Izi

Ale:
Do you mind starting with your name, your pronouns, your age, and where you’re from?

Itzli:
I go by Izi, or Itzli, 35, and I use they/them pronouns. I was born in North Carolina, but I’ve been living in the Bay Area for over 30 years.

Ale:
I want to ask what made you want to participate in the project.

Itzli:
I feel like I’ve just had a lot of interactions with medical professionals, and specifically around my trans identity, that have rarely been good. I always have this weird feeling, or I can never tell what it is about me until much later, that it’s transphobia. It always takes talking to many people, with my friends or other trans people, to decipher what I did wrong, and it takes so long for me to come back around and be like, “Oh, this is not an uncommon circumstance.” This happens to many other people. But it’s interesting, it’s a common thing that you often experience if you’re trans masc or nonbinary if you have to be in OBGYN spaces specifically, and navigating that system, and I don’t think I would have been able to get through any of that, any of these experiences, without any type of community care outside of the hospitals. Doctors are not as important to me as my community is.

Ale:
You mentioned that you had really bad experiences. Do you want to share with me some of the experiences you had, or the ones that stuck out to you the most, that were especially harmful?

Itzli:
It’s kind of like a chain reaction of experiences. That’s the most unfortunate part. The more I think about it, the more it’s one thing after another. But it mostly surrounds having really terrible periods all my life, and wanting to get help around them. And you know, when I finally spoke up about how bad they were, the one solution that always comes around is getting an IUD. I kind of just gave in to it eventually, because I wanted to start testosterone and transitioning, and they told me at the time that an IUD wouldn’t affect your testosterone, that is not the same hormonal interaction. Kinda like a cure-all.

Ale:
I remember when we first talked, you mentioned how you had been in chronic pain for such a long time.

Itzli:
The type of periods I have start at my knees, and it’s hard to walk, and my hips and my lower back are in a tremendous amount of pain, I get full-body pains. I didn’t realize it until several years ago that it was probably part of my fibromyalgia that was also being triggered. Later on, I would come to understand that I needed pelvic floor physical therapy. When I had tried to talk to my OBGYN about how painful the insertion of the IUD was, and how I was not able to walk, they kind of pressured me to get out of there. I probably could have stayed in that office for much longer than an hour.

And then for years, I was in so much pain after the IUD, I wasn’t having periods anymore, but certain movements like orgasming were really painful. I had told my OBGYN about it, and she was like, I’ve never heard anybody say this to me, I’ve never heard of this problem before, I said, “Oh, that’s funny, because everybody online says they have it.” Everybody I’ve talked to who’s had an IUD has said they’ve had some issue, some type of pain, I’m not making this up.

Ale:
For how long had this been happening?

Itzli:
I had it for seven years because my OBGYN was like “no, you’re fine, it’s in the right position, there’s no irritation, nothing looks out of place”. She just kept telling me for years that I was fine.

“I’m so desperate to just live comfortably. I don’t want to say this, but I just want to go to work, you know, and not have to think or be scared for my health. I don’t want to know what life-threatening is, I don’t want to wait for it to get worse.”

Ale:
How did you eventually get rid of the pain?

Itzli:
This type of IUD has a lifespan of about seven years, and then it starts to wane. I have other health conditions, like fibromyalgia, and I have a fainting issue that really depends on fluid loss. I knew that when you get an IUD removed, more often than not, you would have a tremendous amount of fluid loss. I was also getting to the age where I was like, am I gonna have children or not? Like, what does it mean for me? Will I have dysphoria or not to give birth to a child? And I just decided that I do not want to give birth to a child, if I do want to have a child, I will most likely adopt. So I decided to have my tubes ligated, but a lot of the doctors do not take my fainting condition seriously.

Ale:
What do they say when you tell them you have this condition?

Itzli:
I’ve only ever had my anesthesiologist and the surgeons take me seriously, or my cardiologist, but every other person has not. They tell me, “You’re fine, just drink more water,” and I will sometimes faint five times in a day. So of course, when I had my tubes ligated, I demanded to also have my IUD removed, and my anesthesiologist said this is serious, so we’ll give you three IV bags to compensate for the blood loss.

Even after all that, I was still having pain, and they considered it contractions and assigned me pelvic floor physical therapy. After all that, after the removal and the litigation, they said the pain I was experiencing was actually residual trauma from the IUD. Even to this day, I still have to practice physical therapy methods to try and interrupt the contractions from having them for seven years.

Ale:
So you were in chronic pain before and after the IUD, and during the seven years that you had it, nothing happened, even though you had been insisting that whole time that something was wrong?

