Talking about violence

Here’s a quick note.

Today is Transgender Day of Remembrance. This tradition started 16 years ago, and at the time, I was three months into my freshman year of college. I had just learned that being transgender was something one could be.

I am an LGBTQ person who has identified with each of those letters at one point or another. Violence is something I think about. We all do. For trans people specifically, violence and the threat of violence comes at us from all directions – family and friends, employers and educators, health care professionals, religion and the media, institutions and governments, people we know and strangers. It is sometimes loud, sometimes quiet.

I remember pleading with an ex-girlfriend before I socially and physically transitioned, for what seemed like the millionth time, to tell me if she thought I looked more male or female that day. I was going to a new place later and wanted insight on which bathroom would be a better choice. We’d had this conversation many times before, and she exasperatedly told me she doesn’t see gender on me, that I’m just Shayle. She refused to answer. I begged her to try to be objective. She wouldn’t. At the root of my pleas was fear. I was asking for help, help in making a decision in hope of avoiding any restroom altercations (verbal or security), but I was also reaching for any thread of control I could have in the situation. I was asking for the safety of reassurance. She could have said male or female and that would have been fine. It would have helped me make a choice when there wasn’t an answer that would guarantee safety anyway. Instead it would have provided me with the feeling of control, because if I made a decision, even the wrong one, I would have the opportunity to make a different decision in the future. Things wouldn’t just happen to me.

I am really lucky. I’m thinking a lot about this today. Most of the verbal and physical hate I’ve experienced was when I teetered on being visibly identifiable as queer. I’ve learned that people don’t like to be confused, and when they are, they might lash out. I learned to walk away from invitations to fight and to nurse my pride when I was safely at home. When I did begin my physical transition, there was a long stretch of time when I couldn’t predict which gender strangers would identify me as or how people would react. This was during the time when I just started testosterone and hadn’t had surgery or changed any of my legal documents. Something interesting I experienced in these moments was a new safety net. Before, being on the more masculine side of female was what made people uncomfortable. Now, in these more loaded moments (for example the TSA), when push came to shove, my drivers license still resembled some sort of semblance of what my body could represent. The times have changed since my freshman year in college, and at the end of the day when it came down to it, most strangers who aren’t familiar with trans people felt apologetic if they “sir-ed” me before realizing I was legally female. I was willing to trade dignity for safety in some of these moments. That all changed the day my new drivers license showed up. By then, my voice had dropped, I’d bulked up, and had scars across my chest. This was it. If I am in a car accident and the paramedics arrive, if my shirt is ripped off in a fight, if the TSA wants to know what the “anomaly” is in my pants, they’d know I am trans.

In my last blog I talked about how since moving to Hawaii I have a new social privilege of being socially identifiable as the gender I identify with. Part of that makes me safe. Being FTM is more invisible, but also makes me less prone to violence than my MTF sisters. Today, blogs from all over the country posted the names of the transgender individuals who were murdered this year. This issue is a big deal. It is scary when large groups of people do not want you to have rights. When they want to kill you because of your identity. We are seeing a lot of this in the US right now, and in the world. And we are seeing the ugly side of a lot of people with extreme power. When I say I’m scared, this is the violence I’m thinking about. It’s not my everyday, but I think about it, and it will continue to play a role in where I live, who I work with, and where I travel. For my friends who aren’t trans, take a moment today if you can, and read an article or two about the violence against trans bodies this past year. It’s real. These people were trying to live authentically, just like me.


This was taken from the Advocate’s article on Trans Day of Remembrance.





This is deliberate

For the first time since starting this blog, I am having a hard time writing. Every week for the past two months I’ve made update videos that stack the storylines from the previous weeks, which I keep promising myself I’ll use when I finally post today. Tomorrow. Next week. I haven’t posted in two months. This is deliberate.

I moved to Hawaii and everything changed.

For the first time, I have a choice about being out. This luxury only extends as far as the internet, because there lives the stories, quite literally the complete history of my transition. But in my every day, I’m holding my breath less each time I meet someone new like I used to do until the new person uttered a clue as to how they read gender on me. Guys shake my hand after hugging our female friends. I get asked to help move heavy things. Dude. Bro. Man. Brah. There is a fine line between the elixir of new comfort and of course the nagging discomfort with the privilege that comes with it. There are noticeable instances when someone with power will make prolonged eye contact with me when addressing a group of us where I am the only male. And then the usual: I rarely get interrupted; I’m trusted to a good job with little explanation; I’m not the target of mild yet present sexist jokes. I’m a different target but no one can see me.

I’ve been wrestling with the guilt of how amazingly good it feels to experience this specific type of normal. How good it feels to not have to fight to carve out space, or constantly rebuild the lattice that holds up and out the boundaries of patience I’ve grown used to in the name of protecting myself. If you can imagine the pain of claws retracting. Or the weight of an invisibility cloak, soaked. Tired. Because at the end of the day that is the price. It is a trade off.  A temporary release of pressure whose consequence masks hollow. I fight those demons against a deep desire to be whole.

The week before school started, before I met my two queer friends, I sat in a full lecture hall of new graduate students being trained as teaching assistants. It was the LGBT session and the facilitator had us all scribble down on a scrap of paper the names of three people we love, three places we love, and three things we love to do. He then told us to turn to our neighbor and tell them about ourselves without saying any of the words we had just written down. Light laughter filled the room as the absurdity of this request was realized. It was hard. He pointed out that this is a burden LGBTQ individuals face daily when they don’t feel safe to be out. I glanced around the room, surprised at how successful this activity was – people really never had to think about this before. After this, he asked how we would handle it if a student in our section said “that’s so gay”. The room was silent while all of the lgbtq students sat quietly hoping we wouldn’t have to be the ones to answer this. The first response: That doesn’t happen any more. The second response: I’ve only heard gay people say that, it’s like when members of X group call each other “insert potentially objectionable term in the name of reclaiming”. Someone else said something with the words “normal person” in it. She quickly backtracked, but it hung in the air. At about this point, I raised my hand. I asked about violence.

