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).

fearfullymadejpeg

songadalacover

Advertisements
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 …

2017-02-16-16-55-36

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).

2017-02-16-18-52-49

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).

2017-02-16-18-53-30

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.

0

Dear Brexiteer. What we need you to do now.

Totally off-topic, but this has been all too much on my mind of late. I dread to think how this may affect Cal, whether he will be able to remain in the UK after the dreaded exit, and even if he is allowed to, will he be able to keep accessing NHS services (which he needs to transition).

I have no hope to offer, alas. The exit seems like a bad decision every way I consider it, except from some very vague desire or fetish for national self-sufficiency (which I strongly believe is a myth) or xenophobia. So I offer healing words from someone else…

frpip

So well done, first of all. You listened to the arguments, the same ones I listened to. You heard all the same information I did, you listened to the same debates that I did, but you voted to leave. And you won. I take that – it was a democratic process and sometimes in the democratic process you lose, as I have done.

The referendum has activated the political energies of people who haven’t been interested in politics for some time, so we are told, and many of them are like you, who voted to leave. So here’s the plea of the losing side to you now.

Firstly, don’t stop – don’t stop with your political passion and activism, because we need you now. We need you to be active, we need you to keep talking to the people who you trusted with this vote, and we need you to…

View original post 386 more words

15

Fighting Back

orlando

Cal returned from the GIC last Tuesday, and the news was all good: like me, he has been granted a second appointment in February, at which point all going well he will be approved for HRT. The clinician seemed absolutely charmed with him (only naturally), and they had a good conversation. The fact that we both have had such positive experiences with the London side of things is certainly something to be very grateful for. It touched upon a subject of grave concern to us both right now, though: the UK’s impending referendum on whether to remain within or leave the European Union. The clinician was pessimistic, and when we consider the implications of leaving (which now seems the likely outcome) it is hard to feel too blithe about our future. For one thing, if it throws the UK back into recession, the NHS will suffer more cutbacks, so our transitions could be stopped by simple market forces. For another, it is liable to make the UK more isolated and right-wing, which rarely goes well for LGBT+ people (no more than one might expect of a Trump presidency…). Even if neither of those scenarios develop, we are bound to be affected as Cal is French, and will thus have to change nationality (at high expense) or risk losing his job, his right to stay without a visa, and his rights to NHS treatment. If Cal has to leave the UK to transition, I will of course leave with him, which will thus stop or at least hugely delay my own transition. Thus, if you are one of my Brexit-supporting work colleagues and you wonder why I am less than friendly with you these days, you can probably work out why now…

Furthermore, though, it has been next to impossible for anyone in the LGBT+ community to be particularly happy and easygoing this week, in the wake of the Orlando massacre. Cal and I attended a memorial vigil in Cardiff Bay (image above) and were moved to see so many of us and so many allies come out in support and recognition. The priest at my very LGBT-friendly church also gave a sermon and prayers on the shooting (acknowledging that it was an anti-LGBT hate crime, unlike a certain prelate). Still, it is hard to get away from the sense that the world is still not exactly on our side, whatever the mansplaining, cisplaining voices at work would have me believe: “Of course it won’t make any difference to you if we leave the EU. You people have full rights now. We’re a tolerant society.” And so forth, while I bite my tongue.

Cal thinks we may have spent too long biting our tongues, and now is the time to speak out, fight back, and be uncompromisingly courageous and visible. He has determined to make this year his first Pride appearance, and thus our first Pride as a couple. We have also initiated complaints proceedings against our GP, whose non-response to our progress at the GIC continues to infuriate us. Such combative behaviour does not come naturally to either of us, but it helps to remember that we have, in such a short time, gained many friends within our community who are also affected by these issues. God willing, this will be the year when we cease to be the timid little trans couple living almost like recluses for fear of offending, and not before time. Perhaps the world could use a little offending…

keepkissing

14

GIC – First Assessment

Apologies for the delay, but things haven’t stopped moving since I returned from London last Friday. As for the reason I was there at all… well, it certainly took a long time (albeit 11 months rather than the dreaded 13) and there were plenty of times I dreaded it wouldn’t happen at all, or would be cancelled and rescheduled time and time again, but in the end it all went to plan.

The Gender Identity Clinic was well hidden away in an unassuming part of west London, and I shall respect their secrecy and be no more specific. Suffice it to say it was over a shop, the purpose of the building was unstated, and that one had to be rung in via a door intercom. It may well be that they fear the potential of harassment to their patients, although as I had lunch nearby and saw various transpeople exit and enter the building, it occurred to me that some locals had surely noticed over the years. Nevertheless, I had no trouble in the area. I never tend to experience transphobia in London, would that it was not so expensive to live there.

