Gender, Mental Health and other ramblings

I don’t feel safe crying at hospital

I was crying in the operating room before the surgery started

Not because I thought I was going to die

Not because the procedure was especially dangerous

Not because the staff were cruel to me

I was crying because I was lying there in a hospital gown while my body was being moved around underneath me. I was staring at the ceiling unable to really see what was happening while people around me touched and arranged my body

Everything was medically normal but it struck a painful part of my brain

The surgery

The surgery was wound closure under general anaesthetic after self-harm which already added a lot of weight to the experience

I had cut myself and been the one to cause the wound so needing treatment already came with shame attached. I did not feel like a normal patient with an unlucky injury, I felt like someone who had created a problem and now needed other people to fix it

If I cried too much, asked for too much or made the room harder I was scared it would become part of the mental health story around me

Attention-seeking

Difficult

Not coping

Needs to be treated carefully so they don't get upset

I do not think the staff were thinking that, the shame was mostly internal as all the staff were professional

But I was already scared of being seen that way

So I tried to be easy, even while crying

...Especially while crying

Even though I logically understood that the procedure was medically necessary and nothing bad was happening

The only thing my head understood was the feeling of being exposed, being touched and moved, hearing people around me that I couldn't see and knowing things were happening to me that I couldn't control

In the end the easiest thing to do was stay still, stay quiet and let it happen

Wanting to disappear

From the moment I put on the gown I wanted to disappear, having to wear one strips away one of the few ways I have to affirm my gender (clothing) so just the act of wearing it was already highly stressful

Then I started crying.. quietly

I did not want my crying to become a bigger scene. I did not want to take up more resources. I did not want anyone to have to stop and manage me

I wish someone did notice though, I wanted someone to check if I was okay. I wanted someone to understand why it felt so bad and tell me it made sense

But I also know that doing anything to invite that care would make me attention-seeking

So I cried in the smallest way I could, I tried to be easy to ignore

I really do just suck at asking or receiving care

Waking up somewhere else

Then I woke up crying again

I do not remember much except crying and hiding my face

Before the anaesthetic, I was already overwhelmed. I was attempting to answer small talk questions from the anesthetist while trying not to break down

Then suddenly I was somewhere else

A different room

A different environment

No memory of the middle

My body had gone through something without me

I know that is the point of general anaesthetic but it is still strange to wake up crying in a room you did not experience arriving in, knowing something happened to your body while you were gone and all you can remember is the feeling of being touched, exposed and talked about in the moments before you black out

The cystoscopy

Months later, I had to undergo a flexible cystoscopy (flexible camera inserted in the penis)

I was awake for that which I thought might make it easier. At least I would know what was happening and I could have some control

I went in not expecting to wear a gown until suddenly I was told to get changed and sit in the waiting room wearing one

I had prepared myself for one version of the procedure and then the emotional preparation was gone

Again, as stupid as it sound, the gown mattered. It made me feel exposed and not quite like myself

There is also the shame and disgust of having that part of my body become the focus

Trans shame

Body shame

All of that was already in the room before the doctor was

When kindness gave me hope

The nurses were kind

When I told them this kind of procedure was difficult for me they did not make me feel like an idiot. They did not make me feel like I was dramatic or difficult. They did not punish me for saying it out loud

It made me think for a moment that maybe saying something had been the right thing to do

Maybe this time I would not have to hide how difficult it was. Maybe I could be upset without it becoming a problem. Maybe I had done the responsible thing by flagging it early

Then the doctor came in and everything moved quickly

He was efficient. I can understand why that might matter medically

But emotionally, it meant there was no space for me to catch up to what was happening to my own body

I felt like I had to speed-talk my history before the procedure began. I had already told the nurses but once he was in the room it did not feel like that information had changed anything

He did not really acknowledge what I had said but things moved forward anyway

At first it was uncomfortable, then there was sudden physical pain I was not prepared for...

Holding back tears became impossible

Once it started

The nurses asked if I was okay but by that point point it was useless to ask

Not because I thought they were being cruel or didn't care but because there was no answer I could give that would turn the procedure back into something that felt safe

I could not explain why being asked “are you okay?” did not help when the procedure had already moved past the part where I needed it to slow down

So I said I was okay or fine or something like that

Just so they'd understand:

Once the procedure started my comfort was unimportant, the only kindness left was getting it done quickly

The perfect patient

I think a lot of my feels around being afraid to cry come down to my anxiety around being the "perfect patient" in two different ways

As a trans patient I wanted to be the perfect trans girl

Not perfect in the pretty or passing sense but in the harmless sense

Easy to treat. Reasonable. Grateful. Not dramatic. Not someone who makes people feel like treating trans people is complicated. Not someone who creates a future prejudice in someone’s head

As someone with a mental health history, I wanted to be harmless too

Not attention-seeking. Not difficult. Not someone who had caused the problem and then expected everyone else to manage the consequences gently

So I tried to do everything that made me easier to deal with:

During the cystoscopy, I kept saying I was okay or fine. Not because I was or I wanted them to fully believe it. I think I just wanted them to understand the social meaning underneath it

I am cooperating

I am not making this harder

I am not trying to draw attention

Even when I was obviously crying

Even when I had marks on my arm from digging my nails into myself

My mouth was saying I was fine

Safe enough to cry

I think I am more afraid of causing someone discomfort than being uncomfortable myself

I don't feel safe crying at hospital because I do not know what my crying becomes once someone notices it

I don't know what the system could realistically do with someone like me

I don't know what I can ask for without feeling selfish

Is it selfish to ask to speak to the doctor first?

Is it weird to ask to know when the anaesthetic is being administered?

Is it too much to say I feel uncomfortable and need things slowed down?

I do not expect a hospital to magically make me feel safe and comfortable

I know what the room is for, I know the staff have jobs to do, I know my body is not the only body they have to deal with that day but I wish I could at least feel safe enough to cry

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