I was on a panel

I’m much more of a writer than a conversationalist – and definitely not a public speaker.  Tons of people have a fear of public speaking.  I don’t mind being in front of audiences, so at least I have that first hurdle out of the way.  I just have a fear that I won’t be able to talk naturally and coherently.  Despite this, I’ve had aspirations for a long time to verbally share my experiences, be on panels, join the speakers’ bureau, etc.  I’ve talked a few times in front of audiences, mostly as part of drag performances.  I’ve gotten around the talking thing by preparing statements ahead of time, reading out loud what I’ve written.

I’ve never seen someone on a panel read before, but I figured, I could do it!  Why not?  I had seen a message posted to a facebook group, from an acquaintance who works for Planned Parenthood.  She was organizing a half-day of training about trans-healthcare for the PP health center staff:  clinicians, nurses, health center managers and front desk staff.  It was going to include a 45 minute panel, and she was looking for trans-people to talk about their experiences with health services – both positive and negative.

I thought my recent consultations with surgeons for top surgery would illustrate a stark contrast, so I emailed her about it and included links to these two posts:

Top surgery consultation #1

Top surgery consultation #2

She wrote back saying it’d be great to have me, and I could certainly read out loud.  Over the weekend, I edited these so they’d work better spoken out loud, and I tried to cut them down shorter.  Because, dang, they seemed short when I wrote them, but it takes more time than you’d think to read things out loud!

I arrived at the venue Monday morning, and I wasn’t even that nervous!  I recognized one of the other people on the panel, which was cool.  The third person came in shortly after, and we introduced ourselves – her name is Leah.

I went first to get it out of the way; I introduced myself and then just launched into it.  I think, in retrospect, that I was talking too loudly (definitely not quite my natural speaking voice) but, that’s OK – better too loud than too quiet I guess.  The other two people went, and they both did an awesome job speaking off the cuff.  We answered a bunch of questions, and I was grateful that the person on the other side of me naturally answered first, giving me time to formulate something to say.  It all went really well – people had great questions!  (As an interesting aside, there were about 75 people in the audience, and it appeared to be made up of 1 man / 74 women.)

The organizer then presented us with gift bags and gift cards, which was awesome!  I feel like the norm is that panel participants are just volunteering, so that was awesome that we were compensated.  We lingered while the group wrapped up their training, ate some bagels and had some coffee, and then stuck around in case anyone had any further questions.  No one did, but we got lots of compliments and thanks, as people were leaving.

This was totally worthwhile and something I’d like to do more of.  I’m not sure how I will transition from reading things into actually becoming a speaker, but, well, it’s something to work on.

The next day, one of the bloggers that I’ve been following for a while, The Overflowing Closet, wrote this post (as part of the 30 day trans-challenge she’s doing:  Day 8 – “How do you deal with being misgendered in the beginning of transitioning by people?”  She started by saying, “Yesterday I gave a talk in front of 75 medical staff and personnel about my experiences being transgender and seeking medical help.  The crowd was filled with people who wanted to provide better services for trans people, and one of their biggest concerns was misgendering people.”

I suddenly realized that the Leah I had met the day before is the same Leah whose blog I’ve been reading!  Has this ever happened to you?  Where you’re reading a blog and then you meet someone and then you connect the dots in between?  Such a cool experience!  I contacted her to see if I could share this, and she said of course.

So hey, here’s to making something out of all this writing and online connecting with people!


That specific trauma is no longer a big deal

Around this time, 16 years ago, I voluntarily admitted myself to a psychiatric unit, but then I got stuck there for 19 days without knowing what was going on.  The lack of communication was horrendous.  I suffered a psychotic break and left with a diagnosis of bipolar disorder.  I accepted this for years, and I internalized that I have a mental illness in some pretty detrimental ways.  This has always stayed with me, always felt like something I needed to work through and get past.