When I first arrived in Hawaii I was scared of violence, so much so that it drove my decisions around outing myself. It is hard for me when people I don’t know well try and reassure me that things are getting better for trans people, when that statement doesn’t reflect an acknowledgement of the systematic oppression and brutal and growing violence on trans bodies, and lack of alarm. After learning the landscape in Hawaii a little better and having some real conversations with the LGBT coordinator on campus, my initial fears subsided. Violence wasn’t the enemy, ignorance was. So while I didn’t seem to need to worry about being beat up, I needed to brace myself for long explanations, offensive statements, and crude joking. Today, I feel like being trans is less like being a unicorn and more like being a shark. There is less resistance against existence. People tend to have an opinion or stance against us as a whole. While we are gaining more attention in the media and our ally base is growing, some love to hate us. Or fear us. And kill us. And they do, at an unprecedented rate. And while someone might be able to name someone, I still might be the first you’ve met in person. And once someone knows, they don’t forget it. You can tell by the way they look at you. You can see it in there eyes.

I am out to some people here. How many, I’m still trying to figure out. This is also part of the problem. I’ve personally told only a handful of folks on the island, and I’m trying to connect the dots to figure out who was told by someone else. The act of coming out takes a lot of mental energy, and it’s nice to know if I don’t have to muster that up. My first few weeks in the lab, I had no idea who knew if I was trans (I still don’t). Even though I wish it wasn’t true, I act different when I’m around people who don’t know. I’m more careful to hide my scars, I turn down the (gay) flame, and I’m more self conscious and less myself. As I began to piece together who knew, I decided I’d rather just come out to the whole lab at a lab meeting (I haven’t yet), because at least then everyone would be on the same page. I’ve learned that the energy and potential uncomfortability of answering questions far outweighs knowing people are talking about you behind your back. And at this point, I think the question is more who doesn’t know. While I think most people do, since I wasn’t the one to tell them, there’s a silence around it that I’m not sure how I feel about. I’m tempted to let it go. I’m ready for this not to be a big deal.

Another thing holding me back on posting is who is now on the other side of the screen and how I want them to feel. There are the friends from home and now the new Hawaii friends. In many of the new Hawaii friendships I’m forming my trans identity hasn’t had the chance to come up, but since we are friends on facebook and I post these blogs to facebook, this post essentially serves as a coming out.  I’m sensitive to the potential disappointment of finding out personal and important things about your friends on the internet and not in person. I also don’t want them to think that they are in any way part of what’s hard for me here, or that I don’t like Hawaii. I do! I love it here, and would be hard pressed to find another place and program that makes me as happy as I am, and that includes you new friends. Perhaps just try and understand that I’m loosening the reigns on what a big deal coming out has to be for me, I’d love for it not to be a big deal. I think I’m getting closer. Thank you to those of you who told me it doesn’t have to be.

To the friends back home, I wanted to start this post like this: Friends! I moved to Hawaii and everything is so much different than San Francisco. I miss my communities, I miss seeing visibly gay people all the time, I miss being one in a huge population of trans folks so my other identities precede that one when people think of me. Rainbows here don’t mean the same thing – I can’t tell you how many times I’ve seen a rainbow somewhere and had to remind myself that it doesn’t mean gay or safe. My appreciation for living in a city where I felt safe to be out and to take risks in coming out to help others struggling with their own identities, where I can tell someone I’m trans and they just get it, where even my science community was pretty queer, has grown. Anytime you move to a new place, we all want to feel understood, recognized. I’m struggling with how I want to do that here in this new place with this new cis-privilege that makes me happy and uncomfortable and completely unrecognizable by LGBT folks (which is the worst feeling). It’s hard. I’m working to make it better. It’s already getting better. I think I waited for that to happen to write this.

I’m going to try to get back to the regular monthly blog schedule. Since the end of July (my last post) a lot of things happened. The president of the company that compounds my testosterone, the ones who contaminated my last prescription, personally called me after I sent my contaminated vial back with a letter explaining to him how this mistake impacted me. We talked for an hour and he apologized, the first time anyone from the company has. He was completely transparent about what happened and what they are doing to make sure it doesn’t happen again. It was a simple M1V1:M2V2 error. It was closure I didn’t see coming. I reached my 1 year post-op landmark. I went to the beach without a shirt on and no one stared at my scars. I was invited to be part of an awesome team proposal to talk about trans medical care at a huge science conference next year. I moved to Hawaii and I love it. I’m experiencing living a life I had only dreamed about. And I know that it’s only a matter of time before my politics and scicomm and event planning and community service kick in and everyone will know I’m trans because it is an important part of my identity, of who I am. I have a Google Alert for “transgender”, and every night all the articles from the day show up in my inbox, and both the stories about trans teenagers whose parents have their backs and the reports of yet another devastating murder or suicide remind me how important community is. And I’m brewing plans for building it. But for now, I’m enjoying these few moments where life has loosened her grip and I get to experience what easy feels like for what seems like the first time, ever.

