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lastsonlost · 4 years ago

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Crossing the divide

Do men really have it easier? These transgender guys found the truth was more complex.

In the 1990s, the late Stanford neuroscientist Ben Barres transitioned from female to male. He was in his 40s, mid-career, and afterward he marveled at the stark changes in his professional life. Now that society saw him as male, his ideas were taken more seriously. He was able to complete a whole sentence without being interrupted by a man. A colleague who didn’t know he was transgender even praised his work as “much better than his sister’s.”

Clinics have reported an increase in people seeking medical gender transitions in recent years, and research suggests the number of people identifying as transgender has risen in the past decade. Touchstones such as Caitlyn Jenner’s transition, the bathroom controversy, and the Amazon series “Transparent” have also made the topic a bigger part of the political and cultural conversation.

But it is not always evident when someone has undergone a transition — especially if they have gone from female to male.

“The transgender guys have a relatively straightforward process — we just simply add testosterone and watch their bodies shift,” said Joshua Safer, executive director at the Center for Transgender Medicine and Surgery at Mount Sinai Health System and Icahn School of Medicine in New York. “Within six months to a year they start to virilize — getting facial hair, a ruddier complexion, a change in body odor and a deepening of the voice.”

Transgender women have more difficulty “passing”; they tend to be bigger-boned and more masculine-looking, and these things are hard to reverse with hormone treatments, Safer said. “But the transgender men will go get jobs and the new boss doesn’t even know they’re trans.”

We spoke with four men who transitioned as adults to the bodies in which they feel more comfortable. Their experiences reveal that the gulf between how society treats women and men is in many ways as wide now as it was when Barres transitioned. But their diverse backgrounds provide further insight into how race and ethnicity inform the gender divide in subtle and sometimes surprising ways.

(Their words have been lightly edited for space and clarity.)

‘I’ll never call the police again’

Trystan Cotten, 50, Berkeley, Calif.

Professor of gender studies at California State University Stanislaus and editor of Transgress Press, which publishes books related to the transgender experience. Transitioned in 2008.

Life doesn’t get easier as an African American male. The way that police officers deal with me, the way that racism undermines my ability to feel safe in the world, affects my mobility, affects where I go. Other African American and Latino Americans grew up as boys and were taught to deal with that at an earlier age. I had to learn from my black and brown brothers about how to stay alive in my new body and retain some dignity while being demeaned by the cops.

One night somebody crashed a car into my neighbor’s house, and I called 911. I walk out to talk to the police officer, and he pulls a gun on me and says, “Stop! Stop! Get on the ground!” I turn around to see if there’s someone behind me, and he goes, “You! You! Get on the ground!” I’m in pajamas and barefoot. I get on the ground and he checks me, and afterward I said, “What was that all about?” He said, “You were moving kind of funny.” Later, people told me, “Man, you’re crazy. You never call the police.”

I get pulled over a lot more now. I GOT PULLED OVER MORE IN THE FIRST TWO YEARS AFTER MY TRANSITION THAN I DID THE ENTIRE 20 YEARS I WAS DRIVING BEFORE THAT.

Before, when I’d been stopped, even for real violations like driving 100 miles an hour, I got off. In fact, when it happened in Atlanta the officer and I got into a great conversation about the Braves. Now the first two questions they ask are: Do I have any weapons in the car, and am I on parole or probation?

Being a black man has changed the way I move in the world.

I used to walk quickly or run to catch a bus. Now I walk at a slower pace, and if I’m late I don’t dare rush. I am hyper-aware of making sudden or abrupt movements, especially in airports, train stations and other public places. I avoid engaging with unfamiliar white folks, especially white women. If they catch my eye, white women usually clutch their purses and cross the street. While I love urban aesthetics, I stopped wearing hoodies and traded my baggy jeans, oversized jerseys and colorful skullcaps for closefitting jeans, khakis and sweaters. These changes blunt assumptions that I’m going to snatch purses or merchandise, or jump the subway turnstile. The less visible I am, the better my chances of surviving.

But it’s not foolproof. I’m an academic sitting at a desk so I exercise where I can. I walked to the post office to mail some books and I put on this 40-pound weight vest that I walk around in. It was about 3 or 4 in the afternoon and I’m walking back and all of a sudden police officers drove up, got out of their car, and stopped. I had my earphones on so I didn’t know they were talking to me. I looked up and there’s a helicopter above. And now I can kind of see why people run, because you might live if you run, even if you haven’t done anything. This was in Emeryville, one of the wealthiest enclaves in Northern California, where there’s security galore. Someone had seen me walking to the post office and called in and said they saw a Muslim with an explosives vest. One cop, a white guy, picked it up and laughed and said, “Oh, I think I know what this is. This is a weight belt.”

It’s not only humiliating, but it creates anxiety on a daily basis. Before, I used to feel safe going up to a police officer if I was lost or needed directions. But I don’t do that anymore. I hike a lot, and if I’m out hiking and I see a dead body, I’ll keep on walking. I’ll never call the police again.

‘It now feels as though I am on my own’

Zander Keig, 52, San Diego

Coast Guard veteran. Works at Naval Medical Center San Diego as a clinical social work case manager. Editor of anthologies about transgender men. Started transition in 2005.

Prior to my transition, I was an outspoken radical feminist. I spoke up often, loudly and with confidence.

I was encouraged to speak up. I was given awards for my efforts, literally — it was like, “Oh, yeah, speak up, speak out.” When I speak up now, I am often given the direct or indirect message that I am “mansplaining,” “taking up too much space” or “asserting my white male heterosexual privilege.” Never mind that I am a first-generation Mexican American, a transsexual man, and married to the same woman I was with prior to my transition.

I find the assertion that I am now unable to speak out on issues I find important offensive and I refuse to allow anyone to silence me. My ability to empathize has grown exponentially, because I now factor men into my thinking and feeling about situations.

Prior to my transition, I rarely considered how men experienced life or what they thought, wanted or liked about their lives.

