Comfortable? Good. This is going to take a minute to get the full picture:
This past Wednesday I had an appointment with Dr. Miller, endocrinologist. I came across his name on a trans resource website for folks in or near Chicago. I wanted to have some reassurance he would actually talk to a trans person, as not all endocrinologists treat folks like me. So, I googled “trans friendly endocrinologists in Chicago” and came across this rather colorful website, and there I found Dr. Miller’s name and contact information.
I made an appointment with him for a consult, and double checked with the receptionist that he served the transgendered population. Her accent was rather thick, so thick* that I questioned the doctor’s decision to make her the first voice potential clients would encounter. I wondered what kind of a doctor would hire a receptionist for whom english didn’t seem to be a second language, but rather a fourth or fifth, one whose importance seemed to be somewhere down the line behind rude hand gestures and pig latin.
K went with me on Wednesday, and when we entered the tiny office on Michigan Avenue, a thoroughfare that is know for its trendiness and contemporary sensibilities, a street in Chicago synonymous for the very best of the best, I felt like I had left the world I knew and trusted as reality and stood below a dingy awning in one of the streets in Empire of the Sun. Dr. Miller’s office was in the only building on that stretch that hadn’t been remodeled since the 70’s. There were far too many mirrors in the hallways, floor to ceiling, for the comfort of Mies van der Rohe. There were too many floor to ceiling mirrors for the comfort of a porn director.
Oh, but then we got to the actual office.
I am going to play a game with you now, one I play with my students, but we will modify it since you are reading this, not hearing it as they would.
I am going to give you a description, and I want you, after reading this, to close your eyes and imagine it.
Here we go.
The office: small as a prison cell, a huge mirror behind the receptionist desk so overwhelming that for the first 20 minutes I thought there was another room and desk behind her, until she turned around and the chair in the mirror turned in time and revealed her face to me. Objects in our immediate space: a full kimono hung in display fashion over a running indoor fountain so loud no one on this earthly plane would find it relaxing. Stacks of appointment books and paperwork crowd the receptionist, who is using a Dell computer. It might as well been a telegraph machine. There is a Viagra clock on the wall. There is a row of five chairs for visitors, K and I take the two closest to the door (which has a buzzer for one to be buzzed in to the office), and a particularly-antsy woman in her 50s sits, or bolts out of, or jitters on, the chair closest to the doorway with no door on it (this door-hole leads presumably to the examining rooms, or maybe some other mismatched shit like an antique roadshow or a fat lady in a tube top). Something was distinctively Lynchian about that office: nothing was particularly menacing about the atmosphere, but I couldn’t imagine anything else in the place of all this weird stuff. And the receptionist? A mousy girl of Asian decent, wearing all clothes that were too big for her: a billowy silk-ish shirt**, some kind of MC Hammer pants, and shoes whose heels hit the ground with a thud every step she took.
We get our first glace of the good doctor 20 minutes into our wait: he is very thin, elderly man thin. He is wearing a white button up dress shirt and grey dress pants that were too big around for his frail frame but the right length, so what do you do? You wear billowy clothes too when you’re frail but still man-tall. Oh yeah, and he is also wearing a beige leather multi-compartment fanny pack. No shit.
45 minutes into the wait, the jittery woman goes into the secret hallway, comes out soon after that, and it’s our turn. I am giddy with nerves, partly because I am going to talk to a doctor about the pros and cons of hormone replacement therapy, but now, and mostly, I am nervous because I find Dr. Miller to be potentially insane. In the creative writing biz, he has the appearance of what I would refer to as “an unreliable narrator.”
He leads us to a small examination room, where there is still a patient’s file on the examination table, Joseph so-and -so***, and it occurs to me that the jittery woman who just left must have been born Joseph. She was waiting for her shot. Indeed, we lurk among the cisgendered people, because I would have never guessed that woman to have not been female her whole life. I thought she was a drug addict, not a trans woman.
