Should I use Kaiser Permanente's Gender Health Program or Wait?
June 24, 2019 3:19 PM Subscribe
I'm realizing that gender dysphoria has messed up my (AFAB) ability to get the gynecological care I need and I want to rectify that. My insurance provider, Kaiser Permanente, has a Gender Health Program and I'm deciding if I should go through that program to get my needs met. Would like to hear from trans people who have experience with Kaiser, and/or people with expertise in gender identity and health care.
I'm in Washington State, and Kaiser does seem to have a good reputation among trans people here.
I have some reproductive health issues that I've been avoiding dealing with for about 10 years. Actually, I have been basically neglecting my reproductive health for my entire adult life. I have an extreme aversion to gynecological care, which I used to think of as being sort of weird and childish and repressed but after talking with several AFAB trans and non-binary people, I'm realizing is probably a form of dysphoria. It tracks with some issues I've had with sex as well. (Please: let's just take as a given that this is the source of the issue)
Now that I have a frame for thinking about this aversion, I would like to take some steps to address my health issues (I also suspect that resolving some of these issues may help alleviate other forms of dysphoria I'm experiencing). But that is going to require actually going to a doctor and talking about both my health issues and my aversion. I'm still in a very fragile and uncertain place with my gender identity, and I know I'm only going to be able to do this with a sensitive, gender-competent provider.
Here's the thing: from my local queer community, I've gotten recommendations for gender-competent gynos and PCPs. None of them are accepting new patients, but I've heard that if you go through the Gender Health Program, they can get you in that way. I've also heard that the people working in that program are really good and well-trained and act as advocates for patients.
But here's the other thing: I don't know if I'm trans. OK, well, I'm experiencing gender dysphoria so probably? I guess more accurately, I have no idea how I identify or what I want to do about it. The idea of having to say words like "trans" or even "gender dysphoria" to a health care provider is frankly terrifying.
More specifically, I worry that if I enter this program unsure of how I identify, it might make it harder to get medical transition things covered later if I decide that's what I want. Or conversely, the recent FPP about trans health care makes me worry about getting routed into a "trans track" with my insurance provider, which pings a lot of different anxieties!
And then I feel guilty about the idea of taking up an appointment slot or other resources that could be used by a real trans person. Generally, I wonder if I should wait until I have a firmer sense of my gender identity before approaching this. But these are real health issues I'm dealing with.
So that was a lot of words, but mostly I'm looking to hear from folks who have navigated systems like this, either with Kaiser or elsewhere, or who have expertise in dealing with health care and gender identity and can give me some advice.
I'm in Washington State, and Kaiser does seem to have a good reputation among trans people here.
I have some reproductive health issues that I've been avoiding dealing with for about 10 years. Actually, I have been basically neglecting my reproductive health for my entire adult life. I have an extreme aversion to gynecological care, which I used to think of as being sort of weird and childish and repressed but after talking with several AFAB trans and non-binary people, I'm realizing is probably a form of dysphoria. It tracks with some issues I've had with sex as well. (Please: let's just take as a given that this is the source of the issue)
Now that I have a frame for thinking about this aversion, I would like to take some steps to address my health issues (I also suspect that resolving some of these issues may help alleviate other forms of dysphoria I'm experiencing). But that is going to require actually going to a doctor and talking about both my health issues and my aversion. I'm still in a very fragile and uncertain place with my gender identity, and I know I'm only going to be able to do this with a sensitive, gender-competent provider.
Here's the thing: from my local queer community, I've gotten recommendations for gender-competent gynos and PCPs. None of them are accepting new patients, but I've heard that if you go through the Gender Health Program, they can get you in that way. I've also heard that the people working in that program are really good and well-trained and act as advocates for patients.
But here's the other thing: I don't know if I'm trans. OK, well, I'm experiencing gender dysphoria so probably? I guess more accurately, I have no idea how I identify or what I want to do about it. The idea of having to say words like "trans" or even "gender dysphoria" to a health care provider is frankly terrifying.
