Holy smokes! Times sure does fly when you’re living your best life! August 3rd was my “Manniversary”. My manniversary marked 2 years on HRT (hormone replacement therapy) aka testosterone or “T”. If you’re just jumping in, testosterone is the little miracle drug I take intramuscularly each week. For trans men, HRT leads to a boatload of psychological and social benefits. The testosterone helps to masculinize our bodies, bringing our outer appearance to more align with our identities. 

The Vancouver Coastal Health, Transcend Transgender Support & Education Society and Canadian Rainbow Health Coalition put together a fantastic Hormone Guide for FTMs. Give it a read if you want to learn more about hormone therapy for trans men. As they note in the guide, “People who have had gender dysphoria often describe being less anxious, less depressed, calmer, and happier when they start taking hormones”. I can vouch for that, but I can also attest to the awkward transition period we often call our “2nd puberty”. During this time it feels like we are back in the horrible days of middle school. 

The physical changes are exciting, but also pretty visibly public. We feel the pressures of still being seen and treated like something or someone else. The changes can make us feel alienated from society and extra uncomfortable in public spaces. It should also be noted that not all trans folx can or are able to socially or medically transition, but they are just as valid in their identities. Here are some things you, the community, businesses, and allies can do to make your spaces more safe and inclusive for trans and GNC (gender-nonconforming) people.

1. Bathrooms

I know plenty of people that hate using the restroom in public. I get it. They are often dirty, the seats almost always have pee, poo or backsplash on them. They often lack soap, paper towels, or toilet paper and let’s be honest, even if you washed your hands, there’s a high probability that someone else didn’t… So that doorknob on the way out of the restroom was just as gross as whatever else you experienced inside the restroom.
We can all agree that we’d much rather relieve ourselves in the privacy of our own homes, but we don’t all work from home and there will be times we have to rely on public accommodations. For a trans person, the restroom experience can be a HUGE source of anxiety. (And not because of the germs). According to the TransEquality Report, more than 59% of trans identifying people avoided using the restroom in public out of fear or other potential issues.

https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf

I wasn’t polled, but I can tell you I’m one of those people. The worst for me was UofL Football games. For years I was a season ticket holder. I love watching my Cards fight it out on the gridiron, but despite my online and in-person searching, I could not find a gender-neutral or “family” bathroom anywhere in the stadium. When I began my social and medical transition, I felt even more uncomfortable using the women’s restroom and decided it was inappropriate for me to do so. The trouble is, parts of me still outwardly aligned with society’s narrow view of gender. I was uncomfortable in any gendered bathroom. Either situation could draw attention to what I was or wasn’t. My fix was to just avoid the bathroom altogether. 

Football games are around 4 hours long, so I took steps to make sure I wouldn’t need to pee during games. I didn’t drink anything starting about an hour before I hit the stadium. I’d use a port-a-potty at the Entrance gate. I even thought I arrived early enough to enjoy the $3 beer on the Terrace before the game, usually didn’t. 

If I felt the urge to go, I’d hold it. Sometimes it was so uncomfortable that I found myself thinking more about the restroom than watching the game. With no gender-neutral options around, I’d start watching the men’s room, making sure there was no line, and even paying attention to who went in and came out. I’d plan my visit based on the lowest potential amount of traffic. When I’d enter, I’d pray that a stall was open. When it wasn’t, I was forced to cross my arms and stare at a wall while I’d wait. I sometimes I got looks from other guys as they wondered why I didn’t use the row of open urinals. I was so embarrassed, sometimes humiliated. I used a great deal of self-talk to get through those situations. I’d remind myself things like “you’ll never see these guys again”, “people are drinking, they aren’t paying attention”, or “dudes don’t make eye contact in the bathroom, they probably won’t notice you”. 

Because I had to plan my trips when it was mostly empty, I couldn’t go during halftime like everyone else. I’d have to miss some of the game, which sometimes meant missing TDs and interceptions. I’d hear the stadium roar with excitement while I was essentially hiding in the bathroom. When my dysphoria was extra high, I’d leave my seat, walking down the zillions stairs to the entrance port-a-pot to go. This was great cardio, but took my time away from the game the excitement of the stadium. I felt alienated and excluded, like an outsider. I gave up my tickets after that season.

