Washington States prison medical system is one of controversy, particularly at Monroe Correctional Complex in Monroe, WA. In recent years medical malpractice, deliberate indifference, potentially unnecessary inmate deaths have plagued the correctional system, many times in a very public manner just search for it on the internet and a plethora of related articles will give your eyes a Thanksgiving feast of credible content.

Several years ago I undertook the arduous task of getting Hormone Replacement Therapy (HRT). After a major battle and some therapy to help undo the abuse and trauma a now no longer DOC employed Psychologist subjected me to I got my HRT. For me that was a sigh of relief because my little cocktail (“cocktail” is what many transgender folx refer to as their prescribed hormone regiment) was hard to come by in this system, just like respect. However, I breathed a sigh of relief too soon.

I am now 96 hours until release and one DOC employed ARNP has made it their personal mission to reduce my HRT prescription or eliminate it entirely and here’s the best part: they’ve never even seen me. Yeah, you are reading the correctly, never even seeing their patient. No wonder DOC medical is plagued by pages of bad press, lawsuits, and high turnover rates. I’d say being a medical provider at Monroe Correctional Complex is a career killer at this point. Transgender health care is fairly new but it’s not so new that no science exists. In fact Sweden, a leader in transgender practices, has been producing science on transgender health care for many decades alongside reputable organizations like John’s Hopkin’s and the University of Washington, to name just a few. Transgender health care is also guided by industry best practices that the World Health Organization has been refining since at least the 90’s. But none of that matters when the provider is biased and, quite frankly, bigoted.

I have never read the warning label on a medication that didn’t have serious, of not fatal, potential side effects. Tylenol (Acetaminophen) taken in large enough doses is highly toxic. The popular diabetes medication Metformin is also potentially fatal. Yet, it is the potential side effects, side effects I am NOT experiencing, that this particular bigoted ARNP is hiding behind to lower the one set of medications that cause my body to finally be congruent with my mind and dare I say, soul. If medical providers stopped giving medications because of a potential side effect, a side effect the patient never experienced, then modern over-the-counter medications such Tylenol or Advil would never be used. This goes alongside more aggressive therapies such as Chemotherapy.

The truth is, not taking HRT was one of the most damaging experiences in my life. I waited far too long to expose my truest self to the world and it cost me, dearly. Not expressing my actual internal gender and pretending to be a gender that didn’t match my true identity for 3 decades was harmful, dare I say nearly fatal. It produced side effects that I did experience like feelings self-harm, low self-esteem, and feelings of depression that compounded with attempts to try immoral and morbid means to feel the way some suggested I should feel, masculine. In all that mess I had unresolved childhood trauma and when we put everything together I did something I deeply and profoundly regret, my crime.

Now, if I don’t take my HRT I am not at risk to commit a similar offense because I have undergone significant therapy to address the co-morbidities that accompanied my Gender Dysphoria. Now that I have addressed those other, non-related issues I have just my Gender Dysphoria (GD) which is regulated and “cured” (so-to-speak) via HRT.

When that treatment is threatened it causes a slight panic within me because for the first time I am happy with how my body is looking. I am excited to face the world as this truest me, finally, and I’ll protect that. But I shouldn’t have to. Instead, I have to protect myself against the misguided opinions of an ARNP who doesn’t abide by industry standards, science, or best practices. Instead, they are guided by antiquated ideals about gender roles, or whatever hatred resides within them.

And your tax dollars fund it.

With Love
Ruth Utnage