I noticed the swelling on the front of my right calf around midnight. It was a small lump, as if the top third of a golf ball was poking through my skin.

I stopped pecking out work on my laptop and sat up on the couch, tracing my finger over and around and over the smooth bump. It didn’t hurt, except when I pushed on it. I took a gulp of the White Russian I’d just made and thought about my first visit to the doctor who prescribed me hormones.

“The number one thing you’ve got to worry about is blood clotting,” he’d said softly. “You’re at much, much higher risk for one now that you’re on hormone therapy. That means if you ever get any swelling in your leg or your ankle, you go to the emergency room. Just go, drop what you’re doing, and go. Because if it is a blood clot and it gets to your lungs, you can die in less than half an hour.”

“Ah,” I’d said. “Got it.”

I set down the drink and scrambled over to my roommate’s door.

“Yeah?” A boxer-clad Stephen looked up from watching Community on his laptop.

“Hey, look, I don’t mean to cause a panic or anything,” I said in the high-pitched mutter that can occur when the prospect of imminent death suddenly presents itself, “but I feel some swelling in my leg and I think I might have a blood clot and I might need you to take me to the hospital.”

Stephen closed his computer and started putting on pants. “Let’s go.”

“Hold on.” I looked up the number for my school’s after-hours health crisis line, hoping they could give me a diagnostic to tell me it wasn’t a blood clot, or at least some preventative action I could take to prevent me from dropping to the ground on the way to the hospital.

“I probably shouldn’t drink any more of that,” I said to Stephen before dialing, gesturing to the White Russian, “You should have it.”

I walked around and around my living room. Some pleasant guy whose name was probably Brad or Dan picked up.

“And why do you think you have a blood clot, sir?” He asked, after I’d explained the situation.

I sighed, not about the sir—I was too frantic to be bothered by that—than of having to explain: “I’m transgendered, and I take estrogen. So I’m at an increased risk.” I traced the swelling with my fingers, around and over and around.

A very short silence. “Oh. Okay. Got it. I’m going to transfer you to a nurse, okay?”

“Okay. Thank you.” A transfer ring and then Hello, all of the nurses are currently unavailable to—

YOU GOTTA BE FUCKIN’ KIDDING ME!” I screeched, bending my knees and almost falling onto the floor.

“Dude. Calm down,” said Stephen.

“I’m sorry,” I said, shaking, “they’re not—” Another transfer ring and a friendly-sounding nurse with a Southern accent said hello.

“HI,” I said, and explained again, mentioning this time that I was on estrogen, while throwing a bag together and layering on hoodies.

“And why do you think you’ve got a blood clot again?”

“I’m transgendered. I take estrogen,” I repeated, “So I’m at an increased risk for clotting.”

A longer silence. You should just leave, why are you even on the phone, they can’t help you, just go, I kept tracing the lump to make sure it was still there, around and over and around. “Oh. Okay. Yeah,” she said. “It sounds like you’re probably alright, because blood clots generally happen in the back of the leg, but you’ll probably want to go to the emergency room, I think that’s what we’d recommend, because you’re on that estrogen.”

“Okay, I will, thank you.”

“You’re welcome. Goodbye. Good luck.”

I hung up and Stephen and I burst out of our apartment, walking rapidly over to Broadway. I calmed down a bit after I’d flagged down a cab and was at least on the way to a hospital. We were in front of the emergency room in ten minutes. “Hey,” Stephen took out a cigarette, “I’m going to smoke while you go in, if that’s alright?”

“Could you please not!” I said, the high-pitched mutter back. “Wait until I start talking with someone, at least?” He saw my face, and softly said, Sure. Okay.

Inside, a large bald Russian nurse took me back for triage.

“Do you take any medications?” He asked, after he had taken my vitals and looked at the swelling.

“Yes. I’m transgendered,” I said, a bit more confidently this time, “so I take six milligrams of estradiol and two hundreds milligrams of spironolactone.”

“Ah, yes, okay. I was going to ask you about your gender. Don’t worry, we’re not here to judge,” he said matter-of-factly. “What do you prefer to be called?”

That’s so professional to ask! I thought. “I’m female, but my documents still say male. I have a letter from my doctor which says I’m female though.”

“Ah, okay. See we just need to know because if we have to put you in a bed tonight, we have to put you with the men, because you still have the genitals.”

“Got it,” I said, nodding. He printed out a label for a blue hospital bracelet, stuck it on and attached it to my wrist. I got up, beckoned Stephen from the waiting room, and followed the nurse down a white concrete hallway, glancing at the bracelet and the M that appeared above my age.

- – -

It wasn’t a blood clot. I was fine. The wait to be examined was long&mdash’two hours—but Stephen called Tricky, who lived half a block away, and the two of them kept me company while I waited. The doctor was pleasant and kindly, called me “Ms. Plett,” and said, “It’s not a blood clot. They usually happen at the back of the leg; it’s extremely rare for them to happen at the front. It’s good you came in, though. You always want to get those checked out.”

I hugged Stephen (“Thank you for being there.” “Of course.”) and walked back to Tricky’s apartment with her fingers folded around mine (“Thank you for coming for me.” “I’m glad you called me.”) I was a little freaked later that night, reflecting—the health complications that come with hormone therapy have long frightened me. But the next day, I was largely feeling fine. I thought about how quickly I’d gotten to a hospital, and how rapidly the doctor had determined I was okay.

That was two weeks ago. I’ve felt uneasy about that whole night since then, and I haven’t quite been sure why. The doctors treated me professionally, and my friend and lover were there by my side. I did some research and found trans women on hormones don’t have any more risk of clotting than do cisgender women on birth control—checking into this was a calming suggestion of Tricky’s—and the big risk factors for cardio problems like clotting are still the usual stuff like smoking and being old, neither of which I have to be too concerned about at the moment.

I only worry about a few things: The silences on the phone between “I’m transgendered,” and “Oh. Okay,” for one. The phrase, “We have to put you with the men, because you still have the genitals.” The idea of who those men might be, and what they might do to someone like me. The data showing half of trans people have had to teach their doctor about their health needs, and that a quarter who were out to their providers were denied service altogether. That a doctor’s letter can’t erase the M on the bracelet.

I realize that my body, for medical purposes, currently doesn’t fall so neatly on the side of either letter—though my school’s health services division took my doctor’s letter as sufficient for changing the M to F—and that my concerns of that night are somewhat trifling when my physical needs were professionally taken care of. I live, of course, in a very queer-aware city, and not only that, New York State legally bars doctors from denying me care because I’m trans. There are other health concerns to keep an eye on because I’m on hormones, but I get blood work done pretty regularly and I’m well taken care of.

So, I’m only a little worried. Mostly, I’ve found, what I am is angry. Angry that I should feel lucky that everything went the way it did, angry that I should be grateful for getting the care I did, angry that a quarter of the folks like me in this country get shown the wrong end of the doctor’s door, have to order their hormones on the Internet, never get blood work to check their health, can’t find any doctor for hundreds of miles around who will take care of them for transition-related care or not. Angry that getting a hospital bed means being outed as trans to a roomful of strange men, and angry that that is something—I don’t say this sarcastically—to hope and be thankful for.