Itzli:
I had no idea it was related, I just knew I was uncomfortable. Along the way, the nurses were super rude about my gender and nobody’s using my pronouns, nobody’s using my name, nobody’s taking anything I’m saying seriously when it comes to pain. I shouldn’t have to go to such an extent to be taken seriously. Along the way, I was on the phone with the doctor, and they’re asking me to take a pregnancy test. I was like, I don’t need to do a pregnancy test, I haven’t slept with anybody who produces sperm in a while, and they kept asking me several times leading up to the surgery. The day of the surgery, I’d go to use the bathroom and the nurse bum rush me and physically pushed herself between me and the bathroom and demanded that I need to take a pregnancy test. She insists that what if I’m pregnant, until I was like “I’m gay”.

Ale:
So you were basically forced to come out?

Itzli:
Yeah, and that person ended up being my nurse for the whole intake of the surgery. When you have fibromyalgia, you also have brain fog, and I couldn’t remember my partner’s last name at the time, and she shamed me for it. The anesthesiologist had increased my ID [Intravenous Drip] at the time to make sure my intake was more than usual, and then she tried cinching it down, but I was like, “Hey, don’t do that, my anesthesiologist just adjusted that,” and she tried lecturing me about it to the point that another nurse had to interject to back me up on what I was saying.

Ale:
So this person is not believing absolutely anything you’re telling them.

Itzli:
No, and all these things are just happening, and I feel like I’m not supposed to be there, like I’m not welcome there. After all of it, I’m still in pain even though I’ve done all the things I could do. Luckily, they gave me a packet so I can do the physical therapy work on my own, but they’re supposed to continue the work with the person until they’re no longer in pain, but that never happened.

Ale:
You also mentioned that you had talked about wanting a hysterectomy, and that they denied it to you?

Itzli:
Yeah, I was really advocating for it. There are multiple things going on – because the fainting condition I have is based on fluid loss, I really didn’t want to have more periods, and they couldn’t guarantee that the ligation would solve it, like it could result in me still having periods because we’re not removing the ovaries. Luckily, the amount of testosterone I’m taking does enough to prevent me from having more periods, but traditionally I’ve had really heavy periods, so it’s just coincidental that based on who I am and what I want [with gender presentation] that this is working out perfectly enough to keep me from having more fluid loss.

I have this condition that could lead to pulmonary embolism, which is basically caused by blood clots. I mean, if you have periods, you’re already more prone to blood clots, but this condition heightens your chances of getting a blood clot in your lungs, or blood clot in your legs, and then on top of it I’m already fainting if I’m a little bit dehydrated or if I go get my blood drawn. I had been blacking out and fainting a lot, so I couldn’t afford to have a period anymore. But I’ve been told by other people that they’ve been granted hysterectomies just based on the fact that they don’t want to have children, they have other conditions that interfere with their ability to do work or live comfortably, or the fact that they are trans, and my doctor was like “No, it’s out of the question.”

Ale:
What was their reasoning behind denying you a hysto?

Itzli:
That it wasn’t life-threatening. I was fainting at work, and I work on steep hills, I’m working inside of trucks, I’m working with mechanical things, and I’m having to prohibit my ability to do things now based on whether I’m a little bit dehydrated. The older I get, the more that the condition I have is going to make me more prone to blood clotting.

“…even my doctors, to this day, whenever there’s an issue that comes up, they like to blame it on my testosterone, and I have to always ask or talk to my endocrinologist and just make sure it’s not.”

Ale:
Have you had any doctor or any person in the medical field at all give you any solutions?

Itzli:
The most I’ve gotten from my new OBGYN was the litigation, that’s the best they could do. They said that if it doesn’t work out, hysterectomy is something that I could advocate for, but she was like, the chances of you getting one are just so low, you’d have to really push for it, but I feel like I’m already pushing for it. The only reason I show up to a doctor’s office nowadays is because I’m so desperate, but they talk to you as if “have you tried drinking water?” haha

Ale:
They talk to you like you’re stupid haha

Itzli:
Yeah, and I’m so desperate to just live comfortably. I don’t want to say this, but I just want to go to work, you know, and not have to think or be scared for my health. I don’t want to know what life-threatening is, I don’t want to wait for it to get worse.

Ale:
You mentioned earlier that the only way that you were able to find out all of the things that were happening in your body was by talking to other people, going online. Do you want to tell me more about that? Who did you talk to? Who do you have around to just vent to?

Itzli:
Yeah. They never tell you to do this, but I did so much online research, and the first thing that comes up is a lot of research papers and it’s not the best to read through research papers, but what you also end up finding is people who are talking about their own experiences, and verbatim what I’ve gone through. You don’t have to reinvent the wheel; people have already done the work, and they are sharing how to navigate this system.

