Monday, March 19, 2012

Oh lordy, she's driving!!

Yes, it's official.  Drivers in Virginia-be sure to fasten your seatbelts because DJ earned her driver's permit today.  It is glorious seeing her succeed in another area of getting her life back on track. It is not so glorious rubbing Ben Gay on my neck after she stalled the standard shift pick-up truck about ten times trying to master getting it into the elusive first gear, however.  Actually, I don't mind at all.  She did a great job for her first time ever behind the wheel, not counting the tractor, of course.

High five for DJ!!!

For another reason:  her driver's permit/license reads with her legal name and her gender is identified appropriately as F- yes, that's right. FEMALE.  And in the incredibly conservative state of Virginia, no less.  I never would have though it possible but Virginia has made it possible for pre-operative, or post-operative transgender folks to have their gender correctly identified on one's Driver's license.  My wording might be a bit confusing:  one does NOT have to be in the process of attempting surgery, only that it allows folks who are trangender without having surgery to obtain the license correctly AND it also allows folks to change their license if they obtained it bearing the genetic gender, had surgery, and want to change it post-surgery to accurately reflect their insides, and outsides.

Those of you who live in Virginia-this is how you do it.  Go to your DMV and ask for a Customer Medical Report form.  It's possible you can get one by going online to  Follow the instructions and complete the form.  The drawback is you will need a healthcare professional to confirm that you are being treated for Gender Dysphoria.  You then submit that form to the DMV in Richmond.  We also submitted letters from the therapist and DJ's surgeon stating she was under their care.  I will scan a copy of the letter DJ's surgeon wrote.  Feel free to use the wording.  Disc Jockey came up with it and we copied and pasted it and sent it to DJ's surgeon where she could put it on her letterhead, sign it and mail it to us.

The Medical Review Services committee is supposed to make their decision in two weeks and should send you a letter granting you permission to have the gender with which you identify noted on your license.  You take that letter to the DMV, along with other documentation to include any legal name change paperwork, your birth certificate, even if it's in your previous name, as long as you can show provide the paperwork that it was legally changed, your social security number, and if you're a minor, your parent's driver's license, along with their signature.  Hopefully, you will have your parents' support, or even just one parent's support, in this.  If you have trouble, the phone number for the Virginia Medical Review Services desk is (804) 367-6203.

If you don't live in Virginia, consider looking up the medical guidelines for the department of motor vehicles in your state. 

Remember, however, in most states, as I understand it, your birth certificate gender will remain as the gender identified at birth based on your physical presentation at that time, until gender confirmation surgery in most states.  But, once you get a legal name change through your local court system, then it's a matter of filling out an application and sending a check for about $25 to have your name legally changed on your birth certificate too.  Yes, passports are issued based on birth certificate information, but if you have not had gender confirmation surgery, but do have a driver's license with the appropriate gender identified on it, then when you apply for your passport, have your picture taken as you normally live and present.  While the passport may not reflect the correct gender, the picture will, your driver's license will and hopefully you can avoid disaster at the airport.  But just to be safe, carry a copy of the letter from your therapist or healthcare provider, a copy of which I will provide below, that you can present to any official who is questioning the fact that the gender on your passport does not agree with your presentation and/or your driver's license.  You want to stack the deck in your favor to make traveling by air as stress free as possible.

Whoda thunk The Commonwealth of Virginia would provide a way for non-mainstream folk ?  Not this author.  Virginia, I applaud you on this one. 

Please find below, at the very bottom of the screen, on a brown backdrop, a scan of a "carry letter" that Disc Jockey recommended for DJ to make use of when necessary. Do not include what is in parenthesis in your letter.  I don't think I should have to mention that, but you never know what people are thinking if they're anxious for success. I recommend you have your therapist or healthcare provider print it on  his/her letterhead, and have at least a couple of copies bearing his/her original signature and a number of photocopies.  Keep one on your person if you feel like you may ever need it.

Can't say it enough-educate yourself.

DJ is home.  I say that happily and with tiredness in my cyber voice.  Bulldog and I are so glad to have her home, and she is glad to be home.  When she was discharged from the Reflections unit (the eating disorders unit) her therapist ended our last session by saying:

DJ, what I'm about to tell you is not a canned speech.  A lot of girls come here and leave because they don't want to be here; others leave because their insurance won't pay.  Some girls leave because they need to be in a long term residential care facility to manage their eating disorders.  You are leaving because it's the right time for you to go and that doesn't happen very often.  We are all so proud of you and you did so well.

