Big one for me is I think the lack of support. You know, I don’t see the GIC as somewhere that should be just as assessment-based place, that your only interaction with them is being assessed. Support prior to you know, there’s a huge waiting list for the GIC’s, I get that, they can only see people as quickly as they can see people on limited resources, a hundred percent understand that, but the fact that there is nothing between that point of referral and the point of, and the point of getting to that first appointment really, really does worry me. You know you think, the, you know the vulnerable positions that a lot of people are going to be in, the mental health implications of that are huge.

Yeah, I just feel like there’s a, there’s a lack of a space to discuss things with anyone. You know you sort of go to the GP and have to, feel like you have to be in a position where you’re sure enough to convince them to refer you, and then the next person you interact with is the one who’s assessing you to decide whether you can have hormone treatment or not. Or whatever it is you’ve gone there to, to access. Nowhere in the middle is there anyone to, to, where it feels like you can have an actual discussion with, and work things through. And for me I feel like I’ve only had that through going and seeking private counselling to find that space. So, it, in the healthcare setup as it is now, I do feel that is lacking.

A lot of sensationalism. A lot of just incorrect stuff. It, you know the, the, the discussions around the discussions around treatment of trans youth and trans children I find very frustrating because although I appreciate that it is a incredibly complex topic, and incredibly complex issue and, and you know it, there are a lot of different factors to consider in that, those discussions in the media are often filled with stuff that isn’t true. So those discussions cannot be had in a, you know in a productive way because people are reading things and, that aren’t true, and then the discussions haven’t, you know you, you read through a conversation that’s gone on on Twitter, in response to an article in a paper or something, and the whole conversation has developed around one sentence that is, you know that you know isn’t true, so you know that, those conversations are incredibly frustrating to read. You know around what age people can access hormones, and you know the confusion between hormone treatment and puberty blockers, and the stuff like that. Yeah it, so I guess my, yeah. A lot of it’s sensationalist, a lot of it’s just incorrect. And therefore all the discussions that happen off the back of it are based around incorrect things.

I’d put a lot of thought around sexuality prior to realising that there might be something going on with my gender identity. But you know the, the confusion around my, I guess I’ve never come to any real conclusions around my sexuality prior to that anyway, I was still very confused about that as much as I was, you know, having this other realisation, this other set of things that were going on. That one hadn’t been resolved as such. So I feel like I don’t necessarily feel like a lot of my journey in that has been hugely related to my gender identity. it’s just been an ongoing process that has been going on throughout what’s going on before that realisation and has carried on all the way through that, but you know there, there, you know I’ve always had thoughts about what extra complications it might add on top of you know things that I was already thinking about, in terms of who I would look to be with. You know who would, who would be attracted to me, that, that kind of you know that, that was the, I guess those were the only, those are the only parts of that that have really overlapped for me. it’s more about other people’s response to me than how I, than my thoughts around my sexuality and who I’m attracted to and stuff like that. Yeah, they kind of feel like two separate journeys that have run quite parallel, and that you know my sexuality journey was much more prominent in my mind early on, and it kind of took a back seat when I started thinking about gender and I just wasn’t really interested in thinking about that at all, or trying to work out what, where I thought I was with that. I was more concerned about working out where I was with my gender identity.

With my private counsellor that I’ve been seeing for quite a few years now that process has been you know, that invaluable in me working through any of my decisions around getting a referral, like testosterone, that has been my space to work through all of that, and still is now with, you know concerns and thoughts around surgery. And that has been a, you know it’s, you know I haven’t, I’m not, my counsellor isn’t someone who specialises in gender identity, but it has been a positive experience of, I’ve felt free to explore things without any judgement or anything you know negative from her in that. it’s, it’s just been an absolutely invaluable space and I’ve been able to have conversations in that space that I would have been very hesitant to have anywhere else, you know, even with very well meaning friends, it’s, you know it’s a very different kind of place to have those conversations, again you know about, certainly the point about you know not having any space within the within the healthcare system to have those conversations really around, to me it feels like the, at the moment the pathway, from entering the GIC to starting hormone treatment is, or to getting surgery is an assessment process that, you know the support side is, isn’t, lacking from, has been lacking in my experience. So that support from elsewhere has been very, very crucial for me.