There are people who are willing to talk about their experience and then also say, “this is what I did to get through it” and I’ve hit them up through messages, and sometimes it’s even my own friends who have not felt comfortable talking about their health publicly. I’ve posted online about what I’m going through, and they’ll come to me and talk about it, they said they wouldn’t ever have talked about this publicly, but would disclose going through something similar, especially when it comes to chronic pain or chronic health.

The amount of people who have come forward who’ve just been so scared about people knowing about what they’re going through, whether it jeopardizes their job status or whatever, and just had to figure it out. I’ve talked to people who said, “If you have this symptom, you should also check to see if you have this other issue,” and they’ve helped me resolve, or just help me manage fainting. I didn’t know there were other options besides electrolytes.

Ale:
When did the fainting start?

Itzli:
During puberty, which is why I was like, maybe this is connected to my periods and fluid loss.

Ale:
It’s wild that the doctors didn’t even make the connection

Itzli:
They don’t, and I feel neurotic at times for saying that I’m doing all this research and whatnot. But other people are making those connections with me too, they’re asking broader questions about what your history is with these symptoms? And I was like, “Well, I’ve had these symptoms for this long,” the same with the chest pain. I’ve had chest pains since puberty as well.

Ale:
Did you ever find out what the chest pain was about?

Itzli:
No, but I think it’s related to blood clotting. It’s just scary not knowing, and it’s also scary having to read up on a lot of these things and making these conclusions on your own. Trying to beg doctors to believe you, and coming with all this information when they could easily look into it, but just choose not to. And I have people who I’ve talked to for hours about how I’m doing when I’m eating, sleep patterns. I’ve had community members spend so much time with me, talking to me about how my health is, compared to the amount of time a doctor has spent with me. It’s helped tremendously. Not only does it help me try and figure out what’s going on with me, that’s still in question, but it [the community] has helped me feel heard and like I’m not, like, crazy and I’m not the only one. It’s kinda wild that we’re all having the same experiences, and we all know we shouldn’t be in this amount of pain – I just want to be able to function.

Ale:
From being vocal about it, from posting, do you have people now that you could go to specifically?

Itzli:
Oh, yeah definitely. We all have our tips and tricks, and there are definitely people we follow online who are constantly posting. I mean, people show up to their doctor’s office with binders of information that they’ve had to collect. But you end up just realizing that a lot of health conditions are connected, and I think that’s the most helpful thing. Stuff is less shocking now, less scary than before, after you’ve had somebody kind of just sit you down and say, “hey, these health conditions are all related and here are certain things you can expect,” and that’s something a doctor has never done for me. A lot of them are strangers.

Ale:
That’s really cool. Are any of them POC or trans, and do you ever talk to them about why you’re not being believed?

Itzli:
Oh yeah, most of them are, I don’t know if any of them are white, I think all of them are POC, and if not, they’re trans.

Ale:
Since we’re talking about not being believed because you’re trans, how did your gender journey and reproductive health come together?

Itzli
Definitely hand-in-hand. I mean, I went to the trans clinic here at The Bay, and when I was asked what gender I identify with, there were like three options. There was a trans man, nonbinary, gender nonconforming. I think I picked nonbinary at the time because I didn’t feel like a trans man per se, you know. But at the time, I didn’t know if gender nonconforming was the right word either. The only reason I ended up at the trans clinic was because my OBGYN at the time was trying to sell me on birth control, and I was like “actually, I only want to get on birth control that’s not going to interfere with transitioning,” she said “ get back to me once you get a hold of your endocrinologist.” And it was great, they do an interview to see what you want to start with and at that time, eight years ago, they were like, “you can get you to top surgery tomorrow.”

Ale:
Now you have a gigantic waitlist. Did they ever talk to you about how T will affect your periods?

Itzli:
The endocrinologist said it was such a low dose, can’t guarantee anything. She said, if that’s your goal, I really suggest an IUD, so I went for the IUD to kind of solidify not having to deal with it. My biggest priority at that time was having it not be such a night and day, or noticeable difference at work, so I just didn’t have a coming out plan. My partner at the time was susceptible, we had started a relationship at the time, and I had notified them that I’ve been in enough relationships where my partners weren’t supportive of me transitioning or supportive of who I am, so this had to be acceptable, or I’m not gonna get into this relationship.

Ale:
What effects did the T have on you?