More specifically, I worry that if I enter this program unsure of how I identify, it might make it harder to get medical transition things covered later if I decide that's what I want. Or conversely, the recent FPP about trans health care makes me worry about getting routed into a "trans track" with my insurance provider, which pings a lot of different anxieties!
And then I feel guilty about the idea of taking up an appointment slot or other resources that could be used by a real trans person. Generally, I wonder if I should wait until I have a firmer sense of my gender identity before approaching this. But these are real health issues I'm dealing with.
So that was a lot of words, but mostly I'm looking to hear from folks who have navigated systems like this, either with Kaiser or elsewhere, or who have expertise in dealing with health care and gender identity and can give me some advice.
"And then I feel guilty about the idea of taking up an appointment slot or other resources that could be used by a real trans person. "
this kept me out of gender affirming medical care FOREVER and I just want to say do it do it do it! being unsure is valid, and cis people just really tend not to question things like this. the "Q" part of LGBTIQA+ can stand for questioning, and questioning your gender in any capacity qualifies you to be welcomed wholeheartedly into a Gender Health Program with an affirming provider who might help you clarify some things but most importantly, you will be much more comfortable speaking about all of your medical needs with an affirming provider.
I am just hearing so much of myself in your question so it is coming from that angle, but I am SO glad I made that jump. I hope this is helpful! and I wish you all the best :) :) :)
also this... it made me smile when I fell down the rabbit hole of quizzes etc to find out if i was trans enough...
Am I Trans Website
posted by emirenic at 3:54 PM on June 24, 2019 [2 favorites]
this kept me out of gender affirming medical care FOREVER and I just want to say do it do it do it! being unsure is valid, and cis people just really tend not to question things like this. the "Q" part of LGBTIQA+ can stand for questioning, and questioning your gender in any capacity qualifies you to be welcomed wholeheartedly into a Gender Health Program with an affirming provider who might help you clarify some things but most importantly, you will be much more comfortable speaking about all of your medical needs with an affirming provider.
I am just hearing so much of myself in your question so it is coming from that angle, but I am SO glad I made that jump. I hope this is helpful! and I wish you all the best :) :) :)
also this... it made me smile when I fell down the rabbit hole of quizzes etc to find out if i was trans enough...
Am I Trans Website
posted by emirenic at 3:54 PM on June 24, 2019 [2 favorites]
trans woman here. please don’t worry about taking space from other trans people. you are questioning, and gender-affirming spaces, programs, and services are just as much for you regardless of where your questioning leads you.
if you still feel uncomfortable at kaiser, i can recommend Trust Women Seattle. they are an informed-consent reproductive health clinic. i did not have an issue with name or pronouns while there, nor any discomfort being AMAB in that space. i have seen both of their MDs (cis women, one is an ob/gyn, the other is in family medicine). i found they were both good listeners, took lots of notes, and provided the level of care i wanted (general physical and vaginal health). when i have presented them with trans-woman specific issues, they were willing to express their limits of knowledge, but still listened and were willing to research and follow-up on issues they didn’t know about.
posted by kyliej at 4:22 PM on June 24, 2019 [2 favorites]
if you still feel uncomfortable at kaiser, i can recommend Trust Women Seattle. they are an informed-consent reproductive health clinic. i did not have an issue with name or pronouns while there, nor any discomfort being AMAB in that space. i have seen both of their MDs (cis women, one is an ob/gyn, the other is in family medicine). i found they were both good listeners, took lots of notes, and provided the level of care i wanted (general physical and vaginal health). when i have presented them with trans-woman specific issues, they were willing to express their limits of knowledge, but still listened and were willing to research and follow-up on issues they didn’t know about.
posted by kyliej at 4:22 PM on June 24, 2019 [2 favorites]
Response by poster: Thank you so much for these lovely (and affirming!) responses so far! I should say that while I appreciate the Doctor recs, I can pretty much only see Kaiser’s own providers. Anyone else is out of network
posted by the sockening at 5:45 PM on June 24, 2019
posted by the sockening at 5:45 PM on June 24, 2019
Best answer: Trans man here, in WA State, and has Kaiser.
I absolutely love their Gender Care Clinic; it got me both speech therapy and Top Surgery. He's in Capitol Hill Kaiser in Seattle, but my GP is Dr. Colin Fields. He's really good as a doctor, and also the head of their Gender Clinic there at Kaiser.
