Tuesday 1 October 2013

Telling Andy's Story: Andy Inkster Versus Baystate Reproductive Medicine

The story of transgender folks butting heads with health care professionals is not a new one. The power struggle over access to both trans-specific and general health care has a long and varried history that would probably shock you if you haven't lived it. I have a friend who tells a cringe-worthy story about the time he needed a prescription for yeast infection medicine (in the days before Monistat was available at every corner). Having candida susceptible reproductive organs but presenting as male made the prospect of a doctor's visit less than appealing and he waited longer than anyone ever should to deal with that uncomfortable problem.  When he could take it no more he visited the doctor and tried to whisper the reason for his visit to the receptionist. However, she was unable to wrap her head around the situation and yelled at him for being a pervert and wasting the doctor's time.

So it was not shocking when Andy Inkster had his back-up as he approached a fertility clinic in Toronto in 2008 in search of help conceiving a child. He had all the requisite baby growing parts and was not taking hormones that could interfere with the process. But still. He expected some push back. To his surprise, he was met with support and encouragement.

Several rounds of inseminations with the fertility drug clomid were unsuccessful in Toronto and it was time for him to move on to something stronger. During this time he moved from Toronto Ontario to Springfield Massachusetts to pursue a doctorate. The closest fertility clinic was Baystate Reproductive Medicine at Baystate Health Centre. Baystate was known to be (and advertised to be) a leader in trans health care. So Andy set-up his first consultation with the belief that he would be able to access the care he needed without a lot of difficulty.

His first appointment was a bit rocky as he was asked questions like "where's your wife?" and "aren't you overly masculinized to have a baby?" He was put off by their lack of tact and respect but he certainly didn't imagine that he was about to be refused care because of the trans identity. They suggested another round of clomid and although he was fairly certain that clomid was not going to work for him he decided not to push back too much and let them follow their own trajectory of escalated care. He left his first meeting with a copies of the protocols that would follow and instructions to call on day one of his next cycle.

On day one he called and left a message but it wasn't returned. On day three he went to the lab with his requisitions and had blood work done. Later that day a nurse from Baystate left him a voicemail message telling him that they would need him to visit with their "psychological counsellor" first and that until then they couldn't give him any of his test results or let him meet with a doctor.

Annoyed, Andy agreed to meet with the counsellor (Susan Lynn, MSW). And that's when things got bad. She asked for a letter from his current therapist regarding his emotional competence to undergo fertility treatments and pregnancy. But Andy's therapist refused. She said that ethically she could not participate in a process that she thought was discriminatory. When pressed, Baystate claimed that they did not have a specific policy in place requiring such a letter but that it was standard practice. However, Andy's current therapist, who specialized in queer families and infertility, had never been asked for such a letter prior to the request on Andy's behalf. Andy felt disrespected during his interactions with Ms. Lynn. She asked questions such as "what was your old name?" and "aren't you confused about your sexuality?" She told Andy that she had no prior experience treating trans people and put the onus on him to educate her. When Andy argued that her lines of questioning were not relevant to the matter at hand he was dismissed.

While he waited on a decision from Baystate about whether or not they would agree to treat him he called the clinic and read their own Patient Rights Policy to them. Click over to see the entire policy if you wish but the important part comes in the very first line. They claim that patients will "access treatment or accommodations that are available or medically indicated, regardless of race, creed, sex, national origin, sexual orientation, gender identity or expression, or sources of payment for care." When confronted, the clinic responded that their reluctance to provide care was "not about gender" but instead was because he was a male seeking female services. 

Ultimately, Baystate decided that they were not prepared to move forward with his treatment. Andy was then forced to seek care in Boston which meant multiple two hour trips, being farther away from his care providers in moments of necessity, and generally disrupting his life during a time that was challenging enough on its own.
In the meantime Andy went on to seek fertility treatment in Boston and conceived and birthed a daughter whom he named Elise. Unfortunately, during his pregnancy there were complications and it was thought that he might need to be induced. Not feeling secure about his ability to receive care at Baystate he and his birthing team had to come up with creative scenarios to avoid the hospital that was closest and would make the most sense to visit. 

Andy and Elise walking the dogs (4 months old)
Andy and Elise (two and a half years old)

This month MCAD reached a decision in the case of Andy Inkster versus Baystate Reproductive Medicine. They found probable cause that Baystate had denied care to a transgender person. I asked Andy how it felt when he received that news and he said that he felt a mixture of relief and anger. He had never intended to set out on this David versus Goliath style fight. He said that the last three years had been draining but that he was glad he had continued to fight. Glad not just for his own victory but for the hope that now Baystate, and other institutions, will be forced to examine their own policies and practices and encouraged to provide trans people access to respectful healthcare. And, as he said, "transgender people shouldn’t have to go to court to go to the doctor."

Andy reached out to a number of LGBT advocacy groups but struggled to find someone willing to fight on his behalf. On his own, he filed a complaint with the Massachusetts Commission Against Discrimination (MCAD). That process has taken three years and has involved rounds of claims and rebuttals between himself and Baystate Health. 

The lingering trauma of his experience at Baystate did not end there. With a newborn to worry about it was not sufficient for him to rely on having her care providers a two hour drive away in Boston and he could not trust Baystate with his family. So he left his PhD. program and moved back to Canada, ultimately changing the trajectory of his life entirely. 

At this point the finding of probable cause means that both sides will come together to discuss retribution. Guessing on what that will entail would not be productive. But Andy says that he is most looking forward to their acknowledgement that they were wrong.

If you would like to get in touch with Andy Inkster to learn more about his story please feel free to contact him by email at AndyInkster@gmail.com or on Twitter @AndyInkster. 

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