I should note that UofL’s stadium guide now says:

“Family Assisted Restrooms: Anyone needing access to a private Family/Assisted Restroom can contact staff at the three (3) Customer Relations Booths located on the main concourse and receive the code that is used to open the door. Family/Assisted Restrooms are located near Sections 107, 112, and 130.”

I don’t recall that info being there in 2017. But for a college that is “’Best of the Best’ LGBTQ-friendly universities”, come on, we can do better than 3 family bathrooms, all on the 100 level. Adding port-a-potties to other sections and renaming some currently gendered bathrooms as gender-neutral with floor-length stall doors would be awesome.

So why all this anxiety around using a restroom? Let me break it down.

Single-User Labels

The anxiety begins when the bathroom is labeled. “Men/Women”. If your gender identity is different from the label that you’ve has been assigned, it’s extremely likely that you will feel uncomfortable and even unsafe in a gendered bathroom, especially if it’s a shared bathroom. Sure, a single-use gendered bathroom is better than a multi-stall situation, but if your business is going to offer a single-use restroom, what is the harm in making it gender-neutral?

Multi-Stall Labels

If you’re going to have large, multi-stall bathrooms, I’d also request that you have at least one gender-neutral, single-person bathroom available somewhere else in your business. For the multi-stall bathrooms, I recommend taking a page from Actor’s Theatre of Louisville. A few years ago they changed all their signage to be more sensitive and inclusive.

On the bathroom sign itself, they clearly and unapologetically states that:

 “Gender diversity is welcome here; please use the restroom that best fits your gender identity or expression. To access private restrooms, please take the elevator to Level B.”

By providing this language, they send a welcoming message of inclusivity and validation to the trans and non-binary community. They also let you know what to expect when you walk inside the restroom: private stalls, urinals. This takes some guesswork out of the equation.  

Stall Doors

Once you’re in the bathroom you’re praying that a stall is available. There are some STP (stand to pee) devices available, but they tend to be expensive and take LOTS of at-home practice to master. Can you imagine the anxiety of not passing coupled with being rushed, followed up by accidentally peeing on yourself? Yikes! A stall door gives you more privacy and allows other dudes to assume you’re taking a poo, but a full-length stall door gives you total privacy and allows you to do your business a little more worry-free. With a full-length stall, you’re not wondering if someone is noticing your feet or holding your pee until the bathroom is clear so no one will hear and notice that you’re peeing from a seated position. (Which some cis guys do, btw.)

A full-length stall door also gives you added privacy against small children. Ever been in a restroom and all of a sudden noticed a small head poking in from under the door? I have. Kids are curious, and a curious kid popping in and yapping about what they see (or don’t see) can make for anxiety and create an unsafe circumstance in some settings.

Stall and Door Locks – That Work!

This seems like a given, but I have visited many a restroom to find that the locks were broken, misaligned or missing. Businesses, add “check the locks” to your daily checklists. I’m pretty sure any person using the restroom prefers that the lock feature is enabled.

2. Greeting/Welcoming people

It sounds like a simple thing, but the way you greet someone can make a big difference. By taking the initiative to introduce yourself and offer your own pronouns you are communicating that you are open and willing to respect whatever name and pronoun the person introduces themselves to you as. It also takes away some anxiety from a trans person who may be shy or concerned that they’ll be greeted with hate or opposition.

A simple way to do this is:

“Hi, I’m [your preferred name]. My pronouns are [preferred pronoun/s]. It’s nice to meet you, tell me about you.”

Ex: “Hi, I’m Kasen. My pronouns are he/him/his. It’s nice to meet you, tell me about you.”

You can shorten this too so it doesn’t feel like as much of a mouthful. “Hi, Kasen. He/Him.” Once this becomes a part of your everyday language it won’t feel as strange. I’ve also seen email signatures that include pronouns and even name tags and pins. Volunteering your own information as if it weren’t obvious really helps to breakdown barriers and create a space of inclusion. Be prepared for pronouns like: he/she/they or sometimes no pronoun at all. I know folx that prefer to use their chosen name or even their initial. Whatever you’re given, respect and use it.

