Coming to a Dentist’s Chair Near You…

A few weeks ago, I had my semi-annual visit to the dentist’s office to get my teeth cleaned.

Usually, this would not be so remarkable, except that this particular visit was six months after I had come out to my dentist and pretty much everyone in his office.

During that visit six months prior, I checked in at the front desk by handing over my shiny new insurance card, freshly embossed with my new name.  The woman behind the desk was professional and efficient, making the change immediately in their database and informing the hygienist who would be working with me that day.  She came into the room after I was in the chair and corrected my file, placing little stickers imprinted with my new name over the old one wherever it appeared.  She and the hygienist then confirmed that the use of masculine pronouns in my case would be correct.

After the hygienist had finished cleaning my teeth and fetched the dentist for the examination, he came into the room already informed of my transition.  He shook my hand, congratulated me and remarked how courageous he thought I was to have taken this step.  He said, “You must be feeling much better now.”  Indeed, I was, especially after this professional, positive and affirming experience in his office.

And so there I was six months later as my true self in the dentist’s chair.

What was I expecting?  Nothing, really, as in, nothing different from any other semi-annual visit to the dentist.  After all, the prior visit had gone so well and, other than the administrative actions of the receptionist and the congratulations by the dentist, had been the same as any other appointment I’ve experienced there over the past nine years.

I suppose now, looking back on it, expecting that nothing different would happen during this routine visit to the dentist’s office was a bit naïve on my part.

When I arrived, I was greeted by the same hygienist who had worked on my teeth the last time I was there.  As I settled into the chair, she regarded my file and asked the question that formally begins each semi-annual teeth cleaning:

“Has your health changed since the last time you were here or are you on any new medications?”

“Yes!” I replied, not realizing that I was about to give her an answer that was different from the one she was expecting.  “I am taking Vitamin D and calcium supplements.  I just found out that I have low Vitamin D levels and osteopenia.”

What I thought would follow was a conversation about the effects of osteopenia and low Vitamin D on my teeth.  Instead, she engaged in a mild interrogation that was tinged with disbelief.

“You’re not on any other new medications?”


“Nothing else you’re taking that’s different from the last time you were here?”


“Are you sure?”

Was I sure? What the…?

And then I realized what was going on.  She wanted to know about the HORMONES.

Of course, as a transsexual who had recently come out, I was expected to be on HORMONES.  Wasn’t that in the rules somewhere?


And so what was the proper response here? Should I reply with a hint of aggravation that of course I was sure what medications I was taking?

I figured that getting snippy with a hygienist just when she was about to put sharp objects in my mouth was not the best strategy, so I nixed that option.

Should I give her a lesson in Transgender 101, that not all trans people take hormones?

I decided not to go that route because that would not only require an assumption on my part about what she was thinking that, although unlikely, might actually be wrong, but it would also draw attention to something I didn’t want attention drawn to:  my trans status.  I am more than just “trans” and I didn’t want to be distilled down to the transsexual in the dentist’s chair.

In the end, I decided to simply answer her question the same way that I would any other that she might ask.  I hoped that I would instill in her the sense that I was just like anyone else who sat in that chair every day, just a regular ol’ person with plaque on their teeth who didn’t floss often enough.

So I replied, “No, I’m not taking any new medications other than the Vitamin D and calcium supplements.”

And guess what …  it worked!  She let it drop and moved on.

Well, at least, that’s what I thought.

She seemed to be working faster than usual, but I had also told her that I only had an hour I could spare in the chair before I needed to get back to the office for a meeting, so she might have been hurrying to accommodate my schedule.  What I hoped was that she wasn’t nervous because she was cleaning the teeth of a freshly outed trans person.  I will never know for sure if it was one or the other or both, but her speed translated into a brusqueness that had physical consequences.

As she scraped and poked and measured the depth of the gum line, there was more pain than I had experienced in the past, and I could also tell that my gums were bleeding more than usual.  I could taste it in my mouth and see it when I rinsed.

I wasn’t the only one who noticed.  She said,

“Your gums seem to be bleeding a lot today.”

“Yes,” I replied as I rinsed into the little white porcelain bowl next to the chair. “I noticed that too.”

“Can you think of anything that might be making your gums bleed?”

“Could it be the Vitamin D or the calcium supplements I’m taking?”

“Well, those wouldn’t usually cause this,” she replied.

I was trying to think of a nice way to tell her that perhaps she was being rather rough and banging up my gums pretty good to the point that they were bleeding, when she blindsided me.

“You know, hormones can cause your gums to bleed.”

Bloody hell!  Was she really doing this again?!

And then she just came right out and asked.

“Are you taking any hormones?”

That was it.  I couldn’t stand it any more.

