EPISODE — 3
TRANSITIONING IN HEALTHCARE : EXPERIENCE AND THOUGHTS
Our guest today is Sasha who is a twenty-two-year-old from Bangalore. They are genderqueer and have been medically transitioning since 2019. When they are not doing their corporate day job, you can find them listening to BTS, watching queer-themed shows, cooking, and painting.
In this episode, we learn about Sasha’s experience with mental health along with general healthcare spaces through their transitioning and prior. We explore some of the ways in which healthcare practitioners are ill-equipped to help queer-trans patients and the negative impact this phenomenon holds.
Rishma: Let’s get right into it. From the time of your self-identification as queer, how has your approach to issues of healthcare and medical treatment changed, if at all?
Sasha: I think ever since I started discovering my gender variance in my teenage years, I hesitated to approach hospitals or medical establishments in general because they will definitely misgender me there. I tried to not go as much as possible until it becomes like an emergency situation because I really do not want to deal with the distress of trying to communicate my identity to them and them not understanding it. So, I think I’ve become much more reserved in terms of getting medical support.
Rishma: Right. Do you think your identity or its perception and its impact on your interpersonal relationships has ever affected your mental health?
Sasha: Yeah, absolutely. When you’re first figuring out yourself and your identity, you feel like you are the only person who has thoughts and feelings and identifies in that sort of way. I have been on this self-discovery journey since I was about fifteen years old. It’s still continuing and I don’t think it’ll ever stop. Coming out it’s never just a one-time thing. It’s a repeated process that as you figure yourself out, you have to keep talking to people about how you’re feeling and introducing yourself to new people as you go through life and get older. I have become a lot more reserved, again, in terms of interpersonal relationships. I try to limit how much I talk about myself with others about my identity. Especially when it comes to, extended family members. I restrain from meeting them as often as I used to before because they don’t really understand or respect my identity. It’s very distressing and it does take a toll on mental health because I see everybody else being very close and happy with their extended families but I rarely ever meet them because I know I will be uncomfortable around them. It’s not that they’re unsupportive or hateful about it; they’re not keen enough to learn more about my identity. So, I tend to stay away. It does bring me down and I tend to think- ‘I wish things were different.’ If I talk about people that are not close to me and people I encounter and interact with in everyday life, I constantly have this thing in my head of ‘How are they perceiving me? How am I presenting? What pronouns will they use for me? Should I change my clothes to look a certain way?’ All of these thoughts are about fitting in, socially. It just makes me very on-edge and anxious the entire time when I’m outside the comfort of my home.
Rishma: I’m at a loss for words to express how brave you have been and how much strength it takes to be you. It’s just incredible that you are doing this. I have friends who are transitioning and I know how difficult it is for them because we have conversations about it. I applaud your courage and I hope that everything turns out great for you. That’s my sincere hope.
Sasha: Thank you but I do think that being brave is not something many of us choose to do- it is something that we have to do in order to go through life and survive it.
Rishma: Absolutely. To take on this societal aspect takes a great deal of strength so that is fantastic. You said you have been transitioning for a few years. Have you ever had to go through mental health professionals or healthcare professionals who have been insensitive and transphobic because we know that it’s difficult getting healthcare professionals who will listen to you and accept you. In my personal experience, I had had to go to therapists that have not been very kind with the crisis that I had been having so what have been your experiences so far?
Sasha: Prior to even transitioning, I had been seeking mental health help since I was thirteen years old due to various reasons. When I talk about psychologists or psychiatrists, my first interactions with them were around the age of seventeen. That time, I knew that I was genderqueer and that was kind of impacting my life at school because coming out to a bunch of close friends at school was alright. They were okay with it and very supportive. But, word gets out and rumours started to spread. Then, I had to be like, “Yes, I’m queer. What’re you going to do about it?.” There was also a fair share of people that I wasn’t very close to who did not take it well and did not treat me kindly during school so that really brought me down. I needed some mental health help for that. I went and spoke to one of the therapists that I saw. She was just very uneducated and uninformed about queer identities so when I told her I’m genderqueer and go by certain pronouns saying that “I would really appreciate if you refer to me like this.” She would just sort of gloss over it and not take it seriously. She continued to misgender me which was quite distressing because she would also talk to my parents about me- to report on progress and everything. As it is, I was having a difficult time making my parents understand what my identity is and when you’re therapist doesn’t refer to you correctly, it just makes it worse. So, that was my first experience with a therapist who wasn’t really outright transphobic but rather uninformed and unwilling to learn more about it.