Additionally, avoid the urge to assume you know someone’s gender pronoun until they tell you themselves. If you’re not sure, stay neutral by using they/them to describe someone you don’t know. If you want a reminder about how hurtful being misgendered is, revert back to Trans.parent_Kasen No 1.

3.  Forms, Medical and Other

Oh man. This is huge. Imagine that you need medical care, but you are afraid to call for an ambulance or make a routine visit with your Doc out of fear of embarrassment, harassment, disrespect, denial or other. As with all people, sometimes it comes down to money or access to insurance. After all, transitioning is not cheap, but assuming you have insurance and all other means, being vulnerable and 100% honest about who and what you are with someone is terrifying, especially a stranger.

Ask Your Child About Their Comfort Level and Preference

I avoided my annual physical/preventive care for most of my adult life because of how uncomfortable my childhood Doctor made me feel. I remember being 10-13 and him shaming me for my weight. This is also the Doc that gave me that “check” when I hit female puberty. I was given no choice or say as to whether or not I felt comfortable and was okay with it, or him. I wish I’d been able to voice that I didn’t want that check or that if I had to do it, I wanted a female Doctor. He was a professional and a female nurse was in the room, but that memory still haunts me today.

As it turns out, I’m not alone in avoiding the Doc. The 2001 National Transgender Discrimination Survey of 6,450 transgender and GNC study participants by the National Center for Transgender Equality and the National Gay and Lesbian Task Force, Female-to-male transgender respondents reported postponing care due to discrimination and disrespect at (42%, sick/injured; 48% preventive).

I was well into my 20’s until I decided to take advantage of my health insurance and seek out a Female, PCP. Shout out to the Norton Highlands Medical Clinic. They have been nothing but welcoming and inclusive for my 10ish years with them. I also owe my current life as a proud and out trans man to a really vulnerable, but honest conversation with my Doc.

Medical Forms

Medical forms are some of the worst paperwork a trans or GNC person has to fill out. Most forms don’t care what your gender identity is, they care what your legal identity is. I know fully transitioned people who haven’t been able to change their legal names or legal gender due to funding, access or discrimination. Some states make it really difficult to change your documents. Some counties in Kentucky require you to appear in court and explain yourself before being granted permission to change your own name. States like Tennessee will not allow you to mend your birth certificate, even after gender confirmation surgery.


Tennessee’s Department of Health FAQ on “How do I get my certificate corrected?”

Here at home, big healthcare organizations like Norton (who I use and mostly love) will allow for a “nickname” or “preferred” name in your file and on your NortonMyChart, but you better believe that all of your mail will still have the “Mr. or Ms.” associated with your legal name. This is also how you’ll be called from the waiting room. Medical folks: please call us by our preferred names if you’ve asked and have the name on record. No need for “Ms. and Mr.” Even better, last name only. Last names are gender-neutral. It’s embarrassing to be sitting in a waiting room with a beard and called to the window as “Ms.”. 

This gap on forms does healthcare providers a disservice. Your Doctor and the medical staff really has to go out of their way to remember who you are and what your preferred pronouns are. Some Docs excel at this, but the system is stacked against them when they see so many patients and their own software won’t allow them to correct it. They’ll have to resort to a diagnosis of “TRANSGENDER PERSON”. This will be printed on every single piece of documentation you get post-visit. This type of information could lead to a potentially dangerous situation if it fell into the wrong hands.

Lastly, ever been a blood donor? Me too. I’m O+ and feel like it’s a super small thing I can do to help someone else. I try to donate a few times a year. Imagine my surprise when I was “deferred” as a donor shortly after beginning my medical and social transition. Why? Because the gender identity I selected didn’t match the gender on my license. Yep. Real story. Just like the doctor’s office, these forms force you to answer questions based on your assigned sex. 


