The economics of trans healthcare

CW: dysphoria, american exceptionalism

It seems that I bounce around between doctors a lot.

Its not my choice, trust me. I do wish I could have at least this bit of stability in my life but it escapes me. Elusive for all of my life.

I am tied to my medication. It keeps me happy and healthy and in my head. With it, all is right in the world. I feel normal. Undeterred by the onslaught of mud and grime pushed in my face by society, I can glide through life with confidence that what I can directly affect is right in my world.

Without it I lose myself.

Dysphoria can consume you whole.

Struggling to make sense of the feelings of everything being so wrong.

Words that won't come because there are none for it.


Changing a doctor is an incredibly stressful event for me because it means that I suddenly have a deadline on how long until I run out of medication. It means that I need to schedule a visit, describe years of medical history, explain why I need my medication, hope they don't require I see a specialist, fill it at the pharmacy, pick it up, and then never forget to pick it up from that spot until I shuffle off my mortal coil or a clod of mud knocks it all out of balance again. 300 years is a very long time to remember to do something.

That is merely a glimpse below the surface of my own medical gordian knot. Below lies a psychologist. Endocrinologist. Dentist. I do not endorse the proliferation of my genes.

I do not try to change my doctor often. There's only one real thing that will get me to do that: changing my insurance.

The last few months of 2015 I was endowed with the benefits of a Kaiser health plan. Before, for all of my life, I had been on various Preferred Provider Plans (PPOs) and never encountered the Health Management Organization (HMO) model.

My god. It was amazing. It wasn't cheap, but it was amazing.

All of my doctors were in the same system. I had one card to show anywhere and everyone who needed my medical records could get them. In particular, there was the Multispecialty Transitions department which exclusively handled Trans and Queer gender patients. Therapists, endocrinologists, surgeons, connections across the entire medical profession, social workers; online mail order prescriptions; all the things I needed. There. In one place. I had stability in my life for what felt like the first time in years.

For $reasons, I was forced to switch away from Kaiser healthcare for 2016.

I've run out of medication twice in this period. The first was due to not having insurance issued yet through Zenefits, which took well over a month to perform. Luckily I could still get a refill through Kaiser at the last minute. The second due to my new pharmacy needing a few days to reorder. I am currently in this second drought.

This has been your monthly reminder that the American healthcare system is broken beyond description.