Two years ago, I wrote about how I came to finally acquire my medical records from my hospital stay, and how I started to process things differently with the help of my therapist:
Continuing to work through a specific trauma

Last year, I wrote about finally bringing that record into therapy and how it felt to have her go through it.  I was starting to realize that maybe I didn’t need to pick it all apart; maybe my perspective was shifting naturally, over time.
That specific trauma is still there

This year, although I’m acknowledging the anniversary, it feels like just the slightest emotional blip on my radar.  I talked about it in therapy yesterday.  I finally got my hospital records back from my therapist (she had been holding onto them for me for a whole year!)  I looked through them again last night – there was always one page I skipped over.  It was handwritten by me, explaining what had been going on in my social life that led me to feel like I needed to be hospitalized.  I read it and felt OK about it.

Although this seems counter-intuitive, I think it helps that I was hospitalized in January.  Where everything went wrong the first time around, everything went right(?) (maybe not right, but it went smoothly) this time around.  I can overlay this experience on top of my shitty traumatic experience, and things make more sense.

I resisted the diagnosis of bipolar disorder for a long time,  I’d been off all meds for 9 years; I felt relatively stable.  When it was re-affirmed that I have bipolar disorder by the psychiatrist I was assigned, (“Once a bipolar, always a bipolar.”) I bristled at that.  Actually, I bristled at him in general every step of the way.  Appointments with him lasted a mere 2 minutes.  He was inflexible and adamant I stay on meds forever.  He forgot pertinent information about me.  (At one point he told me I needed to stay on meds because I had been hearing voices.)  After 6 months, I just stopped making appointments with him.  With all his intensity toward me staying on meds, it was surprising how easily he let me just get away.  Maybe he didn’t even notice I left.

My therapist helped me find a new psychiatrist; she’s awesome!  She’s willing to follow my lead on what I want to do about drugs, and she’s willing to dialogue with me instead of ordering me what to do.  I still don’t know what to do about drugs, but at least I have the space to feel supported with whatever I do choose to do.  For now, I’m staying on them, but I can’t pinpoint why.

I respect this new psychiatrist.  When she (also) told me I fit the criteria for bipolar type I, for the first time in a very long time, I felt like I could accept that.  I don’t need to incorporate that in any particular way into my identity; it doesn’t need to mean I view myself differently.  Personally, it’s not a core part of who I am.  It just is an aspect of me that can just be, and I can leave it at that.

And I can finally integrate the difficult journey toward mental health as parts of myself, rather than things that happened to me.


Top surgery consultation #2

Content 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!


Moving forward with the process of getting top surgery

I have two consultations within the next two weeks with surgeons.  I can’t believe I made it this far – I didn’t always know I would get top surgery.  Even now, I’d say I’m about 99% certain, but I’m still hesitant to talk about it or write about it.  I’ve never written about it here other than just quick, vague mentions.

There were some hang-ups I had to work to get past (and I’m still working through) in order to allow myself to feel like I can do this:

It is a want, not a need.  I don’t need this – I’d say it’s been a persistent nagging feeling for years and years and years, but never an intolerable feeling of disgust or revulsion.  If my chest is not a source of gender dysphoria in a way I can’t live with, can I still get top surgery?  Yeah, why not?  It will definitely improve my quality of life.  Throughout adulthood, I have fantasized about wearing t-shirts or tank tops in the summer, without a binder.  I avoid binders when I can, which leads me to another hang-up…

My chest is small.  My chest is so small that it seems like I could just live with it how it is.  Can’t I just live with it?  It’s not cumbersome; I don’t have to do much to hide what I have.  In the winter, it’s not much of a problem.  I can just layer and I don’t have to bind.  In the summer, I think about it all too much.  Sometimes I bind; other times I just attempt to layer and be hot.

