - but because I am transsexual, I have to pay the entire cost of my transition out of my own pocket.

OK so that may not sound like such a big deal. But when you consider that my current annual income is less than twenty thousand dollars, and has to feed, house, clothe, educate and provide everything for 3 people who live in the same household and one who comes 35% of the time on access visits, that doesn't really leave a lot of wiggle-room when it comes to paying for anything that isn't "the basics" (and hell, a lot of the time even the "basics" are hard to afford).

I am currently in a position where I am unable to work due to physical and psychological health issues, but my doctor is refusing to give me the paperwork to access a disability pension on the grounds that she wants me to go into fulltime work so that I can afford to have the aforementioned gender reassignment surgeries. So here arises problem #1: I can't work at present, not without a TON of therapy and medical assistance - but my doctor also seems to have an attitude toward mental health that comes straight out of the 1950s. No problem you say, get another doctor. Herein arises problem #2, the lack of trans-friendly doctors where I live and the difficulty in accessing those who ARE trans-friendly due to firstly, distance issues (I don't drive so I have to rely on public transport), and secondly, some of the aforementioned psychological issues (PTSD, OCD, anxiety disorder and social phobias). In addition to this, I would have to pretty much go back to square one to explain my current situation to another doctor, and that's something that I am just not in a position to handle doing (thanks to the PTSD).

So, I need surgery but have no money and no way of earning any until I get therapy and other medical help that I am currently being denied. I can't get my Gender Recognition Certificate without having had said surgery either, so all my official documentation currently says I'm female because I cannot legally change my gender marker without a GRC. This leads to all kinds of fun and games with ID and being told "that's NOT your ID, it says you're female", and pretty much having to out myself every damn time it happens to attempt to explain to some Neanderthal exactly WHY my ID says "female" when the person standing in front of them looks and sounds like a man. All of which is REALLY good for my mental health... </sarcasm>

Will someone please explain to me WHY, for the love of Pete, when I am asking for therapy and whatever else I need in order to be fit to work and be a productive member of society, I am being denied access to it and told basically "suck it up buttercup, dive in with both feet and work fulltime and we'll just sit back and watch it all blow up spectacularly and say it's your fault for not applying yourself." 

I listened to RTRFM's "All Things Queer" tonight featuring an interview with Blair Archbold (a fellow Perth transman) regarding the battle for 2 other transguys to be legally recognised as male (the Board denied them this right, they appealed and the Tribunal found that they had the right because they had met the conditions they were required to meet, and literally the same day they were granted this right, the Attorney-General turned round and appealed the Tribunal's decision - the appeal was heard, and subsequently the two guys were stripped of their legal right to be recognised as men on the grounds pretty much that they had not had a phalloplasty or a hysterectomy - and both had very valid medical reasons not to do so). I won't even start on the ridiculous double standards that have been applied here because that will take a whole 'nother post (maybe I will write that another time when it doesn't get me so up in arms, might be a long wait).

So anyway, during the interview, it was brought up that there was a transman in Perth who had recently been refused a hysterectomy at the last minute after being given the approval to have it. Well folks, that transman is me, and I have decided to write the full story for all to see. It is not a pretty tale, nor does it have a happy ending so far.

Back in August of 2009, I was given the approval by my gender therapist to undergo a hysterectomy (I know most guys do the chest first, but I chose to go this way because I can't afford 8-12 grand to get my chest done and at least this way while I am trying to sort the other aforementioned issues, I would be doing *something* for my transition other than taking hormones). So, I got the relevant referrals and such from my GP, and in April went along to Kaleeya hospital and had the pre-op consult with the gynaecologist there, including the traumatic and uncomfortable physical exams that really triggered my dysphoria and made me feel like crap for days afterwards. At this appointment, I was given a surgery date and time, signed all the hospital paperwork and talked to the anaesthetist. In addition I was given a referral for an ultrasound scan so that the gyno could see exactly what he is dealing with for the surgery (I have somewhat "awkward" anatomy lol, I won't go into details here but it meant that he may have had to resort to a full abdominal hysto instead of a laparoscopic one if things proved too difficult to access). 

All was great, I thought - until a couple of weeks later I received a letter from that same gynaecologist, stating that the executive of Kaleeya hospital had refused to allow the surgery to be performed at Kaleeya. The reason in the letter was that I am "not part of a formal gender reassignment program" (of which there are none currently in operation in Western Australia), and that while they were aware that no such program existed, it was "worth noting" that in the UK and US, patients had to travel long distances to obtain treatment for transsexualism. I was advised that my best course of action was to either go private (which I can not afford because I don't have private health insurance on my income), or to relocate myself (and my entire family) to the eastern states and join a gender reassignment program over there in order to be given the go ahead for surgery.

Now I don't know if you are all up on your geography, but "long distances" in the US and UK are NOT the same as "long distances" here in Australia. The gyno in question focused pretty heavily on the UK system and the fact that while the NHS does cover the costs, patients have to travel. Now if I were to travel the same distance as one of my UK trans friends does, seriously, that would be the equivalent of me taking a day trip to Mandurah or Rockingham, which is still part of the Perth outskirts. NOT the same thing as suggesting that I, on a tiny income, relocate myself and my entire family several thousand kilometres away, thank you. 

The icing on the cake was that the gyno stated that he was sure I "must find this very disappointing" - NO SHIT, dude! You give me the green light, give me a freaking surgery date and I sign all the hospital stuff and talk to the guy who's going to put me under, and then you turn around and say "sorry, the boss-man says no?" WTF is that?!