But, when I started transitioning in 2019, I had to meet a therapist and a psychiatrist in order to get on hormone therapy. My therapist was thankfully very understanding and very gender-affriming. Even my psychiatrist was kind about it. However, It was the doctor who prescribed me the hormones who was very strange and transphobic even though she said she had a lot of experience prescribing hormone therapy to a lot of trans people. I think it was her first time meeting someone genderqueer and not exactly a binary trans man or trans woman. I have very different goals when I say that I am transitioning. It’s not that I want to get every surgery possible or look a certain way with hormone therapy that you’d think a trans person would want. When I tried to explain that to her, she was very unkind about it and tried to coax me into getting things I didn’t want. So, I stopped seeing her. On the mental health front during the transitioning, I’m very grateful and lucky that the people I saw were very kind about it.
Rishma: Thank you for sharing that with us. It is an insight that I hope will help the people listening to this podcast because that’s been the objective of this podcast- to get information and perspective out there. That is, I think, the major problem with regards to the healthcare system and the queer community right now. The lack of information and lack of healthy curiosity makes it so that heteronormativity is fine but anything otherwise, is not.
Sasha: I’m willing to learn about the expanse of identities out there and tell you about when I got my top surgery done two years ago, the doctor kept referring to me with ‘she/her’ pronouns and not really understanding why I wanted that surgery. It just ended up being not how I wanted it to go. Now I need to deal with the necessity of saving more money to get reconstructive surgery because it didn’t go well due to her not taking my trans identity seriously.
Rishma: That must’ve been really difficult for you. It sounds like not the best experience to have.
Sasha: Yes. Even now on a daily basis, I deal with the discomfort of dealing with the surgery that didn’t go the way I wanted it to. I’m just waiting for the time that I can get it reconstructed but that is another whole process and very time-consuming. I don’t know. Maybe in the next two or three years, I will get it redone. That transphobic doctor has made me need reconstructive surgery now so that sucks.
Rishma: We hope that everything works out for you and hope you don’t have to go through insensitive, and unkind people again in your journey. Hopefully, it works out just the way you want- that’s our wish for you.
Sasha: Thank you so much.
Rishma: How do you think demographic factors like class, location, and religion affect our access to mental health services for queer or trans people.
Sasha: I do not have experience of facing any discrimination with regards to class or where I’m from or any sort of demographic factors. But I do know people who have faced issues while trying to avail themselves of mental or medical health services because the people who they consult already have preconceived notions like ‘people from a certain background will be a certain way.’ It doesn’t go according to the way they want it to. Sometimes, they are unable to avail those services at all. I can’t really elaborate more on that because I don’t have first-hand experience with this.
Rishma: That makes sense. So, that is it from our side, Sasha. It was wonderful talking to you and it’s a great perspective for us to know. We really appreciate that you could make time for us and you could share your journey and experiences with us. Thank you, from the bottom of our hearts.
Sasha: Thank you as well. Also, if I can just add that going forward in the medical or mental health space, I really do hope that there is more sensitisation when doctors are getting trained to do what they’re doing. Hopefully, they get a more diverse education about different identities and how they can be more respectful to people because it really matters. How you talk to a patient matters because they’re trusting you with all the information about themselves and things that they would like to get done. If you’re not respectful about it, it becomes very difficult for the patient. I do hope that things are changing for the better.
Rishma: Right, I think we had a similar conversation about this with another guest about how education has to be restructured from the very basic and primary stages in order for this to not persist in the layers of higher education and people going on to become doctors. The entire curriculum, I think, needs to get a queer lens because the one that we currently have is not sustainable and working.
Sasha: I agree with that.
This article has been transcribed by Priyanshi Prasad, Junior Research Manager at Rangeen Khidki Foundation.