Dr. Miller comes back into the room, shut the door behind himself, clears his throat. He says to no one in particular, and while looking at the floor, “That last patient got on my last damn nerve, and when I get mad I yell, and when I yell I lose my voice, and that’s why I sound the way I do now. (Another pause, another cleared throat.) Then he looks around the room and says, “You sure you wanna be here?” And he gives a sidelong glance at me and a slow smile spreads across his face.
I warm to him immediately.
There is a pause, and then he finally looks at me directly and says, “So, what is it exactly you think I can do for you today?”
And I say, “Well, I’m trans and I see a lot of information about hormone therapy on the internet, but I wanted to talk directly to a doctor about the pros and cons of it.”
And he says, “There’s a lot of bullshit on the internet.”
He gets no argument there.
And then he takes another long pause, and tells me a story about when he first started practicing medicine, how he wanted to publish a controversial paper, the topic of which he alluded to but never fully revealed, and that the medical community never warmed to that idea. I think he was trying to get across the point that treating transgendered patients with hormone therapy is now a controversial course of action, but, well, he thinks it’s the right one, so fuck what the establishment has to say. There was a lot of cussing coming out of him at this appointment. It didn’t feel inflammatory to me, just conversational and sincere.
I asked him about the link between the hormones that ovaries produce and heart health (more bullshit, according to Miller, “women don’t die from heart disease like men do,” and science attributes it to the ovaries, but he finds this a dubious claim, or I am translating it as such.)
I asked him about the potential for damage to my liver (“No no no, there is no damage to the liver because I do a blood test every three months to insure your testosterone stays within the acceptable levels, not too low, not too high, and if it shoots outside of those levels we adjust accordingly.”)
He said, “I’m fucking 83 years old and I can’t do this shit forever; I’m going to die someday. But I do enjoy my work, and so I will keep doing it for now.”
He said, “I don’t know where the spirit comes from, whether it’s God or nature or what, but if you follow your spirit, and you try to be a man with a male spirit, or a woman with a female spirit, you will have an easier life, it doesn’t matter what body you are born into.”
He told me I would (potentially) get very hairy. He told me I would get more aggressive, and my sex drive would increase. He told me God is a woman. He told me not to worry about acting like a man, not to fall prey to the stereotype, and that if I thought about more than fucking, eating, and the score of last night’s game, that it doesn’t make me less of a man.
I don’t know if he will be my endocrinologist. But I certainly appreciated his perspective.
This may all read like a bit of an about-face to many of my readers. I have spent more than one entry writing about the reasons I didn’t want to go on T. But there also, in those same entries, have been outlined the reasons I would like to go on T. So here I am: I want to go on hormone therapy, I want someday to pass as male, to be rounded to boy for good. I am more male than female, and I think the part of me that feels female is the part that was put there because of my genitals at birth, not because I have some bond or link with feeling feminine. Truth be told, when I think about being female I feel deeply uncomfortable, and I have always felt deeply uncomfortable being thought of as female. I have tried, very hard (3 decades worth in fact) to be happy enough with checking that F. But I can’t keep lying to myself just because I am used to it, because it is easier, because it is easier for the people around me.
So, I am going to go see one more endocrinologist, and if I have a similar chat with him, that the risks are minimal, that there is no record of trans folks dying in large swaths strictly from HRT, well, then my mind is made up. I do want to spend some time, however, saying good-bye to the comforts of femininity. It might have been a house too pink, but it was home for 34 years, and I want to give it some proper farewell and respect before I move out.
At this point, I would love to hear from you guys on T: what do your daily/weekly/monthly regiments look like; how has T changed your life (aside from the physical and emotional changes) in a practical way?
Be nice to yourselves,
Your Pal Eli
*This isn’t some veiled racism on my part. Her trouble with english was so pervasive she was having a hard time understanding the numbers I was saying over the phone, and was confusing many of the letters of my name with other letters.
**K points out to me that in many Asian cultures the flow-y too big look is fashionable. So, perhaps, her clothes were not too big for her, but rather she was being fashionable in a way that this guy just didn’t get.
***All names are changed to protect the innocent, but the file did indeed have a male first name on it, and a birth year that would have matched the approximate age of the woman in that waiting room.