So I had my two assessments at the GIC. At the end of the second one, I guess I was, it was clear that top surgery was going to be a part of my treatment plan going forward. And I, yeah, I was given a list of surgeons, to go away and think about and do some research on. And then to email back in when I’d made a decision. Again, it, I mentioned it earlier, but I think that’s where I’ve really noticed the, the lack of available information and I don’t feel like I’ve made a particularly informed decision. I’ve, the information I was given at the time was, ‘These are the surgeons, these are where they are, these are the sort of waiting lists for each of them’. So then it was about me going off and sort of looking up what different methods they used, what their results were like, what people, other people’s experiences were with them. And that information I actually found quite hard to find. I thought I’d kind of be swamped with a lot of people talking about it, in different forums and on social media platforms and stuff like that. But actually, I couldn’t find, I couldn’t find that much information. I didn’t think in the end I made a decision partly through because I, and I think I ended up, you know once, once I had realised that I, that I was, that I didn’t have access to enough information to make a properly informed decision on it, I just kind of went with it.

I was like, ‘Okay well, this person is based geographically closest to where I am. That’s going to have a huge impact on my aftercare and recovery and stuff like that, in terms of you know getting days off work to go to appointments, and all these different, you know who’s going to be around to look after me when I, you know when I’m going to need some help straight afterwards’. ‘Cos I guess I’m split, like, you know, I’m based and work in [town], but my family are in [city], so for me it was like ‘Well do I want to be up there, or do I want to be down here? Who do I think is going to be around to help me?’ And also just the fact that this person did or does a range of different methods of top surgery, so I felt like ‘Okay, well I can, you know that feels like somewhere where I can talk through what the options are. Because I don’t really feel like I have a huge amount of information on that either at the moment’. So okay well I’ve heard that there are different ways of doing it, and I don’t know, but I don’t know the ins and outs, what the, you know what the risks are to different ones. What the potential complications are, what might be best for me? That information feels quite lacking, so I, you know I feel like it would be different if I was going into that decision going okay, well I’ve already had a discussion around you know that method’s probably not going to be appropriate for me, but this one is. So, I’m going to look for people who have good results with that method. That to me is a different decision to going, ‘Okay well I don’t know what method I want, so, I need to talk to somebody who does a range of them for them to figure out what they think will be best for me’. And to come to a decision on that. So that played a large part of my decisions, was like, ‘Okay this, this person does, is happy to do a range of different methods, he’s had decent results with those, and therefore I can talk through those options with them’. So yeah, I, I don’t feel like it’s been a particularly informed decision and I guess, yeah, I’m just, my I gave them a name, they’ve passed that onto the surgeon and I’m waiting to, to hear.

I’ve been very sure about this for a very long time, as it being something I want. But that again that doesn’t mean that those doubts aren’t there occasionally. Not particularly often, I don’t find in this, certainly a lot less than in sort of my back and forths with testosterone and the impacts of that. But again I think I’ve got to a point now where I’m like ‘Well, it’s, it’s okay to be nervous about it. It’s okay to be worried about it, it’s a big change to make to your body’. It, you know it’s, it just is. It’s a big thing as you know, as certain you are that that’s the way you want to look, or you don’t. It, you, it’s a big thing to do and therefore it’s okay to be nervous. And it’s okay to have doubts around that.

I was excited. I’d, by that point, I had you know, made up my mind, I’d had my mind made up for a while that that was the route I wanted to go down, and particularly with all the delay around getting hold of it and stuff, I was, I was very keen to start by the time, by the time I actually could. But there was still some apprehension, there was – there was a lot of apprehension. And I think, I think it’s only really something that I’ve, that I’ve got my head around now, is that it’s okay to still have doubts, it’s okay to be nervous, or you know it’s, it’s okay to be worried about certain things. It doesn’t mean that you’re making the wrong decision, or that you know… I think my, my sense in healthcare settings and in clinic settings is that I need to come across as, as sure as possible about everything, and there are no doubts in my head about anything at all because anything I say that could be perceived as doubt could be a reason not to give me access to something. And so through trying to sort of hit that narrative all the time I, I think I kind of lost sense for a while that, that away from that it’s, you know when, when you’re not playing that game, when you’re not trying to get access to things it, it’s okay to be like, you know it’s, it doesn’t mean that you know if one day I’m worried about my voice dropping it doesn’t mean that I shouldn’t be on testosterone, or that I’ve, or that doesn’t mean that I don’t want to be on testosterone. You know like but you know I think now I’ve got to the point where okay, when changes happen they both excite me and when I notice changes, they both excite me but, they do excite me but there is also a, ‘Oh no, what’s this? Like, this is going to take some, some getting used to. And that it’s okay to need to time to adapt because it’s a significant change to yourself. It’s, and that it’s okay to not feel 100% positive about that when it happens.

