Monthly Archives: May 2013

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ROAR!

Tiger Cat Roar

So…it’s taken me a day or so, but I’ve finally processed my reaction to my experience with the Psychiatrist on Wednesday.  With many thanks for all of your indignation on my behalf!!!

And thanks to Tim who also gave me more permission than I gave myself to have a process of realizing my feelings, rather than have the benefit of hindsight or being on the outside of the experience like all of you who read it.

I may not roar often – in fact, looking at Wednesday, I did what I often do lately – tunneled those feelings down into anxiety and sadness.  It feels really healthy to do a little roaring.  I aspire to be the tiger in this picture and am perhaps closer to the cat…but here I go:

Question A – If he didn’t know anything about “homos” (really?  Have I really been so lucky to not encounter that language much at all in my life and certainly not directed at me…maybe I really have, anyway…) – how is it that he could so quickly come back with knowing that same sex marriages weren’t legal in VA, but they were in DC and MD?  Awfully well-versed for being ignorant of an entire spectrum of people.

Point 1 – Taking care of me is a challenge for me.  Especially when taking care of someone I love is another option.  He is not someone I love.  I do not need to take care of him by giving him the benefit of the doubt, educating him or excusing him.  Even if he WERE someone that I love, his handling of my situation was not okay.  I actually believebelieve that it’s not okay in the big philosophical view of the world.  But it’s DEFINITELY not okay for me.  Period end.  (As Sohini would say).
Point 2 – I could just let it go.  That’s a good start.  I could also take some action – that’s even better!  Anything from – call to ask if they have anyone on staff who is familiar with LGBT issues.  Call to complain.  Call my primary care office to let them know about my experience with their recommended practitioner.
Point 3 – I haven’t been very forthcoming in this blog about my own coming out process over the last couple years.  Haven’t felt that I could really go there with everything else that was going on.  And carrying worry about what you all would think and how you would correlate that with Nicole’s transition.  Well – granted I’m sneaking this in in point 3  – but I’m kinda done with that.  I’m trying to figure out who I am.  I’ve had some big revelations of my own and I’m trying to figure out how to own all my pieces.  One of them is a love for women.  I’m generally not racing out to wrap myself in rainbow flags, but I’m telling you – I will hoist that flag in this situation on behalf of my partner AND for my own damn self!!
Especially given the continuation of the story…I called today to ask if they had any psychiatrists on the staff who were familiar with LGBT issues.  The front desk didn’t know and said that I would have to talk to the intake person who was more familiar with the doctors.  I left a message for her.  When she called back (and left a message), she said that she had never heard of this L..G…G…L…B…T…whatever I was talking about.  She didn’t know if any of the doctors had worked there but she would ask and find out.  I called back, leaving a message, and I did choose to refrain from actually saying…”ARE YOU KIDDING ME?” but instead backed down to a growl (for now) and said, “I just want to clarify with you that LGBT stands for Lesbian, Gay, Bisexual and Transgendered” and is the widely accepted acronym for that spectrum of people.  It’s something that I want my doctors to be familiar with if they are going to work with me or anyone else on issues of anxiety, depression, adjustment disorder and so forth.”  See?  I don’t think I’ve reached tiger status yet.  At least can we rate me as more than a “meow?”  Please?  I’m trying here!
If I get the chance to talk to her, I’ll definitely say that it’s not okay for an entire practice of psychiatric professionals in the suburbs of the Nation’s Capital to be ignorant of that acronym.  It’s not okay on a lot of levels.  If they carried a bias or were unwilling to work with “us,” that would suck, but would be almost easier to deal with.  I would understand that better than being ignorant of it.  Not in an urban area.  Not in a psych profession.  And that leads me to think that both the doctor and the practice are being deliberately, willfully ignorant and placing the onus on me to try and make that okay.
Guess what?  It’s not okay!  And…I am okay.  Moreso than Wednesday!
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Sink or Swim

I came across this photo on Facebook several weeks ago and it somehow went right to the center of me…

Is it liberation?  Is it panic?  Is she roaring or screaming?  Is it refreshing or stressful?  My gut says that it is joyful, exhilarating.  And there is something desperate about it too.