Ultimately, my chest doesn’t look how I think it should look, and if I have the means to change that, I don’t see why I shouldn’t.  Urgency (and my lack thereof) plays a role in whether I think I get to do this, but I can get over that.  I think.  I have a lot of shirts I’d like to wear, but don’t.  Because they don’t look right.  I spend a lot of time thinking about how my body could look different.

For a very long time, I thought I would get top surgery one day, but I had no idea how to make a first step.  Which just tells me I probably wasn’t ready yet.  It seemed so daunting as to be impossible.  Finally, this summer, I was corresponding with a trans-guy I know locally, and he said he got surgery in our city.  That blew my mind – I didn’t know there was anyone here.

I started looking at a Facebook group where others had written about their experiences with her, and I could suddenly wrap my head around moving ahead.  I called and booked a consultation for a month away.  As soon as I did that, more doors opened up.  I could suddenly envision traveling, meeting with other surgeons, all the stuff involved in getting top surgery, usually.  I did minimal amounts of research (I already know a bunch of surgeons by name – I’m sure I will do more research.  It’s going to be a long process) and called Dr. Rumer’s office, about 5 hours away.  I’ll be traveling just to meet with her.  That seems huge.  She waived the consultation fee because I have been to the Philadelphia Trans Health Conference, one of the many places she presents at.  That’s pretty cool.

These consultations happen to be only 3 days apart – it’s going to be a busy week, coming up.


Outdated trans programs pt. 1

My partner and I were recently sorting through / condensing our VHS collection.  We came across one that was labeled “transgender videos,” and it sparked a memory.  I was in a support group in 2005-2006, and one of the facilitators put together this tape and made copies for everyone.  It has 4 parts.  Parts 1 and 2 are from 2002 – a program on the Discovery Channel called Changing Sexes.  My partner and I watched this over the weekend.

We knew it was going to be really bad, but we could not envision how utterly atrocious it turned out to be.  This was only 13 years ago, and it’s amazing how far we’ve come; it’s like a public opinion time capsule…

First off, the term “transsexual” was used, and they got it wrong.  They referred to FTM trans people as “transsexual women” and MTF trans people as “transsexual men.”

Part 1 was about MTF trans people, and they focused on the stories of 3 people.  One was just coming out, one had been out for about a year, living her “real life test,” and one was getting ready to have surgery.  A LOT of time was devoted to her (Angela’s) journey toward surgery; they even followed her to Montreal and were in the operating room with her and her wife.  Angela was 59 and had just recently come out and starting taking hormones.  This last step would “complete her.”  (Her words.)  They pointed out how lucky she was, in that she could pass and in that her wife stayed with her.  She lived in Fresno, CA, and hosted a monthly support group in which people came from upward of 100 miles away to attend.

There were a lot of sensationalistic soundbites.  A couple:
“What pushes men to risk everything they have to become women?”
“Believing you were born in the wrong body may be a delusion that won’t be corrected with surgery.”
“Self-diagnosed illness.”
“Watching a parent change from male to female is bound to leave a strong mark on a child’s psyche.”

A therapist was quoted as saying, basically, that people may be convinced they are a transsexual, but once they start the theraputic process, they may come up with alternatives to having to go through a sex change.

Kenneth Zucker, from the Toronto Centre for Addiction and Mental Health, was on the program, basically saying that transsexual tendencies come from one’s upbringing, and that kids have developmental plasticity, even if there is a biological predisposition.  I recently read this blog post, partially about Zucker – apparently he is still around, but his clinic is under review, and is not accepting new patients.

Part 2 started out with, “The story of four transsexual women, and their quest to live as men.”

Someone named Thomas Wise, MD, from Johns Hopkins, was quoted liberally in both sections.  More than once, he made an analogy to people struggling with anorexia.  Basically, would you allow them to continue to make changes to their bodies because they see themselves as too fat?  No?  Why should we allow people who see themselves as the other gender make changes to their bodies?

One of the stories was about someone named Dirk.  He was getting testosterone through a urologist, and he was binding with a combination of ace bandages and sports bras (no mention of how dangerous this is.)