I noisily knocked aside the stainless steel tray with a sweep of my arm, sending metal instruments clattering against the wall.  Sitting up straight in the chair, I grabbed the front of her little blue hygienist jacket in my fists and yanked her forward so that we were nose-to-nose. I looked her right in her wide eyes and growled like Clint Eastwood through clenched teeth, “No!  I am …   not   …  taking  …  any  … damn


Okay, I didn’t really do that.

Her behavior reminded me of a similar situation that occurred at work last year, a couple of weeks after I came out.  I had made it clear in my coming out email announcement that I would not entertain questions about my medical choices.  I wrote,

“I would prefer not to answer questions about my personal transition decisions, which fall under privacy guidelines, and so I thank you in advance for respecting my privacy in this matter.”

You will note that I used the word “privacy” twice, and it was on purpose.

There was not one person who violated that request, neither to me directly nor to my friends or direct reports.  There was one guy, however, who tried to squeak around it.

I passed him in the hallway and in usual fashion, I greeted him with, “Hey Mitch, how’s it going?”  (Note: not his real name.)

He replied, “I’m good. How are things with you?”

“Okay,” I responded as I walked past him.

Then he added, “Do you have a cold?”

I stopped, confused by the question.  I felt fine, and couldn’t figure why he had asked.

“A cold?” I turned and replied, “No, I don’t have a cold.”

“Because your voice sounds different.”

Oh.  Right.  That’s when I got it.


Of course, I had recently come out at work as trans.  I suppose people were then expecting me to undergo morphological changes due to the presumed use of testosterone.  This guy didn’t seem to want to wait to find out how the story ended and instead, cut to the chase, in a sort of round-about way.

How to respond then?  My first impulse was to raise my voice and tell him to knock it the hell off, he wasn’t fooling anyone with that stupid question and it was none of his damn business whether I was on hormones.  Of course, that wouldn’t exactly have been the most professional response.

I considered a calm, direct approach, something like, “I know what you’re doing and you should stop it now.”  Blah.  Too much potential defensiveness to deal with. I was a manager and he was not, which added a layer of complexity to the situation. On the other hand, perhaps I could have instilled a little respect with that tact. Or fear.

To be honest, it just wasn’t worth the effort.  He was so blatantly obvious with his dumb  question that I didn’t feel like dealing with it.  Let’s just move on, shall we?

I replied, “No, I don’t have a cold,” and walked away.

Fast forward to my next dental appointment, and there I was sitting in the dentist’s chair facing the same situation, but I was in the second round with Ms. Hygienist.

This time, I wasn’t feeling so generous.  This time, I decided to emphasize the message a bit more.

And so after she used my bleeding gums as an excuse to ask, “Are you taking hormones?” I replied politely yet firmly, “I believe I answered that question when you asked if I was taking any new medications.”

There.  Done and done.

“Oh, okay,” she responded, seeming to have been caught a little off guard. “I just wondered if maybe…blah blah blah.”

Wonder away, Madam, but keep your wondering to yourself.

Now at that point, I thought that we were all finished with the nonsense, but nooooooooo.  Indeed, there were people in the office other than her.

As I sat in the chair while she worked, I could hear people stopping in the room’s doorway, which was behind me.  They would ask a question of Ms. Hygienist, and she would answer.  I wasn’t paying much attention to all this, but after several interruptions, I remarked,  “Seems busier than usual today.”

“Yes, it does,” she replied, somewhat distracted.

It was when one woman in particular stopped by for the third time that I noticed the hygienist seemed to be somewhat annoyed by all the traffic at the doorway.

“What do you want?” she asked in a direct fashion, which was very different from the helpful banter she had been offering the first two times the woman had come to the door.

I don’t remember the answer because I still wasn’t paying much attention to what was going on in the doorway (I was paying more attention to what was going on in my mouth!) but then I heard the woman say in a slightly raised voice,

“Hi there!”

The hygienist withdrew the instruments from my mouth and paused, looking at me as though she was waiting for something.

I was confused at first, and asked, “Was she talking to me?”

“Yes,” Ms. Hygienist answered, adding, “She’s worked on you before.”

“Yes, I’ve worked on you before,” the doorway woman added, as though that explained everything that was happening at that moment.

The chair was completely reclined, so I had to tilt my head back in order to get a look at her.  As my chin went up, I could see the woman behind me, upside-down.

She waved.

I gazed at her for a few seconds and tried to recognize her inverted face.

“Oh yes,” I confirmed when I realized who it was. “Nice to see you.”

She replied something in an almost gushing manner, but I don’t recall what she said.

After she left and the hygienist continued with her work, I pondered what had just happened.  It was so strange.  I didn’t think this kind of greeting by a former hygienist had ever happened to me before, nor had I ever noticed so many interruptions by people during a routine teeth cleaning.

And then, I was struck with the sudden realization that I had never outed myself as trans at the dentist’s office before.

