Experiences of trans and gender diverse young people

I had so I remember at [university] and [university] I got free counselling through both of those. I had eight sessions at [university] that was reasonably helpful. Yeah, that was at the start of my transition and so I had a lot of that stuff to talk through and the guy was helpful. And then, after that I had six sessions with CliniQ which is the trans healthcare and wellbeing service which was, they were great for what they were. There were only six that was only every two weeks. So, it wasn’t really enough. But again, I had a lot of stuff to work through and a lot of dysphoria stuff, validity stuff, yeah, gender stuff. It was all about the gender earlier on in my transition and then next of all I had, next of all, next I had [Laughs] counselling through Spectra which is another trans service and that was really good. I had eight sessions there, but in my mind it just feels like more because I got so much out of it. At that point, there was dysphoria stuff going on, but there was also alcohol stuff going on and a lot of, yeah, a lot of stuff related to social transition and it was really, I was really big on the social transition then. And my, my issues with it and needing to have this and that, yeah. And then, I tried a couple of appointments with someone at [university] and didn’t get along, so I gave up on that. Then I had a couple more appointments with ClinicQ because I went through their like three month waiting list again. But then I missed a couple of appointments, because I was scatter-brained and on holiday and in the wrong place and I didn’t, I guess I didn’t desperately need it at that time, so I didn’t. So I didn’t make it my priority to remember and they discharged me and sent me back on the waiting list and since then, I remember my mental health had really taken a dip and I hadn’t had any counselling to fall back on. I think I’d go back to Spectra now because that counsellor was the most helpful and yeah I need it.

I’ve got to a point where I did pursue some counselling cos around where I lived in [city] at that time the, they were offering free counselling for 16 to 25 year-olds, so I accessed that, didn’t need to go through my GP, I just accessed it as a self-referral, which was helpful, and unfortunately as lovely as the counsellor was, as I expected, as soon as I came out and said that I was trans, it then all became about my transition. But my counsellor, my counsellor was, as lovely as she was I, I don’t think she was trained in supporting people that you know, I don’t know if she was supported, she was trained in supporting LGBT people, full stop. Which is scary, given they’re offering support to 16 to 25 year-olds, but all the questions that she had about my gender were, so at the time I remember I was just starting to grow a beard, and she was saying, “Oh that’s fantastic, you must feel so great about that.” And I said, “I mean yes it’s amazing, but also I’m here talking to you saying that there’s things going wrong, I need to talk, I need to talk to you about those kind of things,” but she was saying, “But how? Because you’re transitioning, this is a really great thing.” And I said, “Yes, it’s a great thing, but also I feel like there’s things going wrong in my relationships,” and you know the, you know there were lots of things that I needed to kind of explore and actually you know I didn’t feel like, I didn’t feel like she held that very well. And through no fault of her own, because she probably hadn’t had the training to do that.

And you know I remember again she would ask me questions about my transition in order to learn, and as grateful as I was that she was learning, I don’t feel like, you know that, that sometimes took up half of my counselling sessions, so I don’t feel like that was very constructive way to use my counselling sessions. So that didn’t go very well.

That being said as well, I don’t feel like I’ve ever had the opportunity to explore my transition from the mental health side of things, because transitioning as a whole has, again as positive as it is, and as wonderful as this experience has been, it’s still a massive change that a person has to go through, and mentally speaking is just something that you, consciously you just can’t even comprehend sometimes, in terms of the way it impacts on things.

And so I would, I would love to have a space to talk about that with somebody who was trained to do so, in the context of my mental health as a whole, and recognising that my transition and my gender are part of my life. So that’s something that I’m exploring and I’m never going to be able to access that through the NHS, ever.

So I’m again looking into it privately, and even with private counsellors and therapists, there aren’t many that are experienced with working with, with gender diverse clients, so yeah, that’s, yeah that’s where I’m at with that one really.

I went to group therapy for social anxiety actually and that has helped quite a bit. It just, it’s helped me realise that I’m like my own biggest bully all the time and that it’s something that I really need to work on. That’s why I say, it’s not really other people that have given me any cause for concern, it’s just me.

