This Is What It's Like Going To The Gynecologist When You're Black, Trans And In Texas

Guest Writer
I am 26. Twenty-six years past the doctors saying, “It’s a girl!” when I came into this world. Five years past the recommended age of first receiving a Pap smear. One year past starting hormone replacement therapy. Six months into what many believe to be the “peak reproductive years” for someone with a uterus.
I am 26, living in the middle of the shit show that is Texas politics, and the number of laws that criminalize me being Black, trans, and able to give birth are mounting up higher than my 5-foot, 9-inch frame. I am making the brave choice to live in a time when many people in power would rather me not. I haven’t gotten a Pap smear in years due to a lack of health insurance, time, or the spoons to go through with the process, and I maybe want kids someday. So I’m going to the gynecologist to know my options.
Before doing the thing that most cisgender women do ― simply calling a clinic or practice ― I sprinkle my browser history with searches. On Google: “trans-friendly gynecology in Austin, Texas.” On Facebook: “Who knows a trans-friendly gynecologist?” On Instagram to close friends: “Does anyone know any trans-friendly gynecologists in Austin?” I continue searching for an hour. I don’t have more time than that.
Based on my years of experience with doctors, it’s safe to assume that most medical offices don’t know a damn thing about trans people. They don’t know any greeting that’s not “sir” or “ma’am.” They don’t know how to use any non-he-or-she pronoun. They don’t have a field for you to fill out a name that is not your legal name, and they will equate two genders with two body parts every time. I’ve found this to be true of gynecologists, primary care physicians, sexual health workers ― all of them. Unless it’s a clinic specifically catering to trans people, I don’t expect them to know anything. I expect resistance to me correcting them since I’m not the one with a medical degree in the conversation. Some folks I know expect even more violence. It is 2021 and I am trying to see a gynecologist.
Finally, I come across a couple of comments that mentioned an “LGBT-friendly” practice. I type, “When you say LGBT-friendly, what exactly does that mean?” into Google and Google doesn’t have a good answer. I know then that I have to call the clinic myself.
There is this thing that happens sometimes where “LGBT-friendly” means “LGB-compliant” and nothing else. Often, it means the practice has one white gay man on staff, so they think all of their internal inclusion work is done. Like, “‘RuPaul’s Drag Race’ quotes are on the walls and rainbow confetti comes out of their mouths when they mis-pronoun me” type of places. I’ll be pointed to the women’s room when I need to pee and then hear, “sorry, it’s a reflex” in these places. Maybe, before I leave, a “yes, girl” will slip, followed by an “I call everybody girl — even my male friends!” or something.
“Based on my years of experience with doctors, it’s safe to assume that most medicals offices don’t know a damn thing about trans people.”
I call the clinic that was recommended to me.
“Hello?”
“Hey, this is KB. I’m calling to see if y’all take BCBS and have available appointments next week.”
“Yes to both! Are you calling for somebody else?” the person on the other end of the line asks.
Pause.
Over the past six months, my voice has dropped something like two octaves, so the “ma’ams” I used to get have become “sirs.” In a way, this person is assuming that I’m somebody’s husband, son, or friend calling in place of the typical womanly voice that needs an appointment. It would be fine if it wasn’t the 10th time this week that a stranger has mistaken me for something I’m not based on my voice, or face, or something else we shouldn’t use to determine people’s gender. So I answer:
“No. It is for me.”
“OK, what is your name?”
If I could choose a phrase to explain how I feel much of the time, it would probably be trans fatigue. “What is your name?” can be a surprisingly complicated question depending on your class, or race (since white supremacists from 1619 to present have made class and race almost the same thing), or age, or if you feel any affinity for a name somebody else chose. For me, “What is your name?” is a question that elicits a quick pushing of my ID across a table, in hopes that they can read it and not ask me again. Since this is over the phone, I have to explain. And explain again in a couple of minutes. And misname myself, then explain again to more people every day until I find the $500 I need to legally change my name to something else. Trans fatigue is the everyday fatigue of being trans in an embarrassingly cisgender world.
“My legal name is ___________, but I go by KB.”
“Should we put ‘KB’ down as a preferred name?” I’m asked.
“It’s not really ‘preferred.’ It is what I want on anything that doesn’t necessitate my legal name. Is that OK?”
“I have to ask my manager.”
This is a conversation I could have in my sleep. I had it with my friends after debuting my new name. I had it with every job, and new friend, and family member that I think won’t be violent when given new information. And even with myself ― but not with cashiers or baristas; I don’t have the energy to correct strangers during brief interactions, so I am whatever they call me that day.
“OK. Will I have to use the restroom at all as part of my visit?” I ask.
“We may need a urine sample.”
“Do you have gendered bathrooms?”
“What do you mean?”
In 2016, Texas (along with almost every other state in the South) attempted to pass a law that restricted transgender people from using restrooms that coincide with their gender identity. Because of some science-less, needing-a-distraction-ass lawmakers in North Carolina, every trans person who hadn’t had their legal gender marker changed was about to be subjected to violence and embarrassment if they needed to use a restroom outside of their house.
“I’ve heard enough passive-aggressive 'they’re letting men use the women’s restroom now' comments while peeing in a stall that has a sign featuring a faceless blob in a skirt to last a lifetime.”
It is as silly as it sounds, and because I’m nonbinary, restrooms labeled “men” and “women” don’t feel useful or comfortable for me to use. I’ve heard enough passive-aggressive “they’re letting men use the women’s restroom now” comments while peeing in a stall that has a sign featuring a faceless blob in a skirt to last a lifetime. Hearing the f-word from scary-ass strangers while leaving a men’s restroom feels like the norm at this point, so I’d rather take a leak anywhere without a sign on the outside of it altogether.
