#I wish I was on testosterone and I lived further up north and I had an apartment or my car converted fully to a living space I wish I had

[milo-is-rambling]

Me vs confusing gender thoughts vs mental illness

[christophcalledbingo]

The Guessing Game (Dr. King Schultz fic)

I’m not a native speaker of English (I am in fact Spanish), but I do try my best, so forgive me if there is any mistake. I’m also learning German because procrastinating by doing other things rather than college stuff is my jam. I think I’m going to do a second part of this, so I hope you like the first one!

Dr. King Schultz x original female character. 

Warnings: hints of depression, some verbal abuse and attempt of physical abuse and a lot of swearing.

Translations: 

Gute Nacht Fraulein - Good night darling

Sprichst du Deutsch? - Do you speak German?

Bitte - Please

Ja - Yes

Danke - Thank you

Dr. King Schultz is not mine (I wish, duh!)

Another night of pouring drinks for a living. I could not imagine that my life would turn out like this when first I arrived to America with my parents when I was a child. Now I’m completely alone and in a very urgent need of money, so I thought I could handle two jobs… I’m not going to lie, it’s actually pretty difficult being a teacher by day and bartender by night. You might be wondering how I ended up being a bartender, me, a woman. Well, nobody else wanted to do it so there was no objection for me take the part. It is very tiring job and most customers behave like pigs. Some nights I can handle it, other nights I just cry myself to sleep. It’s ok though, I do it for the kids. 

It is a lively Friday night, everybody is out. Being the only tavern open in such a small town is both convenient and a mess. A few bottles are thrown, many spits are being missed and a few tables are being turned in angry poker disputes. Being surrounded by so much uncontrolled testosterone gives me massive headaches, I wish I could go out for a smoke, but today there is nobody than can cover me at the bar. Suddenly someone catches my eye, a stranger enters through the door. I remember every face in this town and no many outsiders come here, but he is in fact a stranger, and quite handsome if I say so myself. He catches me looking at him and I blush slightly. He gets closer to the bar and I can see him clearly now. He looks physically mature but in his eyes look very young, and with a hint of trouble. Blue, brown and green. As if his eyes were a cup of green tea that had been sweetened with brown sugar, and in their reflection I could see a very blue and beautiful sky. He has a very well trimmed greyish beard and mustache, which actually frames his face in a very nice way. I think he is not American and when he opens his mouth my doubts are solved. 

“Gute Nacht, Fraulein.” German, huh. It’s been years since I’ve talked to another European, this is going to be interesting. 

“Good evening to you too, what can I get you?” I say, trying to make him notice that I understood him. 

“Oh! Sprichst du Deutsch?”

“A bit, I can understand it better than I can speak it though.” I feel like I just made a fool of myself, but at least it was a nice icebreaker. 

“So, you are not German, but I can tell than you are not American either.” He is very charming...

“What gave it away?”

“Not many Americans know German, I just took a wild guess.” He is very charming indeed. “From where in Europe are you from?”

“Try to guess” I say with a grin in my face, trying not to laugh. “Oh, wait…”

“Yes?” He says, looking directly at my eyes.

“You didn’t tell me what do you wanted to drink, let me fix it up for you while you guess.” He smiles warmly. 

“Pale ale, bitte.” That hint of German in the end makes my legs shake. 

“Right up!” I say, trying to hide the fact that I’m actually shaking. 

“So, you don’t have an American accent, that’s for sure. You are more like from the south, from the Mediterranean?” 

“Ja!” 

“You’re way of moving is quite rhythmical, not like an Italian though…”

“Nein.” As I say this, a drunk guy comes right at me, right when I’m in the middle of serving the ale, and grabs my hand from the other side of the counter. 

“DaMN! YoU are BEautifuL!” He is grabbing tighter, fingernails and all. I drop the glass, half full of bear, due to the pain.

“Please, let me go…” I say, trying to hold back my tears from the pain, my wrist is starting to bleed. 

Before I can say anything else, the handsome stranger grabs the drunk from the neck, but the latter is not letting me go, in fact he is grabbing tighter, and the wound gets deeper. 

“Let her go.”  Says the stranger with a very deep voice. 

“HeY HoN, Do YOu WanT to Go TO thE BAck aNd SuCk mY-”

Before he finishes that sentence, the stranger grabs the arm that was around my wrist and twists it, I hear a pop and then I’m free.