I mean, group therapy for social anxiety is like that’s a scary thing to do. I think most people didn’t even turn up [Laughs]. I don’t know how much the content of the course itself helped. It was CBT. A lot of the stuff like, I didn’t really find that helpful. I probably won’t use. But it was more just going there, every day put me in the position that I was able to think things through for myself, I guess. And realise what was going wrong, I suppose.

What mental health services? I’ve never met anyone who has received mental health care through the NHS. Like, really. You can have a fluroxetine prescription or get three weeks of CBT or use the app. Worst case scenario, a leaflet. What mental health? They just don’t exist. It’s the same thing with the GIC. It’s a hyper object. We say it so much that we assume it’s everywhere. It contains everything. It’s ephemeral. It’s just out of your reach. You can find like physical manifestations of it somewhere. But like, the moment you look for it and you are like—sorry I need to get my laptop charger. You are like confronted with the reality that like they are tangibly non-existent in the same way that like anything the Tories have touched in the past 15 years is effectively non-existent. It’s really upsetting when, you know, you access sort of British pop culture, something like, I’m thinking about like Sex Ed on Netflix or My Big Mad Fat Diary on Channel 4. Both of these were made in the past five years. They are both about people in like contemporary Britain, like modern Britain at least trying to access healthcare and being able to do so and being told, hey, your concerns are valid. This is what you should do like viewer who should have a parasocial relationship with these characters. You can reach out to your services and get help. This narrative of like constantly being told by like on social media and by your university and by your friends that you should reach out and get help. What mental health services? They do, they categorically do not exist. You know, it’s, it’s just fucking impossible.

I would email different people that I heard gave therapy in the North and I would just get responses like ahhh we only deal with gay men or we only deal with this kind of person or our waiting list is X amount of time long and it was just like this isn’t really helpful and so even going through my GP like there wasn’t really any, anywhere that I could see that I could get free and accessible healthcare which is what I needed at the time as I didn’t have any money to fund anything privately. And so yeah I was just kind of getting thrown around and it became like a process within itself to be sent to fill out this form and express why I needed the therapy and then have to go through like the process of like what, where, because my mental health was already in a really bad place init, I just became so disheartening I was like I don’t want to open up again to another like online sheet that’s gonna turn me away and I was like I don’t wanna share like what’s going on for me internally in that kind of way and so I just kind of gave up.

I think the biggest problem with CAMHS is that they’re really underfunded they’re, I think they do the absolute best they can with what they’ve got and I think they do a great job with what they have available to them. But the problem is they don’t have really anything available compared to what they really do need. So I think my experience has been iffy and it’s changed from time to time, I think it has, I think as mental illness has become more prevalent and you’ve had more referrals to CAMHS I think the service has gotten worse and I think that really is indicative of them being so underfunded and unable to deal with the problems that they face. But I think they do their best with what they’ve got but they’ve just not got enough.

So I guess towards the early stages of my transition, I’d, yeah, I was quite conscious of the impact of talking about my mental health on how my kind of, well basically just how my want to transition would be perceived. So I was, I’d say obviously that, that stage where I was I’d socially transitioned but not physically transitioned, was really hard and I think I came very close to talking about that in, with the healthcare professional, but what held me back was if I, if I say I have a mental health, if I say that I’m worried about my mental health, I’m struggling, and I want to have this conversation with you because you’re a healthcare professional and this is the level that it’s at, I feel like you’re going to think twice about supporting me in my transition, and it then, I’m worried that my mental health will then become all about my transition, and actually maybe there are other things going on that even I need, don’t know about that I need to explore. But my transition will both overshadow that and very much be tainted by that.

So unfortunately even saying this as a mental health professional, which is awful, I did not access perhaps the support that I could have done with, and that potentially would have saved me a lot of issues and potentially I wouldn’t have, it, I think my mental health wouldn’t have impacted on the relationships I had at the time, so yeah, that, that, I was always quite conscious of that and I think when I went into the gender clinic appointments I was always very firm in stating, “I, my mental health is fine, I am absolutely fine. I am totally stable, and safe to be undergoing this transition,” just to give them the impression that I was fine, which is awful cos I’m a mental health professional, and I’m just perpetuating the stigma. I was, yeah still reflecting on that a lot.

