Experiences of trans and gender diverse young people

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.

Ok yeah so since I've been in [city], you know what they've actually been excellent. Obviously, they're quite clued up on things. There's even trans staff member there, trans staff members there. But yeah they’re very welcoming and like you know, I do really feel like they care about me and anything that I ask, they always look into it. They're very supportive and very friendly. Obviously I have to go there on quite a regular basis for my shots because there's no way that I'd be able to do it myself, I'm too scared of needles. Every time I get it done I'm just like “yeah don't tell me when”. You think I've been used to it by now, but no (laugh). I don't think I'll ever get used to it. But yeah, this particular GP practice that I’m with, they are excellent. But in the past it hasn't always been like that in a different area. So when I first obviously came out I remember I went to the surgery where my uni was based. I told him the situation and I had to actually give him the information on what to do, like how to refer me. And he then said to me he needs to get back to me because he needs to do the research. So he didn't even have a clue what to do.

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.

I was told that I wouldn't be able to do my own injections, which I know I can because my previous GP had told me I could. Then the endocrinologist that had prescribed them to me had told me that I could. It was just an individual nurse who claimed that people could not be allowed to do them themselves. They could not be trusted because you could be selling your hormones onto other people or giving them to other trans people. But it’s not the case. You can absolutely administer them yourself. I was trained in it when I had to go back to [country] for holidays and so I get my injections every three weeks. And if I can’t find anyone to do them for me, I have to do them myself. I prefer other people doing it. But you can absolutely get trained to do it yourself and you have the right to do it yourself if you prefer. So, that’s a good example of people trying to control your injections for you.

The first healthcare professional I actually came out to she was, I’d booked an appointment for something else and I also brought up being Trans there and she was really, really fantastic actually she was a nurse and so wasn’t able to refer me but she kind of said I’ve not done this before but, you know, the first thing she said was, you know, how do you want me to refer to you and I said he/him and [name] so she instantly did that switched, she was so good, she said, you know, she admitted that she didn’t have much knowledge but she would tell me, she told me to talk to one certain GP because they have the most experience with that and she said, you know, this is a University healthcare centre I imagine this is not the first person that will have gone through this here, you know, this is the GP I think would be best for you to talk to because they have more experience in mental health stuff, not that being Trans is necessarily mental health but it’s related to or most likely to kind of have knowledge about that. So that was actually a nice experience because of this certain nurse she was really good, really on point, really, you know, admitted she didn’t know what exactly and apologised kind of she was misstepping but then she was really respectful and yeah which is I think why we ask from people, you know, not saying you’ve gotta get everything right but the respect, you can tell when someone is doing something with respect and you can tell when someone is not.

My GP has not been particularly great at anything, I remember when I gave them my deed poll to say I’d changed my name I gave it over and they, well I said, you know, ‘Hey I’ve changed my name by deed poll is there a form to fill out?’ and ‘Yes sure here you go this is the standard form’ so they gave that to, you know, gave that to me to I fill out the form I gave my deed poll and my name and said, you know, ‘Is this good?’ and they said ‘Yeah that’s standard and we’ll file it away, you know, should be done next week’. And then a mouth later I had an appointment and I was called by my previous name so afterwards I kind of went to the desk and was like ‘Hey I did bring this form in about a month ago and I was told it should be done by now, is there anything else I need to bring in, is there a problem or something?’ and the person said ‘No there shouldn’t have been, you know, well what, what did you do, what happened, you know, what name are you changing to?’ and I kind of said and I said, you know, I’ve got I can go and grab a copy of my deed poll because at the time I was living on the University campus and this was the Campus GP so it was like two minutes’ walk, so I did, brought it back and they went ahhh and I said, you know, ‘Is there a problem?’ and they said ‘I think it’s because, you know, the receptionist didn’t really feel comfortable with changing your name to such a masculine one’ and I was like okay ‘Well this is my name’ and she said ‘I’m really sorry about that, you know, I, you know, I just think it’s that receptionist being a bit funny I’ll sort it with you right now’, and she did. But the fact that, as she said at first it as just not changed because a receptionist arbitrarily choose, decided that no this, this can’t be a name for this person because I think it’s too masculine was appalling actually and I wish I’d pushed it further at the time but I didn’t, so. Yeah that was my first kind of experience of the GP surgery a quite negative experience in the GP surgery and it really just yeah, bothered me understandably.