Things to know if you want your FAFSA…

I received this letter:

Dear Shayle,

We received the correction(s) made to your FAFSA application whereby you have changed your response to question # 21. Are you male or female. To be eligible for federal student aid, male citizens and male immigrants residing in the U.S. aged 18 through 25 are required to register with the Selective Service System, with limited exceptions. This requirement applies to any person assigned the sex of male at birth. The Selective Service System and the registration requirement for males preserve America?s ability to provide resources in an emergency to the U.S. Armed Forces (Army, Navy, Air Force, Marines, or Coast Guard). For more information about the Selective Service System, visit
Being that you answered MALE, you must submit proof of selective service registration.
The Selective Service reported that you have not registered with them. If you were born as a female or were born before 1960, registration is not required, please submit a copy of your birth certificate to verify your gender at birth and/or your date of birth if born before 1960 and correct your FAFSA accordingly (see page 2 of FAFSA instructions for further instructions on question 21). If you believe you have already registered or are exempt, please check the Selective Service website at, select “registration info” and then “Who Must Register?”. If you have documentation proving an exemption, submit it to our office. For more information, please contact the Selective Service at 847-688-6888 only after reviewing the SSS website information.

Ok. Things to note. First, I changed my gender marker on my FAFSA when my legal gender change cleared because, surprise, Financial Aid likes your documents to match. Second:

“Are you male or female.”

Note the period and the absence of a question mark. Subtle, I know, but powerful. I’ve been asked this question many times throughout my life, though usually in the form of “are you a boy or a girl(?/.)”, and the punctuation gives me hints towards the askers intention. When a child asks, it is usually with a question mark, and my response, no matter what it is, taken as an answer to a question. As I grew older, I learned quickly that when this was a statement (when there was clearly no question mark), it was followed by violence – usually verbal, sometimes physical. So for the Free Application for Federal Student Aid to be not asking me, but rather issuing the statement “Are you male or female.” was loaded. Clearly, something isn’t right, isn’t normal, are you sure…you don’t want to be making this mistake. Also, as a statement, there isn’t room for negotiation.

As I mentioned in the video, I was prepared for this. A friend had shared his experience with me a few months ago. During our conversation I sat wide-eyed. I had never thought about that particular hurdle. Weeks later I wrote an essay about some of the challenges facing trans graduate students and thought about asking him if I could include his story. Turns out all I had to do was wait a few more weeks and it would be my own.

I spent a week in Hawaii mid-July. My mother had visited right before and I’d asked her to bring a copy of my birth certificate. As it stands today, the state of California DMV and social security acknowledge me as legally male. The state of Illinois and the USA passport agency recognize me as female. And that’s only because I haven’t gotten around to changing those documents yet. It’s funny that birth certificates are seen as the end all in this situation, because Illinois has one of the more easy processes of changing your birth certificate. But the burden of time and money that these processes require has slowed me down. I took my birth certificate to the Financial Aid office and grimaced a little as I saw the very young boy I had to talk with at the counter. An aside: I was just months shy of being accepted into the UH system as male when I applied. So when all my friends were posting pictures of their PhD acceptance letters, I tossed mine aside. UH and Fulbright, both sent letters misgendering me, even after I wrote about it extensively in my application and called both offices to talk with their coordinators about it. I realize it’s automated, I was just hoping for better. So I tell the boy I have a hold on my FAFSA and I need him to file this form for me. He seems confused. We talk until finally I say “I’m trans, I don’t have to register for the selective service.” He’s still confused. “I was born female.” His supervisor assures me everything will be ok. I walk out of the office into the blistering Hawai’i sun and look around at the summer school students and wonder if this how it’s going to be here.

I’m sick of having to out myself because I need money. I was lucky enough to land a TA position last minute, but otherwise I would have been really hurt by the delay in financial aid. I was also lucky that my mom keeps impeccable records, otherwise a request to the State of Illinois for a replacement copy of my birth certificate would have delayed it more. Many trans students aren’t as lucky.

Later FAFSA emailed again telling me to change the answer to question #21 back to female. I just couldn’t do it. I emailed Financial Aid and asked if there was another way we could handle this. There was.

T contamination update (shot 66)

Three quick updates.

In March I posted the letter I sent UCSF about my experience in the ER last September. After a few emails and an hour long phone conversation with the head of patient relations, I found myself pacing around outside the School of Nursing waiting for 8am to roll around. I had been invited to sit on a panel of transgender patients at a training aimed at front of the house staff on transgender health. I hadn’t realized how nervous I was until I was sitting outside watching streams of young doctors and professionals file into an otherwise quiet building clutching their morning coffee. [Aside: I always assumed that my docs who wore scrubs were clean, but I saw so many scrub-wearing folks wandering around outdoors. Normal?]

The lecture hall was packed. I sat down in the second row inconspicuously until the woman in the row ahead turned around and recognized me. It helped that I was a grad student too, but when I mentioned that I studied sea slugs, we had to figure out where else we may have crossed paths. She asked if it was from the Lexington. Being recognized from lesbian spaces by strangers is still complicated. It’s one of the few times I find myself questioning my continued navigation within these spaces – it’s a different experience questioning if I’m “man enough” when I embrace the safety and community of a lesbian bar while fearful of being “she-ed”.

The workshop had three parts.
Part one was a mini trans-101 lead by a transgender UCSF doctor, and she completely nailed it with the crowd – folks were comfortable asking very vulnerable questions. Sitting (almost) anonymously in the audience gave me the chance to figure out what I was going to talk about during my initial 10 mins. Part two was a role play demonstrating scenarios that may happen at the front of the house with trans patients that go wrong, and then how to turn them around. Part three was the trans patient panel. I was disappointed that I was the only person color on the panel, and framed my identities, spoke of my privilege, and the need for recognition that other communities may have different priorities for what safe and accessible health care looks like. Being in a room full of medical staff, students and faculty at the first of what looks to be many of these types of trainings with folks who genuinely care about making trans health better, was incredible. I couldn’t have asked for a better ending to the negative experience I had last fall. Also SF folks who go to UCSF, get ready for some exciting changes.