I’ve had four appointments so far and I’ve still, I’m still at CAMHS, despite having four appointments. I think my next one might be with an actual trans healthcare professional, but I’m still going through the CAMHS paperwork. It feels almost like their, like when I first went they had to acknowledge to me that like yes, so we understand that like that being trans is no longer recognised as a mental health issue. I was like, okay, thanks. Why am I here? Like I’m still going through that process. It feels almost like it’s not being used as CAMHS and more as like the waiting room to the actual process which has been difficult in some regards. But I’m very cognisant of the fact I guess that it is just a waiting room and it’s just another form of waiting list. I am just getting out the paperwork and so I can move onto the next actual step.

I first got taken to the GP by my mum, because I was self harming and she wanted me to be seen. I had a long wait to be seen for an assessment. I got assessed and then we had another long wait to get CAMHS help. And in that time between the assessment and when I was getting CAMHS help, my mum actually received a phone call from CAMHS saying, ''We don't think he's bad enough. Maybe we can move him off the list.'' My mum, and I was in the middle having an argument with my mum, because I was feeling suicidal. Mum was like, no, he's feeling suicidal. You are not taking him off that list, which I'm glad she did for me. I think that that was the kind of block we had to fight through a bit to get to the help.

It’s been helpful. It [sighs] it’s been helpful in the sense for me in that I’ve been able to effectively describe how I feel, because for a long time, all that I felt because of it was words, not words, just emotions like I couldn’t voice exactly how I felt because of it. I couldn’t voice what it meant to me. But counselling and talking about it to someone who knew about it and understood it already helped me almost visualise it for myself and be able to construct a good picture of what it meant to me and how it feels for me and how I should tackle it and take it on. I don’t know if that makes sense at all. I don’t know how it would make, I don’t know how to explain why constructing and visualising my identity was good, but it meant that I was able to cope with it and healthily take it on, because it wasn’t so much as just emotions bottled up inside me, they were something like I’d laid out on the table saying, this is what it is. And then, because of that, I was able to start coming up with solutions and like healthy ways of dealing with it and putting up with it, I guess, instead of just okay, I’m bottling it up and I’m not gonna think about it ever again, if that makes any sense.

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.

She’s been super supportive, and just yeah I mean we discussed it on multiple occasions, and kind of yeah it was discussed in a way that was just completely accepting and part of the conversation. And like there was no kind of, no hint of kind of trying to pry or push me to do anything else, or to kind of pathologize it at all, just like, “Do you want to talk about this? How do you feel?” “Do you want,” you know cos I was talking about, you know, the thing of like I don’t really want to have this like big like party popper going off, coming out thing, can’t everyone just be cool about it? I’ve sent them a memo. Which I guess was a bit unfair maybe, but and she was like, “Well that’s okay, that’s your decision.” And I was like, “Yeah thanks, I thought it was,” So it was, it was nice and she just like gave me the space to talk about it without there ever being a need for it to be any bigger or attached to anything else, or kind of pushed into any other directions. But knowing that if I needed to talk about it more then I could. So, I’ve been quite fortunate with my kind of engagement with, with that.

My therapist has actually been really good you know I’ve been quite lucky, I know it can be really difficult sometimes to find a therapy or a counsellor that you know you fit with, she’s a cis white woman, so you know I’ve, I’ve all, I have been nervous I think when talking about certain experiences, you know, that is this gonna meet with some defensiveness or whatever, and actually you know when I’ve spoken about like racist experiences and transphobic experiences, expecting frankly for her to be like, “Okay but maybe there’s another way of looking at this,” she’s just always been like that happened, that’s racist, that’s transphobic, you know, and I know that she doesn’t fully understand like the trans stuff and the gender stuff, you know but like the fact that she’s been really willing to like listen and take it on board, and understand that like this is a part of my lived experience, and who I am like has been really positive. And yeah, and I think that I think that it would be so helpful you know as somebody with chronic mental illness, you know I’m always having to go in for different check-ups and you know changed meds so many times, and all of this stuff, to the, if I’d been able to talk about my experiences of my mental health without fear that if I’m honest as well about my gender identity within a, within that medical context that I think it would just help in terms of like honestly like maybe just being diagnosed correctly, and being able to go through the process , more smoothly you know, without constantly feeling like you’re fighting with some invisible force that doesn’t want you to be well. You know. Yeah.