I have learned so much about the lives of men through my friendships with men, reading books and articles by and for men and through the men I serve as a licensed clinical social worker.

Social work is generally considered to be “female dominated,” with women making up about 80 percent of the profession in the United States. Currently I work exclusively with clinical nurse case managers, but in my previous position, as a medical social worker working with chronically homeless military veterans — mostly male — who were grappling with substance use disorder and severe mental illness, I was one of a few men among dozens of women.

Plenty of research shows that life events, medical conditions and family circumstances impact men and women differently. But when I would suggest that patient behavioral issues like anger or violence may be a symptom of trauma or depression, it would often get dismissed or outright challenged. The overarching theme was “men are violent” and there was “no excuse” for their actions.

I do notice that some women do expect me to acquiesce or concede to them more now: Let them speak first, let them board the bus first, let them sit down first, and so on. I also notice that in public spaces men are more collegial with me, which they express through verbal and nonverbal messages: head lifting when passing me on the sidewalk and using terms like “brother” and “boss man” to acknowledge me. As a former lesbian feminist, I was put off by the way that some women want to be treated by me, now that I am a man, because it violates a foundational belief I carry, which is that women are fully capable human beings who do not need men to acquiesce or concede to them.

What continues to strike me is the significant reduction in friendliness and kindness now extended to me in public spaces. It now feels as though I am on my own: No one, outside of family and close friends, is paying any attention to my well-being.

I can recall a moment where this difference hit home. A couple of years into my medical gender transition, I was traveling on a public bus early one weekend morning. There were six people on the bus, including me. One was a woman. She was talking on a mobile phone very loudly and remarked that “men are such a–holes.” I immediately looked up at her and then around at the other men. Not one had lifted his head to look at the woman or anyone else. The woman saw me look at her and then commented to the person she was speaking with about “some a–hole on the bus right now looking at me.” I was stunned, because I recall being in similar situations, but in the reverse, many times: A man would say or do something deemed obnoxious or offensive, and I would find solidarity with the women around me as we made eye contact, rolled our eyes and maybe even commented out loud on the situation. I’m not sure I understand why the men did not respond, but it made a lasting impression on me.

‘I took control of my career’

Chris Edwards, 49, Boston

Advertising creative director, public speaker and author of the memoir “Balls: It Takes Some to Get Some.” Transitioned in his mid-20s.

When I began my transition at age 26, a lot of my socialization came from the guys at work. For example, as a woman, I’d walk down the hall and bump into some of my female co-workers, and they’d say, “Hey, what’s up?” and I’d say, “Oh, I just got out of this client meeting. They killed all my scripts and now I have to go back and rewrite everything, blah blah blah. What’s up with you?” and then they’d tell me their stories. As a guy, I bump into a guy in the hall and he says, “What’s up?” and I launch into a story about my day and he’s already down the hall. And I’m thinking, well, that’s rude. So, I think, okay, well, I guess guys don’t really share, so next time I’ll keep it brief. By the third time, I realized you just nod.

The creative department is largely male, and the guys accepted me into the club. I learned by example and modeled my professional behavior accordingly. For example, I kept noticing that if guys wanted an assignment they’d just ask for it. If they wanted a raise or a promotion they’d ask for it. This was a foreign concept to me. As a woman, I never felt that it was polite to do that or that I had the power to do that. But after seeing it happen all around me I decided that if I felt I deserved something I was going to ask for it too. By doing that, I took control of my career. It was very empowering.

Apparently, people were only holding the door for me because I was a woman rather than out of common courtesy as I had assumed. Not just men, women too. I learned this the first time I left the house presenting as male, when a woman entered a department store in front of me and just let the door swing shut behind her. I was so caught off guard I walked into it face first.

When you’re socially transitioning, you want to blend in, not stand out, so it’s uncomfortable when little reminders pop up that you’re not like everybody else. I’m expected to know everything about sports. I like sports but I’m not in deep like a lot of guys. For example, I love watching football, but I never played the sport (wasn’t an option for girls back in my day) so there is a lot I don’t know. I remember the first time I was in a wedding as a groomsman. I was maybe three years into my transition and I was lined up for photos with all the other guys. And one of them shouted, “High school football pose!” and on cue everybody dropped down and squatted like the offensive line, and I was like, what the hell is going on? It was not instinctive to me since I never played. I tried to mirror what everyone was doing, but when you see the picture I’m kind of “offsides,” so to speak.

The hormones made me more impatient. I had lots of female friends and one of the qualities they loved about me was that I was a great listener. After being on testosterone, they informed me that my listening skills weren’t what they used to be. Here’s an example: I’m driving with one of my best friends, Beth, and I ask her “Is your sister meeting us for dinner?” Ten minutes later she’s still talking and I still have no idea if her sister is coming. So finally, I couldn’t take it anymore, and I snapped and said, “IS SHE COMING OR NOT?” And Beth was like, “You know, you used to like hearing all the backstory and how I’d get around to the answer. A lot of us have noticed you’ve become very impatient lately and we think it’s that damn testosterone!” It’s definitely true that some male behavior is governed by hormones. Instead of listening to a woman’s problem and being empathetic and nodding along, I would do the stereotypical guy thing — interrupt and provide a solution to cut the conversation short and move on. I’m trying to be better about this.

People ask if being a man made me more successful in my career. My answer is yes — but not for the reason you might think. As a man, I was finally comfortable in my own skin and that made me more confident. At work I noticed I was more direct: getting to the point, not apologizing before I said anything or tiptoeing around and trying to be delicate like I used to do. In meetings, I was more outspoken. I stopped posing my thoughts as questions. I’d say what I meant and what I wanted to happen instead of dropping hints and hoping people would read between the lines and pick up on what I really wanted. I was no longer shy about stating my opinions or defending my work. When I gave presentations I was brighter, funnier, more engaging. Not because I was a man. Because I was happy.

‘People assume I know the answer’

Alex Poon, 26, Boston

Project manager for Wayfair, an online home goods company. Alex is in the process of his physical transition; he did the chest surgery after college and started taking testosterone this spring.

