9

Quick Update

Alea iacta est, or words to that effect … Preliminaries and assessments are all done, and the surgery date is confirmed for April 11, and I will be admitted to Charing Cross Hospital the day before. Apprehensive as I am about my first ever trip to an operating theatre, prolonged stay on a hospital ward, after care, enema (time off work notwithstanding, you couldn’t easily sell this as a package holiday concept), the fact that everything has gone bizarrely well this year gives me faith. My transition is even running slightly ahead of what seemed a very optimistic Tarot reading that my friend did for me last year, which suggested I’d be “seen to” in the second half of 2018. Not to complain, if the Goddess sees fit to clear the schedule a bit early …

Tickets all booked, now just counting down the days. There will be some hard weeks ahead, but the future beyond is looking brighter than ever.

 

 

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3

Transgender trend ‘School resource pack’ – A teacher’s perspective

Much as I normally keep this blog apolitical, I will make an exception for this, as it strikes close to home. Recently, a group known as “Trangender Trend” (immediately setting off alarm bells) produced a rather slick-looking PDF brochure titled, rather disingenuously, “Supporting gender non-conforming and trans-identified students in schools“: disingenuously, as even a cursory read of the thing will quickly inform one that said “support” consists of discouraging children from socially transitioning at school, and promoting a scaremongering view that greater trans visibility is some sort of dread social epidemic and an intentional, ideological war designed to erase lesbian and gay identities (The author seems convinced that trans children would be better off being encouraged to grow up as gender nonconforming gay people, equating sexual preference and gender identity in a way that totally ignores the fact that trans people have as wide a variation of sexualities as cis people). As someone who was once a trans child in the 1990s, too scared to come out at that young age for knowing that there was no support or protection available, it is deeply harrowing to read such a supposedly well-intentioned work that aims to take us back to that time, just when it is becoming possible for trans children in school to be their true selves (and thus not waste many years of their lives trying to fit in with someone else’s idea of ‘normal’).

On the positive side, however, the responses I have seen to this document by actual teachers have thus far been less than impressed, and here is a particularly trenchant example …

via Transgender trend ‘School resource pack’ – A teacher’s perspective

11

Acceleration.

Last week, not expecting to hear anything so early, I received a letter from Charing Cross Hospital with the details of my first outpatient appointment with them on the 20th of February. Annoyingly, that is the day of a dance class, so I stand a fair chance of missing it (and even if I don’t, I will likely be so stiff and knackered after three hours on the National Express that gracefulness will be an even more alien concept than usual).

Excitingly, though, this seems to bear out what I have heard before; that once one is through the Gender Identity Clinic and into the hospital, meeting the surgeons, things start to move a lot more quickly. 2018 could finally be the year I draw a line under this and reach that point that seemed so impossible three years ago … and three years is not an unusually long wait in this field, alas. The hubby, unfortunately, still has another GIC appointment to go later this year, but expects to be referred for surgery at that point, so hopefully he will find it the same … and hopefully our operations won’t synchronise so perfectly that both of us will be convalescing at the same time, as it would be jolly useful for each of us that other was fit and healthy during our recovery period. Still, I’ve known people get through this completely alone, so we consider ourselves very lucky to have each other as support.

It is a bit ironic, in the very year that I have taken up dancing again (and am obsessively enjoying it) that I may end up having to take a huge hiatus from physical activity. Still, I knew that was a risk, and I do fear I have often put things back “until after surgery” without having any clear idea of how long that would mean putting my life on hold. Life is too short to be put on hold, whatever our long-term hopes may be. At worst, I may have to resign myself to losing a few of the classes I paid for, but I’ll still be able to come back to it in good time … not to mention with a happier relationship with the body that will, after all, have to do all of this dancing. Better that it feels as appreciated as possible …

7

The magic S word …

It is testimony to how long the process of transition on the NHS is that I have posted nothing on trans matters for months now, even though that is ostensibly the whole purpose of this blog: certainly the reason I was encouraged to begin it, though I was afraid it would make a very stop-start narrative with massive gaps from the beginning.