More sensational sound bites:
“What defines a man?  Can women ever become one?”
“Are they real men?  Imposters?  Or something else?”
“She has started hormone injections, rendering him virtually unrecognizable.”

Again, the segment focused heavily on surgeries (both top and bottom), again with footage from the OR.

Twice, a study was brought up, from the Netherlands, in which scientists thought they may have pinpointed a part in the brain, the BSTC structure.  In autopsied MTF people, the size was closer to that of a biological woman, and in FTM people, the opposite.  Other scientists debunked the findings, saying that it was the cross-hormones that changed the brain structure.  It was unclear what finding or not finding this evidence might imply for trans-people.

This program was worthwhile in showing human stories, and that’s what I remember taking away when I first watched it in 2006.  Although it was invasive and sensationalistic, these were real people going through real adversity, and it felt important to me at the time.  I told a friend who was also in the group that I had unearthed this video, and he said he has purposefully never watched it.  I don’t blame him.  I mean, it’s not something I would consider “supportive” of trans people.  (That’s a huge understatement).  So for it to be given out at a support group – I mean, that’s all that was available at the time – it’s what was out there.

It’s reassuring to see that public opinion is changing, but there are still plenty of people who hold on to archaic notions about “transsexuals.”

Stay tuned for part 2 – talking about an Oprah show about transgender children, and an A&E investigative reports:  Transgender Revolution.


Medications orbiting my head

 

 

 

 

 

 

 

 

 

 

I drew this picture to illustrate the jumble I feel is going on.  Just to recap, 6 months ago, had a manic episode and was hospitalized.  I previously was not on any medications, but suddenly I was thrown back into all of that – psychiatric visits, side effects, adjusting dosages, trying different drugs.  I’d definitely say the hardest part of the past 6 months was being depressed for a good chunk of that time.  But almost equally hard, just in a different way, is the long term.

Early on, I was cavalier.  I was sure that I’d get off of all these medications within 6 months – just go back to the way things had been.  I was even reluctant to add an antidepressant – things had to get really bad for me to go there.  Now that it’s been 6 months, I can easily say that time frame was way too short.  And I’m also not so sure anymore:  Which drugs are helping?  Which side effects can I tolerate?  How long will I be seeing this psychiatrist?  Do I potentially want to stay on any of these long term?  (That last question scares me – it’s almost as if being med-free has been a part of my identity…)

Some of this journey has felt crazy.  I was having hot flashes and cold sweats, my mouth tasted metallic, I threw up a few times (and I have a stomach of steel).  At one point, I went on a drug called Cogentin.  Its purpose was not to help with symptoms, but rather to help with side effects.  One of the other drugs, Geodon, typically causes hand tremors and a stiffening of facial muscles.  When a nurse practitioner asked if I was experiencing these things, I said, “I guess so.”  So she prescribed yet another thing to add to the mix.  After 3 days of taking it, my nearsighted vision became blurry.  Overnight.  One day was fine, the next day, I couldn’t read the computer screen.  I wasn’t reading books at the time, so that wasn’t an issue, but I remember eating food and not being able to see it and just feeling enormous sadness on top of depression.  I didn’t put the pieces together, but luckily I had an appointment with my psychiatrist 2 days later, and when I mentioned the blurry vision, he said, “Oh, that’s common with Cogentin.”  What?

I also cycled through 4 different antidepressants within a short amount of time.  Celexa, Zoloft, and Lexapro were making me feel famished all the time, which was just making me feel anxious.  I got on Wellbutrin, and luckily that’s been side effect – free as far as I can tell.

Ideally, I don’t want to be medicated.  And it was so easy when it felt like that wasn’t on my radar.  But now I am faced with all these decisions and timelines.  And although there is strong input from other people (mostly my psychiatrist, who thinks I need to be on at least something for forever), it’s all ultimately up to me.