Itzli:
I had a reaction to the gel, I reacted to the patches, which I guess is common if you have sensitive skin. I had really sensitive welts, so I guessed I was gonna have to switch to doing shots. After the two-year mark, I was like I’m okay with this, I’m okay with everything that’s happening. I finally had energy. I’ve always felt so fatigued all the time, and the fact that I can get stuff done when my periods would just make me so tired all the time, it’s a night and day difference. I’ve just felt normal.

Ale:
The difference it makes once you’re even on the lowest dose, you just feel like you can get shit done, you feel clarity.

Itzli:
A lot of people talk about it as a form of steroid, but it’s totally not that type of sensation. It doesn’t feel like caffeine, it doesn’t feel like any of these things, I just feel normal. I feel like how I’ve always wanted to feel. I’m supposed to just feel like I can do things, and it was the same with having the strength to do things. I feel like I’m not straining my muscles, like I’m not hurting myself, not injuring myself. I’m not even exercising, but I’m naturally gaining muscle without even doing anything. This only makes me feel better, so I wanted to continue to do this. I kept raising my dosage with my endocrinologist because it’s working out for me.

I always get a little nervous talking about this. There’s always, like, controversy about how we talk about testosterone, about mood changes. For me, I’ve always struggled with expressing myself, and the way I was raised, it was just not safe to express myself, and I’ve struggled to be able to be safe enough to cry. Before starting, everybody was warning me about testosterone, saying you’re not gonna be able to cry, you’re gonna feel rage, but it already felt suspicious. It felt really TERFy [Trans Exclusionary Radical Feminist, a fringe group of people who believe gender liberation should not include trans people]. And when I get on testosterone, I feel like I’m on my period every day, I feel like I want to cry all the time. I don’t understand where this comes from. Everybody’s having a hard time crying? I don’t think that’s the testosterone.

“Much like with transition, I really wish I could make decisions without all this external input, especially about my body. I don’t want other people’s opinions about my body, and I want to be able to make opinions without all the noise.”

Ale:
Yeah, people love to blame hormone therapy because they don’t have an answer.

Itzli:
If you’re on any amount of hormones, it’s just gonna amplify whatever is going on with you. It took me so long to adjust to having so many feelings, like the intensity of feelings, because I usually feel like I can micromanage and control myself. Now, I can’t listen to podcasts, I can’t watch rom coms, I can’t listen to any emotional music. I’ll just immediately be bawling all the time. It was the opposite of what everybody was feeling.

Ale:
Whenever people make those statements, it is such a gross generalization. You don’t know how my body’s gonna react to all of this; it has different effects on everybody, and sometimes people do want those changes. It’s a different experience for everybody.

Itzli:
It’s such a wild experience being on, and it’s amazing to push through all of the people who don’t want you to do it. I didn’t realize how much everybody had been telling me, don’t do this thing that you really want to do, and then finally doing it and being like “Oh, I feel so good, and I can’t believe I spent so much time with all these people who were pushing back against me doing this thing I really wanted to do.”

Ale:
Who were the people who pushed against it for you?

Itzli:
There are people in our own community whom I just didn’t realize were transphobic this entire time, and then people that I was dating who really didn’t want me to transition. It’s funny because they don’t want to come out and just say that, but they’re saying it in all these different ways. And even my doctors, to this day, whenever there’s an issue that comes up, they like to blame it on my testosterone, and I have to always ask or talk to my endocrinologist and just make sure it’s not.

Ale:
I’ve heard this so much before, doctors really love to use that line. All of my problems, they blame it on the testosterone.

Itzli:
Now, when I go to message my endocrinologist, I apologize upfront I have to be like, “I’m so sorry, but my doctor’s asking for the 100th time if this issue is related to testosterone.” Sometimes, I’m just like, “is this doctor being transphobic? Why are they blaming the testosterone?” I don’t know, but it’s only until you end up being around people who are supportive do you realize how much people were pushing back against you this entire time, and how much they were against it. I’m with a partner who’s super supportive, and I don’t have to think about it anymore, it’s not something we talk about all the time. Unlike in my past relationships, we were talking about it all the time and the same with friends. I don’t have friends now that bring it up or talk about it, it’s not an obsession for them, and it’s kind of nice to be around so many people where it’s not the center of attention.

Ale:
Your transness is not what defines your dynamic with people.

Itzli:
No. I feel like sometimes you’re a trans person and you end up becoming the measuring rod for all the other trans people, and it’s weird to always talk about very surface-level things all the time. Now, I just surrounded myself with people who we talked about so many other things, and that’s kind of nice. It’s only taken so many years.

Ale:
Trans people are not a monolith. Where are you on your gender journey now?

Itzli:
I still haven’t been able to change my name or my gender marker, and then when I’m in the hospital, it’s like a Russian roulette. I never know if people are gonna use my name or correct pronouns.

