I didn’t go to the dentist for a decade. My excuse was always ‘well I don’t need to, I’m just lucky I guess!’, and the more time went on the fewer questions were asked. He seems fine, his teeth aren’t bad, it isn’t an issue. But that wasn’t the reason. I didn’t go because I was terrified – not of dentists, although it isn’t a pleasant experience. I was terrified of discovering anything wrong with my body that could prevent my transition.
It isn’t a coincidence that this decade neatly overlapped my transition into Eliott, the decade I began to navigate the hellish landscape of English youth transgender healthcare. I’ve written too much about this already, but it's important to realise that these experiences weren’t a horrible, isolated thing that just affected my gender transition. The medical trauma people experience within clinics and the anxiety they induce, with the strict guidelines they have for ‘diagnosing’ gender dysphoria, impact everything. It's taken years to undo the thinking I had to adopt to access life saving treatment.
But within this, I became incredibly paranoid about any interaction I had with medical professionals. I refused to accept help with depression until the last possible moment, and have (still) never sought help for eating disorders. Most bizarrely, I was terrified of dentists. I was anxious of the potential of having eroded tooth enamel on my incisors - the clear sign of bulimia, which peaked in my late teens - which could trigger a chain of events beyond my control. They could potentially report this to my doctor, who could then write to my gender identity clinic, who could then delay or refuse treatment until I was considered mentally well enough to transition. Writing this now, obviously this would not happen: there’s no way this information could get back to the gender identity clinic, and even if it did the chain of communication is so convoluted it would take months or years. But being trapped in a web of unworkable medical systems as a teenager, the brain always creates a worst-case scenario.
Transitioning has had a knock-on effect on the rest of my health. Not in the TERF-y sense that transitioning is unhealthy, bad or wrong, but that navigating the medical systems – especially from a young age – makes me incredibly reluctant to engage in accessing medical help for any other reason. My teeth are just one example. For trans men, this means we often miss cervical smears; partly because we are rarely registered as needing one, but also because engaging with healthcare professionals who are uneducated or hostile towards trans people is incredibly intimidating. The list of non-transition related healthcare that I’m too anxious to access, but would benefit from, could fill a page. Part of it is no doubt laziness, the ‘oh I’ll do it later’ attitude, but the rare occasions I sit down to think about it the old feeling of existential anxiety hits me in the chest, except now it is entirely without basis. ‘What would my gender clinic do if they found out I was being assessed for autism or accessing help for eating disorders?’ – they wouldn’t care, or even find out because their communication is prehistoric.
This was an odd thing for me to write. It's one thing to write about the atrocious state of transgender healthcare, another to consider how being entangled within those systems from a young age has affected how I think about accessing medical treatment as a whole. As well as being denied timely healthcare, it also means we might not visit the dentist for a decade because you become paranoid that medical professionals are conspiring against us to deny us healthcare. But that might just be me.
VERY much feel this!!! distrust and paranoia is so much harder to deal with when you know it’s substantiated in some kind of reality; knowing the healthcare system is a good and necessary resource you should be taking advantage of while also reckoning with the fact that doctors can also be incredibly fucking scary and hostile, and that most medical professionals aren’t adequately equipped to treat trans people is kind of an impossible situation