Traditional Chinese culture is about conforming to your elders’ wishes and staying within gender boundaries. However, I grew up in the U.S., where I could explore my individuality and my own gender identity. When I was 15 I was attending an all-girls high school where we had to wear skirts, but I felt different from my peers. Around that point we began living with my Chinese grandfather towards the end of his life. He was so traditional and deeply set in his ways. I felt like I couldn’t cut my hair or dress how I wanted because I was afraid to upset him and have our last memories of each other be ruined.

Genetics are not in my favor for growing a lumberjack-style beard. Sometimes, Chinese faces are seen as “soft” with less defined jaw lines and a lack of facial fair. I worry that some of my feminine features like my “soft face” will make it hard to present as a masculine man, which is how I see myself. Instead, when people meet me for the first time, I’m often read as an effeminate man.

My voice has started cracking and becoming lower. Recently, I’ve been noticing the difference between being perceived as a woman versus being perceived as a man. I’ve been wondering how I can strike the right balance between remembering how it feels to be silenced and talked over with the privileges that come along with being perceived as a man. Now, when I lead meetings, I purposefully create pauses and moments where I try to draw others into the conversation and make space for everyone to contribute and ask questions.

People now assume I have logic, advice and seniority. They look at me and assume I know the answer, even when I don’t. I’ve been in meetings where everyone else in the room was a woman and more senior, yet I still got asked, “Alex, what do you think? We thought you would know.” I was at an all-team meeting with 40 people, and I was recognized by name for my team’s accomplishments. Whereas next to me, there was another successful team led by a woman, but she was never mentioned by name. I went up to her afterward and said, “Wow, that was not cool; your team actually did more than my team.” The stark difference made me feel uncomfortable and brought back feelings of when I had been in the same boat and not been given credit for my work.

When people thought I was a woman, they often gave me vague or roundabout answers when I asked a question. I’ve even had someone tell me, “If you just Googled it, you would know.” But now that I’m read as a man, I’ve found people give me direct and clear answers, even if it means they have to do some research on their own before getting back to me.

A part of me regrets not sharing with my grandfather who I truly am before he passed away. I wonder how our relationship might have been different if he had known this one piece about me and had still accepted me as his grandson. Traditionally, Chinese culture sees men as more valuable than women. Before, I was the youngest granddaughter, so the least important. Now, I’m the oldest grandson. I think about how he might have had different expectations or tried to instill certain traditional Chinese principles upon me more deeply, such as caring more about my grades or taking care of my siblings and elders. Though he never viewed me as a man, I ended up doing these things anyway.

Zander Keig contributed to this article in his personal capacity. The opinions expressed in this are the author’s own and do not reflect the view of the Department of Defense.

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Old story worth a repost SOURCE

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realrenee72-blog · 7 years ago

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The Facts about Transgender Youth: Research and the Search for Truth

The strict definition of scientific research is: “performing a methodical study in order to prove a hypothesis or answer a specific question. Finding a definitive answer is the central goal of any experimental process. Research must be systematic and follow a series of steps and a rigid standard protocol.”

Research is a search for truth.

And yet, it can be harnessed to reinforce lies.

On the topic of transgender youth, research has been misused for decades. Research that was poorly designed, inherently biased, or haphazardly executed is still being cited as if it holds credibility. Furthermore, sound research on the vulnerability and injury that transphobia inflicts on people is routinely twisted to make a case for a population’s weakness or the undesireability of trans-ness.

This is not truth.

Recently, I was assigned the task of reviewing the existing “scientific research” about transgender youth. I took on the task with gusto, excited to inform myself and be able to speak to what is true on the topic. As I dug in, let me tell you, I had to fight off nausea on the regular just to get through the mountains of lies. To save you the stomach problems, please allow me to summarize the nuggets of truth I discovered that made this task worthwhile.

1. On Liars

There are organizations, some local and some national, who tell lies about the topic of transgender youth. Local groups make claims about research findings in their calls to action against inclusive school environments. The Christian Medical and Dental Association and the American College of Pediatricians use distorted research citations in their rhetoric. The most common distortion, as mentioned above, is citing research about poor health outcomes experienced by transgender people as justification for transphobia. The truth, as evidenced by volumes of research as well as common sense and a heart, is that transphobia causes poor health outcomes. (Duh.)

Don’t let the organization names fool you. The names are designed to make these organizations sound reputable and even objective, but I promise you these organizations are far from unbiased. The American College of Pediatricians has been described by the Southern Poverty Law Center as a “hate group” with “a history of propagating damaging falsehoods about LGBT people.” A number of mainstream researchers, including the director of the US National Institutes of Health, have accused the American College of Pediatrics of misusing or mischaracterizing their work to advance a political agenda.

Yes, these organizations have a political and religious agenda. These are their true beliefs, in the words of the Christian Medical and Dental Association:

“A person’s sex is ascertained biologically, and not by one’s beliefs, desires, or feelings… government has neither the power nor the authority to redefine sex” because sex is defined by God.

“Attempts to alter gender surgically or hormonally for psychological indications… are medically inappropriate, as they repudiate nature, and are unsupported by the witness of Scripture.”

That’s where the messages of these organizations is really coming from.

2. On “Desisters”

One of the biggest lies about transgender youth that pervades the “scientific research” on the topic is the notion that most children desist. That is, the notion that most children who assert a transgender identity in childhood are only going through a phase, and will ultimately learn to accept their sex assigned at birth.

This lie is persistent!! The research that supposedly shows this is cited even today by the World Professional Association for Transgender Health (WPATH) Standards of Care, Version 7 . A handful of studies claim to show only a small percentage of gender diverse children grow to identify as transgender adults. I read these studies in full. Let me give you some highlights of the ways in which these studies are not scientifically sound.