So obviously there’s no way of having like an X marker on your doctors forms and stuff, so that’s kind of, that, cos either doing that or having Mx as my title is like normally a segue into so these are my pronouns, you know but because so often going to GP’s for me is about something that’s considered feminine, or womanly or you know, so there was a time where I had to go to my GP cos there was a lump in my boob, and it turned out to be nothing, but you know I had to go and see a GP and he had to poke around in my boobs, and I was just like now’s not the time to say, “Oh can you use they/them pronouns when you talk about me?” Because I’m not having that conversation when I’m topless in a doctor’s surgery.

But I think the good thing is the online, so we have like an online… I don’t know what it’s called, like a, you can book appointments through it, and like request medication and stuff, and on that I can change my title to be Mx so every time I get a prescription which is, it has Mx [Name] on it, which is it’s a nice thing to see, but off topic again, but my girlfriend because her NHS number hasn’t been, so you know you have to, if you want to have your gender changed you have to get a new NHS number, for that to happen. It seems like a very convoluted way of doing it, but you know, so they can transfer stuff over but they, you know there’s no history of you being a different gender on that file.

So she’s had to have her, she can’t just change her title to Miss, it has to be Mx until they’ve changed her number, which seems like a very bizarre system, like it’s a title, you can change your title without anything else happening, so, I don’t know. But yeah, generally my interactions with GP’s are so gendered in themselves that it’s quite difficult to explain stuff to them, but the same GP’s have been really great with my girlfriend but again I think that’s an understanding of binary trans people. I mean they don’t have a great understanding of binary trans people, but they still have a reference point for what that is.

I haven’t come out I suppose, to my GP ever, I actually had kind of like a jarring conversation with my current partner about it, because I think well basically like when I signed up to my GP there was no, like it was tick male or female, that’s it. There wasn’t anything else there was no options for like Mx as a title for example, and it’s, it’s interesting because actually like I think I was trying to like you know order a self-test kit or something, through my, the sexual health service which has become a, that I use, has become way more inclusive. Like it’s not perfect, but it’s you know it has all these different options and stuff like that. But I couldn’t because the, ticking you know other on the gender didn’t then align with what was actually on my patient records. And so we had, I had this conversation with my partner and I was like, you know that’s just, it’s quite upsetting to me, and you know and he was like, “Oh, why don’t you just change it?” And I was like, “Well,” I had to explain to him that like I’m worried about like how will I be treated, right. And is this just going to be another instance of am I then going to be, identity being ignored. It is easier for me personally to accept misgendering if I haven’t told somebody my identity, if they don’t know then I’m more able to just deal with that misgendering.

I initially did go to my GP which was a pretty horrible experience I booked in with a GP that wasn’t like my regular GP and I sort of sat down with them and said that I’m having these feelings and I want to be referred to like the NHS road of things and he sort of just didn’t make eye contact with me at all he still carried on like calling me she and things and [name] and stuff, like my old name then he said to me, it was like, ‘So do you, do you want to be a boy then?’ and I said ‘Well I am [laughter] I am trans I do identify as like the masculine sort of Trans guy’ and he just sat there like really confused not knowing what to do and he said ‘Oh I’ve never done this before so I don’t, I don’t really know what I need to do’ and I was like okay [laughter] and he went out the room and left me for quite a while and I’m just sitting there on my own in the appointment room and he came back with these sheets and he was just like ‘Okay you need to go home and fill these out and bring them back’ and I was like ‘Okay’ [laughter]. He didn’t even like do it with me or anything like that, but yeah that was my first experience [laughter].

So the initial time I tried to get referred actually, to the GIC was in [city], I went to, and this was my GP, this has been my GP since as far as I can remember, and they, like even though we moved around [city] and technically out of the catchment area with like my family and stuff, we still stayed registered to this GP because you know it was a family doctor, kind of thing. Like a genuine, it felt like you know in the traditional sense, you know like , and so like I went to him and he, he’d said, I didn’t know much of what the process was at all, so I tried talking to him like, and this is when I initially just came back from [country] and stuff, and like I told him I was like, “Oh I’ll need to see,” or “We’ll need to get you to see a psychologist,” is what he said, I think, or a psychiatrist. I can’t remember, I always get the two mixed up and confused.

And so yeah, and so he said that, and I didn’t hear from him at all, no contact. He had like my phone number and stuff and no he could have, but no referral information or anything like that. So I just left it, I was too, I was too busy dealing with other things to catch up or chase up, but like then obviously I realised like, oh wait a minute, he shouldn’t have done that, he should have just referred me to the GIC, there was no, he was gatekeeping me. So like that was kind of demoralising, like obviously I was in [country] by this time, so I wasn’t exactly going to go back to him as a GP.