“MOTHERFUCKER! YOU BROKE MY ARM!” The pain must have made him sober all of a sudden.

“Next it’s going to be your nose if you don’t shut your mouth. I don’t tolerate the rude, even less when it involves hurting others.” He looks at me while I’m trying to stop the bleeding from my wrist. 

Everybody in the tavern is looking at us, not as if they want to start a fight, but as if they were amazed by the stranger, myself included. 

“WHAT THE HELL IS GOING ON HERE!” My boss shouts as he appears from the other side of the room. 

“Sir, she has been hurt, I’m taking her to her home.” The stranger said, while helping me to get up.

“No way, I don’t have-” He shuts in an instant when he sees the other guy’s arm.

“What did you do to him?! Are you insane?! He is a client!”

“And she is your employee.”

“I’m going to call the sheriff!”

“Do it, call him…” I don’t know why, but the stranger is smiling. 

“Tom, go tell Sheriff Cooper that we need him, immediately.” And there goes Tom.

“I just got one question for you.” Says the stranger. 

“Huh? The fuck are you saying?”

“Are you Mr. Frank Last?” Why is he-

“Yes, I am. Why are you asking, old man?” Then, the handsome stranger looks at me, smiling.

“Let me introduce myself. I’m Dr. King Schultz, travelling dentist and bounty hunter. And you, my friend, have a price for your head: for breaking, entering and stealing on multiple houses, north of the river.”

“Wait, how the fu-”  He cannot finish his sentence. The strange- the doctor is so quick that I didn’t even notice that he had his gun out. He puts a bullet on my boss's right leg, making him fall to his knees.  

“AAAAAAAAAHHHH!!! SON OF A BITCH! YOU FUCKING SHOT ME!” There is blood all over the floor.

“WHAT IS HAPPENING HERE!!!!!” Sheriff Cooper is at the door, looking at all the mess. The doctor helps me to get to the sheriff, but he looks very calmed, which is a very huge contrast if we take into consideration the ambiance of the bar: tense as fuck. 

“Ah! You must be Sheriff Cooper. My name is King Schultz and I’m here to recover the bounty for Mr. Frank Last, a delinquent that has 500$ on his head.”

“What?!” The sheriff looks genuinely puzzled. 

“He is a criminal.” He hands a wanted poster of my boss’s face to the sheriff. “And also, that guy over there was trying to hurt this lovely lady.” With tears still in my eyes I look at the sheriff and nod. The sheriff sighs.

“Ok people, this establishment is closed until further notice.” Everybody shouts and screams, but there is nothing they can do about it. 

...

The handsome doctor asks me where I live, and I just tell him, no doubts or hesitations, I just want to get home. We enter my cold and tiny home and he asks me for a first aid kit or any supplies that may help to cure my wounds. I tell him that everything he might need is in the bathroom, and so he leaves me alone in my kitchen. 

“Got it!” He shouts in the distance after a couple of minutes. 

As he examines my wound, I look at his face, which is truly focused on my hand. I see his eyes flickering with excited concentration.

“That detestable man had dirt on his nails and now the wound is infected.” Of course it is, all the bad stuff happens to me.

“You said you were a dentist, right?”

“Ja”

“Isn’t curing wounds more of a ‘doctor doctor’ thing?” He bursts into laughter. 

“Of course, but you do not start working in the bounty hunter business if you don’t know how to cure a basic wound.” I just made a fool of myself, again. “And also, dentists also need to know how to cure wounds. If you saw the kind of mouths I’ve seen, truly disgusting.” As he says this, he starts to disinfect, and I try my best to hold the pain.

“...Spanish”

“Huh?”

“I’m from Spain, but I moved here with my family when I was very young.”

“How interesting, I’ve never been to Spain… Is it nice there?”

“I don’t remember much, but I do remember the nature, the sun and the breeze. Much more steady than here, that’s for sure.”

“It sounds lovely.” He has finished to cure my wound and has putted a bandage on my wrist to protect it from further infection.

“By the way, the name is Clara, Clara Valle. However, everybody is so funny around here that they call me ‘Claire of the Valley’.”

“But… we are on a mountain?”

“It makes no sense, I know. It’s just the literal translation of my surname”

“Well, Clara, it’s a pleasure to meet you.” He grabs the hand that is not injured and kisses my palm, I blush a lot. No one has never been such a gentleman to me, I quite like it. 

“The pleasure is mine. How should I call you? Is Dr. Schultz ok?”