The first time I noticed my voice starting to go I, I freaked out massively, and was like ‘Oh maybe I’ve done the wrong thing’. But now I can see that that’s, you know, it’s a significant change, there is going to have, you know it’s going to have an impact on, it’s going to take you time to get used to it as much as it’s going to take anybody else time to get used to, to those outward changes. And I’ve got to that point now that in those early stages it was almost like I wanted things to happen but at the same time I was scared of noticing things, and sort of going back and forth. ‘Oh, this is happening’, and someone saying, ‘Oh that’s great!’ and me going, ‘Is it? Is it great? I don’t know.’

And you know, now, yeah as I say now I feel like I’m in a much, I’m in a much stronger position on that because I feel like I understand what my responses are to those things. It’s not, when I do have those moments it’s not necessarily that I don’t want to see that change, but it’s that I need time to adjust to that change happening and also getting to the point of realising that some of it was about me worrying other people notice things, if there was people that I wasn’t out to about being on testosterone. I was like ‘Oh yeah, I really like that, but other people are gonna notice that’. So that is scary. And just being able to separate those things out in my head, and, and, and yet as I say, get to the point of realising it, it’s okay to still have doubts occasionally, it doesn’t mean that I’ve, it’s, it doesn’t have to mean that I’ve taken the wrong route, or that this isn’t what I want. But that ultimately, it’s a big thing that, you know there are you know there are changes happening and they take time to, to adjust to really.

So I guess in the early stages of thinking about being trans, first having that realisation that that might be what was going on, it kind of I guess, that was also the time that I’d heard of the term gender dysphoria, gender incongruence, and for me, my early experiences with it sort of started to explain the uncomfortableness that I’d always felt in my body growing up, and not really knowing why I’d, I guess I’d kind of just assigned it all to what happens in puberty, and, and you know everyone’s uncomfortable with their body through puberty to some extent, and I think I associated a lot of it with not wanting to grow up when actually it was, it was more about not wanting to become a woman, now looking back I think I can it that, I can see that But perhaps didn’t, well definitely didn’t at the time see that it, there was something else gender related going on there. So yeah I guess, I guess my experience of gender dysphoria was that there’s always been an uncomfortableness in my skin, in my body and finding the term trans, finding the term non-binary, and seeing different people’s experiences and stuff, kind of helped me to understand what that uncomfortableness was.

I’ve found my experience quite positive there I guess at the moment. They, you know there was definitely both, both the people I’ve seen there have been quite open in saying, Okay this is, you know non-binary people and, and their experiences are something we’re, you know we’re quite quickly adapting our systems to now. And so there was, you know certainly, I guess my worry, my only anxiety going into that first GIC appointment was that I was still reading things online that said that GIC’s weren’t geared up for non-binary people, that I’d face a lot of barriers, and stuff like that. So actually, so to hear those two people both say you know we acknowledge that there are limitations to the way we do things and we are actively changing things at the moment, made me feel a lot more comfortable about that. Cos, I thought this, okay this, in for me, in this clinic, it doesn’t feel like this is going to be a barrier to, to me moving forward in any way. So from that perspective I haven’t perhaps faced any of the barriers that I thought I might, going into that.