But and I did get registered for a GP I kind of, I kind of did something a little bit cheeky I guess, is kind of like I made sure to like, so I’d book an appointment and look up the GP’s name and stuff, because obviously there’s several GP’s in a practice usually, and so I’d like, I’d kind of like make a mental note of everything that goes on this appointment and feel like okay this GP like, and I think at this point I was kind of self-medding, and it was kind of, the aim was to try and get bloods monitored, and like a referral in place. It was tricky, so this, this, the first one I had was like, she put my referral through, I think.

Again it was very touchy about it because the, a lot of people are awkward about it for some reason, and like GP’s in general, I’m just like I’m trying to tell you the process here, like I’m mapping it out for you and I was still trying to, so like, I was okay, this, I’ll cross this GP off, essentially off the list, and I went to a different one. And eventually I found one at my practice, she was lovely, and she’s continued to be lovely, and she’s actively like looked out for like my care and stuff, and like, so it has been that kind of trying to find like a trans friendly GP to an extent.

And like I know that’s an experience for a lot of people, and in fact I, it’s got, like we on our mutual aid group like we run a cart, like a transwales.card.co kind of thing, which is like, it’s currently broken but we have a map on there saying look, which GP’s are trans friendly and that kind of thing, because like you know a large part, like it’s something like I’m even considering telling people to like, when they move or like change, their lease ends up and they’re moving, try to move to a catchment area of a GP that is trans friendly because it would make sense for you, in the long run, but also, and like it’ll just make your lives just easier to deal with, like we don’t have to fight every step of the way if we can find a GP that will help you.

And so yeah like, and luckily like she’s been very good. Like even though like, and this is like even though I was self-medding she didn’t obviously, she didn’t prescribe me bridging hormones, but she was willing to monitor me and keep an eye on my like levels I guess in, in the sense of she’ll give me the blood test reports and I will deal with it in my own time, because again she can’t say anything, and for fear of like her losing her license and stuff. And I understand that, like it’s not, she’s not an endocrinologist, I’m not expecting like her to know and like me doing, I know, me and my own knowledge is a completely different thing.

But yeah so, yeah like finding a good GP is one of the hardest things I guess, in a, like trans health. Because so much of your care goes through your GP and just, and like it’s, it’s very obvious to find like, if you find a trans friendly GP most likely it’s been, they’re not just trans friendly, they are just friendly in all kinds, like they will be less stigmatised against mental health and stuff like that, so you more openly discuss it with them, and they’ll be take, like I, I’ve had people talk about like just not even, they’re not trans but they’ll talk about their mental health and be like, “Yeah they just put me on meds, and shooed me away,” kind of thing, like you know, or like, “They haven’t taken me seriously,” or anything like that. And it’s just, yeah so like finding a good GP can really change, especially like when it comes to like trans healthcare, it can make a big difference.

I’ve never talked about or disclosed being trans with a, with a GP. And partly that’s because I’ve accessed all of my trans healthcare outside of the system. So I’ve talked about top surgery already, but also alongside that I get my, like I self-inject T, but I just order my T and order my needles and things from friends or friends of friends, and so I’ve never, even though I’m kind of like medically trans [laughs] I’ve never interacted with a GP about that.

And that is because of some of the stuff I said before around particularly if you don’t want to kind of be binary, it’s never been a very supportive hospitable service and I have enough trans friends and have heard enough of their stories to kind of know that is true. And I think it is improving, significantly, but it’s also a lottery, of like which GP, and how much, how good it, how good the service will be. I think, there is I think there’s two other kind of like things I want to add about that, and one is that, oh actually there’s two, there’s three. One is that I think I’ve always really struggled with GP’s anyway, and I, like to ask for what I need, and I think that like that’s about the intersection of class and race and that’s something that doesn’t get, because of the fear of private healthcare systems and like the privatisation of the NHS, which I think is absolutely right, that what happens is that we never talk about the inequity in the public healthcare system. And that with the, with it, with the absolute truth being of course it’s better than a private healthcare system, and I’m not, just to make that very clear, but that there’s this kind of myth that public health, healthcare is like equitable, and that private healthcare isn’t. And that just isn’t true, like that’s not just based on kind of like postcode lotteries and like if you live in a more affluent area you get better healthcare services etcetera, but also it’s based on a model of self-advocacy, and self-advocacy is not a neutral skill. It is something you learn through having access to resources, and so and I think like the NHS, what the NHS is exceptional at is urgent care. Like if you’re if you’re, if you want to kind of use A&E, if you are if you have a life threatening condition, if you have a life threatening accident that’s when the NHS comes into its own. If you have more chronic ongoing unknown things it, it really depends on advocacy to get those things investigated, because every test costs money.