It’s a good thing that the woman in the doorway had walked away, because I knew then that during my time in the dentist’s chair, I had become like a monkey on display at the zoo, and I wasn’t happy about it.

Step right up ladies and gentlemen and see before your very eyes, a live transsexual, right here in our own dentist’s chair!  He will amaze and astound you with his wondrous feats of transition — hear his voice deepen, see the hair sprout magically all over his body, watch him put on muscle, see him in his new suit!  Only fifty cents!  Step right up…

This revelation was rather depressing. Was this what I had to look forward to every time I went some place where I was known as trans?  Was I to be repeatedly on display as the transsexual?

I talked to a friend of mine about this and he offered a different perspective on the situation when he said, “For some people, you will be the first trans man that they have (knowingly) ever seen in person, the first they have ever talked to or interacted with.  There’s bound to be some curiosity around that, but it doesn’t have to be a bad thing.”

Well, I suppose he had a point.  Theoretically, there will be more support and less discrimination for us trans folks if people can see us out in the world, can talk to us, get to know us, interact with us and see that we are regular ol’ folks who get plaque on their teeth and don’t floss often enough, just like lots of other people.

And so, potentially coming to a dentist’s chair near you, your friendly, neighborhood trans person.

Say hello, but please try not to stare (and don’t ask about the hormones…)


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18 Responses to Coming to a Dentist’s Chair Near You…

  1. shanesdomain says:

    Hi ATM,

    What the hygienist failed to mention is aging biological women have poor dental health due to “hormones”. Period. Not sure if it’s due to the fluctuation or lack of.

    I’ve had a hell of a time with my teeth (pre-hormones), and I can say they were worse on testosterone. Went off T for 5 months…body didn’t like it (messed up everything)…now back on a dose prescribed for post menopausal women (at double dose 8-10 mg daily bio-identical cream) . I also will mention, I had osteoporosis pre-T….severe during the initial T process…now back to osteoporosis. And we all know osteoporosis will surely affect your teeth.

    If I had to do it over again, I would have never started T (or at least taken male equivelent dosages). Now that I’m back on such a low dose…I feel better…and it’s such a low dose that my regular cycles are still happening which is so important for the balance my body desires.

    Still dealing with dental issues and I’ve decided to go back to my old dentist. I’m sure I’ll be dealing with the same response as you especially since this dentist is located in such a conservative town! 😉

    • Hey Shane,
      Yeah, and females who are menstruating also experience more gum bleeding as well, at least that’s what the dentists and hygienists have always told me over the years. I haven’t ever looked at the scientific data around it.

      Sorry you’re experiencing these health problems. Hope your experience with your old dentist is positive and professional.

  2. ian c. says:

    thanks, as always, for your blog posts. I feel like this one especially made me more aware of my ability & power to not answer people’s questions and not to share more of my life with people than I want to… and to stand up for myself in tricky situations that get personal… and to not feel like I have to be accountable/explainable to everybody’s random inquiries. so good, so crucial. thanks!!!

    • Hey Ian, good to hear from you. And I’m glad to be of help.

      I saw a blog post once written by a trans guy, a sort of Transgender List of Rights or something similar, that listed all the things we are not required to explain to people, like, we are not required to give a Transgender 101 lesson to everyone, we are not required to explain our medical choices to anyone, etc. I didn’t bookmark that post and I’m sorry I didn’t because I’ve been looking for it for a while now – it was really good. If anyone knows the post I am talking about, can they please provide the link here in the comments? — Thank you.

  3. maddox says:

    Echoing Ian here, you gave an excellent concrete example of what to say and when to say it and how to say it when people start prodding. It’s only happened once or twice for me, and while I eat and breathe this stuff online when it’s in person I just freeze and stumble. I’m going to take a cue from you and have a few set lines, then just deliver them with confidence. It’s also good to know that sometimes it’s really not our crazy paranoid overactive brain, and that people really are subtly trying to breach our privacy.

    • Thanks Maddox. I think people are just curious, but there’s also that element that, I think, tends to reduce trans folks to their surgical and hormonal status. The media often contributes to the problem and so unknowing people think it’s okay to ask such personal questions. And then, there are some people who are just nosy and intrusive.

      I absolutely refuse to discuss my medical status or decisions. It’s no more anyone’s business than their medical status is my business. I do, however, recognize that people need to be/want to be educated about trans folks. I reconcile those two views by speaking in general terms about trans people but never about my own transition (e.g. “some trans people take hormones, some do not, some take them for a while and then stop when they have the desired results; some trans people have surgery, some do not, etc)

      • maddox says:

        You’ve pinpointed my conflict about wanting to be out and create visibility while not dishing the dirty details about stuff no one needs to know. I like the ‘general’ approach, I think it’s better than the ‘vague’ one I was taking.