Many of these studies were conducted at Kenneth Zucker’s clinic known for a philosophy discouraging transition. Transgender identity is seen as “complex” and therefore undesireable. Zucker states: “The goal of treatment is to reduce the gender dysphoria… by definition, a successful outcome would be its remission (i.e. acceptance of sex assigned at birth) and a failure would be its persistence.” Yeah, so in other words, children were pressured to “desist.”

In nearly all of these studies, children who did not respond to researcher attempts at follow-up were classified (and counted in their statistical analysis) as desisters. Hmmm, I wonder if some folks chose not to participate in follow-up because of the unsupportive stance of the researchers?

Among those who did not identify as transgender at follow-up, lack of social support may have been a factor in their “desistence.” In fact, it was noted that “persisters” tended to have parents who were “tolerant” of their cross gender behavior.

These studies are products of their time, and many of them are OLD. Even if the study appears new-ish, the subjects are those who went to a gender clinic as long ago as 1975. These studies look at people who were treated in some cases more than 20 years ago, when society and interventions were very different, affected by changes in the levels of transphobia and discrimination over time.

With one exception, these studies used broad criteria of inclusion, i.e. they studied children who were brought to a clinic by their parents for “childhood gender issues.” Some of these children did not meet full criteria for gender dysphoria and did not necessarily profess a trans identity. Therefore, included in the studies were children who simply had gender expressions that did not conform to their parents’ expectations. Surprise! At follow-up, the kids who are not transgender reported they are not transgender!

In stark contrast to these studies purporting to show “persistence” rates of only 12%, 37%, 6%, and 27%, one study of children presenting to the gender clinic in Amsterdam shows NO DESISTERS. The author attributes this to appropriate diagnostic work as children presented to the clinic. In other words, only transgender children participated in the study, and guess what? They are all still transgender.

It is time for the myth of “desisters” to desist.

3. On Mental Health of Transgender Youth

Okay, now let’s get to more of those nuggets of truth I mentioned. Having summarized the nature of the unreliable data on the topic of transgender youth, allow me to highlight the truths revealed by good research. There is a growing body of good research with sound methodology, and the stories this literature tells are much different than the old stuff.

On the topic of mental health of transgender youth, some correlations are repeatedly shown to be true. Yes, on the whole, transgender youth are more likely to be in distress than the general population. Looking more closely gives us important insights about this.

Some of the specific factors that are tied to heightened distress among transgender youth are:

lack of social support, especially from their families,

experiences of transphobia,

avoidant coping strategies,

lack of access to medical care, and

earlier stages of gender transition.

Some of the specific factors that are tied to better mental health among transgender youth are:

psychological support,

social support, especially from family and from community leaders,

access to medical care, and

adaptive coping strategies.

A review of multiples studies on the topic showed that levels of psychopathology and psychiatric disorders in transgender people (mainly depression and anxiety) improve following gender-confirming medical intervention, in many cases reaching normative values. Other major psychiatric disorders, such as schizophrenia and bipolar disorder, were rare and were no more prevalent than in the general population. Gender-affirming medical therapy and supported social transition in childhood have been shown to correlate with improved psychological functioning for gender-variant children and adolescents.

Imagine that.

4. On Social Transition During Childhood

Now let’s talk about the debate on whether it is appropriate to allow children to transition socially during childhood. The Endocrine Society, a professional leader in the field, states they do not recommend social transition during childhood. Why? Because of the supposed high prevalence of desistance.

See how the lies permeate an entire discourse? This is why it’s important to debunk the lies.

The Endocrine Society also cites the supposed distress a child may experience if they have socially transitioned and then change their mind. The single study they refer to here includes two, count them, two kids who commented on anxiety about their gender exploration process and the prospect of being judged by their peers. If those two kids knew that their comments would have such wide-reaching misinterpretation, affecting an entire public debate, perhaps they would have been less forthcoming in their very personal interviews.

In contrast to the position of the Endocrine Society, new studies are showing the profoundly positive impact of social transition during childhood among transgender youth. First of all, socially transitioned children who experience support have lower internalizing psychopathology than trans youth living as sex assigned at birth. And even better, children who have socially transitioned show normative rates of depression, and only slightly elevated rates of anxiety compared with cisgender peers.

Rather than experiencing heightened distress and, if they’re lucky, having it resolve with gender affirmation later in life, transgender children who transition early can potentially avoid the distress altogether!

5. On Puberty Blockers

The last area of debate I’ll cover here is the one around GnRHa, also known as puberty blockers, for transgender youth. I am not a medical professional, and encourage those who are interested to review the literature for themselves for more detail. But I can summarize what I understood from my reading, which is essentially this: The benefits of puberty blockers for transgender youth seem to outweigh the risks.

Puberty suppressing hormone therapy began at the Amsterdam Gender Identity Clinic, and is now widely accepted as an appropriate protocol for treating transgender youth. Even the Endocrine Society recommends this intervention.

A good deal of research is underway to examine all of the potential health effects of this treatment. Some highlights on what I learned so far are:

GnRHa treatment is safe for the reproductive system, bone mineral density, and body mass index. It is shown to have no negative effects on brain development, health, metabolic and endocrine parameters. GnRHa results in no abnormalities of liver enzymes or creatinine.

Trans masculine youth who are treated with GnRHa may be at risk for hypertension and therefore need competent healthcare providers to monitor this.

Furthermore, research shows the following effects on mental health:

GnRHa for transgender youth results in improvement in global functioning and psychological functioning, fewer behavioral and emotional problems, fewer depressive symptoms.

Longterm, after cross sex hormone therapy and gender reassignment, those who had GnRHa become well functioning young adults, with comparable mental health to same-age adults from general population.

Some researchers note that withholding GnRHa from transgender children is not a neutral decision. Those who are denied treatment usually seek treatment later, or find illicit sources of medication. Withholding puberty blockers is just as "irreverable" as administering them, as untreated transgender youth will experiences consequences of puberty of gender with which they do not identify.