I think there’s been a lot of like expectations in terms of how to behave, I think, ah, a really good example maybe was that I, I was on an epic quest to try and find some medication that worked and I had to go through multiple psychiatric assessments just because I think the process got a bit muddled up at some point. But I remember like I think for, the final one I did, before finally being prescribed something, was they were supposed to send me a letter, and they didn’t, but they did send notes to my GP who then got in contact with me and my GP printed off their notes for me to read. And obviously like you’re not really supposed to read their notes, you’re supposed to read like the polished letter, and so sitting down with that was quite emotional, actually. I think one of the main things that hit me really quickly actually was the use of she/her pronouns throughout like, and obviously like I know like I’m not out to any of my doctors, you know I hadn’t told the assessor, you know anything about my gender identity, but like I think just seeing it written there on, on a, in this medical context where it’s like almost feels like a really concrete representation of who you are, right, it’s about your body, or your mind and it’s about how you’re existing in the world, right. And like seeing that and it, but it like it’s not me, cos it’s, you know using the wrong pronouns and stuff, like did, like hit me quite hard.

And it’s like, you know for sure like my gender and perceived gender came into play there for sure like being south Asian, you know, person who was being perceived as a woman, came into play there, and it’s just like, and being disabled, and like chronically mentally ill, right, and it’s always this thing of like, “Yeah but like, are they really telling the truth?” Like, “Things being blown up out of proportion,” and stuff like that, and, and I think it’s just these, it’s those moments of like being dismissed, even for things that’s nothing to do with like the services you’re trying to access, you know like. Fair enough like to ask about like psychiatric history maybe want to know like you know, trigger points and stuff like that, you know but, but then put them in the notes as that, you know. Because otherwise like making, I guess like passing judgment on patients isn’t beneficial to anybody, it makes it you know I didn’t, in my process of like trying to get my chronic illness diagnosis, like the second time I went to see the doctor about it, I burst into tears because she just straight up said she wasn’t going to help me. She just straight up was like oh, “We want to optimise your mental health,” and in the context that just meant she wasn’t going to do anything at all. So, I burst into tears cos I just, I’d never felt so casually dismissed in my entire life, you know.

And… and I think it’s, it’s those moments where you just, you know after that like I didn’t, I didn’t go back to them until it started getting really bad because I was like they’re not going to help me, like what, you know. Ah. It prevents, you know it felt like there was no, there was no way I could access the services that I needed to access, you know. And I guess, yeah, there’s just been lots of little moments like that, you know with that incident in my notes I found out later was that I got a bit tearful, and it was like, you know, I was just full on sobbing like it wasn’t tearful, you know. But it’s just, I guess stuff like that where I guess your own narrative is being controlled. You know it goes back into this question of power, right, it’s being controlled by professionals, you know. And they’re reading each other’s notes, they aren’t getting to hear your own words every time, so when those notes and when those interactions are you know discriminatory, or exclusionary, or downplaying what your experiencing or just you know saying it otherwise, right, excluding certain things, or changing you know even just little ways like how something, you said something or whatever, like, yeah it, it, it makes it quite difficult I think to like trust healthcare services and you know, and I want to because like I’m a massive fan of like the NHS, right, as a concept and like as you know of course I feel very lucky to be able to have like this access, but that doesn’t mean that there aren’t issues as well, that do need to be resolved, you know.

I used to go to CAMHS, cause obviously, I've got autism, I’ve got severe OCD anxiety and obviously gender identity dysphoria. But when I remember being at CAMHS and they were doing some form thing like doctors always do. And they said something about clothes and they were like, I can't remember exactly what it was, but it was something to do with the way I dressed and they were like, ''Oh, do you think that's to do with your autism?'' And I was like, ''Why would the way I dress have anything to do with autism?'' And they were like, well, then they obviously asked questions about why I dressed like a boy and why I had short hair and all that sort a stuff. Not questioning me at all, but just asking why that's the way I was and then obviously I was like, “Cause I'm a boy.'' And they were like, ''What?'' And then obviously they referred it to people to work out more what was going on and then obviously it just came out [laughs].

When I went to see counsellors where they just sort of kept sort of trying to figure out my sexuality and there was one that I went to see where like I wanted to discuss it a little bit like you know, how I’m struggling with gender identity and I wasn’t really sure what was going on but mainly I’d been there to sort of talk about my depression and how I’d been struggling with like the course and everything. But she sort of kept wanting to go back to, you know, me potentially being like Trans or non-binary, because at the time I was living as non-binary and I find every time I went to a counselling session or a GP I had to explain what non-binary was. And there was this weird sort of like enthusiasm like ‘I’ve never heard of non-binary before can you explain that?’ and it as like you can literally Google it like just, you get like five seconds and you’ll get a response online that will tell you what it is.

