Rorschachs hostage.

wpid-wp-1410862083754.jpegToday I was at the last meeting with the psychologist in the investigation team prior to diagnosis.

The last three or four meetings with him have been all about testing my mental resilience and general grade of functioning regarding IQ, memory, concentration, verbal abilities and problem solving. The team wants to know that my situation is stable, that I’m well enough to continue and that the gender dysforia I experience is not caused by a personality disorder or depression, for instance.

I’m usually totally exhausted after an hour and a half of intense testing.The first time I was asked intimate questions such as if I “like to behave like a woman, sexually”, what ever that means. That pissed me off so much I haven’t even been able to write about it properly. Then I had to solve logic problems, do advanced 3D jigsaw puzzles and answer questions regarding general education, like how hot water is at it’s boiling point or what the word “palliative” means.

Today, among other things, I had to do a Rorschach test, the old ink stain test that means to examine my personality characteristics and emotional functioning based on how I freely interpret nonsense paintings. 0 It is well known that Rorschach-tests are not reliable, so I didn’t think they were used any more. But I was wrong, they are widely used, especially in the juridical system in Sweden and it is a matter of some controversy.

It makes me feel awkward, frustrated and exposed to interpret pictures in front of a gatekeeper who decides if I will get the medical care I ask for, or not. The Rorschach test is a projective test, normally used to judge if a person has psychotic tendencies. I’m not convinced that it is a valid tool for evaluating my creativeness and personality, like the doctor said when I asked why I had to do it.

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Me at a larp, wearing a 1930’s doctors outfit matching the style and age of the Rorschach-test.

I feel like I’m someone’s hostage and cannot be free of this process until we are done with it. I have to cooperate and be a very, very good boy if I want to continue with the investigation. No matter how intimidating or insulting the questions are, how irrelevant they may seem or how badly the tests are managed.

The good news is that there will be no more psychological testing after today.

When I had finished the doctor summed up my profile as normal to above average, but uneven. No surprises here, I told him all about this the first time we met, about me being an academic nerd with ADHD. Perfectly in line with that he pointed out that I have dips in concentration that show extra well after a long time when solving logic or mathematical problems. Otherwise I’m generally very quick, performing well and I’m especially good at verbal tasks. Not psychotic at all, no signs of depression, no personality disorder and I have very low rates of anxiety.

That was it, all testing done and all relevant information gathered at this stage. I expect things to go more slowly from here. I’ll get a doctors appointment in a month or three. Hopefully I’ll get the diagnosis then. After that I’ll have to go through a thorough medical examination and get a recommendation to start the hormone treatment. I can’t wait. But we knew that, I have another diagnosis for it. 😉

/ E.

 

More about why Rorschach-tests are not reliable, in Swedish;

http://www.barnasrett.no/Artikler/rattssikkerheten_hotas.htm

http://ww2.lakartidningen.se/ltarkiv/2000/temp/pda20501.pdf

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The first meeting with the transgender investigation team

Yesterday I proceeded with the plan I wrote about after my meeting with the gatekeeper psychiatrist. The plan was simple: Call the transgender teams receptionist and gently ask  when I can come and see the team. Just to say that I’ve met the gatekeeper and that he told me that I was ready to proceed with my investigation. I had expected to be turned down or to be told to be patient, just wait and see. Another nine months or so of nothing but waiting would not be out of the ordinary for this sort of thing. I had expected almost anything for an answer, anything else than “Well, how about tomorrow morning, 9 am?”

I was stunned, so, so happy!! Off course I agreed to come. So now I’ve been there again, at the hospital. I’ve met another psychiatrist. This one asked almost the same questions as the last one, but were different in every other way. Firstly, she is not a gatekeeper, she is the welcome committee. She clearly had plenty of experience working with transgenderd people. She was not overly conservative. And best of all, she’s a part of the team that’ll follow me for the next 2-4 years during my medical transition. That means that I’m finally in! 😀

The last post about my medical transition was represented with a selfie of a very nervous and lonely-looking Emil, taken outside the hospital. Today everything was different. My flatmate and best friend was with me. I was not a bit nervous and I was finally in, under the wings and care of the transgender investigation team.