In most of this video, I give an update on my testosterone contamination. It’s hard for me to report on the disappointment I’ve felt from my own community, and even harder to announce that for now, I’m not following this one through. Today I received a form email from the Transgender Law Center in regards to my initial request for advice that said they’ve had too many requests and to please see their website for advice. If I still needed assistance after that, they asked me to re-submit a request. I want to look at this as an example of how stretched thin transgender resources are. It feels horrible to admit defeat. I feel disappointed in myself for accepting that I deserve this. This really allowed me to experience one aspect of the powerlessness trans individuals experience in circumstances like these – where trans-friends, trans-medical provides, cis-medical providers, and now trans-legal providers all either don’t have the bandwidth to help, or tell me that I should be happy that it wasn’t worse or stood up for the pharmacy that made this mistake because they’re the only affordable option for many trans individuals to get hormones. To the people responsible for this mistake and the incredibly poor response to it, I hope you appreciate the emotional, physical and psychological damage you inflicted on me and countless other transmen, and the fact that many of us are between a rock and hard place when it comes to healthcare, so we will continue to rely on you for our hormone treatments. I do. This mistake was a big deal. I’m angry it happened, and I feel a lot of hate towards you, for acting like the damage it caused us is only worth a replacement prescription with no apology, but more for creating a situation where others who I rely on for emotional support and health care also let me down. Hopefully you’ll learn to do better.

The Philadelphia Transgender Health Conference came and went. It was incredible being back there almost a year now post-op, and seeing old friends, reconnecting with even older friends, and meeting new ones. It wasn’t without its issues of course. Of particular note to my concerns is that they rejected the STEM workshop this year, a workshop that was attended by over 100 trans folks in all areas of STEM education and research. It reconfirms the desperate need for trans science education, activism, and community. (I’m writing this post from yet another conference right now on Advancing LGBTQ Initiatives Across Higher Education thanks to a friend who also believes in this).

That’s it for now. Over and out.

What happens when your testosterone is contaminated (shot 59)

Now that I know, when I think back over the past few months I feel like a cellophane balloon that woke up on the floor of the gymnasium long after the dance ended. The trip down was so gradual I hardly noticed. I held my shape on the ground for what now seems like forever before realizing the air was gone.

Eight hours after shot 58, I walked out of the museum with my phone wedged in the crook of my shoulder as a voicemail from the pharmacy that compounds my testosterone played. No information, just a “please call us back.” It had been three months since I last placed an order with them and my mind quickly jumped to the worst conclusion – something must be wrong. But it was after 5pm and I couldn’t call them back, so I tried talking myself out of it thinking maybe it was a credit card issue. It wasn’t.

The next morning I got a call from my doctor letting me know that the pharmacy had called them too. The batch of testosterone that I had been injecting into the thick of my muscle every week since January had been contaminated…with estrogen. <pause> I felt everything you’re imagining. Probably worse.

I called the company. I asked them how much contamination there was and how it happened. They told me a “small amount,” that they didn’t know. I pushed. I work in a lab and I know that a “small amount” doesn’t actually mean anything, could they please give me a number. They said they didn’t know, but that they would send me a new vial and a return label to send them back what I’d been using. They patted themselves on the shoulder that their quality assurance testing helped them catch this. They never said they were sorry.

I hung up the phone filled with the anger you get when you know someone you trust is lying to your face. And as the initial panic died down hours after, I was filled with revelations of what I wish I would have said. I knew I was being lied to because they had to have measured something to warrant the call in the first place. I also recognized that they couldn’t tell me anything  because depending on what had happened, their license could be on the line. I told myself that’s why they couldn’t apologize.

There was disappointment. And the loss of safety. There was fear and uncertainty. I spent the next few days somewhere between panic, anxiety attacks and breakdowns. There was the guilt that I was so angry at one of the only companies that provides hormones to trans patients at an affordable cost. I was between a rock and a hard place. It was lonely.

I googled estradiol to learn about the side effects. I scrolled through MTF hormone treatment pages to see what the prescribed doses were and how often they injected.

There are two likely ways contamination could have happened. Someone could have made a mistake. Then the likelihood that I was injecting full doses of estrogen on top of the testosterone was high. Someone could have also been negligent. When I’m sequencing sea slug DNA, despite protocol and my best efforts, sometimes contamination happens and instead of slug DNA sequence, I get fungi, frog, shark or even human. It’s close to impossible to pinpoint at what step in the process it happened. The contamination could be a “small amount” too, but it opens the door for who-knows-what to be in there too.

I felt crazy, really. Like the kind of crazy where you aren’t sure you can trust your feelings and aren’t sure what’s true or placebo.

A week before I found out about the contamination I received some sad news. I almost cried, which is something you lose the ability to do when you start taking testosterone. It has been over a year since I cried in a meaningful way, and I felt excited enough to be possibly getting that back that I told my friends. A week later, after I found out I had been injecting estrogen, I had a disappointing and hurtful experience at work and I also almost cried. When I told my female friends I said, “you know that feeling when you’re at work and you’re doing all you can to not start crying in front of your coworker?” It felt like that. I was’t excited that I might be able to squeeze a few tears out, I was mustering up all I could to not. I caught myself saying this only to women. Every one of them nodded that they understood.

Then a week later I had my first uncontaminated shot. There was something about the inkjet-printed label that irked me this time. It looked more like a sticker on a mix-cd from the 90s or what you’d find on a bake sale bag of brownies. I didn’t trust it. I didn’t trust them. But if I wanted what was inside, I needed to get over it.

