Updated: May 4
"That’s when the panic set in. My mind grasped for clarity; I scrambled to make sense of what I was hearing while forcing myself to appear unfazed."
Walking the Walk
While talking with the nurse who ran the birthing class, I found myself struggling to clear my head - my ears rang, my heart thudded, my face flushed. There was a side table in front of us offering coffee with plastic creamers and wooden mixing sticks, as well as an assortment of pastries. Staring at this display, I fought to continue the conversation while standing upright, to stop myself from leaning on the table for support. Desperate to conceal my sudden embarrassment from this no-nonsense, gray-haired professional, I turned away to hide my hot cheeks.
During the first portion of the day, when the students shared the name of their obstetrician with the class, the nurse instructor commented on each of them: “Oh yes, she’s wonderful.” Or, “I’ve never worked with him but I hear great things.” Yet when I said that my obstetrician was Dr. B, the instructor merely nodded before turning to the next student. Puzzled, I sat at my desk worrying. Why hadn’t she made some kind of comment about my doctor? Did she forget to? Did she think badly for some reason of Dr. B?
I had vetted my obstetrician as soon as I knew I wanted to get pregnant. My main criterion was that she be a woman. As a young adult, when I began choosing my own doctors, nurse practitioners, and even hairdressers, I had deliberately looked only for women (the one consistent exception to this rule was dentists; somehow I’d accepted the dentist as king, surrounded by his efficient harem who cleans, prepares, advises, and administers). Two years earlier I had researched three names from the best private hospital in the area and interviewed the first doctor on the list. I never felt it necessary to see the other two physicians. Dr. B was slender and stylish, warm and personable and knowledgeable.
Dr. B talked me through my fear when I didn’t get pregnant in the first eight months of trying and, convinced I was sterile, started taking home brochures on infertility and thinking of joining support groups. She was calm, efficient, and effective. When we decided to try a test that x-rays the fallopian tubes after injecting them with dye, a procedure that sometimes had the welcome side effect of enabling women to conceive, she agreed to do it herself during her lunch hour because she knew I was nervous about being assigned a male radiologist.
The test worked. As the months passed, Dr. B talked me out of my plan to have an elective cesarean in an attempt to avoid pain, citing the inadvisability of electing a cesarean when there isn’t a clear indication that one is needed and a modest risk of complications. She then listened patiently as I tried to negotiate the earliest application of pain relief possible, agreeing to order an epidural if I really wanted one regardless of dilation or effacement.
At office visits, we sometimes discussed the many family photographs decorating the examining room walls. She told me tidbits about her children, all three pictured in the many stages of their growth and development. There were the baby pictures, the school pictures, the vacation-at-the-lake pictures. Her children were robust, blonde, and cute. Sometimes our conversation veered toward the personal. She told me, after I complimented her Manolo flats, that it was difficult for her to find stylish shoes in her size (eleven). Another time, when I complained that I craved sushi but feared that eating raw fish was too risky for the fetus, she told me she had happily eaten sushi while pregnant and everything turned out fine. We talked clothes, we talked children, we talked women’s health.
That day at the birthing class with the elderly instructor who didn’t comment on my obstetrician, I decided to take advantage at the first break to ask her directly about my doctor – maybe she was merely distracted when my turn came to divulge. “So…I was wondering, do you know my doctor at all? Dr. B? You didn’t say anything about her earlier.” “Oh yes,” she said, “I’ve known him for a long time. Did you know him before the change?”
That’s when the panic set in. My mind grasped for clarity; I scrambled to make sense of what I was hearing while forcing myself to appear unfazed. I heard myself reply in the affirmative, even though I hadn’t had a clue about any gender change in my doctor, and continued the conversation, all the while trying desperately to keep it light until I could escape and sit down. The weight of my taut belly pulled uncomfortably and added to my dizziness, to the feeling that I was about to faint. I needed to lie down, but that was impossible.
The class resumed and I sat at my place in the semi-circle of vinyl desks, barely following the discussion, thinking about what I had just learned and, most troublesome, about what I was going to do with this information. My doctor had been male and had gone through the hormonal and surgical processes to become as female as possible. And she had succeeded. Never had it crossed my mind that Dr. B had been born a man. I had never thought her even slightly masculine in looks or affect. She was tall, yes, and had long feet, but she was also feminine of jawline and neck size and voice modulation and hand gestures. She had chatted with me about fashion, babies, and pregnancy from an unmistakably female point of view.
During that time, my husband and I often watched television together as we ate dinner to wind down after a long day. We had recently seen a program that explored the anguish of transgendered individuals trapped in the wrong body or born as the wrong sex. It also outlined the different procedures people endured to change their sex in an attempt to match their bodies with their minds. It was a dark program for me, with bodies made less perfect: no longer able to feel sexual pleasure in the same ways, no longer able to conceive or carry a fetus, no longer able to impregnate a partner. Instead there were scars and sutures, numbness and pain, sometimes debts and divorce and ostracization.
