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Sunday, May 19, 2013

"The Other Side of the Mountain" OR "Today is the First Day of the Rest of Your Life"

Two weeks ago I went to work for the first time as myself for the first time. While I thought that I would be nervous as I got ready, I felt just like I did on any other day. I felt quite content and happy with my decision to transition and was glad that (FINALLY!!) my day had arrived. I would never have to tell another patient that I was intending to transition. I was looking at starting out with a full caseload for the week.

By the end of my period of preparing to transition at work, I had informed over 70 patients of my intention. I am very pleased to report that a little over 96% of the patients that I told either chose to continue to work with me or to begin to work with me. These are important figures because it represents enough data points to be categorized as a large N sample as opposed to a small N sample which makes the 96% more powerful statistically speaking. Using a one tailed T test to analyze the data demonstrates that people from a rural environment in Virginia conclusively are willing to work with a health care professional who is transsexual and transitions on the job. In other words, the results of this data are valid for this geographic area.

Unfortunately, there is no way to test the reliability of this data. In order to do so, I would have to gather another sample of more than 64 patients in order to attempt to replicate the results. I would have to inform them of my transition and I am not willing to do this. My intention from the beginning has been to live my life as a woman, not as a publically trans- identified person. Informing so many people about my transitioning at work has been a quite stressful, but quite manageable experience. I just don't wish to repeat it.  

I think it is notable to report that of the 4% of people who did not wish to work with me, 75% of them were new patients for who I completed an assessment and disclosed my transition at the time of the assessment. There were no differences in the numbers of each gender: two males and two females declined to work with me. Two were fundamentalist Christians, the other two had no particular expressed religious beliefs other than being Christian. The age distribution was not significant. But enough of those dry statistics. Suffice it to say, it is often a better world than we are led to believe.

Despite having a full schedule for the week, on my first day only three patients kept their appointments. As the day wore on and more patients did not show up, I began to think "Oh my God, what the hell have I done?" I was having periods of anxiety and was thinking that the decision to transition at work was the biggest mistake of my life. But then I would think, you've been waiting all your life to do this and my sense of peace and contentment would return. I called the patients who didn't keep their appointments and they rescheduled.

Most of the week this pattern of patients not keeping their appointments continued until Thursday. It was then that I discovered my patients were not getting their reminder calls. While I was off to take care of the necessary legalities involved in my transition, the office staff removed me from the automated system. They had not put the new reminder message into the system by accident. Discovering this oversight was a tremendous relief for me and our staff called my patients individually to remind them of our appointments for Friday and my schedule was full for that day.

Having taken 8 business days off and then not having my patients notified took a toll on my schedule this week as well. It usually drops after returning from a vacation and my patients not being notified for 4 days did not help the situation. But last week my schedule rebounded and I saw almost enough to meet my productivity goal for the week. Next week my schedule is soft and I may be forced to take some time off, but I am confident that it will soon be back to full strength. I feel just as confident and at ease working with my patients as I did before my transition and my patients have all responded positively to my actual transition on the job. The new patients I have seen in the past two weeks seem quite comfortable working with me as well. I am glad for that and grateful to God for being by my side through this part of life's journey.

Before I returned to work, I thought to myself that while my work transition was a monumental personal accomplishment, it is not the destination, nor is my transition complete.

Life itself is a transition. Now I must continue to live and work in a life that feels as congruent outwardly as I experience it inwardly. I can now live my best life with all the joys and sorrows that necessarily come along with the human condition. I have no idea whether life will be easier or harder. It does not matter. My life could become difficult and painful for so many reasons having nothing to do with who I am. Conversely, it can become filled with joy for nothing to do with who I am. That's just the way life is. I am certain that I will experience both the joy and pain of the human condition in the future. I will no longer carry the oppressive burden of not being outwardly who I am inwardly. That brings me a simple sense of comfort and contentment.

While I was off from work, I spent some time in reflection. I spent a lot of time thinking about and writing about the little girl that I was, the little girl that no one knew and I didn't want to be. I had spent so much of my life not wanting to be who I am and not wanting to think about her. I was able to remember a lot of things I had forgotten about her and what she was like. I was able to remember what she was like and the things that she liked and dreamed about and hoped for. That helped me to heal some of the wounds from my past and made me feel much better about who I was when I was little. I can't think of many things sadder than a child who hates herself or an adult who hates the child she was simply for being. I no longer hate that little girl for the simple fact of her being alive. I can see her for who she was with clarity and I can embrace her now as a good and healthy part of who I am. She was who made me someone who is kind and has a lot of compassion for others. She is with me always looking out and seeing the world through my eyes, even when I pretended that she was never there.

There is another thing I knew at some level, but perhaps wasn't always consciously aware of a lot of the time that also became clear just prior to returning to work. It is something I hope that will help you on your own life's journey, no matter where it leads and the experiences you encounter day to day.

Many people don't realize that fear is not the opposite of being brave or having courage. If they experience fear, they often think it means they are cowards, especially if they don't act because of their fear. In reality being brave or having courage has nothing to do with fear. My fear may have gotten in the way of allowing me to become who I am, but it ultimately was an act of courage to be outwardly who I am. While fear may have slowed the process of becoming way down, fear could not defeat the courage to do what I needed to do. Being brave allowed me to act in my own best interest to become outwardly who I am. Ultimately, no amount of fear could have prevented me from what I needed to do for myself.

On your own journey, I hope that you also will find the courage to be true to yourself, despite the sometimes overwhelming fear that comes along with life's journey at its worst moments. Sometimes it takes time to find that courage, but it is there inside you to find.

I have not spent time condemning myself for not having transitioned when I was 18 or 22 or 25 or when I was 36, all ages and at turning points in my life when I seriously considered it. The past is gone. I shall not regret it. It would be a detriment to myself to dwell on it. I prefer to remember all the good things that did happen and while the life I led did not allow me to live outwardly as I am, good things did happen to me and I did good things as well. That allows me to have a sense of peace and acceptance about my past life.

Tomorrow is not promised to me or anyone. I have to live in the present and make the most of today. It is my most sincere wish and hope that you are able to do so as well, no matter what your day to day circumstances may be and never give up your hope. We must be mindful that there is no such thing as perfection. I think that sometimes we have to recognize the incremental progress we make, even if at times we seem to be standing still.  If we sustain our hope, things will improve over time and that belief will carry us from day to day.