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How badly are trans cancer patients treated by American doctors?

The LA Times has an op-ed by Lex Rivers today with this title:

Why is it so hard to get healthcare as a trans cancer patient?

Nothing could have prepared me for what I was about to endure as a trans cancer patient. The abusive treatment I have experienced makes clear how having cancer and being trans are stigmatized in our healthcare system.

Rivers, who lives in the Bay Area, was diagnosed with a rare eye cancer at age 26:

Panic at the “C” word barred me from access to transition-related care. Once they learned I had cancer, some providers suggested discontinuing my hormones without offering any medical justification to explain how this would support my health. One provider told me I needed to start taking antidepressants because I was “emotional” and that if I did not, they would stop prescribing my hormone therapy. As a result, I was coerced into taking psychiatric medication I did not want.

....The discomfort and hostility came from not just doctors, but also nurses and other health professionals who participated in my care, such as technicians for my MRI and CT scans. The dehumanizing discrimination I dealt with included having my clothes tugged and being told I was dressing inappropriately for wearing a skirt.

It is really and truly not my goal to minimize Rivers's experience, but once she makes this public it's fair to offer criticism. And I have a problem with it: Rivers never really demonstrates that she suffered "abusive" treatment or anything close to it. Let's run it down:

  • Within the trans medical community, some doctors suggested she discontinue hormones "without offering any medical justification." Maybe so. But as a cancer patient myself, I'm keenly aware that doctors are sensitive to how little we know about chemotherapy and how it affects different people. Suggesting a conservative approach to the intersection of two big, whole-body therapies—chemo and hormones—isn't uncommon. Sometimes there are things that have to be put on hold until chemo is over.
  • Another doctor suggested antidepressants. I have no idea if this was justified in Rivers's case. But again, it's a very common suggestion for cancer patients, who unsurprisingly suffer from high rates of depression.
  • During her cancer treatment, her clothes were tugged. And one time she was told she had dressed inappropriately for wearing a skirt. This doesn't really make sense and as written it sounds almost frivolous. What's the bigger story here?

I wouldn't write about this if I disagreed with some of it but didn't think it caused any harm. But I'm afraid it might. As written, this piece uses sweepingly radical language—abusive, dehumanizing, hostile, stigmatized, structural violence—to describe things that seem pretty ordinary to anyone who's gone through cancer treatment. I've had doctors refuse to prescribe sleeping meds even though they know that corticosteroids (dexamethasone in my case) play hob with sleep. I've had doctors who recommended demanding lifestyle and diet changes that I later learned were entirely unnecessary. I've become weepy and emotional and ended up taking antidepressants. I've had my treatments changed with no warning. I've become blindingly angry over some of the ways I was treated—sometimes justified, other times, in retrospect, an overreaction caused by the fatigue of chemo and poor sleep.

Needless to say, I'm male, white, cis, hetero, middle class, conventionally abled, and pretty much everything else society codes as normal.

In a lot of ways, the medical system sucks. In other ways it's great. Eventually I found a doctor who had sensible ideas about how to treat steroid-induced insomnia. Nurses clued me in on how best to deal with pharmacies. My current oncologist has been completely supportive and helpful about getting me onto the waiting list for CAR-T treatments. I continue to take antidepressants because that turned out to be a good idea.

In other words, Rivers's essay describes a lot of stuff that might not be related to her trans status at all. Without better evidence of abusive treatment and stigmatizing attitudes, this comes across as routine irritation about medical care that's been lightly overhauled in the service of trans activism. Aside from lefties who are eager to believe it regardless, I suspect most people will come away from this essay thinking that trans people are just willing to complain about anything. That doesn't help anyone.

30 thoughts on “How badly are trans cancer patients treated by American doctors?

  1. kingmidget

    Rivers didn't like the treatment and so, obviously, it must because he is trans. Yet, the type of treatment and advice he received is not uncommon.

    This is a fundamental problem with a lot of what comes out of the left these days. If you don't like something somebody does, it must have been because of your skin color, your gender, your orientation, or some other "unique" aspect of who you are. It can't possibly be for any other reason.

    1. realrobmac

      You're argument would have more weight if you'd be courteous enough to refer to her the way she prefers.

      1. kingmidget

        Please share with me where in Kevin’s post it reveals the preferred pronouns. I saw Lex and assumed, apparently incorrectly, that was a male name. I actually tried to figure it out but there was nothing in the post or the LA Times op-Ed to indicate the preferred pronouns. So … if that’s the best you can do.

        1. KenSchulz

          Paragraph preceding the bullet list:

          It is really and truly not my goal to minimize Rivers's experience, but once she makes this public it's fair to offer criticism. And I have a problem with it: Rivers never really demonstrates that she suffered "abusive" treatment or anything close to it.

          ‘She’ appears twice. I’m going to stop thinking of myself as a slow reader, and start thinking I’m a careful reader.

