I
try to keep this blog as positive as I can, because I feel that this is the
best way to move forward to greater understanding and tolerance in general. By
nature I am an optimistic person and I prefer to highlight what is going well.
Yet life is not always rainbows and butterflies. Sometimes we must tell our
sorrowful stories in addition to those of gratitude and joy.
Trigger
warning: This post is about a pregnancy loss.
We
got our positive pregnancy test on Thanksgiving Sunday (Canadian). We had been
in our new home just a few weeks at that point, and decided it was meant to be.
We moved to this beautiful forested property with a cute red barn, and of
course we were newly pregnant!
We
told some family and close friends. I had a little nausea but nothing as bad as
with our first. Now I remember reading a few years ago that the more sick you
feel, the less likely you are to miscarry. Vomiting is a particularly good
sign.
Last
week we had our first meeting with our midwife, at around 10 weeks’ gestation,
and discussed having a home birth outside the city limits. We talked about the
logistics of a potential hospital transfer as well as how quickly the midwife
could get from her home to ours.
I
told her that in terms of care, the biggest deal for me is pelvic exams and how
much I hate them. I don’t think anybody enjoys them, but for a lot of trans
people they are particularly excruciating. The midwife accepted this well and
said that only under rare circumstances would she really insist on doing one – if
there was a huge amount of bleeding or if the baby’s heart rate suddenly
tanked. That sounded fine by me. We left the appointment feeling happy. The
pregnancy seemed much more real, and we told more family and friends.
A
few evenings later I noticed some light bleeding. It wasn’t much, but I had
been feeling poorly all day and wanted to go to the hospital. I just really
wanted to go. We didn’t yet have our midwife’s pager number, so I wasn’t able
to talk to her about what I should do. I drove myself into town and left Ian
and Jacob on their own for the first time overnight.
The
intake nurse asked me what was going on. Here. We. Go. “I am transgender. I was
born female and transitioned to male.” I paused and looked at her. “Is that ok?
Do you understand that?”
She
nodded.
I
once saw a walk-in clinic doctor about a urinary tract infection and
erroneously assumed that he knew what ‘transgender’ meant. Then I realized part
way through the visit that he was utterly confused about what I have ‘down there’.
Ever since, I’ve spoken more slowly and spelled out my situation clearly. I
always stop for a moment and give the care provider time to absorb what I’ve
said. Then I ask as gently as I can if they are ok and if they know what I’m
talking about. I try to leave space for the person to admit that they don’t
have a clue.
I
told the intake nurse that I was pregnant, experiencing bleeding and feeling
unwell. She gave me a paper wrist bracelet and told me to wait.
After
a couple of hours, I got moved to an exam room, where I waited another three
hours without speaking to anyone.
A
nurse came in and asked why I was at the hospital. I started again from the
beginning – transgender, born female, pregnant, 10 weeks, light bleeding, one
previous healthy pregnancy, no testosterone for years. She said a doctor would
see me in a while.
Another
nurse came in later to check my vitals. She, too, asked why I was in the
hospital. I went through the same spiel, and she, like the others, was
professional and respectful.
A
student doctor came in and asked what was going on.
“Ummm…
Do you know the background at all?” Did I
really have to come out as transgender to each of these people, one at a time?
“Well,
yes, I do know the backstory a bit.”
“So,
you know I’m transgender?”
“Yes.”
“Are
you ok with that?” I asked him.
“Yes.
I did a bit of research, but I think I am caught up.”
Cool! He looked in the chart
ahead of time, realized he was unfamiliar with transgender folks, and decided
to look us up. Then, within a few minutes of doing some reading, he was able to
use the correct pronouns and have a frank discussion about my medical problem.
THANK YOU, whoever you are. YOU will be an awesome doctor when you are all
grown up.
He
asked me lots of questions, including checking several times that I had not
been taking testosterone recently. I confirmed that I haven’t taken T since
well before conceiving my toddler.
He
asked if I’d had any surgery, so I told him about my top surgery from a few
years ago. He seemed genuinely interested to learn what that was all about –
what the procedure was like and how it differs from a double mastectomy.
“Have
you had anything done on the… bottom? Anything that we should know about?”
“No.”
Thank you for asking politely rather than making assumptions because you find
this embarrassing to talk about.
The
teaching doctor came in and said something like, “So I understand you are
pregnant.”
Thank you for signaling to me
that I don’t have to start by discussing my genitals at birth with you.
We
talked about what was going on, and the doctor said he would order an
ultrasound. He thought everything was probably fine given it was very little
bleeding, but he wanted to be sure.
I
was moved to a waiting area in the hallway near the nurses’ station. I saw a
doctor arrive in his coat and scarf, coffee in hand. He was wearing a pair of
black Blundstones, the same kind of boots that I use for riding horses. They
seemed incongruous to me in a hospital, but I suppose they must be much more
comfortable than traditional dress shoes. Another doctor asked him how he was,
and he replied that he'd spent two hours cleaning up vomit in the middle of the
night – his kid had been sick. Still, he and the new nurses coming in for the
day looked much more cheery than the night shift had.