The difference was instant and extraordinary. My heart felt like it was going to beat out of my chest – a feeling I had almost weekly when I first started hormones. My energy rose, my confidence and calmness arrived, my mind and body felt connected in the exact same way I felt when I had my first injection. Over the next few days, my adolescent ache started coming back. I was relived and thankful to feel like myself. I was horrified at how different I felt.

The psychological struggles of the past few months haunt me, and I push the idea that any of this was linked to increased estrogen away. I spoke with my doctor again and learned that the pharmacy was alerted to this “mistake” when a different doctor tested the estrogen levels of one of her transman patients, a test rarely done during routine blood work for transmen because estrogen levels in cis-women are very low and within a small range. His levels came back unusually high so she phoned the pharmacy. Then they performed a “quality assurance test.”

I’m not feeling very assured. I am feeling uncomfortably lucky that because I’ve been injecting this for three months, I know that there is nothing medically alarming happening (that I can tell from the outside). I’m also thankful that if it is only estrogen, that everything is reversible, and that it will clear my system shortly. I’m thankful in that way that I was able to have an emotional reaction because there was space for me to do that because I wasn’t dying. I hate consoling myself with thoughts of “it could have been worse”. But it could have.

It’s never a convenient time for this type of thing to happen. I talked with friends, doctors, my therapist. I reached out to the Trans Law Center for advice on learning the truth, and to see that I’m taking the right steps towards getting answers. I’m getting ready to pull some strings and reach out to some of my medical center connections to see if I can get the contaminated medication tested myself. I’ve been busy this past week though. Busy writing a talk for an lgbt scholarship that would significantly help me afford my first year of my PhD. These types of applications are difficult because I don’t like to think of my life as more difficult as a result of being trans.

Tomorrow, I’m going to put on nice pants and a button-down shirt and sit inside a courtroom filled with people I don’t know and a judge is going to ask the room if anyone has any objections to my name and gender change.

Every night I get a Google News alert for the keyword “transgender”, and read about legal battles and laws, pop culture strides and setbacks, teenagers and youth who take their own lives, murders. And the cultural needle shifts while a comfort inside myself decides where it’s going to settle.




From LGB to T in the ER

18 March 2015 (Shot 55)

When I was three years old I was diagnosed with cancer. I learned quickly that being a cancer survivor meant that people looked at me differently – they felt bad for me, they treated me like I was breakable. To healthy kids, having cancer meant you lost your hair, and a shameless teasing similar to the karate, hello kitty, and fake-talking in Japanese jokes that stewed my own internal discomfort of being mixed-race-Asian in a black and white suburban town.  Confiding in others that I survived leukemia was as sacred as confessing my attraction to women would be in my later teens.

Being a cancer survivor meant that I was no stranger to the hospital. Going for annual check-ups was non-negotiable (as was health insurance), and even today I still fight an internal alarm every time I get sick; could this be the “big sick” as I used to call it. Entering my 20s as a gender ambiguous queer person who still checked the “F” box on doctors forms, I experienced my fair share of ignorance and judgement from the medical institution. I quickly learned to take solace in student health centers with their “Safe Space” signs, young-hip staff, and gender neutral restrooms. When I had to go to a public medical center in Florida, I learned to bite my tongue while I held my girlfriend’s hand as the nurse ignorantly spit safer sex tips with a grimace. Despite these challenges, I always went to the doctor.

This past August for the first time I felt the widening divide between the LGB and the T when it comes to LGBT health care. It was a holiday weekend and I needed urgent care. I was less than one month post-op from top surgery and still pretty weak, emotionally and physically. The experience wasn’t malicious, but as I walked out I said to myself, I’m only going back there again if I’m bleeding to death. The moment I thought this I literally stopped in my tracks. I didn’t want to approach health care this way.

Six months later, after a very positive experience I had at SFSU’s medical center, I wrote to UCSF about my past experience and a few easy suggestions to make things safer for trans patients (see below). Last week I had an incredible phone conversation with their directors of patient services and relations about my experience in August, what they are currently working towards to make UCSF ER more trans-friendly, and to participate in future conversations and panels.

[some other good reads: UCSF earns perfect score for health care equality, Do no harm: queer patients and the med school closet]


—————————-Letter to UCSF (edited)

I was a patient at the UCSF Emergency Room in August 2014 and had an experience that I wanted to share.

I’d like to tell you a little bit about me to situate my experience and this story. I am a biology graduate student at San Francisco State University and do research on sea slugs at the California Academy of Sciences. I grew up in the midwest and have called California home for the last 15 years, San Francisco specifically for the last nine. I work part-time at the Academy as a Graduate Assistant and qualify for the UCSF Financial Assistance Program. I’m mixed-race, 33 years old, and FTM transgender. I’m out to my family, friends and colleagues and have a fantastic support network. I’m also a childhood cancer survivor and take my health care very seriously.

Back in August, I had been on testosterone for eight months and was still recovering from the top surgery (bilateral mastectomy) I had in late July. I experienced my first UTI a few weeks after surgery and was treated. Over Labor Day weekend I felt what I thought might be another UTI coming on. I was planning on gritting my teeth and waiting to go to my primary care physician on Tuesday if it didn’t get worse. It did. I was at a friend’s house when the pain suddenly skyrocketed and I started to pee blood. It was a holiday weekend Sunday and I drove myself to the UCSF Emergency Room.

I walked in the door and sat down at the receptionist desk. On the drive over I had been worrying about how to let them know I was transgender. The receptionist said little and our interaction was brief, but she didn’t ask about my gender. I was nervous and in pain as I sat in the crowded waiting room. Then I heard being called out loud across the waiting room, I heard “Ms. Matsuda”. I haven’t been referred to as “Ms.” in a very long time. I couldn’t move out of my seat. I was embarrassed and looked around the room to see if anyone noticed. I felt unsafe and fought the urge to get up and walk out of the building. I sat there frozen until a male patient was called. Then I got up and quietly identified myself to the nurse.

