Sunday, 13 September 2015

Physicians: do no harm and practice empathy

After the doctor's appointment on Friday morning I noticed just how tired I was by the time I got to work shortly after. Most of the day I just drifted through things, being quite aware of how sleep-deprived I was and only keeping myself going through liberal application of caffeinated drinks, pretty much. Not that surprising after getting barely any sleep since Monday thanks to that physician's outright rejection, followed by having to prepare for this appointment with my family doctor.

In the end I probably didn't have to worry as much as I did about this latter appointment. I got the feeling that my family doctor had been giving that question of what the difference between intersex and transsexuality is some more thought herself as well. After sketching out the scenario of what would happen if I were to simply play along with this transsexuality thing, as described in the previous blog post as well, she saw my point of the issue quite well. I also added to this having to spent at least half a year trying to convince a psychologist that I truly am transsexual, adding to this the issues of a) not wanting to become a regular woman, b) already being a woman officially and c) caring only about getting some answers related to my intersex condition, not some horrific sex-reassignment/'normalisation' surgery which would wipe out parts of my identity I actually care about.

Having established that point of understanding with my doctor, the next question of course was what to do now. For this I could recount to her the advice I had been given by a number of friends, first of which was to establish my current hormone levels. Pregnancy-like symptoms are also common when for some reason oestrogen levels are relatively high. The other item was to get into contact with a reproductive endocrinologist, which fits together fairly well with the first time. My doctor will be making an appointment for this now.

The reproductive endocrinologist would be to have my hormone levels examined in general, but also to examine this apparent menstruation cycle I have undergone for the past twenty years. This might also shed light on the question raised by a friend this week as well as over the past years by others, namely whether or not I have functioning ovaries. A possible consequence of that might be that I could be (partially) fertile as a woman.

The pattern this monthly cycle follows has been quite regular for the past decades, as far as I can determine. It starts off with the sharp pain in the lower right or left side of the abdomen for a few days, then basically nothing for a week or two, then abdominal cramping for a number of days and increasing pain in the vaginal area until that too fades away. Then a week or so later it starts all over again. It's really incredibly joyful. It would be nice to learn in how far I have normal female reproductive organs underlying all of this.

A last item we discussed during this appointment was that of further help options. She understands that getting help from a psychologist is a risky proposition, especially after I told her some more about my experiences with Dutch psychologists doing their utmost to make me believe that I had to be transsexual and even attempting to get me to agree to be locked up inside a psychological ward for 'treatment'. In this light, she suggested maybe looking further into genetic research as well. There are a couple of genetic research centres here in the city, so I could at least ask them whether they maybe do chimera testing as well. This would be fairly involved testing, requiring around 30 tissue samples to get a half-way decent sample size. It could tell me however whether I am in fact an XX/XY chimera as the current evidence seems to suggest.

Finding said XY chromosomes could be tricky, however. In one documented case of a hermaphrodite woman who was fertile and gave birth to a child, she only had XY chromosomes in about 4% of her cells. The phrase 'finding a needle in a haystack' is most definitely apt there.

At any rate, I'm fairly happy with how things went with this doctor appointment on Friday. I also hope that this endocrinologist can give me some answers, clear up many questions which have bothered me for decades now. Now I just need to catch up on all the sleep I missed this week, which might be the trickiest thing of all.

I must say that I'm still happy to have this family doctor. Most important thing is that she never seems to judge me. Not like many other doctors, psychologists and others did, using their voice, body language and words. From my doctor I only sense a desire to figure this issue out somehow and bring it to a good ending. Almost as I am a fellow human being, with feelings and a mind of my own. I think it is pretty amazing when a health professional gives you that feeling, which is a bloody shame, indeed. No doctor should ever willingly and knowingly harm a patient. No doctor should be devoid of or lacking in empathy, empathy is a crucial part of doctor-patient interaction.

Here's to 'hoping for good results' part five-thousand something or other. I lost count already...


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