The
student doctor came up to me and said that
they would be discussing my case with the next set of doctors coming in. “So
you might hear us talking about you.”
I
watched and listened to it all. Not a single wrong pronoun, no poorly-covered
laughs, no unnecessary discussion of my body or my transition. In comparison,
the last time I had to go to the hospital for something, I heard the doctors
and nurses laughing about me in the hallway, not even trying to be discreet.
The
doctor in the Blundstones sat down next to me and said I would need a Winrow
shot because my blood type is Rh negative and I’d had some bleeding. “It will
not only protect this pregnancy, but all future pregnancies as well.”
Thank you for understanding that
this pregnancy was planned and wanted. Thank you for accepting that I deserve
the right to have children as much as anyone else.
I
called Ian. I was anxious to hear how he and Jacob did overnight.
“We
saw FOX!” Jacob said over the phone.
Jacob
had been very brave and did not cry at all, even though he woke up in the
middle of the night a few hours after I left. He also did not want to lie down
in bed. Ian held him for the rest of the night in the rocking chair by our
front window. At one point Ian looked out and saw a fox standing there, very
near the house. He woke Jacob so that he could see it, too.
I
was relieved to hear Jacob sounding so happy. I said I would call back when I
had some information.
Finally
they were ready for me to have the ultrasound. The technician put goo on my
belly and started taking pictures.
“Are
you sure the baby isn’t 5 weeks instead of 10?”
I
knew this was bad. I was sure about our dates. He wasn’t finding a 10-week-old
fetus.
He
said we needed to do a vaginal ultrasound. I told him I was not so comfortable
with that procedure. He said he didn’t like doing them either but it was
important to find out what was going on with the baby, and he couldn’t get a
good enough picture otherwise. He asked if it would help to have another person
in the room, male or female. I said no. Thank
you for asking. Thank you for considering it from my perspective, and helping
me make my own choice.
It
wasn’t as bad as I thought it was going to be, except for that the room was
very cold for someone wearing a paper gown. The technician said that I should
go and talk to the emergency room doctor, who would get the ultrasound pictures
soon.
A
half hour later, the Blundstone doctor told me, “I don’t have all the pictures
yet on the computer, but I can see what they wrote on the file. It looks like a
healthy 6 week fetus. You probably just have the dates wrong. It happens all
the time.”
I
had trouble holding back tears. “I don’t see how I could have the dates wrong.
We were trying for this, so it’s not like I wasn’t paying attention. I don’t
see how this is possible.”
The
doctor said he would wait for the images to be on his computer, and he would
look closely at them.
Another
30 minutes later he took me aside to a separate room.
“You
were right about the dates. The fetus stopped growing at 6 weeks. I’m so sorry.
We almost never know why this happens. I’m going to call for an OBGYN consult.
This happened 4 weeks ago but you have only had very light bleeding. Have you
heard of a D&C before?”
I
had. Vaguely. “I’ve heard it is really unpleasant.”
“Yeah.
I’m sorry. There might be an alternative. There’s a medication you might be
able to take instead. It depends on certain factors. We’ll see what the OBGYN
recommends.”
I
called Ian and told him. I felt like I was stabbing him, giving him such
painful news. I’ve never heard his voice sound so broken the way it did that
day. He and Jacob got picked up by a friend and came to the hospital while I waited
for the OBGYN.
The
doctor and student who came to talk to me were profoundly sympathetic and kind.
They discussed the risks and benefits of both the D&C and taking the
medication, and left the choice up to me. I chose the medication. Jacob and Ian
came in and I got some amazing, big hugs. Jacob nursed a ton while the various
doctors and nurses gave him adoring looks.
The
doctor said, “We usually give this medication as a vaginal injection, but we
looked it up and found that you can also take it in pill form. So we can give
you a prescription for it and you can take it at home when you are ready.”
Wow. They get it. I don’t have to
say anything. YES, a trans guy will likely prefer a pill. Why that isn’t
normally available for cis women as well, I have no idea. I am only grateful on
this day.
They
told me what to expect and how to contact them if I had any questions. On my
way out I thanked every nurse and doctor I saw. I caught Dr. Blundstone in
between tasks and I said, “Every single person here has been so respectful and
understanding. I really appreciate it. I’ve had some pretty bad experiences in
the past…”
“You
will have them again. You know that. But I’m glad that people were good this
time. I think things are changing. We are getting much more education about
trans health care in med school and it is making such a difference.”
Ian,
Jacob and I ate sushi with our friend and her son in the hospital lobby. We
picked up the prescription and some heavy pads and then went home. I was
exhausted from staying overnight in the hospital and decided to wait until the
following day to take the medication. That was another process to go through.
We all needed to rest and have time together first. We had to somehow catch up
to the realization that for the past four weeks, while we were planning and
dreaming about a new family member, our baby was already gone.