For now, I just advocated for myself to lower the amount of Geodon (mood stabilizer / antipsychotic) that I’m taking.  I feel really happy about that.  I have plans to tackle Klonopin (anti-anxiety medication that I’m using as a sleep aid) next.  As for Wellbutrin (antidepressant), I’m not quite decided.  I’m just going to take these things one step at a time.


A manic episode

I could easily write a 5,000 word essay on this topic; maybe one day I will.  This is an abbreviated version:

Over night, my brain became a frenzied jumble of free associations.  Every system I could imagine (friendships, technology, routines) opened up, and I was in the center of all of it, connecting all the dots.

I thought that Leelah Alcorn, the trans-teen from Ohio who committed suicide, was an elaborately staged message created by a group of people on Tumblr.  Meaning, I thought she was not a real person – more of a call to action, one more thing to add to “The Transgender Tipping Point,” and finally really make some changes happen.

But I thought a lot of things right around this time period, for a couple of days.  I believed I’d been chosen for amazing things, I was choosing my own adventure, and the further I could get before running into a dead-end setback, the more rewards I would gain.  If I made it to my therapist’s office, she was going to give me this new phone I’ve had my eye on.  If I made it through the entire day, I’d be going to a party thrown by everyone I know.  I briefly had the thought, “My partner wouldn’t like that; that’s too much.”  So my logic led me to believe I shouldn’t make it through the day at this rate.  I should definitely get the new phone, but I should see what my therapist thought after that.  Maybe.

Some things were already in motion, and there was no stopping me!  My social media outlets were blowing up!  My blog was going to get huge at this rate, and I was going to get a book deal out of it.  Should I quit my job?  I kinda like working there, as a janitor, so I’ll keep my job.  I better write a note so that everyone will know I wanna go back to work.  I pulled out one of those Mr. Sketch scented markers – it was Blue Raspberry – and scrawled out really big and doodle-y on a piece of artist’s paper, “I will want to go back to work.”  It was barely legible.  When I showed my therapist a few hours later, in fact, she couldn’t read it, so I just had to tell her I want to go back to work.  I wouldn’t want to be someone who sits around all day, writing their book.  I would get bored!

I called my therapist at 2AM and asked her, “Can you just come over?”  I called her again at 7AM, just to see if she’d drop by instead of me meeting her at her office at 9.  I was making some really cool displays in the house, and I wanted her to come check them out.  I was playing a record – The Days of Wine and Roses by The Dream Syndicate, and everything was clicking into place.  (Actually, the record is still on my turntable, untouched 4 months later – I’m playing it right now.)  The lyrics were making perfect sense and informing me of things I should write down.  “You say it’s a waste / not to learn from mistakes.”  “Textbook case.”  “It’s Halloween.”  “She remembers what she said.”  These messages were of utmost importance.  This record was THE record to end all records.

By 8AM I was so bored and fidgety from doing stuff all night long, that I decided to take off for my therapy appointment early.  I had everything I needed packed – My toothbrush and toothpaste, notes from work, and 6 bottles of hoarded Androgel (my prescription allows me to get more than I need, so I just collect them).  I had no clue what would be happening next or how long I’d be gone after therapy (I might be put up in a hotel!), but I could figure out clothes and other stuff later.

Driving was a bit tricky.  I was relying on intuitive cues, more than the rules of the road.  Fortunately, my gut was telling me to slow way down and put my hazard lights on, rather than try to drive at the speed my mind was racing.  I still got there early; when I arrived, I slammed my backpack into the corner of the waiting room, above the door.  To alert the security cameras that I knew all about it.  A man briskly walked past me and out the door.  He was planted there to exit when I arrived.  I proceeded to be loud and messy.  I dumped out a bin of toys.  I knocked over a chair.  I said, “I’m borrrred!”  I talked loudly about a Mazda advertisement on the back cover of a magazine.  I finally understood how advertising worked – they weren’t fooling me!  In fact, this whole magazine was rigged.  I should just take it with me – I’ll need it later.  I stuffed it into my backpack.  One other therapist was there (this was a Saturday) and she tried to gently corral me until my therapist got there.  She picked up the toys.  She said she’d call my therapist for me.  She talked to me in a steady and soothing voice.  She wasn’t patronizing me.