I made sure to travel very early, just in case there were any transport delays and also in case I had not correctly estimated the time to reach the clinic, but in the end had about a two-hour wait. I had a meal, a quick walk, and pestered the hubby on the phone, which whiled the time away and kept my morale up until I actually pressed that door buzzer. Then, I had another 45-minute wait within the clinic itself, along with various other nervous-looking transwomen, as they were running late. I began to have a paranoid fear that someone would only come at me with an apology that the clinician was for some reason unavailable and I would need to reschedule, when thankfully the gentleman himself emerged from an office and invited me in. I smiled, took a deep breath, and followed.

The meeting lasted a further 45 minutes and covered all expected bases, repeating much of what I had been asked during the community mental health assessment in Cardiff last year: how long had I known, was I inclined to suicide or self-harm, how was puberty for me, medical history, work and social circumstances, etc. The clinician acknowledged that much of this would be repetition, owing to that extra hurdle one is expected to pass within the Welsh NHS. I was rather pleased he did not seem to consider this fair.

His final assessment, at any rate, was the most morale-building experience I have had in ages: I seemed, evidently, to be a totally straightforward case, and he had no issues in referring me onwards to discuss surgery, and also in writing to my GP to, at last, authorise HRT and get me off my self-medication. This latter habit of mine, which I had been warned could stand in my way, thankfully did not become an issue. He acknowledged it was not the best thing one could do, but also one that many people and especially those in the Welsh NHS turned to for lack of GP support, and I had at least attempted to do so in an informed way (A general hint I might give, to anyone considering that option, is always to seek as much information within one’s community and support groups as possible).

He also said, to my immense gratitude, that in his opinion I had successfully completed my social transition. While I can imagine a few gender-critical feminists balking at the notion of a male clinician supplying that seal of approval, at all events hearing it from him was reassuring, as it always is when I meet someone who only sees me as Eleanor. There are days when feel I could happily enact my transition 1970s-style, tear up all roots, move among strangers, and start life afresh… only the hubby still loves Cardiff. Well, I could probably do most of that that here. It’s a big city, though a new job will still be essential, hopefully sooner rather than later.

So, my next step is to visit my GP today bearing the clinician’s written authorisation, which will hopefully soon have me started on the first true stage of my medical transition (Anti-androgen injections, and continuation of my regular estradiol doses, but medically supervised). As for surgery… my second assessment will be in February. Another test of patience, but at least now I know I am on track, I no longer have anything to prove, and I can, in a way I did not quite feel free to before, finally embrace the fact of being a woman, being myself, instead of being cursed with that nagging sense of anxiety, that fear of being disbelieved, deemed as delusional or perverted, and told for my own sake I should backtrack and reconsider my options.

There is no going back now, and I could not be more delighted.


P.S. Thank you to all my followers here who have supported me through this. Your encouragement has done a great deal to keep me on track, and I only hope I have managed to be a little entertaining for my part. xxx

20

End of Act I

I find myself lacking a proper theme or any real news, indeed, but lest this blog be facing its permanent wind-down at any time I would rather it did not vanish without explanation.

Not that this is necessarily the case, but I think it may have a long hiatus, at least. Its purpose was always to give me a sense of progress during my transition, but of late that sense has been very elusive. The NHS has been silent, my self-prescribed meds are having little discernible effect (other than to give me very flaky nails), and after twenty hours of electrolysis I could probably still grow a full bushy beard if I had a mind to it. Oh, and my Facebook feed keeps chucking up articles on detransitioning, of all things. Sometimes it almost seems as if the universe is trying to send me a very unwelcome message…

Given the little progress I have made, If I stopped this now I could probably resume my former life in fairly short order. Not a remotely appealing prospect, but the wiser course may be to impose a delay. For it seems I am faced with having to choose between trying to continue transition on my own terms, paying for treatments and medication and so forth, or investing the money into a college course instead and putting my DIY transition “on hold.” Not an easy decision. Work has been grim of late, with some embarrassing episodes of anxiety to liven the tedium. Finding a job better suited to me will be no easy task – introverted transwomen with useless PhDs and four years’ work history of sorting mail (and not much else) are only of so much use in a modern workforce – so further study would be highly advisable if I don’t want to be stuck there the rest of my life. But ending my ongoing transition-related expenses would be a hard sacrifice to make.

In the interests of rebuilding my morale and clearing my head, I am planning to spend much less time on the internet. I’ll keep a fairly regular check on my email, so please feel free to contact me, but social media and blogging will be joining wine on my Lenten abstinence list. Hopefully this will also give me the impetus to start writing again, which also raises my spirits (as long as I am not writing about trans topics). Hopefully this will not be the end, so much as it is just a rather downbeat close to Act I…