That’s a little dramatic for a summary of me – but not totally inaccurate.  I’m doing pretty well at living in the middle (between everything and nothing), avoiding big rabbit holes, setting my goals for a different summer, going with the flow.  Sometimes it doesn’t FEEL like I’m doing this well.  Take yesterday.  I actually achieved a fairly ideal mix yesterday – healthy food shopping and preparation, mostly healthy eating, good exercise, a chunk of work that needed to get done and even an hour spent with my music and writing.  I mean – that is exactly the mix that I want!  And yet, I felt pretty crummy and down.  Just one of those days I guess, but really hard to explain and, especially in the case of my partner, impossible for me to say what would help to make me feel better, which she is trying so hard to do.  Which stresses her out.  Which makes me feel crummier.

It didn’t help AT ALL that I had a first appointment with a psychiatrist yesterday morning that was…well…nearly traumatic!  I’m only going to get the right guidance/management for an anti-anxiety/anti-depressant medication and so decided to just go to the practice that my family doctor recommends and is in my insurance plan.  I have a good therapist for my real talking!!  I kind of knew from the moment that I set foot in the place that I didn’t like it there.  The reception staff all looked non-plussed and kind of miserable themselves.  Then…gosh, it’s hard to describe the actual doctor encounter…not only did he have NO knowledge or experience with anything related to transgender…I’m not sure he’d encountered even a lesbian or gay patient ever and the concept was, frankly, too difficult for him to grasp.  It started right up front with those basic questions of where do you live and who do you live with – before we even got asking directly why I was there!  Let me see if I can recreate the feel of it:

“Who do you live with?”

“My partner.  <pause>  My husband who has recently become my wife.  She is transgendered.”

“You said ‘she’ – are you a …<awkward pause>…homo?  How do you say?”

[this is where I seriously considered just getting up a quickly leaving]

“Yes, I said she – she’s well into a male-to-female transition.”

“So, what is your relationship?”

“We’re married.  Have been married for almost 8 years.”

“OH!!!  But, this is Virginia – same sex couples can’t get married.  Did you get married in DC or Maryland?”

“We weren’t a same sex couple when we got married.  We were husband and wife. Technically, according to the state, we aren’t a same sex couple now either…so, we’re married and got married in Virginia.”

I’m still not sure that he comprehended this at all.  Later, he said he had “maybe heard of this transexual thing” but I think he maybe hadn’t!!  How is it POSSIBLE for a working psychiatrist to not have heard of this?!!  I understand not have worked with it, but not actually understanding that it exists?  Anyway, moving on to the next part – which wasn’t any more fun.

He asked me why I was there.  I already knew that I did NOT really want to get into much with him – in fact, I wanted to say that I was there for medication management, cite that I had a good therapist for the actual emotional content and stick out my hand for the prescription.  Actually, I guess that’s nearly what I ended up saying – just refrained from sticking out my hand!  I started my response by saying that there were a lot of changes going on in my life and that I had been struggling with high anxiety and some depression.  He asked me to tell him about the anxiety.  I tried a brief sentence of context – just mentioning that, in addition to the transition, I had been navigating a host of emotional and physical responses to massive weight loss – but he cut me off and said – just tell me the symptoms of your anxiety.  So, I clinically summed up myself this way:

“I cry a lot.  I get stuck in worries about the future and, well, everything really.  I used to shake a lot.  I’ve had a lot of dizziness, which we’ve been investigating through a lot of medical tests and probably is some combination of stress and my response to a lot of anesthesia from my reconstructive surgery last summer.  There is probably also some nutritional deficiency from the weight loss.”

At this point he interrupts me to tell me how a gastric bypass works and that it does affect the absorption of nutrients.  No.  Shit.  Sherlock.

ANYWAY – in the end, after the necessary questions about suicide, violent tendencies and hearing voices in my head, he had one helpful moment of telling me that this was clearly what they would call an “adjustment disorder” and could be very effectively helped by the therapy I was already doing and a low dose of medication (which he promised was one that did not promote weight gain) and would certainly resolve once the adjustments settled down.  Which I believe is very true.  He gave me the prescription.  And, of course but unfortunately, I will have to follow up with him on that occasionally.

ANYWAY AGAIN – I guess I wasn’t able to really put that whole experience in the trash where it belongs.  And I spent a good part of the day avoiding rabbit holes.

I do feel like this tiger a lot – or what I perceive in the picture.  No…scratch that…I feel like I’m in the moment before this happens.  I’m neither bursting out in liberation or panic, but I desperately want to!  I’m afraid of both.  I’m WAY too well managed for my own health and well-being. I’ll just keep looking at her.  I’m sure she is in a joyful moment.  I’m sure of it!  And I’m working on mine.