Finally, my therapist arrived.  We engaged in a delicate dance around each other.  I knew on some level that I was going to the hospital.  But I also knew that wasn’t necessary, and she was totally going to come over and check out my displays and then I’d be reunited with my partner to proceed with the most fun day ever!  In reality, my partner was on her way to North Carolina with family (I’d successfully convinced her everything was fine / I believed she was just out with friends and I’d see her in a couple hours.)  My therapist started calling hospitals for availability, and I conveniently went to the bathroom to shield myself from that stuff.  I came back and dumped out all the contents of my backpack.  This would be more fun.  She immediately sorted things into piles to make sense of it.  She called my partner and left a message.  She asked me what my best friend’s phone number was and I told her.  I left the room again while she talked on the phone.  Before I knew it, my best friend was there!  Magic!  Everything was going my way.

I talked to my friend about the displays and we played Rubix cube.  Suddenly we were all leaving.  They led the way, and I went into the bathroom again.  I wasn’t so sure anymore.  I yelled out, “I set some things in motion, and I don’t know if I want it to go this far.”  We were still just going to my house, right?  My therapist replied, with forced enthusiasm, “Come on!”

I got in the car with her; my best friend went separately.  I curled up into a ball and shielded my eyes from the world.  I started to feel sad; I verbalized what I thought about Leelah Alcorn.  I said, “I don’t know much about it.  I know her name, where she’s from, and that’s about it.”  She had been on the news.  That was big.  What I was trying to convey was that no one knew much about it.  If everyone just saw her picture, her name, and her suicide note, maybe she wasn’t real.  And maybe this kind of stuff happens all the time.  What is real in the media?  Scattered thoughts breaking down.  My therapist said, “I don’t actually know where you live.”  I replied, desperately, “Yeah, but you can find out.”  She had a smart phone.  People with smart phones seamlessly glean information all the time.

We weren’t going to my house.  When we stopped and I uncurled myself, we were at the hospital.  But it still wasn’t too late.  If I just told her this is where it ends, and we go to my house from here, everything could still be OK.  I looked her straight in the eye; I put my face two inches from her face.  I said, “This is where it ends.”  This had worked with my partner a few hours earlier.  I looked her straight in the eye and said, “Everything’s going to be OK.”  I gave her the green light to go on her trip.  This time was different.  My therapist probably interpreted that as, “The journey ends here, at the hospital.”  I meant here in the car.  Still though, I complied and followed her.  After all, my best friend showed up here too, so it probably was all OK.

Five hours later, I was on the psych ward.  I’d been in the emergency department.  My mom had shown up.  I had talked to my partner on the phone – it finally sunk in she was 6 hours away, and she and her family were turning straight around.  My best friend had been with me.  My therapist had left at some point.  I’d peed in a cup.  I’d gotten blood drawn.  I’d signed some papers by drawing big loops over the entire page, not knowing what I was signing, exactly.  But now, it was just me, and suddenly my choose your own adventure had come to a dead halt.  There was no more choosing.  I started yelling, panicking.  “I NEED MY VITAMIN D PILL AND ELDERBERRY SUPPLEMENT!”  I needed to maintain my body’s delicate homeostatic state.  I was given a pill and took it; it was Haldol.  It knocked me out for 18 hours.  Before I faded out, the nurse was talking to me really sternly.  She was really butch.  “Do not start shouting on my unit – we don’t do that.”  “I know I know it’s not like me at all…”  “Also, you smell really strongly bad so I’m going to shut your door.”  Then she started yelling.  “He gets whatever he wants!”  And I was out.


