Top surgery consultation #2
Posted: November 6, 2015 Filed under: top surgery | Tags: androgyny, ftm, gender, gender identity, genderqueer, lgbtq, medical treatment, non-binary, queer, self-injury, surgeon, top surgery, trans, transgender 27 CommentsContent warning: discussion of self-injury.
On Monday, I traveled to consult with Dr. Rumer, and the appointment went well. In stark contrast, I had a terrible consultation with a local surgeon, at a cancer center, yesterday. She mainly works with breast cancer patients, and the mail / paperwork I received in advance reflected this. (The center could easily draft up non-cancer related documents for trans-clients!)
I was there for a total of an hour and 45 minutes – lots of waiting! When I got there, I filled out paperwork about my breast cancer diagnosis. I just put N/A for a lot of it. Here’s a sampling of questions I was prompted to answer:
– What do you know about your diagnosis?
– Previous breast history?- Some cancers are more prevalent in persons of different racial and ethnic backgrounds. The following information will help us to better understand your potential risk in developing certain types of cancers and to understand your prognosis. [Followed by questions about ethnicity.]
– What percentage of waking hours do you spend up and about?
– more than 50%
– less thank 50% – I am confined to a bed or chair
– I am completely disabled, totally confined to a bed or chair
On the phone, when I scheduled the appointment, the woman was sensitive to the reason I was coming in, and to the fact I hadn’t legally changed my name yet. Regardless, that didn’t translate over to the present day, and I was called by my birth name and even, “Mrs. [last name].” I don’t think I’ve ever before been called “Mrs. [last name].”
I finally was brought up to the breast cancer suite and my vitals were taken. I waited in an exam room and a nurse came in and went over some of the questions with me. She left for a while and came back, saying, “let’s fill out this paperwork.” This one WAS relevant to why I was there. I asked her, “Why was I filling out papers for breast cancer patients?” She replied, “Oh, well, they just gave you the wrong one down stairs.” No big deal… ???
She left and a doctor with an intern student came in. The doctor asked if it was OK if the student was present, and introduced her. She then asked, “Are you so-and-so?” I said no I’m not. She said, “oops, sorry, wrong room.” I sat there waiting a while longer and finally the surgeon came in with TWO student interns. At no point did she ask for my consent for them to be present. They introduced themselves and we got started. She started by putting words in my mouth – “So you’ve felt this way since you were a teenager. That’s when you started feeling different…” I just let her roll with that. She asked about mental health, suicidal thoughts, and even self-injury. I’m not sure why. She asked very little about gender identity. I answered her questions honestly, including that I’ve had vague suicidal thoughts, and I used to use self-injury as a coping mechanism.
She then said they were going to leave the room and prompted me to put the robe on. They were gone a very long time. They all came back, rubbing hand sanitizer into their hands. I had a flash fear thought – are all these people going to be touching me?!!! Fortunately only the surgeon touched me, but the presence of all these people was enough for me to check out for this part of the appointment. A few things that registered:
– She commented on my tattoo, asking if that was magic marker – it looked like marker. ???
– She talked a lot while I was sitting there half exposed. She described the procedure she would do, and manipulated my breast in her hand to demonstrate it. I looked down briefly, and seeing her grabbing my breast was totally surreal. She was talking at my chest, and not to my face. I was poked and prodded a lot more than seemed necessary.
– She actually said to me, “This scar, is this from cutting?” I could not believe I was being asked this. I was in shock.
– I was aware of interns in the background, watching this whole thing. They were fuzzy.
– I said to her, “I’m just in the consultation phase, and I have some questions for you.” This changed the dynamic and she wrapped up the part where I was sitting there, vulnerable.
When this part was finally over, they left and I got dressed. I waited a very long time again. When they came back, I went through my list of questions. She has a year and a half of experience working with trans-patients (really?!!), and does chest masculinizing surgeries a couple times per month. She requires patients to be off T one week before and one week after surgery. 50% of patients will immediately retain nipple sensation, and 80% will eventually over time regain sensation. She could not show me any examples of her work that would be related to my surgery type. She could not tell me how much it would cost, not even a ballpark estimate.
Before leaving, I gave her feedback. I told her how I had been misgendered by the staff. She conceded that they needed to work on that. I also, in front of the students, said, “As someone who is transgender, I have gender dysphoria around my naked body. These may not be the best types of appointments to have students present. It felt like I had an audience, and I didn’t feel comfortable being partially exposed.” She responded, “Thank you for that feedback.” I understand she might not have control over when she has interns with her, but she could CERTAINLY ask for consent, or ask that the interns not be present for the naked part. I wanted to give her more personal feedback, such as, “It’s not appropriate to comment on my body,” but in the end I didn’t go there. I just couldn’t right then.
