When I showed up at my local LGBTQ health center, doubled over in excruciating pain and unsure of what was going on, my vision was so blurry I could not read texts on my phone. I was hopeful that relief was in sight, trusting that NYC’s most trans-savvy doctors would be able to give me some preliminary answers, or at least some basic sympathy. However, the first doctor I saw asked me, “Are you sure you’re not just anxious about your period? That might explain the dizziness. I mean, you weren’t even supposed to be born with these organs, right?” She then told me to take some deep breaths and sent me home without so much as a referral to a specialist. I was in bed for the next week, and my symptoms continued to get worse.

Doctors are quick to point to trans identity as the source of people’s symptoms, rather than to recognize it as a barrier to treatment. Assuming I experienced dysphoria, my doctor completely attributed my symptoms to her perception of a lack of congruity between my gender identity and my physical body. If only it were that simple. As I gingerly walked out the office that day, I said to my friend, “It’s 2015. Are they actually still telling people with uteruses that they’re ‘hysterical’?” Turns out, the answer is yes.

It’s been decades since doctors have actually diagnosed women with “female hysteria,” a catch-all diagnosis that used to cover everything from mood swings to faintness, from chronic pain to insomnia. However, the idea that people with uteruses are mentally unstable, acting out, and exaggerating their pain still shows up in doctors’ offices every day.

There is still the cultural understanding that abdominal pain in female-assigned-at-birth people is normal, something that requires acclimation and acceptance, something to be endured, silently. Doctors frequently do not take this pain seriously. Nearly every person I know with a uterus, regardless of gender identity, has been told at some point, by a parent, by a doctor, by a teacher, that they are overreacting, that they need to buck up and deal with it, that this is normal. Being regularly, predictably incapacitated by pain should not be considered normal.

Furthermore, being trans amplifies the problems people already have in getting this kind of essential health care. The intersections of sexism and transphobia, as well as racism and economic oppression, make it particularly hard for trans people to receive adequate care for these issues.

Accessing care for these kinds of symptoms is complicated not only by medical provider bias, but by the lack of research on both transgender health care and conditions like endometriosis, uterine fibroids, and PCOS. While it is standard practice to recommend a total hysterectomy within five years of testosterone hormone replacement therapy, little is known about the long-term impact of testosterone on typical FAAB reproductive organs. When I first began experiencing pain before even starting testosterone, not a single provider at NYC’s most well-known LGBTQ health center could tell me if testosterone was more likely to worsen or improve my symptoms. Minimal research exists, and in many cases over-worked providers are not up to date on it.