Am I bipolar?

Today is the 2nd annual World Bipolar Day, an event that strives to educate the public about bipolar disorder and encourages an open discussion to end the stigma associated with brain illness.  There’s a facebook page where people can share stories, and there’s lots of links to different organizations.  It was chosen to fall on this day because it’s Vincent Van Gogh’s birthday.  He is said to have suffered from bipolar disorder, and he committed suicide at age 37.  Bipolar disorder is fairly rare – roughly 1% – 2% of the population are bipolar.  Some estimates say up to 5%, but there is this sense that it’s over-diagnosed.  When I have questioned in therapy whether I am bipolar, she has replied something to the effect of, “That was a very popular diagnosis then.  A lot of teens were being diagnosed.”  Sometimes people think they have it because their moods are extreme; really something else might be going on.

I thought I’d take a minute to reflect today about whether I am bipolar or not.  I mean, I did just go through a delusional manic episode 2.5 months ago, no doubt about it.  And I am currently sinking through a rebound depression – definitely a clinical level depression.  But I strongly do not think I am bipolar.  It’s been 15 years in between episodes, and I’ve only ever had 2 episodes.  Much of that time I’ve been off all medications.  I can accept that I have bipolar-like tendencies (and I’m hyper-sensitive to stress levels), but I don’t think I fit the criteria, nor do I think I need to be medicated long term.  In fact, I plan to go off my medications in a couple of months once this passes and I feel like myself again.

My new psychiatrist told my partner, “Once a bipolar, always a bipolar.”  Meaning, I’d been (mis?)diagnosed already (at age 17), and there’s no taking that back.  ???  He thinks I need to be medicated forever.  He doesn’t get that I’ve been stable and have managed issues in my life in other ways for a long time.  I’m pretty sure someone who is really bipolar doesn’t get to do that.

I can’t imagine what it would be like to actually be bipolar.  To have to balance a medication cocktail indefinitely or suffer the consequences.  Because when you’re actually bipolar, you can have an upswing or downturn without much prompting, if you’re un-medicated or if the medications are not right for you.  If I was pretty sure I would be going through more mania and more depression in the near future, I would be living in fear of that.  I honestly do believe I am prone to going through mania and depression again, but to a much lesser extent than someone who actually has bipolar disorder.  And that’s scary enough.

One other factor that makes me think I have bipolar-like tendencies has been my reaction to SSRIs.  I took Paxil for a few weeks about 13 years ago, and it caused me to feel super agitated and become hypomanic.  Apparently this will happen if people with bipolar disorder take SSRIs.  I do take this seriously, but ultimately I’d have to say I do not have bipolar disorder.  Today I’m thinking about everyone who actually does.


Feeling trapped in by medications

I’m on a 2 week leave from work again right now.  I was basically planning to just push through depression and just go through with obligations and routines.  That’s what I tend to do.  But I was switching medications, and I really hit a wall.  I had been on Geodon, and was switching to Latuda (both atypical antipsychotics).  The Geodon was causing some strange hormonal side effects, so for 2 weeks, I was on a half dose of that and a half dose of this new one.  That was working out OK.  Switching to a full dose of the Latuda really set things off though.  I couldn’t sleep and was starting to feel agitated.  Depression plummeted and anxiety skyrocketed.  Last night, I threw up an hour after taking the pills.

I had a therapy appointment yesterday, and going out of work again was her idea.  As soon as she said it, it sounded like a good idea.  Why didn’t I think of that?  Haha.  I have plenty of sick time; might as well use it when I actually need it.

I really do not know what I’ll do for two weeks.  (OK, I do have some ideas – I can get my car recalls taken care of, I can start thank you cards from our party last summer, I can give my friend a hair cut, I can try doing some writing, I can just take it easy.)  I feel relief.