The story of my experience could easily seem anti-climatic, which is in part why it has taken me so long to reach out. I experience a lot of quiet trauma as a transgender man. It takes mental energy and emotional strength to initiate the conversation about being trans and requesting that strangers use my preferred pronouns. That day in the ER I couldn’t muster it. It was especially triggering for me because the medical condition I had come in with directly related to my genitals. Unlike coming in for a sprained ankle, in this case I had to weigh the costs of my fears around how to out myself against getting the right type of medical advice.

Some of the nurses I interacted with assumed I was male, which felt good emotionally, but concerned me medically. I sat alone in the sectioned off part of my examination room listening to the conversation between a young male patient and his friend on the other side of the curtain, fearful about having them hear me when I had to “come out” to my doctor. Luckily, they were seen first and were gone by the time my doctor came in; she was the first person there that slowed down and gave me the undivided attention and safety to let her know that I am transgender.

I know that many transgender individuals are too afraid to access the health care they need. I walked out of the ER that day vowing to never come back unless I was essentially on the brink of death. I caught myself right after that thought crossed my mind; this is not how I want to approach my health care. I’m someone who has a strong support system and the privilege of being in graduate school. I had close friends and family to talk with about this experience to help me emotionally recover from it. I know there are many other trans-identified folks who are not in this position, and how much more traumatic and difficult this experience may have been for them.

There is a big split between the LGB and the T when it comes to accessing the care we need. I spent a lot of time thinking about what I could have done differently to have made this experience less traumatic for myself. I used to think that the LGBT Safe Space post cards that were hung in the waiting room at the health facility at my undergraduate institution were nice but didn’t play a big role in defining safety for me. While I experienced tough situations with health care when I identified as a queer woman, they were never as emotionally traumatizing. I had never gotten to the point of considering not accessing the services I need. I realize that the power of seeing those Safe Space cards rests in knowing that the staff have been trained or at least been made aware of transgender patients. This is something that would make me feel safer starting these types of conversations in an environment that is already charged.

What led me to writing to you today is a very positive experience I recently had at the San Francisco State University health center. I realized that there are some simple and easy ideas that I think would make the UCSF ER a much more positive experience for trans-identified folks. When I arrived at the SFSU health center I checked in on a computer system that began by asking my name and gender identity. The options in the pull-down menu were: Male, Female, Transgender MTF, Transgender FTM, Genderqueer, Decline to Answer, and Additional Category. Their awareness of multiple gender identities was part of my first interaction there and instantly made me feel at ease. I felt comfortable initiating conversations about being trans and talking about the medical side of my transition. I deeply appreciated that they brought it up first. Just like the Safe Space cards, this small gesture goes a long way in facilitating accessible safe health care for transgender individuals. These first interactions at a health facility really set the tone for the entire medical experience.

Thank you for taking the time to hear my story and considering my suggestions for making the UCSF ER a safer space for transgender patients.

All my best, Shayle




Court and the costs

I was surprised to realize that the civil courthouse shared a street with my second story San Francisco apartment.

I have coasted by their front door countless times during the eight years I’ve called San Francisco home: biking to and from my therapist’s first office and the discount art supply store; on my motorcycle loaded up with fresh veggies and flats of eggs from the farmers market; lost in a sea of people at the parade when the Giants won the World Series (the first time); on the bus to my best friend’s City Hall wedding. This time I knowingly walked past it on my way to a protest organized in response to the murder of yet another trans woman of color. There was a small but strong crowd gathered in front of City Hall and I recognized familiar faces from over a decade ago. The at-home-karaoke sound system couldn’t compete with the ambient noise of downtown San Francisco and I thought about how I could play with the properties of sound to fashion a DIY amplification solution for situations like these. As I lingered at the edge of the crowd, newlywed couples slowly emerged from the belly of the building and looked briefly into our crowd as they crossed the street hand in hand to their future. My immediate future was waiting for me down the block.

I wasn’t sure if I should dress up. This wasn’t my official court date, I was simply going to file the endless stack of papers I’d spent nights scrawling over to begin the legal process of changing my name and gender. I had Googled the steps to take months ago and had weighed the costs – filing for a name and gender change at the same time meant that I could forgo having to publish the name-change in a newspaper and that I only had to file for a fee waiver once. But what I had really been waiting for was to take my first steps out of the gray area.

I’ve been tuned into two barometers:

  1. The lion’s share of the internal pressure was relieved the moment after I had my first injection of testosterone and continued to weaken over the course of the following months as the hormones took effect and I grew stronger and more at peace. It dipped again the day I had top surgery and has been in flux these past few months as I’ve struggled with the internal battle around quickly bulking up. I desperately want to be bigger, but my internal alarm still rattles as I watch the numbers on the scale slowly increase; an artifact from being socialized (female/in general) for so long?
  2. The second comes from everything outside of me. Recognizing and coming to terms with being transgender was a huge emotional hurdle, and when I finally cleared it and raised my head and looked up and out into the crowd of my life (and they looked back) I still appeared the same. I asked people to change pronouns and they did because they loved and supported me, but strangers still gendered me female 30% of the time. Then things started to change. When I left for the Philippines (month 3) I also doubled my T injections and things began to change quickly. I didn’t notice at first while I was surrounded by people who knew me, but when I went off on my own, things became different. I was being treated like a dude by strangers in a subtly different way than I’d experienced before being just on the masculine-side of the female spectrum. I say “like a dude” because that’s how it started. “Hey dude, have you seen my glasses?” the Australian guy in the hostel asked. I shared a taxi to the airport on my last night with a 21 year old “dude” from LA. He talked about penises for 80% of our two hour ride. This new recognition stuck when I got back to San Francisco, and didn’t shift again until the fall. By that time I was post-op and my voice was rounding out. And each and every time I left the comfort of my city and my community, I was was once again surprised at how wonderful it felt to be seen just as me. Not as trans-me.