“Just call me King, if you want of course.”

“Danke, King.” He turns away as if is looking for something, when in truth he is hiding the fact that he is blushing. I can see it in his ears, they are completely red.

“For what?”

“Saving me? Curing the wound? I don’t know, you name it. Most of the times working at the tavern is bearable, but it’s nice to know that someone has your back.” I say, looking at the ground. Half ashamed that I needed help today, half happy that it was him who came to the rescue. 

“You don’t have to thank me, it was the least I could do. They were behaving like neanderthals, absolutely detestable.”

“I couldn’t even serve you your drink!”

“That is the least of your worries. Being completely honest, I just wanted an excuse to talk to you.” Oh my Lord, is he flirting with me? I just stay in silence, I don’t know what to say… If I open my mouth it would be to press it against his, but that is a very bold move. I just met him! I don’t know if he finds me attractive enough, no one ever does... “Well, I should get going then.”

“Wait! You could sleep here if you don’t have anywhere to do it. My sofa is quite comfortable. I could sleep in it and you could sleep in my bed. It’s the least I can do…” I stop talking when I realise that he is smiling, a very wide smile, and that he is looking at me in the eyes. “I’m so sorry if that was inappropriate! I was raised that way, I’m very direct!” I’m practically shouting because of the embarrassment. 

“I can see that, but don’t worry. I will go to the inn and stay there for a few nights, preparing for my next travel.”

“Oh…” It was obvious, but somewhere inside of me hoped that he would stay.

“Well, if there is nothing else you need help with-”

“Actually, I cannot move my hand very well as you can imagine. Could you help me untie my corset?” I say, while I grab my hair and show him my back.

He says nothing, he just gets close to me and starts to undo the knots of the corset. It is convenient that I’m no facing him, because my face is red once again. I can feel his breath in my neck. I also feel like fingers brushing my back intentionally, but I’m a bit scared of my own feelings, so I just ignore it. I do everything I can to hide my face and my intentions until he finishes.

“There you go, glad that I was able to provide some further assistance. Goodbye then, dear Clara.” He says, while looking at the floor.

“King, could we meet before you leave town?” He raises his head and he looks at me while I hold my loose corset to my chest.

“Of course. In fact, I can look for you tomorrow. We could go for a cup of coffee, if you want.”

“That would be truly delightful.”

[gabrielholt]

Societal Barriers to Transgender Health Care in North America

Term paper for CSOC104 (Intro to Sociology) July 2016

*Glossary included below*

Eight years ago, I realized that I was transgender. At that time, I was in an all-girls’ school, closeted, repressed, and depressed. My school provided no counselling services, and my GP did not know or care what it meant to be trans. I had no idea that I would end up in a nursing program after my first degree, or that I would have to wait until my early twenties to embark on a medically-induced second puberty.  I also had no idea that in a few years I would see people like me on the covers of Men’s Health, Vanity Fair, and Time magazines. Eight years ago, I had never heard my identity spat like profanity from the mouths of politicians and news anchors on mainstream television. Today, the general public is more aware about the existence of trans people, but not necessarily more informed about the barriers we face within health care settings and society at large. These barriers include the pathologization of trans identities, pervasive binarist and cissexist societal ideologies, and intersectional struggles.  

The pathologization of trans identities in medical communities is similar to the sensationalizing of trans stories in the media: trans people are seen as an oddity, afflicted by a disorder of perversion. Trans identities are frequently understood as a medical and psychological illness requiring medical treatment (Johnson, 2015). To access treatment in the form of hormones, psychotherapy, or gender affirming surgery, many transgender people must obtain a formal diagnosis of “gender dysphoria,” a term which has replaced “gender identity disorder” in the DSM-5 (Johnson, 2015; Roberts & Fantz, 2014). Though the term no longer contains the word “disorder,” it remains in a book of mental disorders – as homosexuality was until 1973 – and must be diagnosed and treated. Our identities are controlled in paternalistic ways: doctors must document our dysphoria, stamp our name change papers, sign our surgery letters, orchestrate our insurance coverage, and approve our actions. We must gain official permission to be ourselves. This medical control over trans identities leads to an even greater power imbalance between medical professionals and transgender patients, further disempowering trans individuals within society (Johnson, 2015). Poteat, German, and Kerrigan argue that the stigmatization of trans people serves to replicate and reinforce unequal power relationships within our society. The pathologization of trans identities also reinforces the stigma that transgender individuals face from society at large: that we are not “normal;” that there is something wrong with us that must be fixed. Many transgender people keep from disclosing their identities to doctors, for fear of being refused care based on such stigmas (McClain, Hawkins, & Yehia, 2016; Roberts & Fantz, 2014).

