Navigating access to care
Image description: A close-up of the lilacs in my front yard, covered in rain, with the light grey sky behind them.
As a note, I’m going to be posting more often on the blog! I’m shifting my social media presence and will be doing less personal posting and more of my work here. So keep your eye here and on the Patreon. I may also be starting an email list, so if that sounds appealing to you, let me know!
And if the topic of this post interests you, the upcoming Self-Care Salon: Justice and Access to Support is the place to be! The event will be held at Loft 112 in the East Village, from 1-3 pm, on June 3. The cost is $50, and sliding scale is always available.
This morning, I sat in front of my window with the grey skies above and the rain falling. It was lovely.
I’m thinking about how many of us have to try and survive within hostile systems and environments.
How many fat folks have to go to doctors who are steeped in fatphobic prejudice, have to deal with antagonism from the medical system that is meant to help them, and have to advocate for themselves… but not too loudly, not too assertively, or they risk being written off as belligerent and non-compliant. (Especially if they were women or femmes. *Especially* if they are women or femmes of colour.)
How many folks living in poverty have to deal with support systems that vilify, pathologize, and stigmatize them. Have to debase themselves to receive access to food, to shelter, to any kind of medical or mental health support.
How many racialized folks have to deal with racism in their medical and mental health support professionals, have to educate and advocate for themselves but never too much, never too loudly, or risk being seen as “angry.”
How many trans folks have to deal with gatekeeping by professionals meant to help them access transition support, and stigma and pathologization by professionals meant to help them access other support. How advocating for yourself becomes so much harder when you are trans and also racialized, or trans and also fat, or trans and also poor (which is true for far too many), or trans and neurodivergent (despite the high correlation between autism and gender creativity!).
How so many folks stand at multiple points of marginalization, and how few professionals and experts also stand there.
(There are some, and there will be more. Support and love to all the professionals who came from poverty, who are fat, who are Black, Indigenous, or people of colour, who are trans, who are queer, who are disabled – you’re so needed, and you make such a difference!)
I am thinking about all this power that exists in dynamics that are meant to be supportive, how it ends up being hurtful. Harmful.
How that can leave us scared, hopeless, isolated.
If you’re dealing with a system, a professional, an institution, or some other brick wall today – take a deep breath.
What you feel is valid.
If you feel angry at the injustice, that is valid.
If you feel hopeless, that is valid.
If you feel scared, that is valid.
I do not have any easy answers for how to navigate these systems, how to work within harmful frameworks, how to get through. It’s so hard. The more I read about it, the more I work with people who have *not* received the help they needed from professionals who had more privilege, or from systems and institutions that were not justice-oriented, the more I realize how pervasive and persuasive this problem is. The way it makes us doubt ourselves. The way it shuts us up, keeps us quiet and compliant, and how that is a valid survival strategy.
Breathe, friends.
If you have to go into that office and you know you’re going to face yet more racism, ableism, transantagonism… keep breathing. Find something to hold onto – some thread of whatever it is. Hope, or anger, or coffee with a friend tomorrow.
If you’re heading into that appointment and you know you need something that the doctor or social worker or banker or lawyer or whoever else has the power to withhold, and you’re scared, that makes so much sense.
It *is* unjust.
It *is* unfair.
It *is* hurtful, harmful, violent.
But you are good. You are good enough. You are enough.
Just like you are.
You are just the right you.
There is nothing wrong with you, just because you don’t fit into the box assigned to you.
Take a breath.
Do what you need to do to get through.
You’re doing a good job.
Further reading:
- Stigma in Practice: Barriers to Health for Fat Women in Frontiers in Psychology
- “In our experience, for fat people, it doesn’t matter if you are bad with a “fatty” disease, or if you are in “good metabolic health” (but NOT FOR LONG, according to several medical professionals), the discrimination, humiliation, and stigma, from health care providers is the same. The fact that we, and every fat person we know, have experienced this fat stigma, no matter what their health status, is an indictment on the health care profession. Health care providers, public health policy makers, and institutions of health such as hospitals have substantial work to do if they exist to treat all patients, and improve the quality of life for all patients, rather than deterring and deferring appropriate health care and reducing quality of life through fat stigma, shame, and eventual patient avoidance of health care providers.”
- ‘Trans broken arm syndrome’ and the way our health system fails trans people at the Daily Dot
- “Not a single medical school in the United States has a curriculum devoted to LGBT health issues, much less transgender health issues. Green said the only existing courses that do focus on LGBT health needs are electives taught by students, and it’s not exactly something the medical school leadership wants to change.” (It is important to note that this article is a few years old, and WPATH itself has been critiqued in favour of ICATH – Informed Consent for Access to Trans Healthcare. This article at Slate covers some of the issues.)
- Why I Left my White Therapist at Vice
- “Being on the receiving end of the defensive anger of white fragility from someone who I had not only trusted to be a professional care provider with the ethics and background to deal with my needs, but with whom I had also shared some of my most vulnerable thoughts and feelings, means that I am loath to seek out therapy moving forward. To be blunt, I felt exploited. This is something that no individual, and in particular no one opening themselves up for healing, should ever have to endure. But sadly, it’s not uncommon.”
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