Gender Affirming Care

19 Jan, 2025

Gender Affirming Care is a layered experience that gets flattened out inside of mainstream discourse like most other parts of the trans experience. The multitudes of Gender Affirming Care shine through directly in some of the words that make it up: "Affirmation" and "Care."

While Gender Affirming Care should not be confused with Finding Love in a Hopeless Place ¹, it can be a gateway to it. And the gateway there is paved through Care.

Hospitals are a quintessential Hopeless Place. It is a marvel in these places to feel cared for, to feel held.

It feels like love.

The way love sees you, cares for you, cares that you are well and pushes you to be brave with your body. Pushes you to explore the parts of you that can change and the parts that can't.

When I found a primary care doctor who was curious, and approached my most resigned report-backs as possible areas of inquiry, I was floored. Not just floored, I took care. I took care to schedule follow ups, to face my fears of procedures I'd put off my entire life. I paced myself but brought my lists. I slowly let myself trust that if something was wrong she'd tell me. I found love inside of a hopeless place.

I have of course felt very affirmed in my gender through my doctor, but the word "Affirmation" also carries a different and important meaning than the emotionally cozy context we think of it in. Affirmation is the very vital foundation of receiving care. As the foundation, it's also the floor, or the baseline.

It occurred to me at the eye doctor, that some of the most Gender Affirming Care I have received has arrived in the form of a diagnosis. When the doctor looked at my results and said: "oh yes, this is most common in men aged 30-50 who are Type A and chronically stressed, are you prone to stress?" we both laughed. I had walked into his office so visibly stressed that it was very obvious what the answer was, and he was unambiguously responding to me as a man in my 30's.

To affirm here was not a matter of pronouns but a matter of delivering practical and life changing care. So long as we understood the parameters of "men in their 30's" we could treat me and I went there to be treated. Not exactly to "be cared for" but to, hopefully, receive care. Or maybe, more accurately, to receive tests and to validate. The bridge between affirmation and validation is short and thin.

There are consequences to a lack of affirmation in medical consequences ranging from the social / political (if someone were to refuse treatment to a trans person) to the medical. For a long time in medical settings, much of my blood work would come back with warnings on it because my profile still believed I was biologically female and my levels were only normal if viewed as a man. My doctors knew to tell me that, but there are many nuances to "gendered biology" that we still don't understand. Because trans people are under-researched medically, I generally seek medical context from the community rather than through a medical system.

A strong stance on Gender Affirming Care moves towards Affirmation through rectifying the lack of research and knowledge on trans bodies ² and towards Care by resourcing doctors (better working conditions) and patients (lower costs and a tenable healthcare system) to allow for more curious and compassionate relationships. The experience of not only receiving the care I need as a trans person, but also as a human person has been transformative. When we get imaginative and specific about what changes are necessary, we start articulating a better medical system for all bodies.