While such has been the case, both the hubby and I have been lucky in not having faced much in the way of unexpected delays, with every appointment at the GIC entailing meaningful progress (Not all are so fortunate). Yesterday I had my third and final appointment at the GIC, after which I was discharged and referred to the surgical team at Charing Cross Hospital, from whom I shall hopefully be hearing in the near future.

Excited? Most definitely. Apprehensive? Somewhat. This will be my first major surgery, and the extended convalescence (about ten weeks) afterwards will present its own challenges, but finally knowing the end is in sight is tremendously fulfilling, and of course I can turn for support to the many people I now know who have taken this route successfully (and with the same surgical team). I also know I will not be impeded from getting the sick leave I need.

Here I am with two wonderful friends – Helena and Amanda – standing outside the hospital which I shall be visiting more formally in due course.

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And thank you to everyone here who has encouraged me through this surreal but ultimately positive story. Hopefully its closing chapters should come at a slightly faster rate from now on …

8

T-minus 24 Hours

This is just a quick but significant news update to report that as of this time tomorrow, my husband Cal – who has been waiting since early 2015 to receive treatment for his gender dysphoria – will finally be getting his first dose of testosterone. This has been long delayed by a combination of NHS bureaucracy and actual malpractice (some Welsh GPs – unfortunately including one we were involved with – having seemingly ganged up to stymie trans care in Wales) but all the hurdles are finally crossed. We are both excited, if a little nervous – we are not sure what the effects will be, and the intramuscular injection is bound to be painful – but this is most definitely a time for celebration. I am so proud of him for having come this far, and more grateful than I can ever express for the support he has given me on the same journey (which was somewhat easier from my perspective, since I finally got official treatment last November).

Nothing much else going on in our world. I am still writing, programming, have taken up Tarot and Wicca, and am considering taking up ballet post-op, if I can find (or start) any trans-friendly groups. Hoping to have more creative news soon – I have made a new C64 game recently for a competition, and had a novel accepted for publication – but actually releasing them to the public now depends on how quickly others can move (The competition organisers and the publisher). I am also planning another fanfic to conclude the Movellan War trilogy, since the new season of Doctor Who actually did not close off that promising plot hole the way I was expecting it might (Any feedback on the other two, incidentally, would be massively appreciated, up to and and including “I got bored on the first page.” It helps to know).

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12

Transition Update – Second GIC Appointment

Yesterday I went up to London for my second Gender Identity Clinic appointment. It had been intended that I should be referred for surgery at this stage. Unfortunately, there was a snag …

After my first appointment last year, my GP was instructed to put me on a certain regime of feminising HRT, with a view to getting my hormone baselines to a level equivalent to post-surgery. They refused, citing amongst other things lack of experience, the fact that gender transition is still technically an unlicensed (albeit routine) use of these drugs, and their belief that the GIC recommendations had no authority in NHS Wales. I argued, I took them to advocates and the Assembly Member, but they refused to budge.

I eventually (November 2016) found a new GP who agreed to prescribe me somewhat of a compromise (using a cheaper but less effective anti-androgen), but the damage was done and I have lost 8 months. I return to the GIC in October for a follow-up session, but unless I am on the right prescription by then I will be no closer to being referred for surgery.

It is clear now the NHS in Wales, at least at the primary care level, is substantially opposed to providing gender reassignment, but since there is certainly no Welsh GIC in the works (for many reasons, both cost-based and owing to Wales’ weird geography) unfortunately their cooperation is essential. With the support of the GIC, I now intend to report my old GP to the General Medical Council and hopefully this will set a small fire under the collective posteriors of GPs who are refusing this care (and of their union the BMA, who are it seems not our friends in this political tussle). Since my husband is also meant to be starting his HRT very soon, and we see no likelihood of leaving Wales any time soon, this is doubly personal.

On a lighter note, some snaps I took while I was there …

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Horsenden Hill, Perivale. Its claim to fame is that it is the main location in the last ever episode of “Doctor Who” (1963-89 version). Well, I felt awed, anyway, and tired (It is a fair bit steeper than it looks in this shot).

