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Sally

Age at interview: 25
Brief Outline:

Gender: Female

Pronouns: She / Her

More about me...

Sally transitioned to female at a time when there was a requirement to see a psychiatrist before being referred to the NHS gender identity services and when waiting times for the gender identity service were much shorter, however she still had to wait a year for her first appointment. Coming out was difficult for Sally but her mum has been supportive throughout her transition. She was referred by her GP to the NHS gender identity service, where she was assessed and recommended to start hormone therapy after her second appointment. Hormones changed the way she looked, and she felt gave her younger looking skin.

Making other changes to her appearance, such as laser hair removal, helped Sally to feel more able to go out and engage with the world which she had not felt able to do before. She applied for a new passport in her correct gender. This culminated in her going back into education and is looking to progress onto University.

Her voice was causing her to be frequently misgendered. Sally was referred by her GP to a voice therapist with experience of providing voice therapy to trans people and she also practiced lots at home which was a big success.

More recently she decided to take a further step with her transition by having gender reassignment surgery (GRS) which was successful. Her recovery from GRS was straightforward but she was immensely tired, and her mental health was suffering. Since going back on antidepressants and taking some time for herself she has been feeling really good and doing really well.

She hopes to have breast augmentation and facial feminisation in the future through private healthcare.

Sally has mixed experiences of mental health care. At times she has felt like she is helping the counsellor and teaching them about being trans, which is not helpful, but she has found therapy helpful with anxiety management and confidence building.

She would like to see changes to trans healthcare, in particular for GPs to have better knowledge about how the process of transitioning works, for services to be more accessible, and for more information to be provided before surgery that recognise people may not be confident enough to ask questions. More information about the longer-term aspects of transitioning, of what people can expect in the future would also be useful.

 

Sally says ‘if [mum] had been not supportive, I don’t think I would have had the courage and strength to continue’.

Sally says ‘if [mum] had been not supportive, I don’t think I would have had the courage and strength to continue’.

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I think my Mum, like offhandedly mentioned like being a transsexual, or changing your sex, and I was like “I want to do that.” And she was like, very seriously, like very, very earnestly and seriously, “well if that’s what you want to do, I will support you doing that.” And then there was like a whole conversation where I was like, “Yeah I know I want it; I want to do that.” So, yeah in that case it was, it was very easy. My Mum has been like if I did not have my Mum I probably wouldn’t have transitioned, if we’re being honest. If she had been not supportive, I don’t think I would have had the, the courage and the strength to continue.

 

Sally shares her experience of buying clothes and the benefits of online shopping.

Sally shares her experience of buying clothes and the benefits of online shopping.

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I mean I asked to start being called by a different name. I had a bridging name between my old name and my new name.

 

It was like a nickname, don’t do that. Never do that, it’s a bad idea cos you just get called the bridging nickname, I finally got everybody to call me not that bridging nickname, all my family, so that’s good. I, so I asked that, and like changing pronouns to she/her and yeah then I started, you know buying different clothes. I think I was like, “Fuck it,” I’m just going to start buying more women’s clothes which, which was good. I could finally find skinny jeans I liked, cos I was literally, I was one of those kids who just always wore skinny jeans, and I am still a young adult that always just wears skinny jeans. So yeah, there was a few changes. I think I stopped, I, stopped routinely going from having really long hair to having really short hair, I just kept growing it, I don’t know. I shaved a bit more.

 

I think online shopping has been like really good and because, and especially like, just like being able to order stuff and then send it back. It’s like so good. And like literally someone will come to your house and pick it all up and then just take it away, some of them. It’s good. Yeah. And make sure you buy a bra that is the correct size, don’t wear a bra that is way too big for you. That was, that was something that I always had a problem with, is like, I don’t know what you call it, but I always used to think my body was bigger than it was, and I was like buying clothes that were size 18 and 16, when I’m actually a 12. And it’s this weird experience of finding actually women’s clothes fit a lot tighter and just like you know sometimes they’re not always easy to get on, and that is usually clothes that actually are women’s clothes. So various experiences around that.

 

Sally talks her experience of voice therapy and the shares the exercises she learnt.

Sally talks her experience of voice therapy and the shares the exercises she learnt.

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I started talking with the psychiatrist at the GIC about getting voice therapy, and he was like well the process for that usually is you go to your local GP, and your GP will refer you to a voice therapist that is appropriate for you in your area. And that felt really scary to me, cos I was like, am I going to see a voice therapist with any like relevant experience? Are they going to be like supportive? You know it was a big question mark for me. I didn’t know what I was going to get from that, and I, I did see, I think I saw a different GP who also kind of phones it in, she’s not always the most, now that I’ve experienced some GP’s that like really take a lot of detail, it was like, she was like, “Okay I’ll refer you.” And she did immediately refer me, and I was able to see a voice therapist within like, after seeing my GP like three or four weeks or something ridiculously short. By coincidence, NHS standards for most services, and yeah I, I remember it was like, it was that first week of June of 2018 I think, that I saw this I met and had, starting having my first sessions of voice therapy. And I think of all the different services, and all the different things that I went through, this was easily the best, and I’m not only sure why it’s the best. I think, well I do, but it’s like I don’t what makes, what made it so, so special for me, I think mostly, like having a service that was so quick to get into, that was definitely a tick in its favour. That it was local to me, was another tick in its favour. And that I saw someone that I just really gelled with and she, you know, I met her and she was like, “You know I’m a voice therapist, I’ve had experiences with trans people since, and helping them do voice therapy since like the late 90’s,” so it was like, yeah, so nearly as old as me she’d been working sort of doing voice therapy for trans people. And she was just a really great person. You know she was you know really understanding, she was you know, and she said, “Oh, I’m a bit surprised cos usually I see people further, or less far along in the process,” so she was kind of surprised by how far along I was and then getting voice therapy.

