Published in Nothing to Hide: Voices of Trans and Gender Diverse Australia, edited by Sam Elkin, Alex Gallagher, Bobuq Sayed and Yves Rees, 2022. This is a found poem from medical reports over several years.

Trans Broken Arm Syndrome

Robin is a 22 year old transgender

who is in the process of managing this

Robin has a history of mood disturbance

She reports mental clouding

gender reassignment

not planning at this stage for bilateral mastectomies

She is not on androgen therapy

There is no family history

There is no family

I note the recent biochemistry

For her hyperparathyroidism there are a number of interacting factors

and sunlight exposure

weight loss

.

Robin was born following a full term pregnancy

She bruises easily

She has had problems with joint dislocation      soft tissue injury

tachycardia      hypoxia      hypoventilation     

required brief endotracheal intubation

She wears glasses for shortsightedness

Head circumference was normal

She has normal facial features

neurological deterioration      weakness and pain

always fatigued

regular cardiac surveillance

This is to be further investigated

Her mood was jovial

She suffers

.

Robin has identified overtly as genderqueer

This has included a formal name change to Robin

preference for use of the ‘they’ pronoun

interesting developmental history

Hedonic capacity and energy levels remain variable

Robin presented as of small compact build dressed in blue jeans,

a tee shirt with words ‘the Revolution and etc.’

They wore earrings and glasses and had a clear, pale complexion

Their blue dyed hair was cut fashionably,

and a floral tattoo was visible on their arm

Affect was animated and enthusiastic,

with good eye contact and articulate speech

Thought form was well integrated

with a highly developed reflective capacity

earlier traumatic experiences

Whilst not questioning Robin’s identification as innately androgynous

I do wonder

.

In relation to your gender neutral status

we are unable to change this on the system

.

She has a number of issues to sort out

I suspect that her brain chemistry is complex

significance of this is not clear

At a medical level she has unresolved      symptoms

her blood tests reveal

she has ongoing investigations

I am checking

I am hoping

I am happy

Time will tell

.

whole body pain and diffuse dislocations in joints

congenital defect of the aortic valve of the heart

abnormality of the ascending aorta

require corrective surgery

There is also a history

Robin has had to suffer

.

Robin’s presentation is so apparently complex and so undocumented

I found it very difficult to make headway with her case

I found it very difficult during our consultation

Robin presented with her partner ­_______

who is also known to some of the doctors at my practice

currently we believe transitioning from male to female

provided a supportive presence      often whispering

occasionally inaudible

I had no further information about this

.

She has been labelled I think

She says

she claims

She also has a diagnosis

She claims also a history

when pressed by my surprise      at such a young age

she said there were also ‘gender issues’

she has normal female genitalia

she describes her lungs as ‘more or less functioning’

she is due to have a cardiac MRI but the indication for this is unclear

I had nothing today to corroborate any of this history

she was really unable to give me a reasonable rationale

She is clearly suffering and distressed

unclear to me what problems are organic      functional

This is complicated by having a large number of doctors

On examination she was very unusually

but neatly dressed, had many visible tattoos,

was softly spoken and polite but as mentioned

her conversation was full of      medical jargon

Somewhat reluctantly I am organising an MRI and MR angiogram

.

Clinical notes: Not provided

deficiency noted

persistently unexplained

in excess      exceeded normal

elevation suggests possible sarcoidosis

aplastic      mild opacification

Tests pending

recurrent infections      blood transfusion reactions

other immunodeficiencies may be associated

Suggest testing

Recommend measurement

for screening at risk individuals

subject to the following conditions

.

The patient tolerated the procedure well

.

The primary site of pain is really the whole body

Robyn was extremely cooperative

This must be extremely tiring for her

Her quality of life is now markedly reduced

she has accepted the fact that her lifespan may be markedly reduced

.

This diagnosis has a severe negative impact on her functional capacity

includes but is not limited to ligaments

tendons, intestines, brain and cognitive function

heart, blood vessels and other internal organs

recurring joint injuries

can only be managed      with no cure

.

The best Robin can hope for is to manage

prevent deterioration of her musculoskeletal system

loss of independence

to meet the specific stability requirements of the upper cervical spine

It is the gold standard      to keep the body as strong as possible

.

Robin has been given a significant, permanent diagnosis

The implications      are many and complex

.

It is always a joy to see Robin

Robin often pushes through to the point of exhaustion

They have been excellent with communication around their disability

to pursue a happy and fulfilling life

We still face consistent challenges

structural instabilities      systemic dysfunction

.

values      should be interpreted with caution