So the waiting list for the NHS was essentially that there was no, no contact between the point of getting the letter to say your referral has been received, to the point of receiving a letter to say your first appointment will be on this day. In those two and a, two years and a bit there was, there was no contact whatsoever. And I guess it kind of left me at moments sort of sitting there, sometimes I’d be like, okay, it’s, I knew it was going to take over two years, the process is slow, the letter will come eventually. As soon as it hit the two-year mark that was when I started to panic. Every sort of day that passed, or maybe my, maybe my names slipped off the list somehow, and how do I know if I’m still, how do I know that I’m still moving towards it? Should I ring them? Can I ring them? You know and I, it may just be me but the, the outward sense I get from the clinics is that they, you know, they, they’re short on resources, they’re short on time, they don’t want people ringing up all the time to say, When’s my appointment going to be? Do you know yet So, I was very shy in thinking okay maybe I should, you know just ring and just check that I’m still on the list somewhere, that it’s still moving. So I never actually did that.

But in, yeah in the first two years, I didn’t really think much about that at all, it was only once it got over that, past that two year mark, because my initial letter had said, In excess of two years so I thought well it could be any day now. So it was, it was in that period that I was sort of worrying like, oh you know, cos I think it was probably about two years and three or four months before I got the letter, so in those three or four months I was, that was when the panic sort of set in. But I, yeah I guess, I guess for me it’s, the, my thoughts around that are just that there is nothing you know even if it’s just a letter to say that halfway through or something, to say you are still on the list, don’t worry. Or something like that, and you know even before you start to think about the, that there’s no real other support offered in the meantime while you’re waiting. I think that’s a, you know obviously a, an even bigger thing. But yeah, just something simple as a letter just to reassure us that you know things are still moving in some sense, but for me anyway there was absolutely nothing from, from the point of referral to being offered the first appointment.

I was very anxious going into that appointment, partly because I didn’t really feel like I knew what to expect, but also because I think the research and reading I had done around trying to work out what to expect from that appointment had, had led me into hearing things about, you know, how well non-binary people are understood in those settings. I’d certainly developed by that point a sense that there might be some game-playing that needed to happen for me to access what I needed to access. And I was very aware of that going into that appointment. And in the build up to it I was very aware of trying to make a decision of how much of that game I wanted to play. What, what was I prepared to compromise on, and what wasn’t I prepared to compromise on. And ultimately I decided to go into that appointment, you know, ‘cos all of these thoughts had crossed my mind that ‘Should I, should I wear make-up, should I do this, should I do that? Should I not wear it so that it looks more convincing?’ And ultimately, I just decided no, I’m going to go in as I would, as I would present, would choose to present on this day if I wasn’t going to this appointment. I’m going to do exactly the same thing. I wear make up on a daily basis always have done, still do, so I thought ultimately, I thought, ‘No I’m not going to change that’. And I guess to some extent I felt like I did have to play the game a little bit, but I did stand my ground on a few things which ultimately delayed me getting access to testosterone.

Yeah so in late, late 2016, I guess I kind of, I knew from what I’d read online that from the point of referral it would be a long while before I actually saw someone, so I went to my GP and, and asked for that referral a lot earlier than I’d actually made the decision that testosterone was something that I wanted. ‘Cos I thought ‘Well I might as well get the ball rolling while I’m, while I’m playing out this process’. I was, I was sure enough by, by the point of going to the GP that there was something going on with my gender identity, I wasn’t quite sure what words fit best to me in terms of how to describe myself at that point, but there’s definitely something and may, you know even if I don’t decide to access any medical treatments, whether the gender clinic can offer me anything in that.

So late 2016 I went to the GP’s and asked for a referral, and I think it was February 2017 I got a letter back from, to say, you know, ‘Your referral has been received, the waiting list at this point is in excess of 2 years. We’ll write to you a month before your appointment.’ And I guess still at that point I was, I was like, ‘Oh, oh that’s a long time’, but at, I’d also not… I didn’t feel like I was at a point where I was ready to, to get going with anything anyway. I was still thinking things through, I was still trying to work out exactly what path would, would be right for me, so I wasn’t too, initially at that point I wasn’t too worried about the fact that there was still at least a 2-year wait ahead of me. But things then started to escalate quite a lot over the next few months. At that point, my thinking was, I, I guess my, my thinking all of the time was consumed by it, you know it was something I was thinking about at every available moment every day. And once, once I’d become much more sure that, that testosterone was something I at least wanted to, to look into some more it soon got to a point where I thought, ‘Ah, I can’t wait 2 years. If this is something I want to look to pursue, I can’t wait that long’.

