Navigating Healthcare as a Transgender Patient

Disclaimer: All names portrayed in this production are fictitious. No identification with actual persons (living or deceased), should be inferred

Walking into the local clinic, I immediately felt overwhelmed. The waiting area was packed with people, and the receptionists seemed stressed and rushed. As I sat there, anxieties about being treated differently because of my gender identity swirled in my mind. Accessing healthcare has always been a daunting task. As a transgender man, the fear of discrimination and judgment often kept me from seeking the help I needed. Would the doctors dismiss me? Would they understand my unique healthcare needs? Accessing healthcare always felt like an uphill battle; however when I started experiencing persistent jaw pain, I knew it was time to confront my fears and reach out for medical attention.

I walk over to a chair between a mother and her child, and another middle aged man. I felt my heart rate increase as I wondered if those who had turned their attention to me had done so simply because I was newly entering the waiting room, or if they were trying to figure out if or why my facial features seem at odds with my overall presentation.

Finally, it was my turn to see a doctor. I entered the examination room, my heart pounding in my chest. The doctor, an older man with salt and pepper hair, barely looked up from the computer screen as I entered. “Hello Alexandria, how are you doing today?” I wince and cringe at the sound of my legal name leaving his mouth. I could have sworn I wrote my preferred name on the patient intake form.

Before he goes on, I interject. “Um, actually doctor, I go by Xander. I think I wrote it on the form there.” He peers back down at his clipboard, seeing where I had written it, and mumbles off a quick apology before continuing where he left off. He asked me to describe my symptoms, so I explained the persistent jaw pain, and added that I had been experiencing debilitating headaches and blurred vision.

He responded as soon as I finished speaking. “It’s probably just anxiety,” he said, barely making eye contact. “I see here it says you’re on a testosterone regimen for gender affirmation reasons. You’re undergoing hormonal changes, so it’s not unusual to experience these symptoms.”

Feeling frustrated and unheard, I gathered my courage and spoke up. “I understand that hormonal changes can cause symptoms, but I feel like there’s something more going on. I need help finding the root cause of my pain and discomfort.”

To my surprise, the doctor paused and looked at me. He seemed to recognize the determination in my eyes. “Alright,” he said, his tone changing slightly. “Let’s explore other possibilities. We could consider taking you off of testosterone for some time and see if that makes any changes.”

My head snaps up to meet his eyes. “What happens to my body if I am taken off the testosterone?”

He continues to look at me. “Well, currently the regimen you are on is blocking female puberty, as well as driving male puberty in your body. Should you come off testosterone, your body would return to its normal state, and likely your pain will subside.”

The world around me spun as I was catapulted back in memories from a terrible time, when my body was not my own and I felt so uncomfortable in my own skin. The thought of this made my skin crawl, and I shivered, asking in response if this is the only option.

He ordered some tests before referring me to a specialist. The specialist, a dentist specializing in temporomandibular joint disorders, listened attentively as I described my symptoms and concerns. She took the time to understand my gender identity and the potential impact it could have on my healthcare.

After a thorough examination, the dentist confirmed that I had temporomandibular joint disorder, or TMJD, which was causing my jaw pain and related symptoms. She discussed treatment options with me, including therapy, medication, and lifestyle changes. She also addressed my concerns about any potential impact on my transition and offered resources for transgender- friendly healthcare providers. She explained that male hormones may have a part to play, as they could be causing a growth spurt further contributing to my condition; but this couldn’t be known without some more investigation and examination.

I left the dental clinic feeling a mix of relief and frustration. Relief, because I finally had a diagnosis and a plan for treatment. Frustration, because it had taken so much effort to be heard and taken seriously. This experience served as a painful reminder for how gender identity disparities can lead to inadequate care and put transgender individuals at risk.