I invite you to verify this information I have provided by clicking through to the research studies! Some of this research is very sound and very encouraging. My hope is that this growing body of literature telling the stories of affirming, supportive stances toward transgender youth will replace the misguided, sloppy, biased literature of the past. I’d like to see new, affirming research findings informing the next version of the WPATH Standards of Care. I’d like to see a shift in the position of the Endocrine Society on social transition during childhood. But in the meantime, while we wait for those changes, I am pleased to share this information with transgender community, loved ones, and allies, so that we all can do our work from a place of TRUTH.

#trans #transgender #transyouth #protecttranskids #advocate #lgbtqresearch #wpathstandards #transhealthcare #genderidentity #psychology #transgenderyouth

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jaouinedcan · 7 years ago

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After the Accident [NedCan Week: Day 3 - Warmth/Cold]

I’m a little conflicted about posting this but I decided it was a story that should be told. There are a lot of fanfics out there where characters deal with depression, but a significant portion of them are wish fulfillment fantasies written by struggling teens, and I think it’s important for them to know that it isn’t healthy to wait for someone to suddenly appear and sweep you away from it all like how some popular media would lead you to believe. Love certainly isn’t out of reach for anyone, but it won’t make a difference if you don’t do anything to save yourself, and sometimes saving yourself is as simple as holding on to the idea that there are people who need you now, and there will be people who will need you in the future. Instead of waiting for a hero, you can become a hero. There are people who need help every day, and you can reach out to them in your own unique way.

The NedCan in this can be platonic or pre-relationship, depending on your preference; I went out of my way to write this as unromantic as possible, because dealing with depression isn’t romantic in the least.

WARNING: This fanfic deals with depression and passive suicidal ideation, along with descriptions of injuries, medical procedures and panic, but there is no self harm involved.

Before the accident, Matthew felt like he'd been fading into the background of other people's lives, slowly and steadily, like a glacier caught him by the toe and he stood and watched as the ice gradually crept up his leg. He hadn't known at the time that there was a word for the way he felt--depression--but that would come well after. Before, he hadn't understood that he had been the one withdrawing rather than being left behind. His twin brother Alfred was well known but also had complicated relations among the rest of the school, always in the midst of some sort of drama and therefore drawing plenty of attention. In comparison, Matthew actually had a more stable group of friends and was well-liked among more casual acquaintances, but he misinterpreted their friendliness as forced politeness since the conversation would inevitably transition to something Alfred had done.

It wasn't anyone's fault, really, as a chemical imbalance in his brain was mainly to blame, drawing faulty conclusions from things regular people did while leading regular lives, but as Matthew started to believe that people only spoke to him because they wanted to speak to his brother, his reaction was to start declining group invitations to movies and fast food places since he didn't feel like good enough company, which led to less invitations as his friends began to assume he was too busy with hobbies or schoolwork to hang out, which led to strengthening Matthew's belief that he was nothing more than an easily forgotten tag-along in his social circles. The timing was especially bad as the school year came to an end, and though his accidental self-sentenced isolation had resulted in more time to study for finals and achieve better grades than usual, it led to the loneliest summer vacation of his life. The disconnect with his formerly close friends persisted into the new school year at the new high school full of students he'd never met or felt he hardly knew anymore, and he'd completely lost the motivation to do anything about it as he went through the motions of life doing all the things he supposed he was expected to do instead of anything he actually wanted to accomplish because nothing really interested him anymore. He did his share of the household chores, completed his homework, even beat Alfred to getting a driver's license, but gained no satisfaction from any of it.

If his less-than-life had continued on like that, Matthew might not have lived much longer at all, but, like a disaster sent straight from the heavens to cleanse the earth of its impurities, the accident changed everything.

Maybe the only reason he'd thrown himself out of the path of that wildly careening sports car had been to spare the gift he'd just bought for his mother's birthday, since that had been the first thing to pop into his head, but when he looked up from the curb, scraped head to toe by sharp pieces of broken glass and gravel, another reason to live cemented itself deep in his bones as he watched that same car plow directly into a cyclist further down the road and continue on its wayward path out of sight, leaving an otherwise empty street behind.

Later on, Matthew would be slightly amazed with himself for getting up and running over despite the pound or so of debris that would be extracted from his face and limbs, but at that moment, he truly hadn't felt a thing even as he dropped heavily to his knees next to the cyclist's writhing form, trying so desperately to breathe that his whole body was heaving like his lungs should have been. The first thing Matthew did was try to get him to stay still to avoid further harm, pressing his shoulders to the ground as carefully as possible, but it was still enough of a shock to remind the cyclist's body how to inhale, an explosive gasp of air tearing through him before he choked it back out with a wrenching sob. His face was covered in blood thanks to a deep gash on his forehead but Matthew still recognized him from school. They'd never spoken but he was a year older and had a younger sister in some of Matthew's classes who talked to her brother often in the hall where he'd overhear them speaking as he passed them on the way to class. Their names were Jan and Emma.

"Jan," he said, pronouncing it just as Emma would; Yaan. "I'm Matthew. You're going to be okay. Just stay still."

For all his struggles to introduce himself to new people, the words came so naturally it was like he was born to say them. Without even having to think about it, he reached into the plastic bag still snagged around his elbow and tied the long blue and white scarf around the head wound, retrieved his cell phone from his pocket to call 911, put it on speaker and set it down on the road by Jan's ear to free up his hands and check for more injuries.

Jan, in a rightful panic, grabbed his wrist, needing something to hold on to as he continued struggling to breathe. He bled from numerous places, but none so bad as his forehead, so Matthew eased Jan's grip into his palm instead so he could squeeze his hand back just as tight while he spoke to the 911 operator and followed her instructions until the ambulance arrived. Jan didn't pass out until they were halfway to the hospital, having dragged Matthew into the ambulance along with him by his hand, and he was surprised that the paramedics allowed it until they finished stabilising Jan and one of them started taking a look at his torn up arms, the sight of which ended up disturbing him enough to pass out, too.