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Shipping cranes at West India Quay, near Canary Wharf. Seen in the movie “Hellraiser,” in spite of that film being superficially set in some weird Anglophile American locale (The clear shot of a British Rail Intercity 125 train hardly helps, also).

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Smiling through the chaos, until next time …

22

Jumping Hoops – A Rant on the Welsh NHS

Today, as I learn that my legal caseworker is leaving her job and my MP can’t be of any help in local health issues, I am far from being in the best frame of mind…

Let’s quickly recap… Early last year, my husband and I went to our GP to finally pursue gender reassignment, as is our right under NHS protocols. However, the NHS in Wales is more restrictive than its English counterpart, as the GP correctly informed us, and accordingly set up the various hoops that we would need to jump through to receive treatment. These were…

Referral to the community mental health team for assessment.

Referral from the CMHT back to the GP.

Application to the “gatekeepers” (nothing to do with Ghostbusters) for funding.

Once funding obtained, referral to the West London Mental Health Gender Identity Clinic – the only one available to Welsh NHS patients.

A year’s waiting from said referral to our appointment times.

First GIC appointment.

…and that is as far as we have got, at present. However, our first appointments did go very well, and as far as London goes we have no complaints. The clinicians we saw were sympathetic and eager to help, and in my case even provided me with a prescription for HRT to be handed to my GP. Hormone therapy is, of course, an essential first stage of transition, and one that patients in England (and even some Welsh health boards) can obtain even before their first appointments, to dissuade them from self-medicating on internet-bought hormones… which I have been doing for over a year now. My GP, unfortunately, said that they could only help with authorisation from London, so you can imagine how pleased I was to finally obtain some.

Having imagined that, you can now imagine how displeased and shocked I was when my GP practice – a Cardiff Bay-based clinic that had been recommended to me as trans-friendly – still refused treatment. Their latest justification is that there are proposed changes to the Welsh gender identity care pathway, and they want those implemented before taking the responsibility. They assured me it would not take long.

About a week ago I went to a trans information meeting hosted by a local NHS official, who spoke on these proposals and told me they may take up to three years to implement… though she did also tell me – as one might expect – that my GP is making pathetic excuses, and has a responsibility to treat their current patients according to the existing gender care provisions. Also, much to my surprise, she informed me that our GP had lied when they claimed there was no provision for speech therapy under the Welsh system – though both Cal and I had expressed a great interest in it.

She even told me she would be in touch to help me challenge this state of affairs… but unfortunately was not. I have since told my caseworker and my MP – to the sad lack of effect stated above – and contacted my Welsh Assembly Member, but have heard nothing back. That leaves me, at present, at a bit of an impasse, where all I can think to do for now is express my dismay and disgust that things have had to come to this. Unless the local health authorities will support Cal and I in our transition, there is nothing much London can do all by itself (monitored HRT being, as far as I know, still being a prerequisite for surgery, and Cal not being able to self-medicate in any case – testosterone being far too dangerous to take without professional help).

Our worst fear, though, is that they are playing for time, hoping that if they can stall us for long enough then inevitable NHS cuts will impact on the whole gender care service and they will simply be able to deny us care and get us off their monthly budget for good. Paranoid of us? Possibly, but that practice hasn’t exactly been enthusiastic or sensitive in helping us. I recall asking them if they could prescribe Vaniqa hair reduction cream just after my GIC referral… only to be answered with a blunt “we can’t give that to men.”

Though, to be fair, one doctor down that practice has been sympathetic to us both, though the last thing he said to me was “the squeaky wheel is the one that gets oiled.” Cryptic at the time, but in retrospect we both think he was giving us broad hints that the system is not our friend, and we will have to fight tooth and nail if we want to see this through. Not something I excel in, but I guess it can’t hurt to learn.

If anyone has any suggestions for our next manoeuvre in this battle, please pass them along. I could use some fresh perspectives after today’s disillusionments.