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We’re in.

This time the questions about my background went deeper into my experiences and thoughts on gender identity during my childhood and teens. I told the story of me as a lonely tomboy growing up at the countryside. I was playing with my brothers and their friends, to rough for most of the girls I knew then. Me and my brothers built tree houses and defended them from the other kids in the neighbourhood, fighting each other with wooden swords, bow and arrow. I still do that, only wearing better armour. (Yes, stereotypes come easy for me.)

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I still like to play rough. Here I’m the little one to the left, covering up for my fallen comrade and fighting the enemy of with my stick/spear.

Then she asked me about my marriage. I got married when I was twenty-four years old and my husband-to-be was thirty. I was young, madly in love and struggling to find a way to deal with womanhood. It was a good and mostly sound relationship that lasted for nine years, all in all. We got divorced halfway through 2011 and are still good friends today.

During our time together I adapted into the norms of heterosexuality, but I did not feel like a grown up woman. Even thou the relationship was sound, every time I had to say that I was someone’s wife, something felt slightly wrong. I never felt like a woman, not at all comfortable with my assigned gender role. Only women become wife’s. Since I never felt like one, it was weird being someone’s wife. I felt like I a fraud. I often explained it in a humours manner: “I’m not really a woman”, not understanding the seriousness of it myself.

I tried so hard. But failing to feel comfortable as a woman, I tried to be as girly as I could ever manage instead. I was better at that, but I guess I was overcompensating. The psychiatrist got curious about this and asked if I had any pictures. I have plenty. My friend quickly found one on Facebook and showed it. To see this picture again made me smile – I’ve sure gone a long way since this was taken in the summer of 2007…

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Compare this to the pictures of me from my last post, about claiming masculinity.

Then we talked about what sort of help or medical care I’m looking for, what it was like for me to come out to my parents and about my social situation today. She was impressed to hear about the genuine support I’ve got from people around me. Especially about the fact that I’ve got so many transgenderd friends and experienced transgender allied covering my back, thoroughly supporting me every step on the way.

I think I made a good impression. After all, I mostly feel good about myself and transitioning is improving my life. Only, now when I’ve come so far, I need some help to get further.

She gave me a pile of papers to fill in, a questionnaire with tricky questions about gender identity. I’m to hand it in to the psychologist I’ll see in a month or so. That is the next step, lots of tests and paperwork. I was informed that I’ll have meetings with different specialists in the transgender team every 3 – 4 months from now on. There will be a social investigation about how my life is working, what my relationships are like, how I feel about different aspects of my life. I’ll meet psychologists and psychiatrists on a regular basis to sort out if they can offer me what I want; medical treatment, surgery and in the end recommend me to send in an application for change of legal gender.

I’ll also see a doctor and a gynaecologist to do basic medical examinations, only to see that everything is alright. And in about a year, I’ll see a endocrinologist, a doctor specialised on hormones. I was told promptly that we will not discuss hormones until then. That made me sulk a bit, but there is not much to do other than to cooperate and comply. If I’m lucky things will move on faster, but it is just as well to accept that it mostly will be out of my control.

Finally she asked me how sure I was, about going through with my transitioning, taking it further. I replied honestly that it is impossible to be entirely sure on anything, especially when it comes to committing to permanent changes in your life and body. But I’m at the least 98% sure that this is the right thing for me. At that she smiled and the meeting was over.

The Gatekeeper

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This morning before my meeting, waiting nervously outside the hospital.

I was nervous about today’s meeting, but not in the way people seem to think. I’m not afraid to tell my story or to meet new people. I’m not worried about being denied the medical care I ask for. I’m not afraid to be questioned, I’m well prepared for that and just waiting for an opportunity, for someone to ask and listen. I wont be speechless, quite the opposite.

