Night Cramps

I woke up in the middle of the night last night with a bad calf cramp.  The pulsing tightness makes me want to scream every time this happens.  I tried my relaxation techniques, stretching, moving my foot, but those never work.  It’s a nerve misfire, not a mental state.  Sometimes I’ve been known to punch my calf in the vain hope that will somehow make it stop.  It doesn’t.  But the solid thud of fist impacting muscle can sometimes give a different sensation to focus on for the couple of minutes of pain.

No, there is only one thing that fixes this.

Calcium.

Well, okay two things, either remembering, and affording, to take calcium or not taking the only anti-androgen I can afford, spironolactone.

I go on and off spiro.  I know being on it long term like I am – six years now – it taxing to the body.  Spiro causes potassium retention, which is the source of the cramping.  Too much potassium can potentially cause heart issues as well – misfires, stuff like that.  And it is very difficult to avoid potassium in this highly processed world.  Staying on spiro means risking all of this, but it also reduces testosterone levels so I am not progressively getting more and more masculinized.

Going off it means letting my T level creep back up.

Sometimes I will play the little game of going on spiro for a bit, letting my T levels drop, going off and coasting, letting the estrogen pills I take slow the testosterone recovery.  There are parts of my body, my testicles, which change as my testosterone levels change.

No physician has taught me this.  I cannot afford them.  Most physicians require trans people jump through the hoops laid down over three decades ago – three to six months of convincing a therapist that one really is trans.  At about $100 a session.  And simply for the sake of getting a letter which gives the institutional trans stamp of approval to begin the transition process.

Most physicians are not willing to consider adopting the harm reduction model of at least monitoring hormone levels for those trans people who opt to go to out of country sources and self-administer hormone replacement therapy.  And almost universally, every physician requires a visit a specialist in endocrinology to get that first, magical authorized prescription.

No, I’ve had to educate myself on all this.  Where?  From a network of other trans people who share our experiences with and educate one another.  A sort of modern day trans version of JANE.

Calcium supplements I have learned will address the cramping problem.  Normally I have them on hand, but I had run out some time before during my last on cycle.  And I had only just started up spiro yesterday.  I figured I had a few days before the cramps would start up again.

I was not entirely accurate when I said there are only two solutions.  There is a third.  And it is actually the solution I would prefer. 

That is getting a bilateral orchiectomy*.

But between the costs of the therapy to get the magic letters and the surgery itself, we’re talking about something which can cost upwards of two to three thousand dollars**.  And now that Dr. Marci Bowers is no longer in Colorado, travel costs to a surgeon who will perform such an operation on people who are not cancer patients*** also have to be factored in.

It is times like this when I sometimes think to myself that I would have been able to afford all that if I had just stuck with trying to find a new office job when I got laid off.  Instead I opted to attend college, get an education and watch as my income plummeted.  If I were younger, prettier, more fitting with the desired image of the skinny trans girl, sex work would have been a strongly considered option.

Normally I don’t talk about my hormone stuff.  Not in a public forum anyway.  It is a very private and personal thing to me.  But I wanted to here because it illustrates, for me, the concept of intersectionality.

I have three factors coming together to bring these about – I am transsexual, I am specifically woman identified, and I am poor.  Take away any of those factors and my calf cramps would not have happened last night.  Not that people who do not share these factors do not get leg cramps like that.  They can happen to anyone with a sever electrolyte imbalance.  It is just that in my case I can identity a combination of circumstances related to my identities which lead to them.

And I am not even as poor as many trans people living in poverty.  I am fortunate to have a partner with a good job who is able to provide a good home.  She assists where she can.  But it was sort of touch and go there for a few years before she got her position.  And I still do not like asking for assistance unless I absolutely need it.

And I am not even a person of color.  Or disabled.

Is it any wonder then why so many trans people opt for more immediate income options?  Or opt to go into well-paying and somewhat reliable industries, such as the technology industry, where ones trans status is less likely to factor into the ability to support oneself and pursue the steps needed for transition?

I feel like I am taking a huge risk in pursuing the course I am.  There are so few trails blazed for academics who also happen to be trans women.

* I often ask why I do not simply say castration.  That is because castration is an umbrella term for a wide variety of procedures.  Orchiectomy is a very specific one.

** There have been cases of successful home operations done.  It is an easy enough operation.  However that runs the risk of landing the person performing the procedure in prison for practicing medicine without a license.  Something I, and many other trans people, would rather not risk.

*** The other hope is to develop testicular cancer, since then the procedure will be covered under insurance… maybe.  Gods, how sick is that?  Considering cancer as a viable solution?