Not a Choice: Being Type 1 + Transgender


Editor’s Note: This piece originally appeared on The Diabetes Link (formerly known as the College Diabetes Network) and has been republished with permission.

Keeping quiet

When my parents came to visit me at college during the first semester of my freshman year, I prepared for their arrival by removing the decorations on the door to my dorm room because they had my preferred name on them. I hid anything in my room that could hint at the fact that I was transgender. And yet, after seeing my newly-shaved head, my mom asked me, “Are you trying to be a boy or something?”

I began coming out to my friends that I was transgender in high school, and I took the first steps of my transition during my freshman year of college, starting with cutting off my hair and wearing more masculine clothes. I kept this information from my parents as long as I could out of fear, and most people still saw me as a girl at that point anyway because I had not yet started hormone replacement therapy. Often, I didn’t assert myself and ask people to use the correct name and pronouns. It hurt to deny an important aspect of myself by pretending to be a girl, but there were situations where it was necessary.

Being a person with diabetes makes some of these situations unavoidable. For example, I typically avoid telling doctors that I am transgender because I’m afraid that discriminatory attitudes will affect the care that I receive. However, I was outed at the endocrinologist’s office a couple of years ago, meaning my LGBTQ+ identity was disclosed without my consent. When taking my vitals, a well-intentioned nurse noticed my “they/them” pronoun pin on my bag and asked if I had a preferred name different from my legal name (this happened before I got it legally changed). I cheerily told her, but I didn’t expect her to disclose that information to the office staff and my doctor. When my doctor came into the room, she interrogated me about my desire to go on hormones just to let me know that “we don’t do that here.” After my appointment, I had two of the office staff stop me on the way out and ask how I picked a name so different (and masculine) compared to my birth name. Being outed is a distressing experience for many reasons, and I was so upset that I cried in my car before leaving the parking lot.

Going forward

Eventually, I did start hormones, but not with the endocrinologist who manages my diabetes. As a trans-masculine person, I take testosterone, also called T, as an injection once a week so that I can go through a “second puberty” and take on traditionally male secondary sex characteristics like a deeper voice, thicker body hair, and a beard. Living with type 1 diabetes (T1D) gave me an advantage when I was preparing to start taking T. Unlike many trans-masculine people, I was unfazed by the idea of injections because I had already been self-injecting insulin for the last 10 years. I understood needle gauges, lengths and measurements like mL and cc. Drawing medication out of a vial was not foreign to me either, so I knew the proper technique already. Doing a shot once a week seemed like nothing compared to multiple shots a day. I was pleasantly surprised to learn that taking T didn’t affect my blood sugars. However, I was wrong to think I knew everything because testosterone is more different from insulin than I expected. Mainly, I had never done an intramuscular injection and was unexpectedly intimidated by the thick needle, which dealt a blow to my confidence in my ability to self-inject without fear. At my first follow-up, I got permission from my doctor to switch to subcutaneous injections because that was more familiar to me. From that point, I happily settled into a weekly injection routine.

With time, I realized that there is a lot more overlap between being trans and having T1D. I spent a lot of money on my transition, I endured a lot of pain and trauma, and I dealt with a lot of ignorance. Likewise, diabetes is expensive, it hurts, and not everyone understands what you’re going through. On the other hand, both being trans and being diabetic have introduced me to communities to exchange support, advice and jokes. Most importantly, I’ve become stronger through the obstacles I’ve faced. Since I’m stuck injecting not one but two hormones for the rest of my life now, I’m going to make that count.

Check out another piece from CDN—Non-Binary + T1D: The World of Cpunk.

WRITTEN BY O.C., POSTED 02/11/20, UPDATED 11/17/22

OC is a senior exercise science major graduating in August 2020. They plan to pursue a Master’s degree in Occupational Therapy after completing their Bachelor’s degree. OC chose to study occupational therapy because of their own experiences navigating the healthcare system as a genderqueer and disabled person. They are determined to share their experiences as a member of the LGBTQ+ and disability communities in order to help others. They hope to continue fostering an inclusive environment in their professional life and beyond.