          1. kingmidget

            Yes. I missed those two references, but I wonder how Kevin knows she's a she, since there's nothing in the op-ed to indicate it. Is it possible that only a male transitioning to a female needs hormones and not a female transitioning to a male? I don't know, but regardless, focusing on my mistake in identification rather than the point I was making, is picayune at best.

        1. iamr4man

          Just out of curiosity, Atticus, how do you feel about the former Republican Governor of Missouri, who is running to be Senator of that state, running an advertisement calling for your murder?

          1. Atticus

            I think he should be expelled from the party for the advertisement. Of course he won’t. Unfortunately, too many current day republicans share his mindset.

            I haven’t watched the ad, just read a recap. If he mentions or alludes to an actual person he considers to be a RINO he should be arrested immediately.

            1. iamr4man

              On his web site he is selling a RINO hunting license for $25. Kill all the RINOs you want. From what I’ve read in your comments I believe you qualify as a person he thinks should be murdered.

            2. MontyTheClipArtMongoose

              LOL at you actually believing Greitens should be expelled from the GQP for the RINO Hunt ad.

              Now, had you said he never should have been let in, as an (alleged) former Democrat, I would believe you.

  2. Yikes

    Is medical treatment of any kind in the US for profit system annoying and frustrating, even if its technically good? Yes, for all.

    Is it possible that trans patients are routinely the subject of micro and macro agressions that make it feel even worse? Sure. Although you'd be tempted to believe it more if, say, you were stranded in Oklahoma or something and had to get treatment there.

    Becuase the second question is completely possible, it does not rule out the first sentence not only being true, but not being any sort of a refutation of the second question.

    Sheesh, I hate these Bill Mahar "everybody toughen up" arguments. Indeed, there is nothing wrong with anyone toughening up. We don't all have to become Navy Seals or something, but the ability to perform well under stress is absolutely an ability.

    But just because a person can perform well under stress doesn't mean you just give up on work aimed at minimizing actions which cause stress, especially the in group causing stress on the out group.

    1. MontyTheClipArtMongoose

      Speaking of Bill Maher, now that he's on the same side of the WOKE War as Ari Fleischer, I hope he has his onetime Bush-43 White House spox on Real Time so they can fuck n' makeup.

  3. realrobmac

    Honestly I wouldn't be surprised if, 10 years from now, it comes out that 75% of trans activists are part of a long con by the Republican Party to make Democrats too absurd for anyone to vote for.

    Trans people, like all people, deserve to be treated with respect and should be free to live their lives how they choose. But some of the tempests in a teapot that come out of that community, and the amount of attention they are given are just too much sometimes.

    1. MontyTheClipArtMongoose

      This is my fear about Lia Adams. I am 98% certain she is authentically transfemme, but there is a small part of me that is waiting for news to come out that she was a four year campus GQP at UPENN & cooked up transitioning to swim on the women's team (after three years on the men's) to pwn tha libz in some gonzo variation on a James O'Queef stunt.

        1. MontyTheClipArtMongoose

          I thought I typed Thomas.

          Apologies.

          My fear is marginal, but though I am twenty years out of college, I recall how petty, insecure, & scummy the Collegiate GQP were at my alma mater, so I wouldn't put it past today's GQP collegians to chop their dicks off to pwn tha libz. (After, I am sure, banking their sperms, in the event they want to have children.)

  4. rick_jones

    The boomers were supposed to be the Me Generation and the 1970s the Me Decade. Perhaps it is returning like a bad pair of polyester corduroy bell-bottoms.

  5. golack

    More has to be done when treating the trans community.
    More has to be done when treating any patient.
    The doctors deal with more cancer patients than patients deal with cancer. That gets forgotten and people doing the treatments presume someone else has talked to the patient.

  6. GrumpyPDXDad

    And maybe because all of the testing for cancer treatments has been done on people NOT taking cross sex hormones, the doctors are reasonably concerned that forcing a male body to be female might cause some complications with these meds and they'd really rather not experiment.

    I'm sorry Lex has cancer. That sucks, no way around it. But Lex could well be the first transwoman to be diagnosed with this cancer and no one has any idea how the intersectionality of cancer * trans is going to play out. Want to help the doctors? Simplify your medical state - you can choose to live without cross sex hormones. Living without chemotherapy is probably a short term affair.

  7. Bob Cline

    It has been eye-opening for me to hear about the mistreatment that many of my Black friends regularly receive, particularly from law enforcement officers. But, they were sometimes surprised to learn how much bullying I received in my younger years. Some bad treatment is due to discrimination, some is just people being awful. But, it would be tempting to attribute it all to discrimination, I suppose.

  8. Doctor Jay

    To live as a trans person is to live under the threat that at any moment, someone may decide to exercise hostility upon your person in protest of your very existence.

    For instance, my daughter had some serious harassment while going through a TSA checkpoint. She was detained so that she missed her flight and felt up multiple times. Nothing was said. Nobody made explicit reference to her particular state of gender, but of course that was the issue: What was that foreign object in this woman's crotch?

    That's gonna make people a bit jumpy.

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