To Trespass Invited

Higgins, Gina

Layer on layer, silk over steel.

Wary, but in the way of watchful caution rather than frightened shrinking. The way of one who has been dealt such a blow by fellow humans that the echoes have, with subtle discordance, insinuated themselves permanently into thought and behavior. The way of one who has seen the diverging paths and has chosen to grow in spite of the hurts, rather than yield to their venom. To look beyond the fringe of brown hair that hangs veil-like over keen brown eyes feels almost like trespassing.

I knew I was being read even as I was reading. The face before me was alive with awareness in a way that belied the youthful cast of features. The name on the chart was ‘Anne’. He offered his hand and introduced himself as ‘Shawn’.

A faint flush crept across his cheeks as he steadfastly maintained eye contact, posture both challenging and hesitant. Defiance of a world unaccepting, warring with need for acceptance.

I was struck with the force of a revelation that shamed me because it should not have been a revelation. Can any of us, born into the same shape as our self, blithely making our way through our individual daily soliloquies, truly understand what it means to be otherwise? To know, to the very marrow, that what the world perceives as the person is being measured by the wrong standards, appraised by the wrong rules? From early childhood and every single day thereafter, wearing a badge of belonging that doesn’t belong.
We assume air until we can’t breathe. We assume water until we thirst. Deep down, we assume belonging. So many of the subtle interactions among people are dependent on the differences among us that are so prevalent that they are normalized. The dichotomy of human identity is not, for most of us, a building block but the foundation. I was looking at a person who had grown to adulthood as a Transgender person. He had spent his entire life feeling not only that he had the body of the wrong gender, but had done so in a culture that either did not recognize this as a valid issue or which had responded to it with derision or violence.

And yet…
Yet, he came out of that maelstrom of uncertainty strong, with a set of ideals and goals and a firm sense of self that was staggering in its implications. This young person had become himself, and was comfortable with and aware of who that was. Society misappropriated his right to the bone-deep assumption that to be Transgender is a variation of normal and natural.
He took it back.

He requested Testosterone treatment; T-therapy. He wanted the physical aspect of himself to reflect his nature as surely as did his sense of self. I recall frantically trying to dredge forth any memory of training in how to help him with this. Nothing. Any memory of texts or guidelines I might have. Nothing. In retrospect, I am both astounded and appalled that there was an entire marginalized community of people whose particular health needs I, as a Family Physician, was so ill-prepared to address. In truth, this was also the first time I had been asked for help of this nature. We persevered. He was patient while I delved into this area of study, and he started T-therapy. He has become over time a strong advocate for Transgender rights.
It is difficult to say which of us, if either, benefited more by the experience.

We all have our learned defenses; barriers we erect to control how much and what aspects of ourselves it is safe to allow others to perceive. When the situation calls for disclosing more than we are comfortable in so doing, we are faced with choices. We can choose to trust and try, or we can choose to shut down and deflect. It may not even really be a conscious decision. As Family Practitioners however, we cannot leave to chance so powerful and so delicate an opportunity for true connection. We must be aware of ourselves and our own defenses and responses. We also must learn to recognize when we can and should test limits and boundaries, both with our patients and within ourselves, and to practice doing so in a way that affirms dignity, choice, safety, comfort and trust.

To look beyond the fringe of brown hair into the eyes of one so very strong, so admirable, and yet so vulnerable, is a precious opportunity. It is the opportunity to know another person at the most meaningful level.

To trespass invited.

Theme: Patients | Patients 
Theme: Relationships | Relations
Theme: Physicians | Médecins

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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