 

I think my voice was quite feminine at that point, and I think this is the point where I need to probably try and go into my old voice, which is very difficult cos when she starts to alter your voice, when you start to alter your voice it gets so ingrained you kind of forget how you used to talk, and even when you try, so much of what you’re doing now that just gets kind of like put back onto it, so, but [clears throat] so if I try and, that’s probably a bit further down, [clears throat] okay, no, that’s not really, it’s still [clears throat] so, I have to think through this. Yeah. How am I? Is that? Is that more masculine sounding? Yeah, so I was probably a bit more like this. I don’t know, I don’t know what the pitch on this is. It’s, it’s still quite feminine sounding because some of it is just how, how I always used to talk, and some of it is I’ve probably, I’ve probably done so much to it since then, yeah if I consciously try and do a man voice, I first of all sound a lot like someone from the West Midlands, which I always think is funny. It’s like I don’t really have an accent and then whenever I try to do a man voice, West Midlands like full blast, so, it’s like, “Oh up mate.” Terrible voice. Oh, I can’t even stand this, yeah so if I try and do a man voice, I’ll just start speaking like this. And it’s quite funny. They’ve really started to start laughing at my terrible man voice. But yeah, I just, I really struggle to do a man voice, much and yeah I don’t know, I don’t know, cos I never used to have like a strong, when I had a male voice, I never had a strong never had a strong accent either, so I don’t know why the accent creeps in when I try to do one.

 

It’s absolutely astounding. The difference is incredible.

 

It is, isn’t it? Yeah.

 

So how did you do it? I mean what did you learn?

 

What did I learn? Oh, what did I learn? What did I learn? So I think when my first session was, I know my first session she like did a, took a recording of me speaking, kind of got like general pitch. I think at that point I was like, I was in the like androgynous range, so I was somewhere around the high 160 hertz, low 170 hertz, I think usually they say below 160 is considered the male range of pitch. And above 180 is considered the female range of pitch usually. Obviously it’s a bit more complicated than that, but that is like really basic, just in terms of pitch, that’s usually where voices lie. So, I was coming into it from a fairly good place.

 

So yeah what did I do? I there was a lot of like, so it’s kind of where you, there was, I think starting off it was a lot of like, okay so where is your, where is the sound and the resonance coming from you when you’re speaking? And it was like trying to move it forward to the lips a bit more, so it was like “Mmmmm.” Doing like “Mmmmmm,” and yeah it was, it was a lot of that, so it was trying to get the feeling of like the vibrations in your nose. Just to be a bit more like forward facing and getting that sound coming from less lower, I guess, in your vocal tracts. And then there was like yeah, like slowly moving forward, like doing, I don’t know various things like that. I have, I managed to keep all my notes which was really good cos she did give me like practices and exercises I could do each week, so it was a lot of like “Maa,” “Mee,” “Moe,” “Mum,” sort of things like that. And I don’t, I’m really not sure what it was supposed to do, I guess in some ways it was like trying to get you to start speaking, and when you start to speak like that, your larynx will start to naturally go up a bit because you’re trying to, trying to make those sounds. Oh God yeah and there was a lot of like, “Okay how are you attacking words?” So, trying to be a bit softer so obviously women talk a bit softly, softer than men do. They tend to, it’s like words don’t come out as sort of harsh. So that was another thing I started to do. There was other things, there was like, trying to think of the big ones. There were various exercises, yeah, and yeah it just kind of like built, and the idea was that you, you’d have a session about once a month and then you would go, you’d go home and you’d practice and you’d find some way of recording yourself, or you’d find, there’s a very good App called it’s made by I think two German trans people, called Voice Pitch, Pitch Voice, Voice Pitch Analyser, Analyse, Analyser. Voice Pitch Analyser. That you can find on like Google, the Google app store and the Apple App store as well. And you basically, they give you like extracts from The Picture of Dorian Gray, The Portrait of Dorian Gray? Can’t remember what it’s called. Picture of Dorian Gray? I think it is. I always think it’s a very funny choice of novel for sort of trans people to practice their voice, all about vanity which I’m very into at the moment. And Living Forever and being young, as well actually. So, yeah there was like, yeah. You know it’s a very much sort of like a trans feminine novel in some ways. That’s my hot take.