This surgeon and the staff could benefit from some trans-related training, particularly to the sensitivities trans-people may feel about their naked bodies, specifically chests. Make it short and sweet!
janitorqueer 
Sounds like a terrible experience. Good for you for standing up for yourself at the end and giving honest feedback to the dr.
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Thanks! I would have liked to tell her more, but it felt too personal…
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Melissa called one of the local breast centers in our area on my behalf to see if they’d even consider the surgery and she said they laughed at her on the phone and said “yeah…no we don’t do THOSE surgeries here”. This makes me really glad I didn’t pursue that option.
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Yeah, stick with the people who are actively engaged in trans-experiences, wherever they are!
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Yikes. That would have completely creeped me out. I only saw Dr. Weiss for a consultation – I was going to go to a couple of others if I didn’t like him, but his staff is very comfortable with trans/gender non-conforming people and made me and Donna feel comfortable and like we were in the right place for the right surgery.
The only surgeon I know of upstate is Dr. Jeffrey Rockmore in Albany – but I only know of one guy who went to him (and was happy with results).
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Totally awful! Sounds like this doctor doesn’t know what the heck she’s doing when it comes to trans-related surgeries and probably needs to get a whole lot more training and awareness before continuing. It feels like someone who very nonchalantly said “yeah, sure I can do that. Why not give it a go?” Umm…no. Irresponsible on her part!
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Also, I wanted to mention to you that you might consider Dr. Beverly Fischer who is in Timonium, MD. She’s maybe an hour or two south of Dr. Rumer and has a really good reputation for the procedure you’re having done. I had a consult with her a couple of years ago and am still considering going to her. She was super nice, is very comfortable with working with trans patients and her staff is excellent. Definitely worth a look if you don’t mind driving a little further.
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Yeah, I’ve definitely heard good things about her. I might look into her too…
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This is horrendous.
There are really great doctors out there who have enough human empathy to figure this stuff out. And, unfortunately, many who don’t have a clue.
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Oh no, I feel soooo sorry. Actually, I don’t even think much of what you describe is about understanding or not understanding trans issues. It’s just sloppy practice, insensitivity and bad manners. All which just translates into a very shitty experience for you at a time when you most need gentleness and good care xx
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Thanks for the reply – you’re right, a lot of it was just about a lack of human compassion, whether I was trans or not.
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Talk about clueless! And rude!
And I don’t think that trans-patients are the only ones uncomfortable by being grabbed by a stranger in front of two students!
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Oh wow, that really annoys me how badly they acted! I’m amazed all the mistakes they made there and how thoughtless they were, eugh. Sorry to hear you had to go through that.
Well done for giving feedback though, that’s a really good call, I don’t know if I’d have felt up to that. Hopefully they take it onboard.
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Thanks, yeah I hope she takes the feedback to heart.
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That sounds like an awful experience (((hugs)))
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thank you!
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I am so sorry you went through that. You were so right to give the feedback you offered, and I would have been far less restrained and polite. Consider giving a review for that place on Yelp.
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yes, I did give her a couple of online reviews. Thanks for the feedback!
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What a horrible experience. I’m sorry you had to go through that. Good on you for giving the feedback about it. They really do need some training. Strength to you.
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Thank you!
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Amazed you could stand up for yourself right then and there – awesome! Sorry you had to go through that…
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Yeah, it felt good that I advocated for myself right then and there…
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Hey..just wanted to share some info since I know you’re searching for a surgeon right now. Melissa found a guy at UPenn in Philadelphia, Dr. Sherman Leis, that also performs the surgery. His website doesn’t list it, but we’ve been in contact with his office and they seem really chill and knowledgeable and they also quoted us a couple thousand less than anyone else has quoted us so far. He apparently train both Dr. Rumer and Dr. Fischer in the procedure.
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oh interesting. I wonder why he’s not more well known if he trained some of the most well known surgeons! If you learn more about him, will you share more info too? I don’t know whether I can make another trip to Philly, but I’m now pretty curious…
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I have a consult with him in mid-December, so I’ll be sure to let you know my thoughts.
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It looks like there’s a place called The Philadelphia Center for Transgender Surgery that he works out of…
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Good for you for speaking up! You may want to think about whether or not you want to be the one educating your surgeon about how to treat you in the future, though.
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