Legal documentation can be scary and ironically has also been kind of funny. Inconsistencies tend to rattle people’s internal comfort and I always held my breath as a bouncer or grocery store clerk checked my age on my drivers license. This fear amplified at the airport and for years I’ve managed to catch earlier flights because I got to the terminal so far in advance to scope out who was working for the TSA that day. Before starting testosterone I really did look like a very young man to those who read me male with my smooth face and narrow wingspan. I handed my license to the woman checking IDs at Fat Tire’s Tour de Fat beer and bicycle festival. She gasped and looked up at me exclaiming “this can’t be you!”. My chest tightened. She called to her coworker, “Maureen, can you believe he is 31?!” she laughed, “He looks like he’s in high school.” I exhaled. Usually, no one notices. But when they did, I was androgynous enough that I could easily be explained as being queer. I was still intelligible. I still made sense.

Since the turn of the new year I’m comfortably being socially recognized as male 100% of the time. The people who still mis-gender me are those who have known me throughout this transition, and where at one point the mistakes used to sting like a punch to the chest, my confidence and inner peace now allow me to just let it go.  These instances where I am “she”-ed continue to impact how I gauge the degree that I’ve moved out of the gray area, and they tend to come in waves. Just last week a handful of my friends and colleagues mis-gendered me and in response I thought, what about how I am presenting is reading female, reading not male enough? It’s in those moments that I feel like I set back into the gray area.

There’s a chance I’ll get to spend my 34th year on this planet out of the country. After getting one too many looks from confused TSA agents asking me if I’m sure I’m not wearing a necklace when my body scan returns peculiar,  and being so thankful that I always wear a soft-packer when I travel after being felt up to my groin when I opt for a private screening instead, I knew I needed to get my passport updated before I travel again.

On April 21st I’ll walk to the civil courthouse to see if anyone turns up to refute my request. This time I’ll dress up. And leave one gray area for a new.


One year later.

Today marks one trip around the sun on testosterone. I remember sitting in my room on the night after my first shot wondering what my life would look like a year later.

1545567_10151844480001167_1509144894_nThe weekend before I showed up at the steps of Lyon Martin for my first testosterone injection I escaped to nature with some friends. I found out later that one of them snapped this picture of me standing on the edge of Lake Tahoe. It was a warm sunset and I was on the eve of change. It felt like the calm before the storm, but instead of bracing for impact I was ready to give in, to ride the waves where they would take me.

The last 365 days have been big – for me and for trans politics. The week I started testosterone the SF Mr Transman pageant was hosted in SF and a few weeks later I was packed into a large auditorium listening to Lavern Cox lecture on womanhood. This year Transparent won big at the Golden Globes, health insurance started announcing transgender policies, Janet Mock schooled Piers Morgan on national TV, Against Me!’s new album debuted, countless fights for trans-inclusive policies hit high schools across the country, and last week for the first time in American history Obama said the word “transgender” in the #SOTU. Social media site Facebook first rolled out multiple options for gender identity, but then sparked major controversy with its “real name” policy. While exposure and conversations have increased, violence in trans communities and against trans individuals is rising with sobering statistics. Here’s hoping for a better and safer 2015.

10924810_10152595482511361_6531238176577295770_nLast weekend I once again headed into the woods and a different friend snapped this photograph while I wasn’t looking. I almost couldn’t believe it when I saw it, what a bookend to this first year. This time I was at the ocean and waves crashed in over a pebble-covered beach. This time I’m more confident, strong, and comfortable in my body. This time I’m driven with a happiness from deep within me that I didn’t know existed before. And it’s propelling me into a future that I couldn’t be more ready for.


On being seen (Dec14/Jan15)


I got on the bus and sat down next to a young woman dressed a step below business casual. At the next stop everyone shuffled around and she got up and moved two seats down to an empty seat next to another woman. I sat there dumfounded. I had just taken a shower so I didn’t smell. I was dressed nicely in a button down shirt and wasn’t talking on my phone (or to her) or eating or doing anything else objectionable on the bus. Was is because I’m a man? Crap.

I’ve been subconsciously waiting for this to happen. The years I spent living on the female side of androgyny didn’t give me a lot of access to female spaces, but I did tend to be recognizable as safe by many straight and queer women. The farther along into my transition the more I’m losing this sliver of connection. I’m dreading the day when my presence makes someone uncomfortable, or worse, scared.


I tightened my grip around the straps of my tote bag and took in a deep breath. Behind me a large extended family was arguing and ahead people were rushing in from the cold dripping wet. All the cubbies were overflowing with backpacks and boots shoved tight and I stood still in the middle of this brightly lit trailer-sized changing room and exhaled. An older woman standing near me said, “it gets this way near the holidays”, and she smiled as a small boy and his dad pushed past us.

After stopping in Truckee for hot cups of coffee and having almost slipped multiple times on the ice slicking the pavement, we arrived at the Hot Springs. The woods were silent on our long walk up to the tiny co-ed changing room by the pools and snow crunched quietly beneath our feet. The crowded room soon emptied and I ducked into the bathroom and pulled on my new swim trunks. I folded my tee shirt and placed it into my bag and wrapped a towel around my neck and bare shoulders.

