For anyone who remembers the documentary "John’s Not Mad", this title doesn't mean I am going to have a bout of Tranny Tourettes. Oh alright then “SKIRTS! SHOES! BAGS!”... Thanks, I feel better for that. I again move away from the linear nature of this tale. This post will cover my treatment locally at the hands of my employer the NHS up to being prescribed those vital hormones. Oooops I may have spoiled the surprise ending!!!
I had almost forgotten about my referral to see a Psychiatrist. In the end I nearly missed it. Tucked away under a pile of loan offers and debt demands was an envelope franked NHS. I ought to send the loan offers to the debt collectors and vice versa, so they could just work things out together. Anyway, I usually filed the exponentially increasing daily pile of junk mail directly into black bin bags. Well junk mail is referred to as direct mailing. It was unusual to get something worth opening, and I could have easily just filed it as usual.
My appointment was in a dept called Liaison Psychiatry. I wasn’t actually sure what that meant but I liked the idea of a Liaison. Perhaps it meant that the appointment was slightly furtive in nature, perhaps conducted on a Station platform after dark. Unfortunately it was nothing as sexy as this. According to the font of all knowledge that is Wikipedia Liaison psychiatry is the branch of psychiatry that specialises in the interface between other medical specialties and psychiatry. In (not very ) short because I maintain that I am actually female and to this end I need to change my body, then the medical proffession sees this as a mental disorder that has a physical impact….or something like that. Anyhow although I would argue that I am not in anyway mentally ill or have any sort of disorder, I was quite happy to go along whichever route was needed. The doctor who I was due to see, I actually knew. In my so called job I sat on a bewildering range of committees and I knew Mike from one such meeting.
I turned up at our Acute Mental Health hospital in plenty of time. I visited this hospital countless times in the course of work, but this felt so different. I was a patient, or service user as they, I mean we, are now referred to. It felt so unreal to be sitting in the waiting area in this role. I have to be ashamed to say I wore my staff id badge as if I was trying to demonstrate I was not here as a patient. That is terrible to admit because I guess it showed a degree of prejudice towards mental illness. In my defence, because staff coming in and out knew me, I didn’t want them all to know my business, which in hindsight is both wrong and futile. As I was the only openly transgendered staff member, sitting in the department that dealt with gender identity, what other reason could I be there for. I am glad to say that since then I have endeavoured to be open and honest with colleagues that I am a service user
When my turn came I was informed that I would not be seeing Mike but one of his juniors. This was for his development reasons. The junior doctor was called Andrew. A pleasant mannered clean cut man in his late 20s, I guessed. I was to be his first case of gender dysphoria (The technical diagnosis for my condition, though sounding impressive actually just means gender unhappiness). I didn’t mind this at all. I liked the idea of being somebody’s first. I really wanted to make a good impression on him, which is not the ideal way to approach a consultation. The first session was to be an assessment, so basically I had to answer a pre-prepared bunch of questions. Although I really wanted to be accepted for treatment and say the right things, I did want to be honest in my answers. There was a temptation to say just what I thought he needed to hear. I did not want to give the “I’m a woman trapped in a man’s body” shtick. I couldn’t have told him that I would have been suicidal if I couldn’t change gender. All those stories I read about in magazine articles, and saw on the TV, didn’t necessarily relate to me. It would be wrong if I had said I felt like a woman. After all how could I know what any other woman or any person felt like. I just knew what felt right for me. I was honest with Andrew the Shrink. If my marriage had been successful, then I would probably have continued my life in that role and been relatively happy. As I never really imagined I could live as a woman, so I didn’t beat myself up about it. Sure, I would always have dreamed, but I was, and am quite pragmatic at heart. Circumstance changed however, and I found that I could release myself, and I have to say I have never been more fulfilled than I am right now. I worried that this in some way meant I was less deserving of treatment than those poor souls who end up on the brink of suicide over their gender identity. Was this just feeling right for me, enough for them. Anyway as soon as Andrew started his list of questions, I started pouring out all this sort of guff. I rabitted on in this manner for the whole session, while he made notes and occasionally nodded. The poor man, I thought afterwards. He barely got much of a say and I’m not even sure I answered many of his question properly. Mind you it was clear from his demeanour that he didn’t really have much experience in this field. Perhaps he would have been better with a less self opinionated, know-all fool for his first patient. We got on ok though. He informed me that although I was his first he would be having supervision from Mike, who had vast experience of gender identity, so I was happy
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My second appointment a month or so later went pretty much the same as before, just without the set questions. I basically just talked at him for half an hour. We did get onto more practical matters. He asked what help I was looking for. I said I definitely wanted to start on hormone therapy and eventually be considered for surgery. At the end of the session, when he was able to get a word in edgeways he dropped a mini bombshell. “I am going to support you”, he said, “but there is one issue”. Slight pause. “It’s my religion”. “Oh…what is your religion” I said. “I am a Christian” he replied. “Well I guess I’m a sort of Christian” I retorted (I guess I regard myself as an agnostic Christian. I like all the hippy forgiving stuff in the bible. I’m just not sure about the god stuff!). “Well I guess I am what you would describe as a fundamental Christian” was his response. Well it was clear what he meant by that. He must have seen my desire to change my gender as some sort of sin against god. I suppose I should have been angry at this, but my first reaction was good on you for being honest with me. He suddenly looked apologetic. For a moment the clinician/patient dynamic was reversed. He was sharing with me, and seemed to want my acceptance. “I can assure you I won’t let it affect my treatment and support of you” he said rather quietly. “If you want to change to another clinician I can refer you back to Mike, if you like” he offered. I seized on the chance to be magnanimous. “Thanks for telling me” I said in my softest most compassionate voice “Lets stick with it, and see how we go” I said, almost patronisingly. I was honestly impressed with his honesty. He didn’t need to tell me about his religious quandary. I would never have guessed. If his branch of Christianity was against people like me, then his religion is just plain wrong, full stop. However I felt sort of sorry for this misguided man hamstrung by his misguided religious views. I actually thought he might be a little upset if I had him replaced. (This was a little arrogant on my part reflecting back). So I decided to stick with him. I secretly decided that it would be my aim to convince him in the error of his ways. I might even get him in a skirt by the end of our sessions.