        • Yeah, it’s not so easy navigating these waters. I have heard a couple different guys tell about how people insisted that they explain what their genitals looked like for the sake of “education.” Being trans does not make us obligated to explain ourselves or others in our community. There is plenty of information on the internet and on TV where people can be directed if someone is not comfortable giving lessons on Trans 101.

          I saw your blog, by the way, and am sorry that I won’t get to meet you at the Philly Trans Health Conference.

  4. j says:

    there is going to be curiosity. Accept it. The original flagbearers of any community always have the burden of explaining. I’d draw the line if it got too personal and involved genitalia. There will be some people who get cheap thrills wanting to discuss. But the only way you can stop the Q&A and the curiosity in the long run is by demstifying the transissue. Drs. themselves need education and free and frank dilogue. I know it gets tiresome explaining and educating. But someone has gotta do it. Saying it is not anyones damn business what you do with your body is true… I know I know … but still… educating someone once a week is good. That’s the only way the curiosity will end in the long run! Twenty years ago the gay community had to face the same thing. now you got will and grace on tv and no one asks questions about it that much.

    • Thanks J. Good to hear from you!

      You’d draw the line if it got too personal and stop at genitals? For me, it already had become too personal. It seems that we both have boundaries — I just happen to be drawing the line in a different place then you would.

      As for educating, I actually was educating them by being there. The first one asked if I was on any medication. I answered that question. If she had bothered to think about it, she would have learned that not all trans people take hormones. Instead, she didn’t believe me. The other didn’t ask me anything at all – she just came to gawk. Her education was seeing me sitting in the chair getting my teeth cleaned like a regular person.

      I could have left that dentist and gone to a new office where no one knew me or my previous name. Instead, I chose to come out to everyone in that office, which I didn’t have to do, and my coming out is an education for them in and of itself.

      If people want to know about trans men, they can go watch Chaz Bono’s movie or read his book or watch numerous interviews with him on TV. He puts it all out there. There’s the “Will and Grace” equivalence, and Chaz is a real person and not even a sitcom!

  5. Jac says:

    This is so insightful. Thank you.

  6. Daisy says:

    It would be nice if you could tell the dentist that his/her staff members were not completely professional. He/she has her eyes/ears focused in another room while the staff interacts with patients, so he/she will not know everything is fine. I know it still sucks b/c you don’t want the extra attention or to be a “complainer” – so it’s really just a favor to the dentist and doesn’t help you out at all to speak up. I got mocked at the OB/GYN for getting the Guardacill vaccine – I guess because I’m in my 30’s? – I should have told the doc that the staff was unprofessional in that case, too, but sometimes you just want to move on. It sucks when your very private issues are in the hands of someone acting unprofessional with that information.

    • Thanks Daisy.

      Actually, my regular dentist wasn’t there that day so the hygienist’s work was checked by a dentist I had never seen before.

      The best teaching I could have done would have been to say something directly to the hygienists themselves, but I just wanted to have a regular visit at the dentist. Although, I guess it wasn’t regular anyway, even though I didn’t speak up. Could have been a learning opportunity for them if I had wanted to teach them. That’s just not where I was that day.

  7. Alex says:

    Thank you for this article. As a dental student with limited knowledge of the challenges faced by trans persons it was very enlightening.

    Unfortunately even nowadays most dental students have little exposure to the transgender community so it is likely that your friend was correct in their suggestion that you may be the first trans man these hygienists have treated. I think the only way to improve understanding is by education and discussion, as a general rule we do our best to be respectful to everyone but we do not always know the right questions to ask.

    • First, thank you for taking the time and effort to look into this topic. I doubt that you came upon my blog by accident, so it’s good to see students in the healthcare field looking to increase their knowledge about working with trans people.

      To address your comment about not always knowing the right questions to ask of trans people, that was actually not the problem with the situation I described in my blog post. The problem was not that the hygienist didn’t know what questions to ask – it was that she didn’t stop asking the same question repeatedly when my answer did not satisfy her assumptions.

      The key here is for healthcare professionals to not make assumptions about trans people. She assumed that because I was trans, I would be taking hormones. I have had healthcare professionals assume that because I am trans, I have had certain surgeries. I have heard of healthcare professionals, when they are confronted with patients or clients who are trans women of color, automatically assume that they are sex workers. I could go on, but you hopefully see my point. The problem when healthcare professionals make these types of assumptions is that they ask inane or even offensive questions based on their incorrect assumptions, similar to what I described in my blog post.

      As you are a dental student looking for information, I can tell you the questions you should ask trans people:
      Why in the world would the questions be any different?

      Question: Are you on any medications?
      If the answer is no, then move on. If I had been a non-trans person who said no to that question, the hygienist wouldn’t have repeated the question multiple times.
      Question: Have you had any surgeries?
      If the answer is no, then again, move on.

      Hopefully you get my point. Thanks again for looking into this and for leaving your comment.

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