We walked out into the crisp cold air to the main pool. The ends of my towel covered the fresh scars on my chest and I looked around wondering if anyone would notice. I gazed out into the forest around us and up into the clear sky. I slid the towel off around my neck and draped it onto an icy plastic chair and for an instant I stood topless for the first time in public. The heat from the pool was sharp against the icy cold air. I felt amazing; what it felt like was normal. My self-consciousness washed away and never came back. Later in the silent tub I got a silent hello and the largest smile from a trans woman sitting on the other side and I ran into another trans guy back in the changing room. He was walking to the shower naked and I was overwhelmed by the idea of one day being so comfortable in my own skin.


A week before I started testosterone last January I went to a biology conference in Austin. At this point I had already come out to everyone, and my friends and colleagues were doing their best to switch pronouns and be supportive. I looked boyish at best and had an entire bathroom plan that involved knowing the locations of all the single stall handicap restrooms and leaving talks a few minutes early to avoid crowds. At one point I was sitting in a hotel room with some new friends after dinner when another roommate came in (he had given a talk earlier on snake venom). He sat down on the bed across from me and friendly asked if I was trans. I nodded as my new friends looked at me inquisitively, and we talked about being LGBT in science.

This year things were different. My labmate and I did a work-trade to pay for our hotel and we were assigned two other guys to room with. They arrived after the first day of talks and even though I haven’t been read female in a long time, my heart was pounding for the first few minutes as I shook their hands wondering if they could tell. Nothing happened. Everything was fine.

The mixing of old and new friends and colleagues at the conference was new in itself. To the folks from my home institution, I’m transgender – they’ve been by my side through the entire process. But to the people I was meeting here, I was just another guy. We all noticed. What really struck me was the contrast between comfort and ease I was able to feel being treated just as a guy vs. the pressure and self-judgment I feel around being seen as trans. I hadn’t realized the extent it weighs on me to worry about who might have heard if someone accidentally uses the wrong pronoun, or be constantly wondering how everyone sees me or what they think.

On the flip side, it also felt weird that my new friends didn’t know I was trans. This was an unexpected feeling, and I still struggle with if and how to out myself, or when. I realize how confusing I must sound to new people when I’m talking about co-hosting an LGBT meet-up at the conference in one breath and then about my ex-girlfriend in another, and then about cute boys and Grindr in the next. Because even though my attraction to men is somewhat new (a topic for a later date), I’ve been part of gay communities for over a decade and I’m struggling with feelings around being uncomfortable when I’m assumed to have a straight history. Yet another artifact of being seen.


Last week I saw my brother for the first time since starting testosterone. I asked him if it was weird for him. He looked at me and said “no.” And that was the end of that.

365 days later…

Everything is arriving early.

I always thought I’d be writing my 1-year post on the anniversary of my first shot of testosterone. But here I am, just a little over nine months on testosterone, and all signs point to this milestone: one year ago, I admitted to myself that I was finally ready to transition. I was ready to be happy.

Much has come full circle.

An unexpected event happened a year ago. An email showed up at work offering a brown bag lunch workshop at the museum called “Science and Gender: He said, She said” that essentially promised to shotgun us back to the 1950s in terms of gender roles. I penned a very honest letter to HR sharing with them some of my own struggles with gender at the museum, and asking them to please reconsider. They did, and that letter later ended up being the conversation starter for many of my second “coming out” conversations at work.

Last week, a year later, all of Research attended what I hope will be the first of many diversity trainings. While we barely scratched the surface (I’d argue we really only looked at the surface), and there was essentially no talk of power or how intersectionality requires us to think critically and differently about our identities, it was a modest step in the right direction.

Last week I  stood on a stage and for the first time talked about my transition to a room full of strangers. Part of my own personal struggle to come to terms with who I am was weighed down by the pressure of knowing that I would have to get to a place where I was comfortable with the idea of being out publicly. At the time, that self-induced pressure combined with the fear and frustration I was experiencing in response to the realities of what it means to be transgender manifested in anger. I carried this uncomfortably with me for months. The last threads of it cut loose the day I started testosterone. From there on, I was moving forward.

I feel a deep social obligation to be visible, which was only strengthened after meeting other trans individuals in STEM fields over the summer at the Trans Health Conference. When I first started my transition my rules for outing myself were: Is it safe physically and mentally? Will it impact my career? How important is it? Is it worth it? Now, I pretty much just jump to “could I get killed?”, and if the answer is no, I usually take the risk.

This past month I’ve talked a lot about this last year. I talked about science and gender on a short TV clip and on the radio; spoke for three interviews for print; and gave one public talk that will also be a podcast. I was happy to do an additional interview for something strictly science based, but am grateful for the practice talking about something so personal in a very public way.

Right around when I made the decision to transition and was struggling with how this would effect my future in science, I googled “transgender scientists” to see who my role models were. Of the 14 people who popped up, only two share my experience as ftm, and only one was still alive [note: there are a LOT of ftm scientists…Wikipedia just doesn’t know]. He is a tenured professor at Stanford, an MD PhD. He is a brilliant scientist, speaker and writer, and I was glued to YouTube videos of him speaking on neurobiology and gender in science.

Last month I sat on an old couch in his office next to a life-size cardboard cutout of the Australian version of Justin Bieber – a holiday gift from a graduate student – and we talked about everything from trans scientists, to health, biology, bicycling, and being happy. I asked him how, if and when I should tell potential PhD advisors I am trans. He asked if I was Googleable. I looked at him confused. He said, we all Google our prospective students, if it would come up on a search you can assume we already know. Guess that answers that question.

This was one of the longest years of my life. One of the fastest. One of the best. Months ago seem like years. I’m 9-months on T, 3-months post-op, out to everyone in my life personally and professionally, and ready more than ever for what’s to come. I’m waiting for time to slow down again. Someday this will be a new normal. I’ve got a feeling that in three months when I write about my 1-year on testosterone everything once again will be different. I have a feeling about the future.