“I mean gendered, unlike the fucking bathrooms in everyone’s house” is what I wanted to say back to the person, but they’re a stranger. Instead I say, “Ones with men and women signs on them.”
“I think the restrooms inside our facilities don’t have signs on them.”
I let out a sigh of relief. Eventually we finish this predictable conversation and I have an appointment scheduled for a few weeks from now. Are you as exhausted as me?
***
I get to the clinic 15 minutes early, as requested. I’m greeted by the receptionist — and a bunch of stares. If you ever want to know what people look like when they see someone they think shouldn’t be somewhere, be my guest at the OB-GYN. I’m sure the white ladies clutching their purses (since my transness comes with Blackness) would love it.
“Hey! Are you here to pick something up?” the receptionist asks me.
“Nah. I’m here for an appointment. KB at 8:20.”
“Oh, OK! I’m sorry. Take this with you and bring it back when you’ve filled it out.”
When you live your whole life with the world thinking that you’re a Black girl, and you decide to give up trying to fit into Black girlhood, and you become a man that you didn’t ask to be, no one gives you an injection of “male privilege” juice. There is no packet that says “you’re a man!” with balloons and stickers on it. When you’re in the doctor’s office, they treat your ass like a Black girl plus worse. All the things that Black girls deal with in medical settings is doubled when someone is uncomfortable with your presence, your nonconformity to their ideas of gender.
If you’re leading the crusade against men, I’m sorry to burst your bubble; I get hell too, and I’m not a man, just forced to be one by a binary world. When I say anything about pain, or pleasure, or fertility, or disagree with anything a provider says, I might as well have cussed them out. Their insistence on being the “expert” gets in the way of care I need. I’ve been made an expert on transgender care due to the gaps in knowledge I’ve encountered from professionals and my desire to learn from medical settings so I can advocate for myself because there is no one else equipped or willing to do so. There is no magic wand or alternate universe that saves me from womanness.
A gynecologist isn’t so different.
“Hey ________!”
“It’s KB.”
“Oh yeah, that’s right. So sorry about that. What are you needing today?”
I wish I could say understanding. I wish I could say someone I don’t have to explain my humanity to. Someone with a more-than-101 understanding of what it means to be trans. Or what it means to be trans and Black and filled with fatigue. Someone wanting to be competent and humanlike to both demographics. Someone I trust to hug me.
Instead I say, “I want to know if I can have kids.”
***
It’s 2022 and Texas abortion providers are still fighting an anti-abortion bill that became law. There are still many, many outlets greenlighting unintelligent, reductive, unhelpful, and inaccurate pieces that defend using bioessentialist language when talking about reproductive justice. There is such a lack of research and competence around trans men and masculine people that providers who actually are trans-competent can’t tell me whether taking testosterone impacts my number of eggs. Yet wanting people to use accurate language like “pregnant people” or “birthing people” instead of the limiting and inaccurate term “women” has so many trans-exclusionary (you can’t possibly be radical if you think this way) and ignorant “feminists” rising to the top of a boiling-over pot.
“It’s not cute, nor is it new, to make the assertion that people like me don’t have a right to be included in conversations that impact their experiences and hopes. No matter if the gender-ignorant gaze makes a split-decision about my reproductive parts based on what I look like, I can still become pregnant.”
It’s not cute, nor is it new, to make the assertion that people like me don’t have a right to be included in conversations that impact their experiences and hopes. No matter if the gender-ignorant gaze makes a split-decision about my reproductive parts based on what I look like, I can still become pregnant. I still have a vagina, uterus, fallopian tubes, and scar flesh where boobs used to be. All the shit that a cisgender woman gets for needing reproductive services I get, plus about two more hours of work — not to mention embarrassment and trans fatigue.
If abortion rights are built on “pussy power” and some kind of sameness attributed to everyone that is identified as a woman, then we will continue to fail. If abortion rights are excluded from some — as they have been from Black women and trans people since their inception — then the movement will continue to fail. Reproductive justice means the right to bodily autonomy for all who are directly impacted by sexist, ignorant policies that attempt to tell people who can get pregnant that they can or should be forced to have babies. If being asked to change “women” to “pregnant people” — or asking you to consider taking a fucking workshop on gender and sex to start unlearning all the toxic shit you learned in K-12 — makes you foam at the mouth, we will never have justice. Instead we will only get small, incremental bullshit “progress” fueled by outrage and money that ultimately only helps a few. We saw that with the “women’s right to vote” movement and how it conveniently excluded Black women. Why are we cool with leaving out people again and again?
I’m not being doom and gloom; I’m being realistic. Anti-Blackness and transphobia is cooked into almost every mainstream conversation of reproductive justice, and that’s a problem. The sooner we name our missteps out loud, stop patting ourselves on the back for caring about cisgender women only, and cease the creation of “woman and nonbinary” spaces based on ignorance guised as inclusion, the sooner we get to anything that is closer to justice. Before I even enter a reproductive space, I am invisibilized. I want you to know men aren’t the only demographic to blame, just like not all women menstruate.
At the end of the day, bodies are just bodies. That’s true in Texas, across all these other divided states, and anywhere that has silly little markers for gender and sex. M and F is bullshit, just like any conversation that refuses trans and Black inclusivity. Reproductive justice means every person that can have kids can have them when and if they want to. It also means I can make a call, set an appointment, and leave with all the answers I need.
Black and trans people deserve better. If you want me to say more, you’ll have to pay me.
KB Brookins is a poet, essayist, cultural worker, and Artivism Fellow with Broadway Advocacy Coalition. They are the author of “How to Identify Yourself With a Wound” (Kallisto Gaia Press, 2022) and “Freedom House” (Deep Vellum Publishing, 2023). Follow them online on Twitter and Instagram at @earthtokb.
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