So, so yeah that, so in the… I think I decided to, to look into it through a private clinic and I had my first appointment with them in the June of that year, in June 2017. Still when I went to that first appointment I wasn’t 100% sure, I was still going back and forth as to well I know, you know I know I’d quite like this impact of testosterone, but not that one. And that, that, but again I guess I was trying to get ahead of things, I was trying to, to get into the system before I’d actually got to my decision. And thought well maybe, you know maybe they’ll, they’ll talk about things in that appointment or, or give me more information that I haven’t thought about that might help me with that decision. Which ultimately I, in the end I don’t feel like I really got any added information in terms of what, you know experiences and testosterone might be from that. It was my interaction with the private clinic was two assessments, you know which was kind of like the whole life history, asking all the different questions that they need to ask being passed on for a second opinion, and then an appointment with the nurse prescriber and that was it really.

So I thought, I guess, my expectation of that process might be that there might be some more guidance, that it wasn’t just an assessment process, there might be some more information to be gleaned from that and it might help me come to the decisions that I needed to come to, and work out what the best path for me was, but ultimately that process, there wasn’t really anything there you know there was the usual sort of list of these are all the impacts of testosterone, go away and read them. But yeah, I thought the process might offer more support, and not just assess, in that sense.

The only thing I have really thought about is sort of whole smear test thing and, and you know sort of when you, when you’re, when it’s overdue you get sort of bombarded at the desk, at reception whenever you’re trying to make an appointment for anything, and you know it’s not necessarily very private, and there are people around, and you know, there’s not much consideration for the fact that what they’re trying to get you to book, quite vocally, might not match up with how other people are perceiving you, and, and what potential difficulties that might cause you in those settings. Let alone once you’re actually, go ahead to actually go in, go in to get the test done, and you know again the gender language that’s around that, and you know the awareness of who’s doing it.

In terms of the system more widely, or that GP practice more broadly I guess it’s, it’s things that would come up in, in all different surgeries and that’s things like the system where you go in and, and click to, on the, to say that you’re there for your appointment, and the fact that it comes up male female. Going into other appointments with, so, you know I’ve gone in for blood tests with nurses and other people, and I’m not sure what my name says on the system at the moment, cos I haven’t had the legal name change , I don’t intend to. And I don’t know what name is on there because when I sit, when I sit in the or where they both are, cos when I sit in in the reception and wait to be called it come up, it comes up Mx [name], which, and I’ve said, I’ve had conversations with my GP about this because on the one hand I’m glad that it doesn’t come up as Miss anymore, but on the other hand I’d rather there just not be a title at all, because I feel like it’s something that neutral title is not something that everyone’s heard of, and I feel like it draws attention to me, in, you know I was worried about Miss [name] coming up, and then me getting up and people thinking oh, that’s not you. But I, I feel like it draws more attention to it, because people are like, Oh what’s that? Who’s that getting up So yeah, I’ve had conversations about whether it’s possible to remove the titles from that system but that hasn’t really gone anywhere.

And I guess more recently I guess the more, the more my appearance has changed, I’ve been on testosterone for nearly two years now, is the confusion that is quite obvious amongst other you know nurses and stuff that I go and see for blood tests. The last time I went for a blood test I walked in and she said, Is it [name] And I said, Yeah And it was, and I hadn’t, it hadn’t, I hadn’t quite realised why there was any confusion initially, but then it was only later on throughout appointment where she, she said, Oh I’m really sorry, I just feel like I need to ask you cos I don’t really know what’s, what the situation is here. Are you, which way are you transitioning Or something along those lines. She couldn’t quite work out which way, you know, I guess in her mind whether it was female to male or male to female. So yeah I guess my interactions with other people at that surgery have been more awkward, I don’t, I’ve never looked at what’s on their records but I assume there must be something to tell them so the sensitivity, I wouldn’t say I’m someone who’s easily annoyed or easily upset by questions like that but like I can appreciate that for some other people that could be really triggering. And a lot more uncomfortable than, than I found it in that moment.

