Growing up as an American-Canadian dual citizen, I came to Canada excited for the accessible health care I’d always heard about that was just out of reach. On my second day on campus, I found SFU’s Health & Counselling Services and made my first appointments, ready to take some big steps on my mental health journey. What I didn’t know at the time was that I was about to take some big steps backwards in the process.
While I was enthusiastic about the Health & Counselling Services the first time I walked in last year, these days I am wary as I chat with their staff. I am grateful for the positive support and diagnoses I’ve received, but the general outcomes of my time spent with SFU Health & Counselling Services have been incredibly damaging.
From the beginning, I noticed and understood that SFU had no idea how to work with transgender students, but it became even more apparent over time. Rather than treating me the way a cisgender student would be treated, my non-binary identity was both brushed off and considered a reason behind my mental illnesses.
It took several visits before reception had figured out how to use my preferred name on file and not misgender me in the short moments we had together. It took weeks before my counsellor learned which name to call me, even with my preferred name on file and in their notes. For my doctor, it took weeks before they remembered that my preferred name in the file is what I wanted to be called. Even when I informed SFU workers of my transgender identity when relevant, I had to take the initiative to explain what it meant — as though they have never encountered a transgender person before.
A close friend of mine, who sought assistance from the same SFU doctor I did, reported that they put down his hormone replacement therapy as the reason for his health symptoms, when it was medically impossible for that to play any role. Like my friend’s experience, the same doctor questioned me about whether I’d been taking “transgender medications,” a vague and informal term, as though hormone replacement therapy would have any correlation to psychotic symptoms.
This troubled me because there’s no way that being transgender, whether medically transitioning or not, would cause the kinds of mood swings I had been having. Ignorance about transgender issues and our mental health is common in health care, and it is just another systemic issue that SFU’s doctors are complacent in.
After only three 30-minute appointments, my doctor prescribed the first medication in early November. This was barely enough time to confirm my OCD, anxiety, and depression — the first of which would soon be ignored by my doctor. Already I was encouraged to start taking a drug, even without trying therapy as a first treatment option. The plan was to try it out and see how I was after a few weeks.
The drug had negative side effects that made it unsafe for me to even walk from my dorm to my lectures. Even after I had adjusted to a standard dosage, I still felt worse than before I was prescribed the medication. After informing my doctor that I was having an increase in suicidal ideation, they decided to keep me on the medication. In fact, they decided to keep increasing dosage in hopes that double or more of the medication would start to treat a different disorder I have. As we kept increasing the dosage, most of the side effects unmonitored, I continued expressing that I was having serious physical side effects and suicidal thoughts, but on we went.
By this time, it was January and I was at four times the initial dosage. On January 12, I had a failed suicide attempt. We stuck to the medication, just to be sure it wouldn’t still have positive future effects. On February 24, a friend took me to the ER for active intent to attempt suicide. On March 2, I returned to the ER for active intent to attempt suicide. At this point, my friends would not leave me with more than a few day’s dosage in my room at a time, because they knew I would otherwise try to overdose on it.
By this time, the SFU doctor finally decided it would be time to lower the dosage, but they also decided that I would add a new medication to my daily mix of drugs. They knew I was still trying to cope with changes from the medications given to me by the ER doctors, and would be dealing with side effects from changing dosages of the first medication. Needless to say, the cocktail of drugs left my physical health in a state of disrepair, unable to complete coursework and physically incapable of going to my classes.
It only took a few minutes in the ER for the doctors to recognize that my symptoms that were initially recognized as typical anxiety and depression were treatment-resistant, and perhaps even a misdiagnosis because they were so hastily accepted and medicated.
After the trip to the ER, the final two months of the Spring 2020 semester were full of medication changes, never giving me a break to catch my breath before something else would change. I was agitated, hallucinating, paranoid, completely dissociating, and of course, brushed off by my SFU doctor.
In between finals, I was seeking help outside of SFU. The first psychiatrist and first doctor I saw agreed that my mood swings clearly looked like bipolar disorder, and likely also borderline personality disorder.
This psychiatrist immediately recognized my emotional regulation issues, and that I was in a state of hypomania. For me, hypomania consisted of restlessness, lack of sleep, mind racing, inability to concentrate on anything while starting a handful of new projects, bouts of reckless behaviour, paranoia, and delusional thoughts.
The recognition of hypomania suggested bipolar disorder, while my SFU doctor of months had brushed off unusual mood changes as just part of medication side effects. This psychiatrist also suggested at first that the symptoms were caused by my transgender identity, like my SFU doctor, which speaks to broader issues in health care.
The primary issue that SFU doctors, and general practitioners as a whole, deal with is to accommodate people with mental illnesses. Suggesting that my transgender identity was the source behind my emotional regulation issues was oversimplifying complex issues.
Furthermore, it appeared to me that my gender transition had been treated as a mental health concern to be fixed, rather than acknowledging the social complexities that accompany gender dysphoria and the trauma that can come with transphobic experiences.
Mental health conditions remain stigmatized, and as a result, they may not keep up to date on how to treat disorders — especially when there are comorbidities and the patient is of a marginalized or historically oppressed group.
Still, I continued to see my SFU doctor as I did not have the financial stability to move to private specialists, or knew any better at the time to make the switch. As late April came, they let me go away unmonitored for the following four months with an antipsychotic medication that normally requires regular monitoring and blood tests, initially suggested by them and then prescribed by my psychiatrist.
I wasn’t even given so much as a warning about its side effects, and after just three days, I knew my nervous system had a severe reaction to it. After those three days, I had to stop taking it because I knew if I listened to the medical advice I was given, it could kill me over the summer.
I spent months describing my mood swings and emotional dysregulation to an SFU doctor, and instead of any kind of therapy, referrals to a psychiatrist, or deeper looks into the causes of my mood swings, all I got was a dangerous mix of drugs.
The SFU doctor I went to for help lost the trust I’d normally give a medical professional. Having lost nearly a year of my life to mistreatment, they left me with medical trauma that I am still struggling to make sense of. Looking back on all of this, their negligence could have killed me, and I am still surprised that I am alive to be writing this article.