He woke later in a hospital bed, bandaged up and clean, stiff and sore, his mother already standing and crying over him before he finished prying open his eyes, and he knew then and there that he could never put her through something like this on purpose, ever. His father was out in the hall talking to a doctor, looking back in through the window in relief, and Alfred awkwardly stood off to the side, uncharacteristically quiet and pale as he tried to joke about how it would be a while before anybody mixed them up again, and Matthew did his best to smile for him but he was sure it came out twitchy and crooked as it pulled at the bandages taped to his face.

A police officer invited himself inside to take his statement soon after, and the memory was still so fresh he had no problem describing the accident and even remembered seeing that same sports car parked in the school parking lot and who it belonged to, which he felt conflicted about sharing but it seemed that they'd already been arrested. He tried to ask how Jan was doing, but when the officer asked for a description, Matthew realized for the first time that more than one person had been hurt that day and fell into an uneasy silence until he was assured that there were no fatalities reported thus far though a few were still undergoing surgery and others were in critical condition.

The officer left to collect his next witness statement and his father came in to explain that the doctor wanted to keep him overnight for observation to be sure that none of his numerous cuts and scrapes got infected. His mother insisted upon staying with him through the night and Matthew didn't object, more for her sake than his since this was the first time one of her sons had been hospitalised. Before Alfred and their father left, though, they had to help him to the bathroom since his cut up knees buckled under his weight and his arms were far too shaky to keep him steady on the provided crutches. An evening meal went a long way toward helping him regain some strength in his limbs, and he asked every nurse making their rounds how Jan was doing, enduring their inability to give him any worthwhile answers until Emma herself finally found her way to him.

"Matthew... it is 'Matthew', right?" she asked, remembering him from some of the classes they took together. He'd helped her and a few of their classmates with in-class assignments before when they seemed to be struggling with the curriculum. Her face was red and puffy from crying, like his mother's, and he'd had to wonder how she'd managed to evade hospital staff to make it to his room after public visiting hours but she must have charmed the nurse hanging around just outside the door--he'd answered his mother's questions more generously than Matthew's earlier, so he must have had a weakness for women's requests.

"Yeah," Matthew replied, letting his mother help him sit up and swing his legs over the side of the bed, so determined was she to do what she could in a situation where she could not do much. "How is... how is Jan?"

Her eyes shone anew but she didn't break down. "He just got out of surgery a little while ago. I couldn't tell you the whole list of injuries like the doctor did--I didn't even know what half the terms meant--I just know that there's a lot of internal damage and broken bones; ribs, leg, and collarbone. One of his lungs collapsed and they're worried about his head, but... but they said he's stable now, and he's sleeping. They let us see him for a little while and he looks awful, but he's alive and the doctor said that's because of you, because you were there to help him and call an ambulance. If you hadn't been there--if the first responders only found him after they started searching the streets for the drunk driver responsible for all the other accidents--my brother would be gone." The tears spilled over her eyelids but she stayed steady and stepped closer. "You think so, too, right? You saw him. You were right there."

"Emma..." he started and trailed off, because it was true, and also because he couldn't imagine what it would have been like if it had been Alfred or his parents left to die in the street. "I know." What his family would be feeling if he hadn't thrown himself out of the vehicle's path. "You're probably right." What would have happened to Jan if no one had been there for him to hold on to and call for help.

"Thank you," Emma said, her voice shaking. "Matthew, thank you for saving my brother." She took great care to embrace him gently, minding his bandages, but she shouldn't have worried since his clothes had mostly protected his torso aside from a few bruises and scrapes here and there. It hurt more to return the hug, his arms stinging in protest, but his thoughts were clearer than they'd been for months.

While he didn't know how to help himself, he knew now that someone had needed him more than he'd ever thought possible, and that was an idea he could hold on to.

Emma had to leave after a while, but she told him where her brother's room was if he wanted to visit him later. Matthew wanted to visit him right that instant, but asking would have been unreasonable. Besides, she'd already told him that Jan was sleeping. Disturbing his rest would have been selfish, not to mention that he shouldn't interrupt the limited time his family had to see him before they finally wore down the hospital staff's patience and were sent home. He wasn't sure if a family member was allowed to stay overnight with patients in serious condition, but he wasn't going to pry, either.

In the morning, his limbs didn't bother him as much as they did the day before, but that might have just been the pain medication building up in his system. The hospital let him borrow a wheelchair to get as far as his mother's car, but before they left, she took him to Jan's room without Matthew even needing to ask, wanting to see the other boy's condition for herself. He could hear her gasp from behind the wheelchair when she saw him through the hall window. Jan was hooked up to multiple machines tracking his vitals along with the IVs feeding him plasma and saline and a respirator controlling his breathing, and there was hardly an inch of skin not covered by sterile white bandages or casts. Someone had taken the time to wash the scarf and left it folded in a small cubby with the rest of his clothes from the accident, but Matthew didn't have the heart to tell anyone, especially his mother, that it was originally meant to be a present for her.

Emma was there, spotted him quickly, and immediately introduced him to her parents and little brother. Luca was still in junior high and took after his brother in appearance, though the difference in height and hairstyle meant that they probably weren't ever mistaken for each other like he was with Alfred. His mother got a little emotional as they all thanked Matthew in turn, gently grasping his hands instead of attempting handshakes, and there was an exchange of names, phone numbers, and promises to help each other in any way they could. Matthew took the opportunity to ask if he could visit Jan again and was told that he could come by at any time he wished.

He would visit every day until Jan was released from the hospital and was sure to talk to him at least once a day forever after, but before then, Matthew had some healing of his own to do. He'd been forced to take the rest of the week off from school to recover, but he spent a few hours at the hospital every morning before returning home after noon since Alfred would bring a few people over after school every day to see him, with one notable exception that they'd whisper about when they thought he was out of earshot. He only saw Ludwig after returning to class that following Monday--he'd never seen him so quiet, pale, and withdrawn. His older brother was out on bail but suspended indefinitely and there were rumours that he'd confessed to the drunk driving charges to protect his little brother, the actual driver. Matthew didn't know what to believe, since he hadn't had the time to glance through the windshield before diving out of the way, and he wouldn't have escaped almost unscathed if he'd tried.