Kentucky Blood Center Health Questionnaire

My “deferral” went like this. Tech: “Oh, you answered for male. That’s a mistake so I now have to go question by question and make sure you understood and answered correctly.” 🤦 So, we did just that. We got all the way through the medications questions. I answered honestly. He grabbed the giant book of meds and looked up testosterone, all clear. Can proceed. Then he asks, hesitantly, “do you identify as male?” “Yes. I’m trans.” He explains that he doesn’t think I can donate because my ID doesn’t match. I explain that my passport does, but since I don’t have it with me it won’t work. He says he’ll call the Medical Director to clarify, so he excuses himself. After a few minutes, he returns. He couldn’t reach the MD, so I am denied. I’m given a referral slip and told that the MD will call in a few days. About 2 weeks later I get a call. We had a candid conversation and after explaining that I was trans and which documents didn’t match. He explained that the system did need to be updated and offered a solution until then. He created and mailed me an “approval card”. He asked what it should say. I offered “FTM?”. A few days later, my card came in the mail. I still have it, but never used it. My ID matched my identity the next time I donated, so I had no problem. 

Aside from being denied on the basis of assumed sex, there’s another issue with this setup. If the form is designed to take a comprehensive look at someone’s health history, all the questions should be asked of all people. This form assumes that the person answering the question is cisgender — which could lead to missed medical information. I don’t sleep with men, but other trans men do. I know trans men that have gotten pregnant and carried their children to term. Don’t they need to know if those men could potentially be pregnant? Gender identity is not the same as sexual orientation. 

Education of Doctors and Medical Staff

Now imagine that you need medical help. You’ve summoned up the money and courage to go see the Doc, but when you arrive, YOU are expected to be the expert. In that same study mentioned earlier, “50% reported having to teach their medical providers about transgender care”. One of the folx in the survey reported that “I was forced to have a pelvic exam by a doctor when I went in for a sore throat. The doctor invited others to look at me while he examined me and talked to them about my genitals.” WTF. THIS IS NOT OKAY. But this type of treatment is the reality for a lot of people. 

“28% reported being verbally harassed in a medical setting” and 19% were refused care. Healthcare should be a basic human right. No one should ever be refused treatment or expected to teach their Doctor how to treat them. (Btw, I’ve had to train Doctor’s too.)

The good news about healthcare is that leaders like The University of Louisville School of Medicine are rising as leaders in the field by implementing EQuality into their curriculum. This “requires students to learn, practice, and demonstrate mastery of skills, knowledge, and attitudes required for excellent care of patients who are lesbian, gay, bisexual, transgender (LGBT), gender non-conforming individuals, and persons affected by differences of sex development (DSD)”. Kudos to UofL for not only requiring this training, but for calingl upon our local LGBT community to be patient actors in the simulations. After the simulation, they ask for honest feedback about our experiences and how the program can do better. I have been one of these patient actors. It was a valuable experience for me and those students. Thank you, UofL.

4. Use the Yelp App to Check-In

When you visit a business, check-in on the yelp app and answer the questions about the business. Yelp asks questions like, “do they have wifi?” and “are there gender-neutral bathrooms?” Yelp serves as a full database of “what to expect” for consumers. As we discussed earlier, bathrooms make a big difference to trans and GNC folx. Oh, and don’t worry. If you’re a private person that is worried about people knowing where you are, you can make your check-ins private.

5. Support local LGBTQ Organizations

There are SO many to name (yay Louisville)! By supporting local organizations like the Louisville Pride Foundation, Louisville Trans Men, Louisville Youth Group, Fairness Campaign, FEVA, CIVITAS, Pandora Productions, Sweet Evening Breeze, Kentuckiana Voices and so, so, so many others, you are sending the message that you are an ally. Your support, be it financial or time, matters. Show up with and for us. 