If you have any sort of inkling that you're possibly trans, I'd encourage you to contact the Gender Care Clinic anyways; if anything, they can set you up with counselors/therapists for you to discuss it with. Plus - if you come to the realization that you are trans, and want gender conforming procedures, you'll already have a relation with a trans-competent therapist who can write the necessary letters, if you need them. Good luck!
posted by spinifex23 at 12:47 AM on June 25, 2019 [2 favorites]
I absolutely love their Gender Care Clinic; it got me both speech therapy and Top Surgery. He's in Capitol Hill Kaiser in Seattle, but my GP is Dr. Colin Fields. He's really good as a doctor, and also the head of their Gender Clinic there at Kaiser.
If you have any sort of inkling that you're possibly trans, I'd encourage you to contact the Gender Care Clinic anyways; if anything, they can set you up with counselors/therapists for you to discuss it with. Plus - if you come to the realization that you are trans, and want gender conforming procedures, you'll already have a relation with a trans-competent therapist who can write the necessary letters, if you need them. Good luck!
posted by spinifex23 at 12:47 AM on June 25, 2019 [2 favorites]
Best answer: One other note - despite using the Gender Health Clinic, I found that it only affected my gender issues. When I had other issues, like my gall bladder deciding to freak out and die, or when I needed bile duct surgery, I was treated just like any other patient who had similar medical problems that had to be dealt with.
posted by spinifex23 at 12:50 AM on June 25, 2019
posted by spinifex23 at 12:50 AM on June 25, 2019
"And then I feel guilty about the idea of taking up an appointment slot or other resources that could be used by a real trans person."
Friend, I've heard this before, and it's like the trans-est sentence you can say. This is not something cis people think.
You're valid and you deserve all the health care you need!
posted by Sterros at 6:10 AM on June 25, 2019 [6 favorites]
Friend, I've heard this before, and it's like the trans-est sentence you can say. This is not something cis people think.
You're valid and you deserve all the health care you need!
posted by Sterros at 6:10 AM on June 25, 2019 [6 favorites]
Response by poster: Thanks, spinifex23, that's the exact information I was looking for! Colin Fields was one of the MDs that had been recommended to me but is not taking new patients, but it may just be that I have to go through Gender Health to see him.
And heh, I thought about taking out the "real trans person" thing because I knew I was being slightly ridiculous, so thank you all for the validation there.
posted by the sockening at 10:43 AM on June 25, 2019 [3 favorites]
And heh, I thought about taking out the "real trans person" thing because I knew I was being slightly ridiculous, so thank you all for the validation there.
posted by the sockening at 10:43 AM on June 25, 2019 [3 favorites]
Response by poster: Just wanted to update that I did finally get up the nerve to call Gender Health - they were lovely, it looks like my therapy will be covered (knock on wood) and they are going to help connect me with a competent PCP. Thanks again, everyone.
posted by the sockening at 1:08 PM on August 5, 2019 [2 favorites]
posted by the sockening at 1:08 PM on August 5, 2019 [2 favorites]
This thread is closed to new comments.
I'm not certain where in Washington State you live, but I see Janna Cuneo at Peter Shalit's clinic on First hill: https://www.doctorshalit.com
In my particular situation I am terrified of finding a gynecologist, I haven't seen one, and I'm actually going to get revision surgery in August. What I can absolutely for certain say, is that Janna Cuneo helped me deal with my vag issues and if I hadn't gone to her I wouldn't have found the validation and subsequent courage to seek any care at all for my vag.
So, if you can get into see Janna Cuneo in Seattle and just explain what you're going through I can vouch that she is wonderful at validating body dysphoria feels without requiring labels and she can help you navigate care for your body in spite of the headwinds of dysphoria getting in your way.
Good luck, it's okay to not have the answers. We're all just trying to figure it out as best we can and any labels are there to serve as guideposts along the way, NOT as fixed identity markers that will define you for the rest of your life.
posted by nikaspark at 3:39 PM on June 24, 2019 [3 favorites]