Furthermore, health care education is based around binarist and cissexist (please see Glossary below) concepts and language: phrases such as “pregnant women,” “both genders,” “the opposite sex,” and “men’s heart attack symptoms,” are commonplace and unquestioned. Transgender needs and issues are absent from most health care curricula (Poteat et al., 2013). In my first year of nursing school, I only heard trans people referred to once, during an equity training session. Yet I, a trans patient and a trans nursing student, am present in a health care context every day. Outside of schools, most medical professionals remain unaware of trans people and our challenges (Roberts & Fantz, 2014). When I reminded my former doctor of my name and pronouns, she turned to me and said, “Oh… still?” Her tone was one of surprise and mild amusement. Also ignorant of trans issues and reliant on binaries are governmental institutions and medical administration (Roberts & Fantz, 2014). The sex on my health card is still listed as “F,” in spite of my baritone voice and the testosterone levels that rival my cisgender fiancé’s. When the clinic receptionist calls a name, it takes me a few seconds to realize that this girls’ name is supposed to be mine.  Medicine, like the rest of our society, relies on a biological determinist lens through which to view trans people. Naiman (2012) recognizes that sex and gender have become conflated in today’s language (then proceeds to conflate them herself), which facilitates biological determinist theories of gender – that gender is inevitably based upon distinct physiological characteristics. Trans people defy biological determinism, as our self-identified gender does not align with our assigned sex and socially-assigned gender. Poteat et al. (2013) describe how stigma against transgender people has been justified by functionalist order theory as well as biological determinism: because we challenge binarist and cissexist gender norms, we are a threat to societal ideological stability. Naiman (2012) might argue that in challenging gender norms, we also threaten the capitalist class which relies so heavily on gender inequality for social control and profit. Naiman (2012) also points out that biology in our society is informed by cultural theories of gender, and vice versa. Our colonial North American society abides by a strict gender binary determined by biology. In this way, social transition and medical transition are bound to each other. Trans people are typically expected to socially “prove” their gender to medical professionals in order to physically transition. We must do this in a way that conforms to our society’s biological deterministic concept of gender. This reflects the sociological model of “doing gender,” in which gender must be socially performed and accomplished (Johnson, 2015; Westbrook & Schilt, 2014). Transgender people are thus accountable for performing gender “correctly;” that is, according to the cisnormative and frequently heteronormative societal ideals of our “chosen” genders. In most medical contexts, there is a typical “trans narrative” that we are expected to embody in order to obtain a gender dysphoria diagnosis and care. For instance: a trans man must have always hated societally-designated “girlish” things (dolls, dresses, etc.), and instead been interested in societally-designated “boyish” things (cars, sports, etc.). He must have realised from a young age that he was “different from the other girls” and must have always wished for a penis. We must prove, even if we must lie about ourselves, that we fit within a biological determinist mold of gender in order to be taken seriously by the gatekeepers of medical interventions (psychiatrists and medical doctors). This occurs not just in the medical field, but across societal institutions. As Naiman (2012) writes, gender is a “core identity,” one which follows people everywhere. Transgender people face barriers throughout society, including in employment, housing, educational systems, prison systems, shelters, treatment centres, governmental administration, and numerous social situations such as bathroom usage and clothing shopping (Poteat et al., 2013).