I’ve been more nervous about getting very conservative questions about my relationships and the gender of my friends and lovers. I dread to be asked to elaborate my own sexual identity or my presumably unhappy childhood. I’m afraid to be judged after the questioners maybe limited understanding of my answers. I don’t want to be misunderstood by the gatekeepers that I have to pass on my journey, but that is a very real risk.

I was disappointed today, at the meeting. I was at the right place in the right time, but when the person in front of me presented himself, I realised that he was not the one I’d expected. He was just another gatekeeper, one of at the least three I’ve met so far. He’s a psychiatrist but does NOT work together with the transgender team responsible for investigation and diagnosis, only in the same house and department so I see now why I was mistaken and got my hopes up.

The procedure is that you must see a psychiatrist before you meet the team and enter the system for real. So it is a step in the right direction, but I thought I’ve already met someone like him and were done with it. I must have mixed things up during the eons of time I’ve been waiting and the long row of people I’ve met in order to get my investigation process started. As things now were, I had to answer all the basic questions about my situation, health, family and such, like I’ve done before with other gatekeepers.

Why do you want to do this investigation? was the first tricky question. It is wide open and I could elaborate on that topic for hours. But for today I was prepared with a short answer, explaining that I feel like a guy and have changed my name and pronoun accordingly. My life would be easier if my registered gender could be changed to match and if I could receive the medical care an investigation such as this could unlock.

So, it is important for you to be addressed as a man? And your name is Emil now? He scribbled something on a piece of paper, thoroughly noting this fact. I was impressed by this, he really got the point without me pushing it down his throat (I’m always ready to do that). This early in our conversation, we had already achieved my set goals for the meeting, him understanding what name and pronoun to use and that I’ve already gone a far way transitioning before we met.

How long have you felt like this, felt like a guy rather than a girl? he asked. This is important since the diagnose criteria states that you have to have felt like this for “a substantial time”. I answered truthfully that I’d never identified myself as a woman, but only lately found out that there are words to describe this, others who feel the same and on top of that – something you can do about it.

He asked about my earlier marriage – Was I married to a man or a woman? Did that person ever question their gender identity? Did I myself, during the marriage? For how long were you married? Where do you live now? In a large apartment with your best friend. What gender does your friend have? Do you live together as friends or as a couple? 

I got a bit annoyed with this, his assuming that friends don’t have sex but couples do. If he thinks it of importance whom I sleep with or not, I’d prefer if he asked directly. As it now were, I pretended not to understand what he was after. Who I have sex with and what my preferences on gender are when it comes to attraction is really not important at this early stage, if ever.

If I have a partner or not (or more than one) is of huge importance tough, I’ll need a good network and solid support to go trough an investigation process as this. But he did not ask about that, so I said nothing. Later, when we talked about my family’s history when it comes to health an heredity, I explained that my friends, partners and family are 100% behind me on this and that I feel that I’ve gotten so much closer to them trough this process, coming out as the person I really am. My intentions where to give him the information he missed to ask me about and I hope he got it.

Then he asked if I was in a hurry with this investigation thing and how important it is to me? I told him that I expect the process to take somewhere between 2 – 4 years and that it means the world to me. He marvelled at this, obviously having no idea himself that it could take so long time. But he seemed to understand that this was important to me and that I had a good idea about the time-frame.

He was confused when I used expressions such as “transition” instead of his “gender swap” or “gender dysforia” to describe the particular sensation of gender related anxiety I sometimes feel. I sighed under the weight of this never ending educational task you seem to have as a transgender person, you have to enlighten and educate everyone you meet, even within the medical care system.

PicsArt_1399056408082[1]All in all, it was a good and efficient first meeting. Now, my plan is to repeatedly and regularly call the transgender team and politely tell them that I’ve seen the psychiatrist down the hall and that I’m ready and eager to meet them as well.

I think I can be rather persuasive.