Jan might have known for sure, having had the clearest view from atop his bicycle rather than the other injured pedestrians and witnesses on foot, but he spent the next two weeks unconscious and it would be a while after before he would piece together his scattered memories and even then he wasn't confident enough to confirm anything beyond the fact that they had both been in the car. His confusion was compounded by the fact that he'd spent the first twelve years of his life in Europe, where steering wheels were installed on the right side instead of the left, but in the end it hardly mattered; Ludwig matched every hour of Gilbert's court ordered community service with volunteer work, and they'd both been too young to face actual jail time no matter who had been driving. As the years went on, they would both spend a lot of time talking to kids at events hosted by MADD, SADD, and other organisations, doing what they could to prevent other people from repeating their mistakes.

Before that, though, Matthew would spend hours at the hospital every day keeping watch over Jan as he slept, giving his family the chance to leave every now and then to take care of various responsibilities, trusting their son and brother in his hands while they spoke to doctors and police and insurance companies and school officials. He had the most opportunities to be alone with him during the first few days, while Emma and Luca had to go to school and their parents had to put in a few hours in their workplaces to prepare their business associates to carry on without them for a while. He spent those times with the door shut and Jan's hand clasped tightly in his, talking about all the things he couldn't tell anyone else, because talking to people in comas was supposed to help, if not Jan, then maybe himself, and he didn't know of any other way to help anyone.

Slowly, over the course of days and weeks, Matthew started to feel better, unloading all the heaviness into the illusion of a sympathetic ear, sparing the conscious of his darkest thoughts. The last thing he wanted to do was upset the people who cared for him.

One day, though, he was interrupted from his quiet monologue when Jan squeezed his hand and he looked up to see bleary, half open green eyes silently regarding him, and he hit the nurse's call button faster than he'd ever done anything in his life. Once she came in, she ran right back out again to return with a doctor within seconds and they checked him over, determining that there was no sign of major brain or nerve damage, but it was too soon to rule it out completely. The nurse hurried off to contact his family while the doctor continued talking to Jan, asking him various yes-or-no questions to be answered with one blink or two, trying to discern how much his patient remembered about the accident and the days preceding it. Jan's family was quick to arrive, having been found in the hospital's cafeteria, their personal code of cleanliness forbidding them from eating where people slept, and by the time the respirator and feeding tube were gently extracted from Jan's throat, Matthew had completely forgotten what he'd been talking about.

Jan remembered, though, and while he wasn't able to start talking right away, he said as much the next time they were left alone together and his throat had recovered enough to permit scratchy speech. "Matthew," he said, his voice audibly sore, "if you can't tell your family then you have to say something to a doctor. You can't go on like this. I won't let you."

Matthew looked down at his hand; Jan had reached out to grab it, holding it tight and with just as much urgency as the first time. He looked back up again to see Jan staring at him with calm, solid determination, absolutely immovable, squeezing at his insides with diamond-forming pressure that burned like fire. The slowly receding glacier previously overtaking him stood no chance in the waves of heat cast out from within, flooding his face with hot tears. It was the first time he'd cried in months of forcing himself to be strong, and the first time he thought it might be okay to not be a perfect person, because Jan refused to let go of his hand and even encouraged him to come closer until his other hand gently cradled Matthew's head against his unbroken clavicle like how he imagined Jan would hold the pet bunny Emma had told him all about.

After he calmed down and washed his face, Matthew told Jan about the scarf his family was so curious about, having never seen Jan with it before, and how in the moment he'd thought to protect it before even considering saving his own life. Jan took to wearing it every day after his release from the hospital as a reminder to Matthew of all the things he had to live for and to never stop taking his new prescription or miss his appointments, like a silent pact they kept between them as their friendship flourished and deepened over the course of their lifetimes.

Many of the people in town knew that Matthew had saved Jan, but only a select few ever learned that saving Jan had also saved Matthew.

(Notes: Never forget that there are people out there that need you. In this fanfic, both Matthew and Jan were struggling to survive in different ways, and neither of them could have made it on their own.)

#nedcanweek2017 #nedcan #aph canada #aph netherlands #aph belgium

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sarahgraham7 · 6 years ago

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Q&A with Abby Norman, author of Ask Me About My Uterus: A Quest To Make Doctors Believe In Women’s Pain

When Abby Norman was struck down by an excruciating, nauseating pain, doctors were unable, perhaps at times even unwilling, to diagnose her symptoms and take her pain seriously, suggesting instead that the condition was “all in her head”.

Putting her own misadventures into a broader historical, sociocultural, and political context, Abby shows that women’s bodies have long been the battleground of a never-ending war for power, control, medical knowledge and truth. And that it’s time to refute the belief that being a woman is a pre-existing condition.

To celebrate the paperback publication of Ask Me About My Uterus in the UK, and as part of #EndoMonth, we sat down with Abby to find out more about her journey with endometriosis and chronic illness…

Ask Me About My Uterus tells your own deeply personal story, but when and how did you realise that your experiences, and your struggle to be believed, were also part of a much broader, patriarchal problem?

I think in the beginning the temptation was to say that this was all my fault; that it was a reaction to me personally. But then I started thinking about it and realised these people didn’t know me. As weird as my life was, I still felt like actually this didn’t feel personal.

Eventually there were some doctors who found out a bit more about my life, and started to make assumptions, but I think from the beginning I felt this was bigger than me. I kept saying to myself, ‘this cannot possibly just be me’.

It wasn’t really until I started talking about it on the internet that I realised the full extent of that, because i was getting responses from women all over the world – all ages, all races, all experiences – saying ‘yeah, I’m having this exact conversation with people in my life’, and I thought ‘OK, this is a sign of something much deeper.’

In a way there was something liberating about that because it gave me permission to not take it quite as personally. But it also infuriated me because it meant this was a pervasive problem, and lots of other people were suffering the same way that I was. Realising that set me on the path of trying to advocate more broadly, and that was also the eventual impetus for the book, which came after I’d given a presentation at Stanford.