I just feel trapped in by medications right now (side effects are weird!  I’m a small person and I feel the dosing has just been way too high!), and by my psychiatrist because it’s all his call.  I thought the Geodon could be OK if I were on less of it.  He decided we’re not going to lower it, we’re going to switch drugs instead.  Now I have to call him and tell him that’s not working out.  I really just want to be on Geodon, just less of it.  I really hope he listens.


Being transgender while hospitalized

I was in the hospital for 4 nights (5 days) a little over a month ago, for psychiatric reasons.  Although this was a very trying time and I was in an extremely vulnerable head-space, I was mostly treated with respect and dignity (as much as seemed possible, given the conditions).  In terms of my trans-status, I was treated with respect and dignity across the board.

While in the Emergency / Admittance Area, my family and friends present must have spoken behind-the-scenes, on my behalf about the fact that I am transgender, because I didn’t mention it at all at that point.  My friend later told me the intake leader (don’t know his exact title) told her that he has a transgender son.

Also my partner later told me there was signage throughout the hospital about their non-discrimination policies.  I found this to be accurate in the way they run things.  Everything was by schedule and protocol, no special treatment and in general no immediate response to a want (like, “can I get a pencil?”  “Can I get a snack” elicited a quicker response.)  At times, I found the ways they were doing things to be confusing, and I wasn’t explicitly told how things are run (when mealtimes are, when med times are, what is allowed and not allowed, etc.)  I just picked up that information as I went along, as best I could.  Not sure why that kind of stuff was never conveyed to me, but it all did make sense in terms of treating everyone fairly.

I got the sense that not every staff member got the memo about male pronouns, but the more “important” positions definitely did, and they took the lead on that when conversing with other staff members.  For example, one of the team leaders asked an overnight staff person to “open the shower area for him,” and that staff member said, “What?” and looked confused.  The team leader just repeated herself and no problem arose.

I was in an extremely fuzzy, drug induced state the first 24 hours of my stay.  As I started to pull out of that and notice my surroundings, I picked up on certain things.  If you woke up early enough to make it to the morning meeting at 8am, you could get non-decaffeinated coffee and also information about the day!  I was surprised how few people came to the meeting (it felt like one of the highlights of each day.)

On the first day I was capable of making it to the meeting, I was still very much in my head and not at all with it.  An out-of-character-for-me event happened.  I interrupted the team leader 1 minute into the meeting.  I stood up and went to the front of the room.  I said I’m new here and introduced myself.  I said I’m transgender and could everyone use male pronouns?  (If only all comings-out could be this easy!!!!!  I feel really proud of myself for this one.)  Another patient asked excitedly, “What’s transgender?  That means you were born a girl, right?”  He seemed ready to continue conversing at length, but another staff member made attempts to derail him and get the meeting back on track, which worked immediately.  I wasn’t done with my spiel yet though.  I concluded with, “And there are no knives allowed – I heard that early on!” before sitting back down.

I also chatted with another patient about my transgender identity at one point.

The first day I was there, I did not have access to Androgel, but that seemed part of protocol – it takes time to clear personal belongings including prescriptions, maybe?  I did not yet have my street clothes or reading material or slippers either.  The second day, the nurse brought my Androgel and seemingly played dumb with how to apply it and how much.  I told her I apply 1-2 pumps daily (I apply 1 pump, but my prescription states 1-2 pumps).  I told her it’s supposed to be applied to your upper arms, but I do my thighs.  I told her I have to go into my bathroom (in private) to apply the gel, and she waited for me.  The other times she came with it, she referred to it as a spray and also as a patch.  She was vague about my dosing.  She let me do my thing and then hand it back to her.  Although this all felt confusing, I think it was an attempt to convey, “this is your thing and we trust that you will take care of it.  We don’t care what you are doing in this regard.”  It felt validating.

Although the hospital was far from a pleasant experience, and I would say there were a couple of instances while I was in the emergency department in which I was treated as less than a person with dignity, in terms of my trans-status, they got it right, every step of the way.