Thursday, 5 September 2013

A proposal to the local doctors who look after me

Dr Curtis wrote a letter to the GP I prefer to see, basically confirming his ongoing role as a consultant 'only as required'.

This was sent via myself, so that I could read it, and take a copy if I wished (of course!). And today I dropped by at the village surgery, to leave his letter at reception for my doctor's attention when convenient to her. I didn't think I was justified in squeezing the time available for patients who were ill by making a special appointment simply to hand over Dr Curtis's letter and chat about it. So it wrote a covering letter of my own, and popped the lot in a sealed envelope.

I made a proposal in my covering letter, about a health care initiative that might improve how the eleven doctors in the large local practice deal with the needs of patients who come to them and say they are transsexual. I very much doubt whether they have more than a handful of such patients between them, and they can't be feeling their way forward with much assurance and consistency. It would be good, I thought, if these doctors, all of them, could have the chance of exchanging questions and answers directly with real-life trans patients whose cases histories they know, or will come to know.

Obviously it would have to be one patient at a time, in a small friendly forum, so that no cross-patient confidentiality issues would arise. Meaning that I mustn't air my medical case history in front of another trans patient, and vice versa, regardless of whatever we might afterwards say to each other over a drink at the pub! And quite apart from the confidentiality issue, it really would be asking too much to expect a group of trans people, who have never met each other before, to explain with one voice how it feels to be trans, and what their essential needs are! We are all very individual.

Anyway, this is what I added at the end of my covering letter:

I do not know how many transsexual patients the practice deals with, but they must still be thin on the ground in Mid-Sussex. That will not always be the case. The gradual easing of public prejudice and discrimination is making ‘coming out’ less of a hurdle for transsexual persons, and medical practices are bound to be approached for help more and more. There is an obvious advantage in General Practitioners being briefed on what to expect, and how to react, not only in the case of a patient making his or her first nervous (perhaps terrified) approach, but in the case of post-operative patients (like myself) who have settled down into their new life, and have health needs entirely similar to anyone in their particular gender and age group. 

It would surely help if once in a while doctors had the opportunity of discussing clinical and other issues directly with such patients. I am thinking less of a lecture, and much more of a low-key discussion group, with the opportunity for both doctors and patient to put the questions they wish, and explore any points that are not clear.  

Ideally there might be a well-populated and willing consultative panel of trans persons of all ages and both genders. But in real life perhaps not very many would be happy to take part. Those at an early stage of treatment might feel too emotionally battered to talk about their experiences and needs. Those who have successfully transitioned into their new life might wish to leave all unnecessary self-disclosure well behind them. However, I for one would like to assist. In no way do I want to push myself forward, but I’d be happy to volunteer for such discussions if they can increase local expertise in this clinical area. 

It’s something positive that I can do, something I can give back for the care I have received, and look forward to receiving in the future. So do please bear this suggestion in mind, and perhaps ask your colleagues what they think.

I wonder what will come of this? I certainly would, if invited, give a proper 'talk' to the practice doctors, and the nurses and reception staff too, at some early-evening session. 

There is the danger that if I were the only person to give them 'the trans patient's point of view', their 'education' would be skewed towards my own experience and situation. But even that would be better than a patient turning up at an appointment sometime in the future, wanting to plunge in - and burn their boats - with a Huge Disclosure About Themselves, desperately wanting immediate counsel, but being handled with bafflement or clumsiness. Or for the doctor to be unfamiliar with post-op routines such as dilation. Nobody can really 'get' what it's like to be trans unless they are trans themselves. But it's very important to assist people like doctors to respond with some basic understanding, and answers from the horse's mouth must help. I do hope there is a positive response.

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