My trip to the CAMH support group, Part 1

I got riled up about CAMH being proposed as the gatekeeper for SRS (sex reassignment surgery), which is being re-listed for coverage under Ontario's health care system.

I really don't like the CAMH Gender Identity Clinic! I think they hurt me, they wasted my time, and they made my family's journey harder. I think their views are hopelessly out-dated, and they're too conservative to change them. I'm surprised they still exist, actually. They're a relic from the days when Sexologists were in charge of providing care for trans people, as though we were insane sexual perverts. This model for care is hugely outdated and needlessly demeaning and demoralizing.

CAMH has upset me so much that I'm upset with them for getting me so upset! I think they tried to offer me some help, and normally I would be able to find some way to forgive anyone with good intentions. I don't expect very much of people, so it's hard to end up in my bad books.

But those fuckers at CAMH really hurt me. I spent 18 months in total crisis. It was hell for me, and for my almost-ex-wife, and my family. Several of those months could have been avoided had CAMH not entered the picture.

Their pathologizing, sexologizing modality dovetailed with my self-loathing and self-denial, and ratcheted up the unbearable tension inside me.

Instead of encouraging me to find the best way forward for myself, they encouraged me to concentrate on minimizing my transness. They diagnosed me with Gender Identity Disorder, acknowledged that I felt a severe degree of gender dysphoria, but encouraged me to view transition as a last resort that would almost certainly leave me lonely and marginally employable.

Dr. Dickie, the only physician at the CAMH Gender Clinic these days, is a part-time resource. His main job is to be head of General Sexology at CAMH, and he also has a professorship with U of T, I believe. He told me I was hopelessly in the grips of my screwed-up sexuality, and that I was a "shoo-in" because of my small hands and stature. This was before the letter that told me not to transition.

Facing huge losses in my personal life, and supported by no one, including my care giver, I fought my transition. I remember knowing the whole while, at some level, that I had to transition. That certainty never wavered. I threw everything I had at it, and it just sat there completely impervious. I resent and regret all the lies I told myself and others (my SO in particular) as I tried to hold each successive line in the sand on my ass-backward tumble from man to transsexual.

The result? I finally came to accept that I needed to transition, and my head started to clear. Had I started out in trans-positive care, I think that process could have been easier, and maybe less painful.

I think the negative influence they had on my life borders on malpractice. Care-givers who are up-to-date in their profession don't tell trans people to deny themselves as much as possible!

Where does they get off posing as experts, while disagreeing with all the rest of the experts in the world save a couple of whackos (e.g. Dr. Bailey at Northwestern)? This is like being a Global Climate Change skeptic, persisting in pretending that reality and an overwhelming opposing consensus hasn't put you out of business.

Dang! I've devoted all my time to ranting about my first time through that place. Tomorrow, I'll tell you about yesterday, when, even though I loaded up on weed and clonazepam in an attempt to calm myself a little, I went into that little meanly furnished meeting room at the Clarke building with both guns blazing.

Hating hating myself

The feeling I hate the most is the self-loathing. I hate it. It’s not the self-loathing of the apathetic, although it sometimes touches down there briefly. This is the self-loathing of the freak. The problem. The black sheep who just couldn’t ever get it right, and has now finally gone and fucked it up beyond all imagining.

That’s not the way that my family or friends feel; that’s how I feel about myself. Silent screaming hatred.

It feels like all sorts of awful things. Like I want to collapse. Like I want to grab hold of the hair at the back of my head, and rip off my scalp and face in one forward and downward yanking motion. Like I want to stab a knife in my chest near my heart, on an angle, and rotate the handle in a circle like I’m cutting and eye out of a potato. Like hopelessness. Like when I try to grab hold of my being, there’s a hole in my fabric, and my hand passes through. An old wound.

It’s old hatred. It’s like I created this monster to patrol my gender boundaries: a reflexive torrent of self-loathing. And now I have no more use for it, but it still performs its function. Not all the time, since I’ve spent two years dismantling the fucker, but now I’m right in the line of fire when the hatred starts to build.

I have become exactly the way I was never supposed to be. Imagine the fury that patrolling part of me feels at failing in its only task—the task it was created for—protecting my manhood and normalcy. I have scorned my own automaton, and turned my back on its work. So it, part of me, rains its hatred on the way I need to be.

Dusting off the blog

For a while, my keenness for blogging disappeared. Life was far too complex and shitty. W. and I were desperately trying to hold our marriage together. Everything seemed too painful and too fraught to muse about in a public forum, even anonymously.

It had been so long since I had felt like posting, I had pretty much given up on the blog for good, even though I like the name. But suddenly, today, I was imbued with motivation to dust this thing off and start again.

Some recent news and events

• My marriage is over, which saddens me desperately, but the split is amicable, and that's a silver lining of sorts.
• I am out to basically everyone in the world except my son. We don't want him to blame my transition for our separation (though he would be on the right track). So I'm holding tight while he absorbs the separation before I drop the gender change idea in his lap.
• I am on androgen-blockers. They have definitely started to make a difference, but all that does is put me closer, but still agonizingly short or my goal. Female hormones will probably start in mid-summer.
  
• Psychologically, I no longer feel like I'm on a runaway roller coaster every second of every day. Now it's intermittent, and at other times, I actually feel like a functioning person. This is good fucking news! :)

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.