 

I really got into practicing my voice, and I got over listening to myself and I really like went through all the notes, and I really started to practice, practice, practice, and that is the key. And that was the key thing that my voice therapist had made clear to me, was that you just need to practice, practice, practice. That is the thing that is going to make it like plastic in your throat, so you can’t, you don’t go back and forth from it, you always just like, as soon as you get up in the morning you’re talking like this. So it was a lot of like constantly checking my pitch throughout the day, like doing that, doing that voice test thing on Voice pitch analyser, and yeah, I started to sound a lot better and people started to not tell, and definitely that was the thing that in terms of I think passing, if you want to pass, voice becomes like this really huge thing I think, in a lot of ways, cos people don’t always look at you, I think like a lot of people are not big on looking at people in the face, I guess. But you’re always going to hear somebody, so that’s an important way of like I guess we gender people in some ways.

 

Sally talks about the changes she experienced on feminising hormone therapy in detail.

Sally talks about the changes she experienced on feminising hormone therapy in detail.

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Definitely your skin, the way your skin sits on your face, you look less angular, I looked very, quite angular and you look less angular. I think you’re like, the tone of your skin starts to change, your skin gets a lot thinner, so I was, as I was getting loads of hair removal, which I never got the funding through for, never came, never materialised. Brought it up multiple times and it just, it never seemed to come so I was very lucky that my Mum basically paid for it all. I think I had about 14 sessions all in all.

 

But definitely cos the Oestradiol starts to thin your skin, your pain receptors go up, so like before even though it was really you know coarse hair, and was probably doing a lot to remove it, it was like, “Okay that’s not too painful,” I mean it’s very painful, but it’s like compared to afterwards, like when I was on hormones, like the pain was just a lot more. So you get more sensitive, and yeah, it’s, you start to notice things like you feel the cold a bit more, and you’re, you’re definitely like sense and everything just changes as your skin starts to change which is a change.

 

Obviously you start, you grow breasts, you get breast development. My breast development has been weird I think like mine kind of like was not great at the beginning and then as I’ve gone on, they’re more like bigger.

And you know breast developing, you go through periods of it just being very painful, very sensitive, and yeah, and I think especially cos I am, I am 6ft 3, and natural development when you’re 6ft 3 can look a lot smaller, even though you’ve had quite substantial breast growth. So yeah I’m, I think once I can come into the dollar, the money, like start making that Yankee dollar I am going to probably look into getting breast augmentation, that’s probably something I’ll probably do. Cos you know I want to make my shoulders look smaller, and all those things.

Who knows. Yeah so I did have a lot of changes and yeah, you know sexual function changes a lot. You, you orgasm differently, you, the way you feel is differently, what you find important I think in sex changes a lot. Cos you know you, I mean it sounds more stereotypically female so to speak, and yeah I think, I think there’s some truth to that you do, you’re not as, I think a lot of people would see it as like a drop in libido, but it’s more like it’s not as on-tap, it’s not something you can just turn off and on, like when you want to. It’s, it’s much more, it takes some finessing, it takes a couple of things.

I think it can be, it could be a roller coaster expectations and disappointment cos you, you think it can so much and sometimes it feels like it’s done nothing, but because you’re, you’re so caught up in how you are at the moment, it happens so gradually you can forget how you used to be, how you used to look. And for people around you it really changes.

I always had a kind of a semi-female-ish fat distribution already, and it just amplified that so, I still have a lot of problems like the way my hips are, like I don’t like, I want wider hips really, honestly. And it’s still something I notice, it’s like, even though I’ve had this fat distribution change you, because your bones don’t change it’s a bit disappointing honestly. But there’s definitely ways you can sort of dress, so I’m always like making sure I wear like high-waisted jeans and just like getting my waist in as much as possible just to make it look as much like I’ve got hips. And I kind of do. So, there’s a lot of things like that. I reckon my memory’s gotten better. I reckon I’m a bit sharper, I reckon I’m just a bit more intelligent.

 

Sally says trans healthcare ‘needs to actually function, and it doesn’t’.

Sally says trans healthcare ‘needs to actually function, and it doesn’t’.

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Yeah, I think the thing that, there needs to be people that are experts and are going to show that expertise, I can’t be the expert in my own healthcare. That’s not always the best situation. I mean sometimes it’s a good thing but it’s like more often than not I need people that know something, at least know something. And I can see on a regular basis. I don’t know, I think that it just needs to be, well it needs to be more with it, I guess. Honestly, I don’t know. Like I think for me if I had seen them on like, a less, if there was less of a wait time and they were closer, that service would have been fine. It still wouldn’t have been like the best thing ever, but it would have been fine, it wouldn’t have been like the kind of mess it is now. I think it’s all just you know, it just needs to be like accessible at some point. It’s nothing really, that’s the first thing that needs to happen before anything else, and I don’t know, I don’t see the point of like tinkering around the edges when you’ve got that huge gaping failure. It just doesn’t matter. It just, it doesn’t matter like you can, like I don’t care, and I guess this is very like, the way it is to me is kind of a very classical transsexual, but it’s like you can’t really change language, you can’t really change like, at some points it needs to be there, it needs to actually function. And it doesn’t.

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