I feel like it’s something that is, on the one hand, very easy to get lots of information online about different healthcare options and different procedures, different treatments, all that kind of thing. Well on the one hand there’s a lot out there and on the other hand it’s all a bit, it doesn’t seem, it’s never seemed very clear to me, it’s all a lot of, just going on what other people have said about their experiences, or what they’ve, you know. And a lot of contradicting information at times. Yeah I know that you get sort of the basic stuff on, on an NHS website or on a private clinic’s website, or something like that but I feel like a lot of it is forums and people, people sharing their experiences, and then you know trying to, trying to patch things together from different places, and that that doesn’t really, it never really felt to me like okay this is the place I’m going to go to find out what I need to know. Which I would imagine is probably quite similar for a lot of health related things but yeah, in terms of having a clear idea of, okay this is how the process is going to work if I decide to take this, if I decide to pursue medical transition and if, or aspects of medical transition, and if I decide to get a referral to a GIC, and all that kind of thing, what is this process going to look like? Yeah, it, I guess, in one, on one hand there is information there but on the other hand for me it felt like a lot of trying to, and still does feel like a lot of trying to you know scroll through Google and find different bits of information to put together to really get any clear idea of what the process might look like.

When I started my PhD I started getting involved with the LGBTQ+ association, at the students’ union at [uni], and that was, that came at a really, a really important time point for me cos that was when I was starting to, really starting to seriously think about my ways forward, and, and working out, you know negotiating my, my gender identity in the world, whereas previously to that it had all been something I’d kept to myself. So that, that source of support at that time, finding a group of people that I can feel connected with and comfortable with, and have space to have conversations about it with, with other people who had similar experiences, that was really crucial for me at that timepoint. And was for a good couple of years through that. Towards the end of my time as a PhD student it became something I engaged with less, because I guess I felt like I was past that point, and I was I was comfortable in where I was going, I, you know it was very crucial for me at a particular time point, and I don’t necessarily feel like I actively seek those spaces as much now, or that I need to seek those spaces as much now.

It was slow initially, I guess, I guess we’re what just over five years on since that first realisation, that there was something going on with my gender for me. Initially it was just all too scary to face I guess, so I sort of had a couple of days of delving into all these stories and experiences and then just kind of shut it into a box again, and was like Well we’re not going to deal with that, just yet And I guess because, because there were parts of trans men’s experiences at that point that just didn’t really seem right for me, I, it was, that was kind of my hook to say oh no it’s probably not that, I’m probably reading too much into it. So sort of tucked it back away again, didn’t really think about it. Or tried not to think about it for a good few months. Perhaps almost the majority of that year really. And then I guess towards, sort of towards the end of that year, the next year I started to sort of just perhaps voice my thoughts to some close friends some people I’d known for a while who’d known how confused I’d been for a long time, and I just sort of thought oh maybe it’s this, I was just trying to start sort of talking it through with other people. And it wasn’t until, when would it have been? It wasn’t until a good two years from that initial point, between two and three years that I actually started to, that I was, that I was certain enough in myself that, that I wanted to tell other people that that was what was going on for me. And yeah I guess late 2017 was when I came out to my family, and I’d already come out to the majority of my friends before that, it was I guess 2017 was the big year where I, where I came out at work, changed my preferred name, and things like that on the systems at work. And yeah, I guess, overall it’s, it’s been a pretty positive experience for me. I haven’t had too much negativity from anyone, I think, I think it was always going to be most difficult to tell my family, and they’ve been great, I guess, like anything there’s a process of adjustment, a process of trying to understand, non-binary wasn’t a word that was familiar to anyone in my family, so just as much as I needed time to process it, they did too. But ultimately it hasn’t changed our relationship or anything like that, I’m still really close with them. . So yeah, I guess it’s been a, it’s been a very gradual process. I’d say I’m not at a point where there’s no-one significant in my life that doesn’t know. So, but I guess yeah, I guess as most of us are aware there’s you know that coming out process never really ends, it’s everywhere you go, it’s every time you meet new people, it’s how much you choose to tell them or not tell them. Yeah, so that’s on, ongoing, I guess.