Semen Analysis is Complex

Yesterday, I went to see my family doctor. As is my custom these days, I presented as a woman.

The truth is that I really don't have a male presentation left anyway. I could assemble one if I wanted to--I've hung onto enough clothing, and I'm not on hormones or blockers yet--but I can't bear the thought of putting it on.

So I have a trans / gender queer presentation, in which people generally see me as male, but would have to be completely blind to miss the fact that I'm trans, since I'm wearing all women's clothes (e.g. jeans and a hoodie), and a fair amount of makeup. I get a lot of stares, especially when my four year old son is with me.

And I have a trans woman presentation, which entails fully camouflaging the remaining beard shadow, wearing my best attempt at natural looking makeup, and wearing a skirt, my fake boobs, and unmistakably feminine footwear (unmistakably--not excessively!). In this mode, I'm trying to pass as a woman, and to clearly signal to everyone who does clock me (a large percent of the people I interact with) that I would like to be a woman, and I would appreciate it if they played along. People are more receptive to this presentation, and I think that's because it's less unsettling for them when I clearly pick a team. They might still think I'm crazy, but at least they know that I'm asking them to think of me as a woman.

I'm not going to be the sort of trans woman who prattles on about her outfits in writing. I went as a woman, and I felt that I looked pretty good. I rode my bike to the clinic, my basket overloaded with my computer, some overdue library books, and my purse. When I arrived, I signed in as Deirdre, assuming they would call people the names they signed in with, and sat down in the waiting room, self consciously surrounding myself with my three bags, having not had time to go to the library first because I took too long dotting concealer on my face at home. A couple of people looked me over a bit, but I was feeling fairly incognito.

"Derek [last name omitted]!" The nurse called my name loudly and clearly. I popped to my feet, determined to smile my way through this, and turned towards her quickly, hoping to stave off a second utterance.

She looked up from her secret printed sheet that bore my real name, and looked me up and down. She smiled at me with what I construed as approval, and led me to an examination room.

"So, do you just want to talk to him?" she asked, once we were inside the small room with its two doors closed. Clearly, the chutzpah to dress up as the other gender is reason enough to see a doctor. She had my manila file folder open in her hand.

"I would like to get my sperm count tested."

"Oh, OK. And you can just talk to him. He'll be in soon." And with that, she bustled out the door, all business.

I began scribbling in my journal, which is my usual way of passing spare moments of late.

The door opened, and he peeked in, and abruptly said "Hello," the pitch of his voice trailing up melodramatically at the end of the word (this is the way sympatheic men greet men dressed as women). He slid himself into the room without fully opening the door, then closed the door behind him.

I brought him up to date, telling him that I plan to transition, that I'm seeing someone else for psychopharmacology, and that I'm hoping to see an endocrinologist fairly soon. He nodded, scribbling on a page in my manila folder.

"[My spouse] has been to see all sorts of people about her fertility, but we've never checked mine. Can I get my sperm tested?" I asked.

"Have you had difficulty getting pregnant?"

"Well, no. We've had difficulty bringing pregnancies to term, but I often wear quite tight underwear these days, and I smoke marijuana as part of my 'anxiety management strategy' (and I don't plan on stopping), and both those things affect sperm. If my count is already marginal, then those things could be making a difference, so we would like to get them checked. [My spouse] turns 39 this November."

"When people have problems getting pregnant, I normally start by making sure they're doing it right," he bent forward a little, conspiratorially, "using the right hole, for example, and sometimes I find that people are doing it wrong in some pretty interesting ways. Then, I test the male, because 40% of the time, that's the problem, and it's one test. 40% of the time it's the woman, and they require a lot of different, expensive tests because it could be a lot of different things, and 20% of the time it's a combination. Some couples have both successfully had children with other partners, but can't conceive together. If you were 26, I would tell you to come back to me in six months, but since [your spouse] is over 35, I'll order the test now."

I presumed he was sparing me the birds and the bees discussion because we have already successfully started three pregnancies, so we must have the mechanics part figured out. He filled in a requisition form for the test, wrote me a prescription for Tylenol 3s to help make lasering my beard more bearable.

"When you go to drop if off, are you just going to pretend that you're dropping off the sample for someone else?" He was smiling, clearly amused by the idea of me dropping off a jar of semen, dressed as a woman.

"I hadn't really thought about it."

"You can collect it at home. They probably have people drop off samples for other people all the time."

I gathered my bags, clutching the form, and made my way across the clinic to the lab, where I paper-clipped my Health Card (which bears my male name) to my form, dropped the package into the in box, and took a seat in a different, more crowded waiting area.

"Derek [my last name]!" intoned a female voice, moments later, loudly and clearly. I popped to my feet, and from all directions, I felt heads swivel to stare at me. I smiled awkwardly, bent and picked up my bags, and brazened my way around the corner, trailing the lab technician.

She didn’t blink when she saw that I was presenting female. She led me a few feet down the hall, and then she turned into a room, and turned around immediately to face me, blocking my passage through the doorway. I leaned against the painted metal of the institutional door frame.

She was a stout woman whose white nylon clad legs were rooted firmly into stable white orthopedic shoes. To her left, various medical supplies were neatly stacked on stainless steel wire shelving. Looking over her right shoulder, I could see another person working amid a clutter of pastel coloured machines, sterile containers of various sizes, and piles of paper.

She leaned on the steel shelves, mirroring my posture in the doorway, and began, in her Eastern European accent, to carefully explain my options for getting my semen analyzed.

“We don’t do here. You will need to go somewhere where they can do this fast enough."

“You don't do it here? Can you give me a container? Can I..”

She waved one hand, concisely conveying to me that I should shut up and listen. “I will give you three things: the names of some labs that do this, some instructions for collecting the sample, and a container. You need to call to be sure where you will get this done, because the sample has to be at the lab in less than 30 minutes. You need to keep it warm. Hold it in your armpit while you travel. Some labs have special rooms where you can do the collection. When you phone, ask whether they have place where you can collect sample there.”

“This is complex,” I said.

“Life is complex.”

“Tell me about it!” I said.

That got a laugh out of her. I stuffed my semen analysis requisition, instructions, and sample container into my purse, gathered up my other bags, and left the building.