Written by Clark Wolff.
Art by Desdemona Dallas.
Growing up, I had quite a few vaginal health problems. Yeast infections, UTIs, and bacterial vaginosis (BV). I have an auto-immune disorder, making me more prone to them and also making me great at advocating for myself with doctors. When I came out as a transgender man, I learned to advocate for my medical needs even more. But needing to feel affirmed while receiving proper care became a serious balancing act a few years after I came out, when I ended up in the ER with the worst abdominal pain I’d ever experienced.
The first question she asked me when I came in was if I had received an intravaginal ultrasound.
In the emergency room, I made it clear that I’m a man; I was so worried about being misgendered. They ran tests and found nothing wrong. Feeling defeated, I scheduled an appointment with my primary care doctor. I wanted to let her know what I was experiencing. I was still in pain but trusting that somehow, the doctors were right.
The first question she asked me when I came in was if I had received an intravaginal ultrasound. No, I had not. The doctors in the ER viewed me as a man, but to the point of neglecting the kind of man I am: one with a vagina.
I began to think that advocating on behalf of my transness had interrupted my medical care.
I got the ultrasounds and they found cystic fluid. A lot of it. The pain I was experiencing when I brought myself to the ER was an ovarian cyst ready to burst. It could have been caught in time and extracted, but that did not happen. It burst. I began to think that advocating on behalf of my transness had interrupted my medical care.
About two years later, I experienced signs of a yeast infection. It was two weeks before my doctor could see me; I did not feel comfortable using an over the counter suppository because of dysphoria, so I waited. When I finally got to see her, she took one look and was visibly shocked. I was not just itchy; I had severe fissures, huge cracks in my skin and large red patches. She thought that, given my auto-immune history, this was a psoriatic rash that should be looked at by my Rheumatologist.
I took a trans man’s risk: I saw a gynecologist.
When I saw my Rheumatologist, she said it did not look auto-immune; I should see a Dermatologist. Now heading to my third doctor in two months, I felt angry and confused. Where was the soothing doctor experience I was used to? When the dermatologist took a look, he said it was a rash from a mixture of sweat and dryness that had escalated because it had not been treated. I felt stupid—all this for dryness? It couldn’t be. But I was taught to trust doctors.
He gave me a cream and sent me on my way. I used it but I only got worse. I finally scheduled an appointment with my fourth doctor in four months. I took a trans man’s risk: I saw a gynecologist.
I explained my saga to him; he sat back in his chair and thought. He asked if I had been tested for common vaginal infections. I thought back to my three other doctors, who had all just taken a look and sent me somewhere else. I said no. He told me his diagnosis: untested, untreated, and highly escalated BV.
And he was right. Untreated for nearly five months, it had grown and worsened, wrecking my body. I took two courses of antibiotics. The itching stopped. The redness faded. The cracks healed. I’d been shuffled around for so long, so many assumptions made, that no one thought to test me for basic vaginal infections. I had a follow up with the gynecologist and he told me that next time, I have to ask for what I think I need. Why is that on me, I asked, isn’t it the doctor’s job to know? He told me not all doctors see the whole person.
*startblockquote*I took a breath, happy to get relief soon.
About a year later I started to experience those same symptoms from before. Knowing that this was BV, but not able to see my doctor, I turned to the internet for medication. I found a website that could send me medication. I took a breath, happy to get relief soon.
The next morning I woke up to an email from the website. It said that because I had listed myself as male, I was no longer eligible and my order had been cancelled. Without even thinking, I had clicked “male” in their gender dropdown list while signing up. Why wouldn’t I have?
Thinking back to my last two difficult medical situations, I knew what I wanted to do. I wrote an angry email.
When I got a response, it only made me more upset. They used the word that negates, the word that invalidates. The word “if.”
“We’re sorry if you feel as though you were discriminated against.”
They reprocessed my order, without apologizing, and I received my medication a few days later in the mail. I got what I needed. But the fact that it took so much effort was infuriating.
Vaginal care is difficult enough to access. The options for a yeast infection? An over-the-counter up to eight day unpleasant vaginal suppository, or one pill that requires a prescription. How are those the options? And then as a trans man, my options are to feel dysphoric or be discriminated against.
But I’d rather advocate for myself and get what I need with trouble along the way than have parts of my body and my life be neglected and forgotten. I had thought that advocating for my gender was interrupting my medical care. But it’s the medical system itself that interrupts my care, the way doctors do not see me as a whole person. It’s an impossible choice. But I make my voice heard and I know that my chronic illnesses will not stop, so my willpower cannot either.
About the Author
Clark Wolff is a small trans man in a big world. He is an educator of youth and adults alike, working for PFLAG NYC. He is passionate about queer and trans rights, particularly around access to education and healthcare. He lives in Brooklyn with his partner and his cat, and is always happiest while sitting in the grass reading a good book.