It's interesting to note that my GP was given an entirely different reason for the refusal - the reason she was given is that aside from the fact that there is nothing physically wrong with the particular parts of anatomy that I was supposed to have removed, and I quote (her words) - "they just aren't going to do it - the executive said not in his hospital." So because I don't have say, cervical cancer or something, they want to force me to keep the bits that I want removed for very valid reasons. And given that they just plain refused to do the surgery, I suspect that there is more than a touch of transphobia involved (particularly given what my GP relayed that the executive had said about his hospital).

And the worst part? Under current law, I have absolutely NO legal protection against this discriminatory bullshit, because I don't have a Gender Reassignment Certificate that says I am legally male (are your heads all starting to spin from all the going round in circles yet? Everything is interconnected and I can't do one without the other but I need the other to do the one).

But back to the story....when I went back to my GP, she sent a referral to another hospital (King Edward Memorial) but I have since found out that the executive of Kaleeya has had a word with the executive of KEMH and as a result, no hospital in Western Australia will perform my hysterectomy. Nice, huh? So now I am denied access to ANY hospital (despite the fact that since I am legally still female, I should be able to have my hysterectomy covered by Medicare as I am on a very low income and that's what Medicare is FOR), and expected to somehow come up with a shit-ton of money to either move to another state (which for reasons I won't go into here other than to say they are legal and involve my children, I am not permitted to do in any case), or pay for the entire procedure out of my own pocket. I don't know about you, but I don't see either of those options happening on my income with my current zero work prospects/ability.

So now I am stuck in gender limbo - I look, sound and present as completely male (to the extent that my son's classmates all refer to me as his dad, even though some of them knew me when I was still presenting as his mother), but all my paperwork says I am female and I can't change that, and until I CAN change it, the law says nobody has to actually recognise my gender or respect it (and believe me I seem to find ALL the public servants who are ignorant as hell about gender and are NOT the kind of jerks you want to be outing yourself to on a regular basis because then it turns into a round of "Name That Freak!" and the public servants in question usually make a big scene about my appearance not matching my paperwork, which entails everyone else who is in the vicinity then finding out that I am transsexual. NOT what I want on a regular basis when I am trying to just get on with my life and don't want to constantly be reminded that I am still stuck in between genders (physically speaking). I am at the stage where when I wear a binder, nobody ever refers to me as anything other than "sir", "mate" or "bro" and if they don't need to see my paperwork or look in my underwear, the automatic assumption is that I'm male, because I am and that's how I present. But when they have to do either of those things, it inevitably gets ugly and triggers my dysphoria because I have to be a freaking posterboy for transmen EVERY. SINGLE. TIME. and explain the WHOLE. FREAKING. DEAL. And it doesn't just happen occasionally - if it did, it would be a little easier to deal with, but it happens far more frequently than I want to know about.

Um....wow. Yup, I'm opinionated, outspoken and I don't take shit from anyone, particularly when I am being either penalised or discriminated against because of my gender. And to people like the transphobic executive of Kaleeya Hospital, I say... Seriously. I'm a guy. Get over it already and just let me BE one.

6 comments:

  1. *hugs*
    that is just, to put it bluntly, very shitty indeed.
    i've passed your blog link on to friend of mine who might be able to offer real advice. all i can offer is support.

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  2. that is fucked up. sorry to hear you're in such a shitty position.

    i swear, i am so sick of transphobic pieces of shit in powerful positions deciding to play chess with trans lives. i'm also sick of the impossible and incompatible 'policies' regarding gender, trans people, paperwork and surgeries.

    i have no idea if you're in contact with the wa gender project for advocacy help? or i wonder if it's possible to organise fundraising for getting a hysto in another city? (not that you should have to, fucking hell!)

    i'm in a similar situation regarding passing as male but being documented as female, and not planning on having any surgery for at least a few years (unlike you, i probably could save up for a while, but i prioritise other things... my chest is still gonna be there in however many years, but my ability to travel the world might not be). it's pretty ridiculous, because just letting me get an M on my passport or whatever would make everyone's lives so much easier.

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  3. @knitickyboo - thanks. Support is welcome, since I have so little of it (no family support either).

    @ nixwilliams - I hear ya on the transphobic POS in positions of power and the incompatible policies, I come up against shit like this literally on a daily basis and I am starting to get very tired of it. I haven't contacted the WA Gender Project but I will now, thanks for the heads-up (I have already been in touch with the Health Consumers' Board, who were initially very helpful but not so much since). To add insult to injury, I have been informed just today that my income is going to drop even further due to the new rules about child support and percentages of care - because the percentages are calculated differently now, I will lose all the family tax benefit I was receiving for the son I have part time care of, and will also lose all child support that I was being paid. So effectively I will have this kid for 115 nights a year (plus a whole lot of days that apparently don't count because they're not overnight) and not get a cent to help care for him. But if I can't afford to have him here, then I will also be required to pay his father child support (which is kind of ridiculous when you consider that his father makes something like 4 times my income per year). So I am NOT a happy camper right now.

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  4. wow, the child support decision is pretty craptastic. are you able to get some legal aid advice or ask them for suggestions for advocates to help you out?

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  5. No, I have no legal recourse on the child support decision because that's how the new rules work out.

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  6. Yep...welcome to the vast stupidity that is Australian child support policy. I'm guessing none of the idiots who make the rules actually *have* kids - either that, or they don't care how the rules affect anyone in a certain low income bracket (because hey, we're just the bottom of the pile, us Centrelink recipients)...my ex knew exactly how the new rules would affect me and that's precisely why he reported a "change" in care to the CSA (when there has not in fact been any changes, the only thing that has changed is the fact that care percentage is now calculated on the number of nights only, and since I have a significant number of days where my son is there for the full day but not overnight, that's where the "reduction" in care percentage comes from).

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