As some may know I have taken over 5 years, many trips to London from the North West and oodles of pain over trying to get the right treatment for my condition on the NHS. This is just a bit of my story.
Over the next few months I am going to unearth some of my diary entries that are randomly scattered across my pc network and post them up here, who knows they may help someone. Anyway I have been in the NHS system for my Transgender (or as I prefer to call it Two Spirit) condition for 5 years. Always fighting against the crazy way ‘the system’ insists in treating people, in part I understand why they are so ridged but really I believe 5 psychiatric appointments with a local guy and 2 at Charring Cross is way too much. All this I may add before I get any systematic help for the terrible gender dysphoria and the ensuing anxiety etc I was suffering – GP’s preferring to try and pump me with Anti Depression pills all the while I screamed “I AM NOT DEPRESSED”. From day one I felt I knew what I needed, an innate sense of understanding of my bio-pshychology, I knew my brain needed something to balance it out. The reasons for this I have searched through for many years given I was always racked with guilt and didn’t in anyway want to upset my children and the associated people around me, but I knew if I didn’t find relief I would end up on the slab in some way, at the hands of drink etc.
I believed for years that a small dose of oestrogen would balance the gender dysphoria flick flack (an old gender psychiatrist on the NHS agreed with me early on too – but wasnt allowed to prescribe, “not like the good old days” he said), I didnt want to change sex I simply wanted to be me and emerge as I began to feel well and more stable in my gender. An eminent private consultant in London (who is brilliant if you can afford him all the time) said I was in a bad spot because in the main I was more Inter gender rather than traditionally transsexual, and that gaining the right balance of treatment would be tough especially in the ‘sausage factory’ of the NHS. He described inter-gender as the bio-psychological version of inter-sex.
Not being rich and having spent my savings seeking second private opinions I resolved that the only option was the NHS route. For all those who don’t know how the NHS Gender Service works this may give you an idea (this happened to me recently) –
Consultant: “look there are males and females, its simple sex is like life and death you either are one or the other, and all this new age mumbo jumbo about gender variance does not tally with my experience in the field and cannot be proved, you need to work with us not against us”
Me: “In other words, before I get any hormones which you have already stated I need, I must jump through hoops of changing my name, presenting differently, upsetting my life more, and effectively ditch my desire to get well first? I have to simply play the game of living as a female?”.
Consultant: “Yes – trust me he said we are not in the business of turning out people in Laura Ashley dresses and making people talk “like proper ladies”, but really a head scarf, vest top, jeans, pumps and no make-up, isn’t exactly showing me you need to be female is it, you need to try harder”
Me: “But I am wearing make-up all be it subtle and I have spent a fortune over the years on laser treatment to help me, and surely my gender identity is mine, and what I wear and how I present is my decision?”
Consultant: “Well I can’t tell you are wearing make-up. Anyway you come here asking me to treat you for your gender dysphoria, we tell you what you need to do, stop smoking and change your name, then you arrive looking like you do, talking of emergent approaches etc, come on, do you really want to be cured? Rest assured this isn’t just me, you need to fit in to society to make it easier for yourself, a lot of your dysphoria is caused by society as much as anything else, all this Bio-Psychology stuff hasn’t been proved. You need to blend in more ‘play the game’. You say you want to be cured for Gender Dysphoria yet if you went to the bus station toilets and asked to be directed to the right toilet we all know which toilet they would send you too – the gents!”
Me: “Strikes me then I’ve been wrong all along listening to me and understanding what I know I am and what I feel I need, and this is all about toilets now and what everyone else wants (tears start to get v v v upset)”
Consultant: “Look I am here to help – if you follow our guidance you will get well trust me I have treated many with your condition and my way works – so are you still willing to work with us? Because remember how can I treat you if you don’t do as I ask? Remember we don’t have to treat anyone who we dont feel is working with us”
Me: “Doesn’t look like I have an option – does it? I can’t afford to be treated the way I feel is more appropriate as laid down in the WPath guidelines, you have told me that the NHS Guidance document I have shown you has been withdrawn, the very guidance that concurs with how I feel I should be treated, you also disagree with professional opinions at my NHS trust. In fact what you are telling me is that if I stop smoking (which will be so so tough considering my anxiety levels) and change my name to a female name then you will prescribe hormone medication.
Consultant: “Hey you got it Mr xxxx. I will write a letter to your GP and once you have not smoked for 4 weeks and changed your name you will be prescribed hormone medication – isn’t too difficult really is it?”
Me: “(More tears) But what’s so wrong with the way I feel I should be treated, its more comfortable for me, causes less stress and trauma, and means I can grow into myself IF any physical side effects occur. Who knows I may get a terrible reaction to hormones, ok I’ll be back at square one with my dysphoria ok, but surely the WPath guidance makes more sense and is less traumatic???”
Consultant: “Anyway all that is just stuff you have read on the internet. Look it will be fine, trust me. I have the experience of treating many thousands of patients with this – I’m the expert.”
Suffice to say I went away more upset and more confused than before – who and what was I to believe. 6 weeks later the letter arrived and my GP gave me a copy – as he said ‘My hands are tied, I know what you are saying and have read the documents you have given me, but I can’t do anything other than do as I am being asked within the framework”
I asked for a copy of the letter, took it away and realised I had to first get symptomatic relief, my innate feelings where that hormones would help me, but I couldn’t get them unless I ticked the boxes and jumped through the hoops, but how do I bring down the levels of dysphoria, I am going round the twist, its always chicken and egg, I hate myself and this condition, I need to feel better to stop blowing myself up on cigs and booze, but how do I start? More over I never wanted to self medicate I felt I owed it to my children to at least try to do the right thing, I know cigs are bad but they are at least more socially accepted than loosing a parent to self medication – which is ironic really. After a lot of thought, soul searching and desperation I decided I would test my understanding and follow the guidance of the WPath myself, with a view to knowing that the hormones would work or not and if they agreed with me. So after 5 years of trying to do the right thing I ordered the same medication at half the dose online. 9P per day it cost – 9P and I’ve been suffering for 9p when if the WPath guidance had been followed I would have been on meds a long time ago and would know if they work for me.
They arrived, after about 3 days or so of taking them I was feeling much much better. After 6 weeks I feel better than I’ve done in 30 years or more, they work! Understanding the dangers of self medicating I resolved that I had to get care and the appropriate tests done, so now I had stopped smoking naturally from 30 a day, on Jan 5th I decided to change my name so that I could at least get care from my GP and work through the rest at a later day. My name change was my choice and I didnt even know if the NHS would accept as the consultant was really a half hearted attempt at a female name – Dee.
On the 26th January 2012 I final got my PX from the GP. Same medication, but now official and with the right blood tests and monitoring to go with it. There’s much more to this story, which I will write about later. But I chuckled as the blood test forms and my registration at the GP said sex – female. WRONG. Sex – Male, Gender – female. One day I hope the system will change and I hope beyond hope that my posting this doesn’t get back to the people who hold the prescriptions because I am terrified they will withdraw them.
The future, who knows what I will need to do, what hoops I will have to jump through, but for now I am literally playing the game, but to my rules, for me for my health. I figure the system may try and raise the bar and not be satisfied that I feel well (very well) for the first time in years. But for the time being I’ll wear the frock to London and enjoy my bandana, head scarf, pumps and jeans for as long as I like.
Please understand, it is dangerous to self medicate it is not advised by anyone I have spoken to ever. So really don’t do it, even though it was a bridge that helped me across a a very deep and scary ravine.
Peace and tranquillity to you you all.