Whereas in a private healthcare system every test makes money. So I think, I’ve always been quite scared of and not really got what I needed from GP’s. So, I think that’s the first thing. I think the second thing is that I think that I have a bit, I have some of my own cultural stuff around it, because most of the GP’s in my service, in my area are South Asian, my family is South Asian, and I think that that acts like even though none of them, like we’re different like ethnic groups mostly, my family is like quite a different ethnic group than, is a very small, globally very, very small ethnic group, so like it’s not like I’m scared of actually literally bumping into my actual uncle, but the experience of it feels like they’re all my uncles, or my aunties and so which is about my internalised stuff, but it’s still a barrier, it still makes it a barrier to kind of want to sit down or like feel safe to sit down and talk about things around trans identity specifically. And then the third and final thing I want to say is that, I think that we often get in this rut when we talk about trans healthcare, about, of only talking about trans specific healthcare, and I think one of the biggest threats and risks to trans people is general access to healthcare because you’re like when you’re trans and the barriers that face, and so it ties into the passing question of like I could pass as much as any trans person, like might ever want to pass, if I go in the doctors and I have, I’m having digestive issues or piles and I want the doctor to investigate that it doesn’t even have to be to do with like my genitals per se, but like as soon as I have to take my trousers down, or you know whether I’m pre or post-surgery, there is a whole different set of expectations and assumptions, and I, you know I’ve got trans friends, obviously when you take hormones, particularly if you take hormones and it’s not, it’s not through the system, but also even I have friends who take them through the NHS, who end up caught up in the system for months waiting for surgery that they need because their hormone tests have come back as an anomaly. Even though they’ve done like, it’s on the record that they’re taking T, and there’s just so little literacy about trans people in the system that it prevents us getting health, the right healthcare for a whole host of other issues, either because of the psychological and emotional barrier of even asking for the help, or because when we do they don’t understand why our bodies are saying the things that they’re saying.

My regular GP, she went on maternity leave, and the doctor who came in and took her place actually came in at quite a difficult moment for me. The gender clinic had said that I could go on testosterone, but that before I went on testosterone I would have to legally change my name, and I refused to have, I was, I’m in my thirties at that point, I was like no-one’s telling me when or how I change my name, and they said that they wouldn’t approve it if I hadn’t done the paperwork. Which to me is ridiculous because there’s no point in me taking, if I, if I get a gender recognition certificate that says that I’m male, as a non-binary person I’m still stranded in the middle of something that I’m not. And so it was not something that I particularly cared to do really. And I, the second GP that I spoke to, I went in with the letter and said, “They’ve done this, they’ve said that you can prescribe the testosterone, but I haven’t changed my name.” And he said, “Well why haven’t you changed your name?” I said, “Cos I don’t want to.” And he was like, “Okay.” He was like, “I’m confident that you’ve thought about this, I can see it’s been a journey, and I’ve got no problems prescribing you testosterone.” And that was really a, it was really an eye opener into how it can be if you have people on your side. It’s not a case, it wasn’t a case of him giving me what I wanted, it was a case of him acknowledging that as a grown-up in the world I may have actually thought about this for longer than he had. And he was, he was very open to having conversations about it, at that point I was on Sustenon, which is the monthly injection, so it meant that I went into my nurses office every month for the injections. And likewise she was fantastic. And so that was the first time that I really felt like I’d had any active support from people who, and it, the difference that it made, the relief that I had from it was, was tangible. Like I could, I could touch it, it was so strong. Because alongside that, you know with the GP’s I also had it where I went into the GP’s cos I had tonsillitis, and I needed some penicillin for it, and she wanted to talk to me about how my transition was going. And I was like, “This is a different problem than the one that I’m here for. My transition right now is fine. My tonsils on the other hand are exploding. “So it’s weird, I think the GP thing of, there is an anxiety there, I tend to believe that someone becomes a GP because they want to do the best for people, and they actively care about helping people. I think there’s so little information that it has always felt like being somebody’s guinea pig. It felt very much, in my GP clinic, like I was the first one that they’d ever encountered, and a lot of it they were going to take their lead off me. And that’s a weird feeling for someone that isn’t a medical professional.

When I saw my [city] GP about it, he’s been fantastic. He’s helped me change my gender marker in the NHS system. And he’s, I, so I’ve tried to get referred a number of times and it was through him that my referral finally actually got sent. So, and he’s just great generally. So I’m disabled and he is great about my chronic illness as well, so. I wonder if there’s something about being in the kind of more liberal space that is [city] that maybe his convictions are a little different. But, yeah, it can be very hit and miss with GPs.