Here are a few upcoming events:

Sept 13-15: Melanin Pride

Sept 13-15: KY Black Pride Festival (Lex, KY)

Sept 20: LYG Glitter Gala

Sept 21: 5th Annual Louisville Pride Festival

Sept 22: KY Black Pride – Louisville Chapter Pride Kick Back

Want to volunteer at Louisville Pride? Sign up here

6. Don’t Support Businesses That Promote Hate

If you’re an ally, I need you to know that I don’t hate Chick-Fil-A, but it hurts me when you, my ally, eat their chicken. Do a little research for yourself and you’ll find that CFA actively gives money to organizations that are anti-LGBTQ, like the Salvation Army and has a history of funding organizations that support conversion therapy. Your seemingly harmless chicken sandwich literally lines CFA’s pockets with hate money. 

Here in the commonwealth, Kentucky Farm Bureau not only discriminates against LGBT folks, but also opposed teachers and unions. These policies are hateful and hurtful. This year, they added an anti-transgender policy that targets students in Kentucky schools.

When money matters more than people, you’re sending an implicit message to the LGBTQ community, even if you otherwise consider yourself an ally. (LouCity FC… I’m looking at you). It’s hard to know who to trust. No one reads the 80-page documents stating what their favorite brands do and don’t support. But when a brand flaunts their hate so loudly that it’s a part of pop-culture, it’s definitely time to verify the policies yourself and dis those brands. 

7. Listen and Take Action

I’ve told you why I write this blog. Change happens when we have open conversations and consider the feelings and life stories of others. I am visible because it matters. You matter too.  Showing up, listening, taking these things to heart and implementing these changes makes a difference. 

I have people stop me all the time to tell me how much my story has meant to them. I’ve been connected with kids in other states, talked to Mom’s and Dad’s trying to be supportive, answered questions about paperwork and policies and been given hugs, just because. These are all important and special to me, but two weeks ago, my life and advocacy came full circle in the most beautiful way. 

I was volunteering with the Metro United Way’s LINC group. We stuffed backpacks full of school supplies for 200 kids in our community. The event was at V-Grits. After the event, I stayed for some hella good vegan mac & cheese and a beer with a friend. As we were talking, a guy approaches me. “Excuse me.” he says, “I’m Christina’s husband. You don’t know me, but I wanted to let you know that Christina attended the Connecting Things event in June 2017 when you spoke on the LGBT panel. She asked what businesses could do to be more inclusive. You said ‘gender-neutral bathrooms’. I just wanted you to know that we were still renovating this space and we changed our entire floor plan because of what you said…in fact, [the work] had already been signed off and we were told we couldn’t change it, but we did anyway.”

This was an absolute WOW moment for me. I had already noticed the bathrooms and taken a  few pictures with this article in mind. When Connecting Things was a monthly thing, I attended every month. I knew Christina in the way that anyone in Lou knows Christina. She’s the cool blonde chick with tattoos that owns V-Grits, the Vegan Food Truck turned restaurant. We’ve always been friendly, but never had super deep conversations, so essentially, this total stranger heard my words and took them to heart in such a way that she revamped the entire layout of her restaurant. THIS, my friends is a lesson within a lesson. 1. Words matter 2. Compassion exists and is alive and well in our fair city. Thank you, Christina. Your gesture still blows me away. I get goosebumps thinking about this moment. Louisville is so lucky to have V-Grits as a staple in our community, and so lucky to have citizens of compassion like you and your hubby. ❤️️

Today, V-Grits has 3, private, gender-neutral, full-length bathrooms stalls AND a family bathroom. The restrooms are super clean and inviting, plus, the sink is outside the restroom. This means less time in the stall and full view of who does and doesn’t wash their hands. I get no kickbacks for telling you this.. Go support this local business! Get the mac & cheese! It doesn’t disappoint!


❤️️ V-Grits restroom situation. ❤️️

Thanks for reading along. These conversations are important, and you taking the time to read all the way through means a great deal. Next month we’ll discuss Things NOT to Say to a Trans Person 😉. 

If you’re attending the Louisville Pride Foundation, look for me. I’ll be around pretty much all day. Find me and say hi. Don’t forget to stop by the Louisville Trans Men booth while you’re there. Want more but can’t wait? Follow my transition on Instagram @trans.parent_kasenYou can also find more of my Yes Louisville series #TRANSparentKasen HERE!

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