Les said, the better: This post talks about genitals

I got a letter in the mail telling me to turf out this morning for a "transvaginal ultrasound" at the Royal London Hospital. People who have been on testosterone for more than two years have a slightly increased risk of uterine cancer. The NHS has a strong emphasis on preventative medicine, because it saves money in the long run. So I get all kinds of tests that I wouldn't get in the States, where no bureaucracy has heard of anything but the next quarter.

I walked over. This is the same hospital I went to A&E at, not long ago. It's in old brick buildings and has a crumbling, Victorian look about it. It's definitely an urban hospital, swarmed with people form the tapestry of urban life. The woman at reception didn't seem to notice my accent, but she must hear as many foreign accents daily as native ones.

The clinic I was looking for turns out to be directly above the A&E, on the next floor. I went to the window at the nurses station and signed in. They directed me to a waiting room. Much to my immense relief, it was co-ed. There were as many unhappy looking men as unhappy looking women. I took a seat on a blue chair and pulled out the book that I had brought. Nobody else was reading. The white, windowless room had no magazines.

Rather quickly, my name was called. I was instructed to go pee and then meet the woman in a back room down a dark hallway. She lead me back to a darkish room. The lighting was indirect and the walls didn't go up all the way to the ceiling. She instructed me to remove my shorts and pants and then sit on a table. She did not leave the room for this, but just told me to put on a gown first. So I did as instructed.

She told me that my GP had referred me for this "because of the drugs [I'm] on." I started to say I wasn't taking post-surgical drugs anymore, but then I realised she meant testosterone. It's funny how I don't think of it as a drug, but rather something linked to a state of being. It's not that I'm on drugs, it's that I'm transitioning. I'm on T, which is, somehow, not a drug.

She asked questions about menstrual cycles, something that's long since been chained up and abandoned like an unwanted bike. Then she got a wand thing and said it wouldn't hurt, but it wouldn't be pleasant.

These bits, I don't speak of them. I avoid thinking of them. I'm unsure what to call it. But unlike Buck Angel, it's also non-functional. Testosterone has caused tissue to atrophy, so even it was not mentally troublesome - which it is, it's physically painful. The cure for this is topical oestrogen cream, which is alarming and for something I don't want anyway. The other option surgical removal.

So I told her it might hurt and she said that it would be fine. Very old ladies have some of the same physical issues and they're unhurt. She prodded with the wand and we chatted, as she looked at the screen. I should have taken paracetamol ahead of time. It's the kind of hurt of getting your teeth scraped by the dentist. Uncomfortable and annoying, but not overwhelming.

She was on the lookout for thickening of the uterine lining. She asked who was going to interpret the results, because it didn't look thickened, but it looked different than what she had seen before. I said my GP would probably forward it to somebody who was an expert. As it went on, I said something about a hysto and she wondered about osteoporosis risks associated with that. I said T would protect me. "We" women are at risk for that, "but I guess men aren't." she said.

She with her invasive, prodding wand, stuck into a site of all sorts of discomfort; a psychic wound; an unwanted opening. Chatting about "we" women. I did not say, "I'm a man," flying futilely in the face of what must seem like overwhelming evidence. I did not say anything about it at all. I talked about how sex hormones work in men. "Men like me," I did not say.

She finished and left me alone to get dressed. I thanked her on the way out. I did not do or say anything to challenge the notion that I'm an unusual woman; I just left. Thinking: I will be a subject of medical curiosity and tests and prodding for the rest of my life. It will never be all right. The surgeries I can get will never be perfect. I will never pass when my genitals are examined. When I most need sensitivity, it will never be forthcoming.

I walked out, past the entrance of the A&E, with the feeling of not passing. Outside, there was a man with a broken neck, smoking cigarette. I made eye contact with him and then thought it was rude to stare at the screws holding his head in place, so I looked down. "Nice DMs" he said. I was sure he could tell, sure he was feminising me, complimenting my body in some unwanted way. "What's a DM?" I asked. He smiled and pointed at my shoes, mistaking them for Doc Martens. "Oh!" I said as the lightbulb went off. It was all blokey and male bonding and fine. I smiled back, "thanks!" I said.

I cannot get a hysto soon enough.