He has always been fantastic. No matter what I’m going to him for, he always takes me as the expert in what’s going on in my own body. So be that with health stuff or trans stuff. He’s never kind of questioned me, ‘Are you sure?’ Or anything like that. He’s always gone, ‘Okay, cool.’ And then that’s how we move towards dealing with that resolving that issue or whatever the case may be. So, I kind of made an offhand comment about it being frustrating that I was still marked as female in the NHS system. And he suggested the solution to that and asked if it would suit me and then implemented it, immediately which was great.

It’s really obvious to me and even though I’m aware of it, and I know that I know what I’m talking about, and I’m confident to you know, in what’s kind of what I need to get out of an appointment, I still find that it can be really intimidating, and there’s a certain, there’s a certain kind of don’t know, mannerism that a lot of doctors seem to have that, and I understand that they’re probably super busy and they’ve seen like twenty patients before you in the morning, but where they’re so business-like and brisk that they often don’t, they’re, they can be quite dismissive of anything that you say, or anything that you ask. Which immediately makes you feel like you’re like five years old getting told off by your schoolteacher, or something. And I’ve found, like when I, when I saw the consultant last, it was really disempowering, cos I knew what was, what I needed to get out of the out of the meeting, but I was kind of ignored, and kind of not, I was kind of, I felt like they were specifically trying to fob me off, and I could feel that in like their, the type of questions they were asking, and the fact that they hadn’t read my notes properly, so I had to query them on things, and I just thought after I walked out, you know, they’re trying to like discharge me completely from the clinic, and I was like if I hadn’t stood up for myself I would have ended up discharged and back at square one, whereas they’ve tried, they sort of half didn’t discharge me and sent me for some more scans and stuff.

The thing about going to GP’s is that they, because they’re in a position of power they can really talk down to you and really like try and sort of talk you out, they gaslight you and talk you out of what you’re doing or say that you’re doing something illegal so you should be like, you know, like kind of like [pause] yeah just like making me feel like I was doing something wrong when I was just trying to when, when they have like a sort of right to provide, you know, like they have a duty of care and instead of making sure that I’m okay or that like I’m not at risk they actually seem more concerned about like making me feel like I was doing something illegal and to try and like encourage me to stop doing that illegal thing.

I’m really lucky my partner is a psychotherapist and also works they currently work with CliniQ actually as a psychotherapist but they, and they’re Trans and sort of non-binary but and they, also went to [institution] so they’re very like good at like talking smart [laughter].

So I brought my partner along to an appointment and it was pretty much I didn’t have to say anything they were just like, yeah my GP completely changed her tune. But just in terms of like the demeanour she wasn’t talking down to me anymore she wasn’t kind of like being condescending so, so like, you know, yeah so it just felt like oh okay so bring along a posh person who like, you know, knows information like, you know, like Trans healthcare and knows about like sort of knows about what my rights are and then it kind of like changed the whole sort of interaction and it was pretty like eye opening to be honest.

As a trans person who has to come into contact with healthcare professionals a lot, just because of the nature of the journey, some, I think you get, I think on one hand you almost get used to speaking to professionals, so on one level you kind of get used to walking into a room, having already educated yourself a little bit, and knowing that you might be questioned a bit so, not that you go into a room in a defensive way but you kind of almost go into a room knowing that you’re going to have to assert your own power in order to I guess get the support that you need sometimes.

So, and I don’t think that’s something that’s obviously you know, it’s, it’s not just an experience that trans people have, but I think that it’s, it’s something that as trans people you just get used to doing every time you walk into a room with a healthcare professional in one. I think that being said though, it can be very easy then to go into a room with this sense of power, and this purpose, and to then be disempowered very quickly when that professional for whatever reason, it’s not, you know if the professional has a reason, I think, for not supporting you for whatever reason, then sometimes that’s valid, and sometimes I think there is room for challenge, because as a patient you’re the expert in terms of yourself, but you’re not an expert when it comes to that, you know medication, and diagnoses all the time.

So that being said, you know I think it can be, yeah you can be disempowered quite quickly and sometimes it happens, like I say sometimes it happens for a reason and sometimes that’s okay, sometimes it happens and it’s not okay. So sometimes you can be challenged by a professional, like I was on illegitimate grounds, and in a way that then invalidates not only what you went in there to say, but also you as a person, and that can stay with you for quite a while. So, going into a room with a healthcare professional and having a conversation with, with a professional can be a very scary thing.

And I guess what terrifies me I think is that, for me, having a Mum that’s a healthcare professional, and being a healthcare professional myself, you know I’m going into these spaces and I’m coming away exhausted, having had that experience on the other side and, and being in a position where I’m, you know relatively I guess in a good place mentally, to manage those power relations. When you’re a young person or somebody who is not in that place then it’s an even scarier thing.