How do you feel the idea of the ‘hysterical woman’ influenced the way you were treated when seeking medical care?

The fact I was a young woman – particularly a young woman who, when I first got sick, was at a college (Sarah Lawrence) that had a reputation for producing really high strung women – seemed to influence the reaction I got from the get-go.

But I was already used to people, or broader society, trying to justify or explain a woman’s behaviour based on the irrationality that comes with having hormonal cycles. I’d been warned about that even prior to getting my period. It wasn’t even something that was coming down from health classes at school – it was a pop culture trope, it was a plot line in books I read. This idea that women were inherently less capable of being rational and calm because they were dealing with hormones was always there.

There are a lot of problems that can be caused by hormonal imbalances, but I think that sort of blanket characterisation is really misleading and really, really old. A lot of that is rooted in the transition from when gynaecological and obstetric care moved away from being something that women did for other women, through midwifery or even just communities of women coming together and supporting each other through those experiences.

When that became medicalised, and men began to dominate that field, you then had men writing the medical text books and designing medical education, so everything is viewed through their lens.

Where do you think you would be today if you hadn’t been so determined to research, understand and advocate for your own health?

It sounds really predictable and a bit flippant to say this, but the very simple truth is that I wouldn’t be here, because one of two things would have happened. I would have either eventually gotten to the point where the infective process would have become septic – it was already kind of headed there anyway – and I would have died for that reason.

Or, there have been several points where I was actively preparing to take my life. I wasn’t necessarily depressed at that point, but I was overwhelmed by the pain and sickness, and the hopelessness of that.I was just exhausted, and so tired that I just wanted to die so I could rest and stop doing this. I really did think at some level my body was just going to give out – and to be honest with you I still feel that way sometimes.

I think part of the reason why it got so bad was because I had to advocate, because I had so many untreated infections, and so many things went wrong and weren’t caught. I had to be under so much stress, physically and emotionally for many years, which has now led me to this point of chronic ill health. In a way it feeds that cycle of asking ‘what if?’, and I try not to do that anymore. You can drive yourself into a really bad place going down that road.

I’m at a point now where it’s more about acceptance than anything else, and that’s really part of what it means to continue to advocate for yourself. One of the big things since the book came out is that now I have a platform, and I feel a responsibility to balance my own needs with trying to set a reasonable example.

What are the biggest and most frustrating lessons you’ve learned since becoming ill?

Trying to come to terms with the fact that, had things gone differently much earlier in the process – if I’d had more resources, if I’d had more support – I would have had a different outcome. That’s not just something that I think, that’s something that has been said to me many times by medical professionals, who are unhappy and frustrated on my behalf that people who came before them missed things or failed to do things that would have changed the outcome for me.

What I can take away from that now is that, although I know I can’t change my own story, every now and then I get emails from people for whom my book has intervened and gotten them on a path that means hopefully they’ll get there sooner than I did. I am very much at least relieved to know I’ve produced something that is a tool and that comforts people. At least I’ve done something useful there.

I am still sometimes frustrated that I didn’t get to benefit from it in that way. My life would have been different if I’d had this book at 17, 18, 19 – emotionally it would have made a difference to me. I get sad about a lot of the things I missed out on, but I feel like it’s now time to let go of what I think I missed out on in my young life.

How has connecting with other women in a similar position helped you, and what have you learned from them?

On one level I find social media very intimidating and overwhelming – but one of the reasons I actually enjoy it is because of the connections I’ve made through my book, or through the advocacy that I’ve done, who’ve turned out to have lots of other things in common with me other than endometriosis or chronic illness.

People are more than just their illness, and I think about that so much because it was the big thing that just changed my life about the New York Times review of my book. Randi Epstein said: ‘Norman’s life is more than her disease’, and that was such a revelation to me, because I do have all these other side things and interests that I’m trying to patch together.

Finally, the big question: how do we solve this problem of medical sexism?

I always say that I do think we have reason to be hopeful. There are a lot of places where things are being done. On the research level, we have people like Noémie Elhadad at Columbia who’s got this incredible citizen science initiative through their Phendo app. They’re trying to build the research to create a phenotype for endometriosis, which is one of the core components of the research that we do not have yet.

One of the big challenges though is the way the healthcare system in the United States works, and the medical education system. We need to challenge those patriarchal structures at a higher level than the majority of us at patient level can get to.

The best thing we can do is support each other and continue to empower each other, but we also need to be aware that there are some things that are way, way, way higher up in the hierarchy. We need allies at the administrative level, at the clinical level, at the research level, and also at the educational and broader sociocultural level that dictates how people learn to be medical professionals. If we don’t see change get made there, we’re not going to make progress.

It’s not going to be easy, and it’s not something that we’re going to change overnight, because we’re working with centuries of historical precedent – not just socioculturally but in terms of this whole structure of medical education. It’s going to take a lot of work.

One of the things about this year that’s been so incredible was that my book came out along with a bunch of other books that were really really good and all very strong testaments for why we need to be looking at this, so we have this growing body of literature now that can be used. My book’s been taught on medical school syllabuses about women’s pain theory!

People have tried to call it the medical #MeToo movement, but I think it’s just a sub-group of that broader movement. Sometimes it feels like you’re taking a step forward and two steps back, and that’s frustrating, but I think the important thing is that we keep hearing many more stories, from many different perspectives, to help this conversation grow and become stronger and more inclusive. That’s really what the goal of the feminist movement needs to be.

You can find Abby online, on Twitter, and on Instagram.

Buy Ask Me About My Uterus on Amazon, out today in paperback.

#EndoMonth: 'If I'd had more resources and support, I would have had a different outcome'. As @abbymnorman's #AskMeAboutMyUterus comes out in paperback in the UK, she speaks to #HystericalWomen about medical sexism Q&A with Abby Norman, author of Ask Me About My Uterus: A Quest To Make Doctors Believe In Women's Pain

#chronic illness #chronic pain #endometriosis

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