So I cycled through three people who were the LGBT specialist therapists and there’s some issues at CAMHS, especially surrounding like confidentiality and stuff but I was quite lucky that I tell my mum like everything so that wasn’t an issue but a lot of the time, I also had like family therapy with them so that was like, that was like a kind of side specialism of one of my therapists where and she came in to my house and tried to explain my gender identity to my family but it was completely wrong. She got it completely wrong because she was also a therapist to my friend who is a very masculine trans guy and at that time like my hair was bright blue and I was kind of like, I didn’t Pass very well, my friend passed really well at that time [coughs] and she was like, “Well [name] feels non-binary and stuff,” and I was like, ‘there’s no problem with being non binary, but I’m not,’ and she explained that to my whole family and that was my last meeting with her before she left. So I was a bit let down by that because I felt that she didn’t really see me as, my identity as a man as valid at that point so that was kind of a let-down.

I saw a couple of different like CAMHS therapists and things, and I never felt like I could fully open up about that aspect because of the cisnormative lens on things. And I like, I couldn’t even open up about like just queerness in general, cos the people that I saw never represented me and I think that one of the difficult things that I feel with counselling and therapy in general is that because you’re told, well they, the counsellors are told not to make it about them, not to share their own experiences, it makes it very difficult for people who come from marginalised backgrounds to feel safe enough to share information and make connections.

And I think that there’s a lot to be said for having someone who understands at least a little bit of where you’re coming from, and I don’t think I’ve ever had any kind of mental health support from anyone who wasn’t a straight cis white woman. I don’t think that’s ever been the case. And I feel like they often felt like they were relating to me because they were women, and they saw me as female and that wasn’t something that I felt back, and so I think well like well I’m a woman, you’re a girl, we have that in common. But I did not feel comfortable with them, and I honestly think despite the fact that I am also not comfortable with men, I would’ve felt more comfortable having a man be the person I talked to, because then they wouldn’t have made that assumption that they had that base connection with me. But also, I’m afraid of men. And not in like a men are scary kind of way, just in a, the patriarchy kind of way.

I am much happier with where I am. But I’m acknowledging the fact that I still have a long way to go before I’m fully happy, if that makes sense. And I’m not saying that being happy should be everyone’s goal in mental health. Sometimes just being stable and being able to regulate your emotions is brilliant in itself. I mean, for me, I’m currently in a space where I can regulate my emotions and I’m very good at controlling how I feel, when I feel and how I deal with unexpected emotions or how I deal with feeling like I’ve been upended in something like I feel very much more in control. So, not necessarily happier, but more in control and more able to understand how I feel and why I feel certain ways, which is why my mental health is better than it was before. At the same time, no, I still do have periods of laying in bed, staring at the ceiling, wondering if there’s any point of being alive at all and obviously being here by existential, existential dread of, hey, we’re all gonna die anyway, so why am I alive in the first place? Does it really matter? Do I matter in the grand scheme of things? But I have these thoughts with the extra perspective of well, yeah, I do matter, ‘cos this is my life and I don’t necessarily have to live it for a reason. I should just live it ‘cos it’s a miracle that I’m here, so it’s cool and I want to learn about things, so. I guess I have a driving force that keeps me going even when my mental health dips or isn’t as good, necessarily now, which I didn’t have before.

Anything is better than bottling it up, ‘cos if you just sit and you bottle it up and you don’t talk about it will just get worse. Other coping mechanisms like put the anger and the unhappiness you feel into something, use that as a driving force. For a long time I used like spite and anger as a driving force behind like how I would revise or how I would like, how I would express myself online and God knows I have so many like abandoned online accounts, which were just vented out for me to just write stupid, angry poems and do stupid pieces of art work that just got my anger and frustration out. I never had, good, healthy coping mechanisms for a while and that’s not a good thing, but learning, like, from a very early stage being able to like learn how to regulate your emotions and control them healthily like that’s probably the most effective thing that could help you in the long-term.