Over the next six months I had a few more “talking at him” sessions. In all honesty that was all they were. He had nothing in the way of advice to offer me. I am arrogant if I assume he wasn’t doing his job and in effect analysing me. By the end it felt like we were both wasting each others time. However he did his job and I eventually got a referral to the legendary, notorious Charring Cross clinic, who would see to the nuts and blots (or removing such) of my treatment and hopefully start me on the Hormone therapy. I was told that it might take some months for my appointment to come through. I was happy though, just to be making progress. My sessions with Andrew eventually ended when he got another job. I was then passed over to Mike…
Mike was a completely different kettle of shrink to Andrew. He had vast experience of supporting people like me. He was a big cuddly kindly bearded man. I liked him immediately. He was wise enough not to let me just talk at him. When I would start wittering off into unfocussed ramble (I should have him edit this blog) he would reign me in. We did have one hiccup. In one session I was bemoaning an experience I’d had visiting my GP.
Now my Doctors had changed my name ok, from my first visit as Jenny. However on one visit, they had changed the system from a tannoy calling out “Jenny Harvey to room 2” or something, to a flashy scrolling LED sign. Now when my time came up flashed the message letter by letter as slowly as a crawll ...G.E.O.F.F...H.A.R.V.E.Y...T.O...R.O.O.M..2... It then just hung there.I had no choice but to stand up in front of a crowded waiting room thus instantly outing me to everyone. As I walked out of the waiting area a trail of murmers followed in my wake. As you can imagine I wasn’t best pleased, and after a couple of maoning phone calls to the Practice Manager in which she tried to blame it on the IT, they have now rectified it. As an aside my surgery now has me listed for a smear test! Which is in its own way equally stupid and annoying.
Anyway after I told this story to Mike he has now referred to me as Geoff on two occasions. Each time he hasn’t realised, and when I pointed it out he was beside himself. We ended up having an interesting conversation on how the brain perceives. He said he had never made this error with a patient before. He absolutely accepted me a Jenny from the start, although he had briefly known me pre Jen. My recounting the GP story had obviously reconnected some pathways deep in his psyche. It showed me that even though people genuinely accept me they cannot totally override what there brain perceives. If the foremost Gender Dysphoria expert in North Staffs can slip than anyone can. Sometimes the brain will see what the brain will see. I argued with him that it would have been different if I was 5’9’’ and build less like a truck, and that it would be easier for that brain to see a female. This hiccup aside, I really valued and still do my sessions with Mike. He has given me confidence and helped me gain perspective when I’ve been down about things, and despite all my neurotic, self opinionated, over rationalised utterances, he told me that all things considered I was pretty well balanced.
It was now 4 months from my referral to Charring Cross and I had heard nothing. I decided to contact them. The Clinic informed me they were waiting for my PCT (Primary Care Trust, the part of the NHS that moves all the money about) to give the go ahead. The problem was that at this time my PCT like most in the NHS at that time had massive financial deficits. Someone somewhere had overspent by about 12 million quid! So… the first thing they do is cut, and what is one of the easiest, softest targets, Gender Reassignment. So right at the time I was referred the PCT publicly stated that they would no longer automatically fund treatment! If I was slightly more paranoid then I would have started to think that NHS was plotting against me (I haven’t totally rued this theory out yet). On my next visit to Mike, we discussed this situation. He decided to make an exception with me and start me on hormones prior to Charring Cross, as it was unclear when or even whether I would get an appointment. By then I had been working and living as Jen full time for over a year, and he was satisfied that hormone therapy was right for me. I was so grateful for this. The hormones were the most important part of the treatment to me. Sorting my bits out would be the important icing on the cake, but I was always more keen on the chocolate filling anyway.
So there it was. I had finally started my journey to physical womanhood
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