Thursday • 2016.07.28
Healthcare Heirarchy Holds up Heroine’s Hormones (a Tirade)
Editor’s note: Temporary disruption in access to hormone replacement therapy in trans women can result in medium-to-long and angry blog posts. If symptoms persist, contact a doctor, because legally you have no gods-damn choice.
In Part 1 of this story, we heard how my doctor retired a year ago, and his clinic randomly ceased renewing my daily prescriptions this month with no prior warning. And so I sit here now, battling the internal disintegration of my bodily organs (I can feel it), to bring you an update on this tale of transgender terror.
So my retired doctor’s ex-clinic randomly decided to cease renewing my prescriptions for Hormone Replacement Therapy (HRT). I’ve been on this therapy solidly for nine years, and will be so for the rest of my life. And yet the pills have been cut off. How can this happen?
The problem is how our system works.
The main reason I was totally blindsided by this is because his retirement didn’t actually cause any problems with my meds, at first. By the time I found out he was retired, the clinic had already been refilling my prescriptions for six months without incident, and it’s been another six months since. After a full year of continuing to refill my prescriptions, and with no indication to the contrary, I very reasonably fell into the understanding that they would simply continue doing so. After all, a professional doctor prescribed these medications to me when I originally transitioned, I’ve been taking the same medications for nine years, and I’ll be taking them every day for the rest of my life (apparently I’m chronically trans). The pills. Are. Prescribed to me. As far as I was concerned, that’s all there is to it, but apparently that’s not how it works.
I don’t have a doctor right now; It’s a special pain in the ass to find a doctor when you’re transgender, and frankly I don’t like doctors anyway. I resent the fact that the health care system forces trans people to submit themselves to inspection and harassment by someone, in order to access the basic necessities of life, and this also isn’t the first time doctors have held me up.
But despite those reservations, I sill would have sought out a new doctor sooner… If the clinic had given me, say, a six month warning, or a three month warning, or a one month warning. Or literally any warning whatsoever. But nope! Surprise fucked!
I don’t understand this. It’s not like these are narcotics we’re talking about. This is a basic daily medical therapy I need, that I am never going to not need for as long as I live.
Does Ontario have some kind of rules against clinics prescribing medications for however long after a doctor retires? I have no idea; I’m not a healthcare worker. It wasn’t my job to know that information. I’m just a person (sorry, “patient”) who was forced to go through doctors to get the treatment she needs to live. Somebody along the way should have told me about this issue, before it resulted in my pills getting cut off.
How can it be legal for a clinic to arbitrarily cut off a long-term medically necessary chronic treatment? I’m researching whether I can file a complaint with the Ontario College of Physicians and Surgeons.
Anyway, I was able to get my pharmacist to extend the last prescription, temporarily (which they can do in some circumstances, for some medications). But she’s only given me a thirty-day supply so far.
Now, I have no registered doctor at my old clinic, and certainly no desire to return there anyway since it’s an hour away by bus, and also clearly a complete and utter shit show. But thirty days didn’t give me much time, so I immediately made the earliest possible appointment for an intake interview at my local health care center. The wait time for the interview was three weeks.
Here’s another twist. On the phone I was initially told that the health center has an “LGBT program” and an “urban program,” but that the LGBT program was full and so I could only get a doctor through their “urban” program. I asked twice, very clearly, whether there was any qualitative difference in care or eligibility between the programs, and I was assured they were identical except that the LGBT program has cultural specialization in dealing with queer people. Fine, I thought. If they’re truly the same, then I’ll apply to the “urban” program, since I need a doctor immediately so I have no choice.
Turns out though, the “urban” program is not for me. They specialize for patients in poverty, or homeless, underhoused, substance abuse, and only then (last on the list) they take overflow registration from the full LGBT program. As LGBT, I could technically have enrolled in their waiting list, but I’d be waiting forever, because patients in higher need than me are prioritized— And that’s fine, I’m not upset about that, in fact I’m glad that program exists so that people in need can get the care they require and deserve. I would certainly never want to take a needy person’s place in that program, anyway. Given that, I was perfectly willing to go seek healthcare services elsewhere, where the resources are more appropriate…
Except, I really wish they would have explained that to me on the phone when I first called in, when I specifically asked if there were any qualitative differences in care or eligibility between programs. Not only would it have saved me three full weeks in my doctor search, it also would have prevented me from accidentally wasting thirty minutes of the Client Resource Worker’s time at our ill-fated intake appointment.
So now, I’m back to square one. I’ve missed hours of work on this problem already— During a critical time-sensitive and challenging project that is important to both my company and my career— And I have to miss another half day tomorrow, for the emergency appointment I just booked back at the first clinic that screwed me in the first place, which I hate that I have to do… And which, incidentally, either doesn’t have my medical records anymore, or that $90 record transfer fee was a lie. Fun times to be had by all.
Tomorrow, I must wake up early, take an hour on public transit each way, to go find out why some doctor I’ve never even met before suddenly decided to quit honouring the prescriptions of his professional predecessor, and to beg him, “please sir, may I have some more.”
Now, I have no idea if he’ll fix the prescriptions or not, and I don’t really want whoever this guy is to become my family doctor. I have a life to live, a job to do, nobody has time for things like this. Welcome to the transgender experience: To be put through ridiculous bullshit at any moments’ notice.
Oh, and I found out this morning that my provincial health card expired on my birthday, and the genders on my other IDs don’t match. So that’s going to end up being a thing. One day I will have my revenge on you, legal gender markers… One day…
Author’s note from the future: I was able to persuade the replacement doctor to renew my prescriptions, and I was later able to secure access to a preferable doctor in the LGBT program at my local health center. My treatment is no longer in jeopardy; Sorry (not sorry) for the rant. The system needs reform.