Here's gatekeeping.

[agent_dani]

I've found that the concept I've had the most difficult time explaining to others, particularly cis people, is the one that has lead most of the battles I've had for transition, and its name is gatekeeping. This was the reason I loaned my parents my copy of "Whipping Girl" in an attempt to get them to understand.

I had it last year with my therapist and my now-former endocrinologist. I was having serious issues with my endo that resulted in her refusing to give me proper treatment. I did my homework and found another in the area who was good - well regarded, experienced, etc. I needed a referral to get scheduled with her so I went to my therapist and told her all of this. She refused, giving reasons that I knew to be false.

Sunday evening I came into some information which, when combined with this experience, made me realize that she might attempt to similarly railroad my choice of surgeon for SRS. She has strong opinions about surgeons, and I'm not just talking against the hack ones, and it's not at all difficult for me to see her refusing to write a surgery letter for me if I want to go to a surgeon whom she does not approve.

I was able to work around the endocrinologist issue by using my GP to refer me since there was no requirement about who made the referral. But a surgery letter is a different matter. I'm changing therapists now for this reason: so that I do not find myself possibly having to cancel a scheduled surgery because she has refused.

Comments

[cmcmck.livejournal.com]

It angers me so much that people are still having to deal with this gatekeeping control freakery thirty years later!
Why do these so called 'experts' persistently have to make it all about them? She's not the one going under the knife!

Gah! :o(

[agent_dani]

Both my (current) therapist and my former endo claimed to me that gatekeeping was a thing of the past when I first met them...

[valeriekeefe.livejournal.com]

This is exactly why I oppose any standards of care that are not: Informed consent, informed consent, or informed consent.

[agent_dani]

Yes! This, so very much! If I knew of a provider that I could reasonably access (e.g. transportation distance and all) who practiced informed consent, I'd so be there.

[pigglet27.livejournal.com]

Wait, I want to make sure I understand this. Your therapist, who is supposed to be supportive and objective , can refuse to give you referrals for furthering your goal? Isn't that counterproductive to the process you are going through? And they are doing this solely because they feel they have some ingrained "right" to prevent you from moving forward?

That's crazy. I don't blame you for switching!

[cmcmck.livejournal.com]

I'm afraid we just got (and from our friend's experience still get) so much 'are you sure'? from the so called 'experts'. I transitioned at 15 and had surgery at 21 (the earliest it could be done back in the late seventies as I had to be 'sure' enough to satisfy them). Surgery back then took almost nine hours, so I guess you could say I was sure! :o)

All the while GD is defined in some countries as a mental illness (it isn't defined that way here in the UK any more) we are going to continue to see this nonsense!

How often do you hear someone being asked if they're 'sure' they want a hip replacement or an op to let them see again?

[maellenkleth]

Once again, there is cause to celebrate the memory of good old Uncle Russell. ^_^

[valeriekeefe.livejournal.com]

It's sort of like if Tom Watson had gone in for a hip replacement the doctor had said:

"Mmmhmm, mmmhmm... let's see you lose that cane for a year first, you know... prove you're really ready for the role of an able-bodied person."

[valeriekeefe.livejournal.com]

The Open Champion not the MP, of course.

[cmcmck.livejournal.com]

Snerk :o)

I had an eye issue a few years back which could have left me blind in the right eye if not dealt with.

I don't recall anyone suggesting I should hang around for a few years before getting it sorted........

[agent_dani]

I'm loving this chain of suggestions. My endo experience was pretty much like that until a couple weeks ago - start on the second smallest possible dose and increases in the smallest possible steps, changing doses only every 3-6 months...

I think it might have been possible to get to the dose I'm now on (which is about double what was prescribed to me by my former end when I last saw her earlier this year) but it probably would have taken another 2 years...and a hell of a lot of emotional aggravation crap.

[cmcmck.livejournal.com]

My pshrink, the estimable 'Uncle Russell' (Dr Russell Reid) that herself talks of above always started us on off on full dosage on the argument that it got rid of an awful lot of fantasists and time wasters- and he was right too! :o)

He could always tell a lot abot us on the _second_visit :o)

[agent_dani]

Quite right, I would imagine. While I'd have loved that approach I'm certain my wife wouldn't have - a very small part of the delays* were due to her being uncomfortable with the idea of me being on HRT yet, mostly based on misinformation she received via fora like Susan's Place.

Three years on, having finally reached what stands a good chance of being my final pre-op dose, I'm in a good place. For me, the biggest (and best) changes have been mental/emotional.

* At the therapy session that marked the end of three months my therapist said she was prepared to refer me. My wife dug in her heels then and agreed to allow it two months later. What she wanted was something nobody could offer - guarantees of what, in detail and timeline, HRT would and wouldn't be/do.

[cmcmck.livejournal.com]

Friending btw as I seem to keep bumping into you here and there! :o)

[agent_dani]

And it's been a long-standing problem trans people faced and continue to face.

Yes, it's horribly counterproductive. Some see their role as to have that sort of authority. Really, it comes down to them declaring themselves to be a higher authority than even I am about my own body and mind.

[cmcmck.livejournal.com]

Funny then how we often know a great deal more about the condition than the average 'expert' innit?

[agent_dani]

Among some very empowering things I realized or have done in the past year was accepting this: I am the best authority on the topic of my own mind and body.

[cmcmck.livejournal.com]

This entirely! You are, after all, the one inhabiting said body and mind! :o)