Ale:
I feel that. I don’t know if this happens to you, but sometimes I just don’t want to set myself up for disappointment, so I just don’t even try. I just try to feel affirmed in some other way.

Itzli:
I have such low expectations for the medical field at this point. Even though they’re the ones that “support” or have “proof” of trans identities and gender expressions, it’s funny that they can’t put it into practice. I think at this point too, with pronouns, it’s not so much that I care that strangers use my name or my pronouns, but it’s the people I care about the most that do it. I used to be really offended, but they don’t matter to me as much as the people who do know how much it matters to me.

Ale:
When you were first going through your whole reproductive health process, did you ever feel any kind of dysphoria or maybe even affirmed in your gender, like when you got your tubes ligated?

Itzli:
It was affirming because I just constantly had people bringing up childbirth, and you don’t feel like your body is yours when you have people constantly telling you that this is what you want and this is what’s going to happen. You know, that’s what it always felt like when people bring up “you’re gonna want to have kids,” and then when they allude to you wanting kids, it always feels like “Oh, you’re gonna birth a child.” I’ve always had dysphoria come up too, but I just never connected it for a long time. When you have wide hips, people like to comment on them as being “childbirthing hips,” which is really gross.

Comments like that, in themselves, are such gross comments, but for me, it was also enveloped in dysphoria. When I was younger, at the beginning of my dysphoria, it would double down on the experience, and for a long time, I was like “maybe I just don’t want kids.” It was a loss of autonomy that people were taking away when it came to my decision about how I wanted to have kids. It wasn’t about the kids or about being a parent, it was about them forcing my lack of choice.

Ale:
It’s textbook social conditioning

Itzli:
Yeah, and it’s so related to your gender because when people talk to you about that, they’re not seeing you as the gender that you are. They’re seeing you as a cis woman, and that’s how they want you to behave, what they want you to embrace: being a cis woman who has a child. I don’t think anybody who’s made those comments about my body has ever validated my gender, you know? So I think that’s where I didn’t realize for a long time how long I had been having dysphoria.

Ale:
You mentioned earlier that while going through all of this, you actually thought about the idea of having babies? How do you feel about it now? And how do you feel that in terms of your gender, in terms of what you’ve been through with your reproductive health?

Itzli:
It kind of sucks to be in the position so early on to make that choice when I’m thinking about my health. It’s not the time or place when I want to make that call, but I had always told myself from very early on, based on the way I was raised, that I didn’t think I wanted to have children at all. People also like to tell you, “just wait until you get older, and you will want to have children.” It’s kind of the same with transitioning. They always tell you what you’ll want.

Ale:
It’s infantilizing when they tell you the things that you want. They’re basically saying you don’t know yourself or your body enough.

Itzli:
They do! It’s hard! Much like with transition, I really wish I could make decisions without all this external input, especially about my body. I don’t want other people’s opinions about my body, and I want to be able to make opinions without all the noise. I really had to push through all the things I’ve ever been told. It’s hard to even go a whole year without several people just commenting. Even after you transition, people still talk about it. I don’t know how to escape this. But I think giving birth wouldn’t have worked for me, but I’ve always thought at one point in time, I would like to adopt.

Ale:
To finish up, how do you feel about your gender now? Where are you in your gender journey?

Itzli:
I usually feel really great. I think as of late, I go back and forth with feelings about my facial hair, and I’ve been reconnecting to a lot of my culture and with family members. Right now, I identify as Two-Spirit, and I’m still nonbinary and trans. I fluctuate a lot with my presentation. Sometimes, my presentation can confuse people, but I have felt more nervous about how I present, especially when I’m going out and about without company.

Ale:
Are there any moments, people, or spaces that make you feel more in your gender?

Itzli:
When I don’t even have to think about what I’m wearing or what I look like. In moments when I’m at work, with people who don’t have my back, it’s clearly different. The most comfortable I feel is when I’m completely surrounded by trans people. There’s a Two-Spirit drum circle in the Bay Area, and we get to meet probably two times a month. It’s a similar feeling when I’m around my friends, my partner, we just don’t have to question it, and it’s nice to have that support.

Previously, it was just so much emotional labor to have to explain myself, or even have to look out for myself. But if something happens, I feel like my partner will catch it before I do, and I don’t even have to explain what’s going on anymore. For me, I’m not super social, but I like being in that space [trans events] because I don’t realize how often I don’t have that space until I’m in it. There are reasons to be here, and I don’t care if it’s nightlife or whoever is playing, I just need to be there, surrounded by people who make me feel so good, it’s like regulating my nervous system.