Pressing my fingers to my temples, I tried to think. I had chosen my obstetrician on the basis of sex: part of my personal brand of feminism was that I dealt only with women in certain professions, the most important being the gynecologist. I wanted a doctor with whom I would feel comfortable physically and psychologically. It was not that I didn’t trust male doctors, it was more that I wanted someone of my sex and therefore, I assumed, my gendered lens to care for me. What would I do now that I knew my doctor had not been born a woman? That she had never been pregnant? Never given birth? Lied to me about these experiences? What should I do? I stared at the clock on the wall, stark and clinical in black and white, and willed the hands to move faster – I couldn’t wait for the lunch break when my husband would join me after his work meeting and I could unload this onto him.
Once I sat on a beach with a friend. We had walked up and down its length, a stretch of coastline bounded by sandy cliffs and craggy rocks. It was a fall afternoon, almost warm, and we picked a boulder with a smooth top on which to perch, sighing with contentment as the mild sun penetrated our windbreakers. The light was delicate, softly brightening the blues and greens of the water that stretched before us. My friend is Hindu and somehow our conversation turned to reincarnation and gender. “I just can’t imagine coming back as a man, or as anything except a woman,” I told her. She seemed surprised. To her, gender was more superficial, a coat of a certain color that one wears in this life, to be changed, perhaps, in another. “Really?” she asked. “I feel I have both male and female already in me…I don’t understand myself, my real Self, as one thing or the other.”
Earlier on our walk we passed the remains of a blue whale that had washed up on the shore weeks before. The body was largely decomposed, but there were still hardening rectangles of flesh to be carefully avoided that had been discarded by the scientists when they descended, vulture-like, to slice specimens from the dead mammal. The end of the tail, thick flippers intact, lay on the sand, as well as giant vertebrae, scattered here and there, scrubbed white by the sun and the sea. Gulls swirled and circled over the bones before landing to pick at any remaining meat. Now the scientists and the gulls, the geometrical slabs of flesh and the unrecognizable mass that was once a whale, remind me of masked doctors poised, scalpels in hand, over an operating table in the early days of surgery, when experimentation was the norm. I sat next to my friend, my arms around me, my face to the warmth of the sun and away from the stench that occasionally wafted down from the carcass, and tried to imagine myself as a man. But I could not.
The day of the birthing class, when my husband arrived at lunch, we sat in the car parked outside the hospital where the meeting was being held and I told him the story. For forty-five minutes, we went back and forth considering my personal ethics and individual rights. Should I drop Dr. B at this late stage and find a “real” female obstetrician? Should my right to peace of mind and psychological comfort take precedence in this case? Or should I face the truth of my own ambivalence and come to terms with an identity that I already supported intellectually? I didn’t have any clear answers. I pondered the different facets of my dilemma, as if squares on a Rubik's Cube, and gazed out the window at the city scene outside – seeing yet not seeing a cracked sidewalk, a straggly tree, a brick wall.
In the end, before we left the car and took the elevator back up to join the group, it was a question my husband posed to me that decided the matter: “So far, are you happy with how Dr. B has taken care of you?” The answer, from whatever angle I approached the question, was yes. If that was the case, according to my husband, then I should continue with Dr. B. “The bottom line,” he said, “is quality of care.”
I knew Dr. B was not only medically knowledgeable and skilled, she was personable and kind, empathetic and helpful. She listened to the litany of my anxieties and brainstormed solutions to help assuage them. She ordered the test that helped me conceive, administering it herself so that I would feel more comfortable. I had no cause for complaint, only this information about her gender. I knew I had to walk the walk. Here I was, about to earn a graduate degree from a department where I studied social constructs, oppressive norms, and alternative identities, where I learned about the suffering caused by prejudice, and yet I was troubled by having as my doctor a person who, profoundly uncomfortable with her biological body and culturally imposed gender, had found a way to be happy through what must have been a long and painful process of hormone treatment and surgical alteration. And, I reasoned, Dr. B was probably more female, in some of the key ways important to me, than a woman doctor who had never had to struggle to attain a female identity.
I did stay with Dr. B, and she did give me superb care. On the night of my delivery, she wasn’t on call. Women in labor find themselves playing a kind of Russian Roulette, and I could have ended up with any obstetrician in the hospital's group, a male doctor, not only a stranger but a man. Dr. B, however, knowing my anxieties, wanted to be there for me. She came in at midnight after a dinner out, changed from her chic black jacket into faded blue scrubs, checked the status of my cervix, and, after sleeping a few hours in the cramped call room, delivered my eldest son herself.