“What barriers to healthcare do you face as a trans man?”

It’s no secret that healthcare is often more accessible to cis people than it is to transgender individuals, and this can cause a lot of problems for the already at-risk trans community. We’re gatekept by medical professionals, discriminated against, and often have to teach doctors what they should be teaching us; about ourselves and the processes of medically transitioning.

Due to this, as a transgender man in the UK, I usually have A LOT to say about the NHS and its treatment of trans people, however, there is another party involved that prevents me accessing adequate healthcare, and it’s time for them to take responsibility. It’s me.

One of the biggest barriers to healthcare I face is my own transness, or rather, the dysphoria that usually comes with being trans. To explain my dysphoria quickly and concisely, it is an extreme discomfort with – and disassociation from – my body. I feel this way because I feel as if I should have been born with the reproductive organs and body parts of a cis male, to match my male gender identity.

Having something that you hate attached to your body is bearable when you can put on clothes and ignore its existence, but can be distressing when you’re supposed to look after it to maintain good health. My main focus of dysphoria is my chest, which is common for trans men. I also have asthma, and in my case it’s pretty bad. For a long time now, I have needed 2 types of inhalers, and I was supposed to go to the doctors for an asthma check-up last year. I avoided it.

The reason I failed to attend was my chest dysphoria, I was not okay with the idea of the doctor placing their hands and stethoscope on my tightly bound chest. Dysphoria is not something that I can just switch off, but I still made the conscious choice to miss the doctors that day.

Missing that appointment resulted in me not getting any more inhalers, and, oh boy, did I feel the effect! I stopped taking them regularly to preserve what I had left of my prescription, and I now only use them in emergency situations, i.e. full on, ‘can’t breathe, think I’m about to die’ attacks. If you’re shaking your head at me through the screen, I know, I’m not proud of it!

Being trans and dealing with doctors is challenging, you have to try to balance the scales between your happiness and your health; but unfortunately, I have to admit I’ve been slacking with the latter.

My troublesome relationship with my chest has had me playing fast and loose with my health more than once. Something that all AFAB (assigned female at birth) people are at risk from is breast cancer, and one thing that you can do to catch signs early on is regularly feel your chest for any abnormalities. You can see where this is going… I struggle even quickly washing my chest in the shower, let alone feeling around for a lump!

However, I’m proud (and a little dysphoric) to tell you all that today, knowing I would be writing this article, I did it. I squeezed my eyes shut, told myself it would be over in a minute, and I fought my dysphoria to check my chest, something that I recommend every AFAB person should do at your next possible convenience. Editors note: Do this once a month – you can find out how to and sign up for a text reminder here. (All is well in Chest-ville by the way!)

One major discomfort that I have not been able to mentally deal with yet, however, is going to the doctors for a smear test. Even typing the words make me shudder. It’s an extremely important thing AFAB people go for a smear test every 3 years, from the age of 25 onwards, or 20 if you live in Scotland. I’m turning 20 in December, so I still have a while before this becomes a necessity, but I am going to start working on overcoming the overwhelming sense of ‘NOPE’ I feel towards this. When the time comes I need to be ready, because I really want to make a change and take better care of my health, even if that does mean a dysphoria-inducing situation once in a while.

The reason I’m trying to take better care of my overall health is because transition, for me, is all about making my body something that I can enjoy and live a happy life with. So what’s the point of struggling through this journey if I’m not around long enough to see the end result and have a good few decades with the body I will have fought for?

Going forward, I will still face some battles with the NHS in accessing adequate health care as a trans person, but I will stop dropping the ball when it comes balancing my health and my comfort, and I hope that other trans people will do the same.

However, if you’re really struggling with this, as I have been, I’d recommend reaching out to fellow trans people, or a support group (if you have one), for reassurance. You might also want to speak to your GP about the dysphoria/anxiety you’re experiencing that is preventing you from looking after yourself as they may have some good advice. And remember, you’re definitely not alone in this!

Mermaids are a charity who help young people who are trans or gender diverse. You can find them here.

Also look out for your local LGBT Alliance (often formerly known as Gay Straight Alliance) who may be able to offer support.

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