By Jakob Hero, Berkeley, California, USA

 

The reality of what happened didn’t sink in until the Emergency Room. It was the morning of Good Friday, as a church employee I had many other plans that day. My HMO offers no other option for urgent care than triage through the ER. Within an hour of my HIV exposure I had already explained the intimate details of my body, my identity, and sexual practices about half a dozen times. And then, all I could do was wait.

 

I would guess that overall the experience wasn’t so different from anyone else who seeks post-exposure prophylaxis (PEP). But the reality of my experience is that my body is different. There are protocols for biological men and there are protocols for biological women. But in order for me—a female-to-male transsexual—to get treatment, I was forced into the role of educator during my own time of crisis.

 

This is nothing new. I usually expect to explain my unique medical history every time I see a doctor. It happens no matter how unrelated the visit is to the first 23 years of my life, which I spent as female. On that day, I did not want to educate. I was terrified, embarrassed, and anxious, none of which are conducive to the calm and patient manner required for teaching others about gender. I knew that my whole life might be about to change irreversibly. I was facing a potential shift in identity and self-perception and I did not feel up to the task of explaining and justifying my gender.

 

At least when I seek medical care for something like bronchitis or a wound that needs stitches, my trans status is just an interesting bit of information on my medical record. It always comes up, no matter how irrelevant, but in those cases I feel more prepared to handle it. I get asked about past surgeries, hormone treatment, and other random medical curiosities. But surprisingly, my actual identity—as in who I fundamentally understand myself to be—is rarely called into question. That is, until the question of sexual orientation becomes totally, and medically, unavoidable.

 

I often feel like it is relatively easy to be “out” as transgendered, and even easier to be “out” as gay. But to be a man who was born and raised as a girl, and now has sex with other men (some who were born and raised as boys, some who were born and raised as girls) is often just too much for other people to handle. I am almost always asked, “If you wanted to have sex with men, why didn’t you just stay female?” As an activist, I am usually happy to explain the fundamental difference between gender and sexual orientation. I like to talk about homosexuality and heterosexuality as more than just attraction to penises or vaginas. I appreciate the opportunity to raise the issue of attraction to sameness versus attraction to difference. Often I am even willing to discuss my own transition from a dyke to a fag. But that day, as I faced yet another person’s inquisitive stare at my driver’s license’s “M” marker and my health insurance card’s “F” marker, I did not feel up to challenging binary gender constructs.

 

I had not stopped to shower after the incident. I had thrown on the previous day’s dirty clothes and flip-flops. I felt tired, unwashed, and hardly suitable for public interaction. This is not the context in which I choose to educate others. Meanwhile, my lover sat there, trying to be brave, but alternating between nervous fidgeting and silent sobs. I was facing my own fear of infection, but also trying to protect him. He has such a precious and gentle heart, and I could feel it breaking but there was nothing I could do to alleviate his guilt or shame. He was terrified that the he had harmed someone he loves and scared he’d be suddenly rejected. We were both worried about our other partner, with whom I share a home. How would all three of us weather this storm?

 

Along with questions about why I have sex with men and which orifice I like to use, I was asked how I came to be exposed to HIV that morning. Was I raped? Had I been tricked or deceived? Did he lie about his status, only to confess after the deed was done? It seemed that once I had proven the validity of my male identity and my sexual orientation, I was then expected to justify my HIV exposure. Not everyone was rude in their questions, in fact, it was often done with a tone of compassion. What troubled me about this second round of questions, was that I felt I needed to provide evidence that I was somehow the innocent victim. This aspect of my PEP experience, I would wager, is not too different from what others go through—regardless of gender status. People wish for someone to blame—someone other than the scared, worried, patient sitting before them. They wanted an image of an evildoer who coerced this innocent young man into HIV exposure. They did not want to see the terrified HIV-positive guy, filled with fear and guilt, also wondering what went wrong with that full condom.

 

The truth is, if there were culpability in this situation, we would share it equally. There is no need for “blame”, we were just expressing our mutual attraction and having a good time. I had made the informed decision to enter into a sexual relationship with this man. I chose to be the receptive partner. And I knew—although only in theory before that day—that condoms don’t always work.

 

I’ll admit that in retrospect I feel some shame about my own eagerness to justify the exposure. Initially I sought the validation of the condom being at fault. I guess I, too, wanted to put blame someplace. I admit to liking that I did not have to worry about T-cells and viral loads, medications and side effects. But I think it is okay to not want to have HIV. This doesn’t mean that I think someone’s sero-status determines his or her worth as a human being. I am not even saying that I am more attracted to one side of the sero-discordant divide over the other. I just did not want to cross that divide myself. I don’t want anyone to cross it.

 

Six hours later I left the hospital with a 30-day prescription for Atripla and instructions to come back to be tested in a couple of months, and again a few months after that. On the way home from the hospital I thought about all the questions I’d faced that day. I thought about explaining and justifying who I am, my own assertion that someone with my history and anatomy can be a gay man. Although it is politically incorrect to categorize HIV as central to the homosexual male experience, I felt strangely validated in my gay male identity. I felt like those pills would connect me to the communion table of my brethren. The majority of my friends are HIV positive gay men, and suddenly I got a window into their life and experience. It was a reality I thought I understood, a place I thought I had already explored, but really it was a community into which I had never fully gained access.

 

What is more surprising is that I also felt strangely connected to my own past identity. We had not yet gotten back to my apartment on that drive home when I silently reflected that had the course of my life gone differently, a condom incident such as this could have potentially brought life into this world. I thought about a close female friend whose similar slip up led to the conception of my beloved godson. Her accident, her failed protection—although also terrifying—created this beautiful creature who is a true joy in my life and hers. What would my accident bring, other than destruction?

 

I momentarily teetered on the edge of insecurity about who I am. I almost traveled down that destructive path of self-doubt, the question of why entered my mind. Why couldn’t I just have been a normal girl and behaved the way other people born with uteruses behave? Luckily, my lover rescued me. Although I had not said any of this out loud, he turned to me as if reading my thoughts, and shared his own feelings about the potential destruction of the love making between two men. He told me about his sadness around his own loss of procreative ability. And although we had discussed this many times before, in the context of my post-surgical lack of reproductive ability and his HIV status, I understood his sadness in a new way.

 

The rest of my story is rather typical. I took my meds, they made me sick and gave me crazy dreams. I waited and waited, hoping that my body would not give in to the exposure. After a month I got my first test at a free clinic in San Francisco. I went through the same questions about who I am and how I got exposed. In that case I chose to come out as transgendered, although I did not have to. I let them fumble with not knowing how to fill out paperwork and a medical history questionnaire that didn’t take into account the reality of my body and personal history. By that point, I thought I was feeling stronger and ready to face the situation. Then I surprised myself by not going back to get my results. I allowed four more months to pass before finally going in to be tested again. I was terrified, worried, anxious, and also ready to face whatever the situation would bring.

 

© 2008 Metropolitan Community Churches Global HIV/AIDS Ministry

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