And yes, she did.  She is religious about following the program in spite of putting on the required weight, which is mentally and emotionally tough for her.  But she is one tough cookie and is motivated by her upcoming gender confirmation surgery.

However, there was, is, one significant drawback of DJ's hospital experience.  In spite of their treating her appropriately in the emotional sense on being informed that DJ is transgender, I have to say, in my opinion, that they fell a bit short on the psycho/social/medical aspect.  They admittedly had never treated a transgender patient in their facility, and took it in stride.  They kept her on the girls' floor, and did not divulge DJ's history and supported her when she chose to share her history with the other girls, who, by the way,  were champs.  Not to steal their thunder in any way, but of course they were champs-DJ is so obviously a girl and they had no preconceived notions.  But I still am grateful for people who can take my daughter's word for who she is without needing to inspect her original birth certificate or her underwear.

But back to the facility-when DJ experienced certain symptoms of stress, which is normal in the transgender person, they instead, wanted to label her.  And they did, which we will have to fight to get off of her medical records.  They viewed DJ as a person with anorexia and anxiety disorders, who also happened to have gender dysphoria.  But DJ is a person with gender dysphoria who is experiencing anxiety, and anorexia, as a result of her gender dysphoria.  And there is a difference.

I'm not doctor, but I'm a very experienced paramedic.   When someone's heart is racing, we must determine why before we wantonly apply electricity and shock our patients.  (The word is actually "cardiovert" for people who have pulses; I want to be accurate for any of you who have medical backgrounds.)  For example, a rapid heart rate is a normal finding in patients who are running a fever, are anxious due to fear, or shock, and is common in people who have experienced blood loss, or are having a seizure...the list is pretty extensive.  So, when DJ manifests certain symptoms that can be indicative of 10 different issues, it seems reckless to me to apply the worst case scenario diagnosis based solely on the one symptom.  It's like saying a person has a heart condition because their heart is beating rapidly after getting pulled over by a cop for speeding.

For those of you who were born in the wrong body, who are experiencing gender dysphoria, and for those of us who love our gender dysphoric relatives, please educate yourselves on what is considered "normal" in the gender dysphoric patient.  It's common for people with Gender Identity Disorder, another name for Gender Dysphoria, (although I prefer the latter since it literally means "unhappy with (genetic) gender") to experience any of the following:  anxiety, depression, OCD, tics, suicidal ideation, low self esteem, and in DJ's case, eating disorders, which are not terribly uncommon either, in the gender dysphoric patient population.  These are called co-morbidities in the medical world.  No one is surprised that a child with an upper respiratory infection also has an ear infection-they often go hand in hand.  However, an ear infection without a typical underlying cause would be more concerning.  The same can be true of the common co-morbities that can accompany gender dysphoria.

The reality is, as far as this person can possibly understand it having been born in a body that matches my identity, that gender dysphoria is probably one of the biggest psychological, social and physical challenges a person can experience.  And yet, people experience it every day and are NORMAL in spite of having co-morbidities.  They adjust, they adapt, somehow and some way, and overcome the challenge of having a "birth defect" for which no mainstream organization sponsors walks or telethons to raise money for treatment.  It's one of a handful of medical conditions that many health insurance companies will not cover and so the folks who thrive, in spite of their medical condition, must also bear the brunt of expensive medical costs to manage their conditions.

So, do not let medical people saddle you with an inaccurate diagnosis.  Do not let someone wantonly label you.  To quote a doctor I know, "Doctors like to pathologize".  And more importantly, do not label yourself.  Yes, you may need support, and therapy, possibly anti-depressents, or other medications to manage your comorbidities;  continue to get whatever care you need, but it does not necessarily follow that you are abnormal, or sick.  Try to find doctors and therapists who are experienced with transgender patients.  They will likely not be surprised at the other symptoms you are experiencing because of the stress and fallout of being born into the wrong body in a hostile world.  Again, check out the links to the right of the screen.  Laura's Playground has a listing of doctors and therapists by state.  PFLAG has support groups.  Go to the people who understand your condition and aren't in a hurry to slap a label on you.  My guess is you've probably experienced enough struggle and discrimination and certainly don't need the trouble that comes with a label.