Since transgender discrimination is present in almost all environments, it is vital to also acknowledge the intersections of other marginalized identities within these environments. Many trans people face discrimination based on other identities such as race and sexuality. Discrimination may also be based on unemployment, disability, mental illness, imprisonment, homelessness, transmisogyny, stigma around HIV positivity and stigma around sex work. Naiman (2012) describes the consideration of diversity and intersectional oppression within marginalized communities as the goal of socialist and Third Wave feminist change theories. Such intersectional feminist theories tend to focus on discrimination against poor trans women of color (TWOC), the most vulnerable members of trans communities. Economic inequality is a large factor in trans discrimination. In the USA in 2010, the unemployment rate for trans people was twice the national average, meaning that many trans people are not covered by employment-provided insurance and cannot afford medical care (Poteat et al., 2013; Roberts & Fantz, 2014). Additionally, when refused or unable to access health care, some trans people may seek treatment such as hormones outside of health care institutions (Poteat et al., 2013). This can, as in the case of street hormones and unsupervised injections, be a dangerous route. Many transgender people, especially TWOC, live below the poverty line due to the double employment barriers of racism and transmisogyny. People who cannot contribute to the capitalist economy are devalued and marginalized in our society, which leads to the further stigmatization of un- or under-employed trans individuals (Naiman, 2012). Some trans people – again, especially TWOC – turn to sex work for survival, which increases their risks of HIV vulnerability, getting arrested, and becoming victims of violence (Graham, 2014). Due to structural inequality, trans and other marginalized groups are already at greater risk of contracting HIV, attempting suicide, and becoming victims of violence than the rest of the population (Bauer et al., 2009). In spite of all these barriers, there is little legal protection for transgender people (Bauer et al., 2009). As Naiman (2012) describes with racism, the responsibility for these consequences falls to oppressed individuals, not oppressive systems. It is left to the victims of trans discrimination to pursue legal action against oppressors, which is often beyond our means. This is a consequence of neoliberal ideology in a capitalist society. Even for the marginalized, emphasis on individual responsibility takes precedence over the accountability of an unequal society.

While I personally benefit from white privilege, masculine-of-center self-identity, and a financially stable family background, I do experience the intersections of transphobia, homophobia, and ableism. I have experienced multiple acts of discrimination in health care; for instance, sitting for years on a waitlist for CAMH’s gender identity clinic, then being refused treatment because the doctor deemed me “too feminine.” I work to remain aware of the marginalization faced by other trans people, especially the fifteen trans people murdered in the past seven months (most of whom were Black trans women). Part of the reason I am entering the health care profession is to understand and work to challenge the systemic discrimination that marginalizes and kills so many of my trans siblings.

Glossary

Binarist

Referring to ideas that reinforce the biologically-determined theory of the gender binary, ignoring the experiences of non-binary individuals.

Cisgender, or cis Not transgender; identifying with the gender corresponding to one’s sex assigned at birth.

Cissexism, or cisnormativity The belief that everyone is, or should be, cisgender; that being cisgender is superior to being transgender. Typically a biological essentialist concept.

DSM-5 The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Transgender, or trans Not identifying with the gender corresponding to one’s sex assigned at birth. For the purpose of this paper, the term “transgender” includes all trans-identified, non-binary, some two-spirit, and gender-non-conforming (GNC) individuals.

Transmisogyny The intersection of transphobia and misogyny; individual or systemic hatred of, discrimination, or bias against trans women and transfeminine people.

 References

Bauer, G. R., Hammond, R., Travers, R., Kaay, M., Hohenadel, K. M., & Boyce, M. (2009). “I don’t think this is theoretical; this is our lives”: How erasure impacts health care for transgender people. Journal of the Association of Nurses in AIDS Care, 20(5), 348-361. doi:10.1016/j.jana.2009.07.004

Graham, L. (2014). Navigating community institutions: Black transgender women’s experiences in schools, the criminal justice system, and churches. Sexuality Research and Social Policy, 11(4), 274-287. doi:10.1007/s1317-014-0144-y

Johnson, A. (2015). Normative accountability: How the medical model influences transgender identities and experiences. Sociology Compass, 9(9), 803-813. doi:10.1111/soc4.12297

McClain, Z., Hawkins, L., & Yehia, B. (2016). Creating welcoming spaces for lesbian, gay, bisexual, and transgender (LGBT) patients: An evaluation of the health care environment. Journal of Homosexuality, 63(3), 387-393. doi:10.1080/00918369.2016.1124694

Naiman, J. (2012). How societies work: Class, power, and change (5 ed.). Halifax: Fernwood Publishing.

Poteat, T., German, D., & Kerrigan, D. (2013). Managing uncertainty: A grounded theory of stigma in transgender health care encounters. Social Science & Medicine, 84(2013), 22-29. doi:10.1016/j.socscimed.2013.02.019

Roberts, T. K., & Fantz, C. R. (2014). Barriers to quality health care for the transgender population. Clinical Biochemistry, 47(10/11), 983-987. doi:10.1016/j.clinbiochem.2014.02.009

Westbrook, L., & Schilt, K. (2014). Doing gender, determining gender: Transgender people, gender panics, and the maintenance of the sex/gender/sexuality system. Gender & Society, 28(1), 32-57. doi:10.1177/0891243213503203