Saturday, 27 May 2017

You don't know what you got 'till you ain't got it

It's something well-known, that before any major surgery we trans women must come off our HRT for a period of a few weeks. There's a risk of blood clots, and the effect of coming off is said to be rather difficult as you go from the hormone balance of a young person to that of a 90-year-old in a matter of days.

I can say with complete confidence that this prospect holds little fear for me, because I have been there. For quite a few months I've had next-to-no estrogen or testosterone, and it's something I only got to the bottom of a few weeks ago.

About two years ago, I started my HRT. I was already a couple of years full-time, but had delayed HRT for fertility treatment. I received my hormone patches, and eagerly applied them. In due course after about a year, I received anti-androgen injections, and awaited the changes they would bring.

People say that the switch from T to E in this way can be a rough ride, but it didn't quite work that way for me. I didn't get the hot flushes some people report, instead I got spots, lethargy, intense dysphoria again, and unexpectedly a return of some of the male aspects down there that I thought were long gone. Oh well, I thought, this is the rough ride, it'll pass.

But it didn't, in fact it got worse. And then I had a blood test. Followed by an URGENT letter from my endocrinologist, then an URGENT appointment. About a week after the last of my two trips, so about a month ago. I had precious little of either hormone, and it needed fixing urgently.

What had happened was this: they start you on a very low dose and increase it gradually. In my case, they never increased it, and I remained on the low dose. So I never had the extra E to replace my missing T, and turned into hormonally a very old lady. A state which persisted from the end of last summer until now. I've been prescribed two different upward steps of estrogen patches and have been promised more, and I've also been given industrial strength calcium and vitamin D supplements in case my bones have lost any calcium.

This was very clearly a lapse in the standards of my care, and I told them so. I've been to the NHS's complaints service, but it's worth considering what I am hoping for. I see little point in asking for a head on a plate, as this was obviously an administrative cockup.

Instead, I've asked for three things. First, an accelerated return to proper hormone levels for me. Then, a couple of things for the rest of their trans patients, now and in the future. A commitment to keeping our HRT under constant review, to make sure nobody falls through the cracks as I did. And then for each trans person to receive a clear timetable, on date X we will look at increasing your dose to achieve Y  estrogen level in your blood, and so on.

In myself, I'm feeling a lot better for finally getting the right HRT. I have several steps to go, but it's on its way. Fortunately I don't think I had any other problems for my intensive stay without HRT, it probably wasn't long enough for that.

I can however add this episode to the long list of my being messed around by medical services related to my transition. When I started all this I was a software developer, now I'm a full-time paid journalist. You can be sure I'll write about all this one day somewhere it'll matter.

Saturday, 20 May 2017

Taking Back Control, transition edition

    I've been a little quiet here of late, but with good reason. When your transition is stalled for several years by circumstances beyond your control it can sometimes take a very long time indeed to get back on the treadmill. In my case I found a shortcut, and took it.
    It would normally make me a bit uneasy, taking a brief sojourn into the private sector to get something that could take me two or three more years in the NHS, but since the NHS GIC took a huge dump on me that has already cost me two or three years I feel I've served my time. So in the middle of last month I went to see a couple of private doctors to get my GRS referral letters. They are both people I've never seen before, but since they both have NHS practices I have plenty of friends who've seen them at their GICs.
    This was my first experience of private gender medicine, and all I can say is that it's a very different place from the NHS. Not necessarily better, just different. I only needed two appointments, so the cost was fairly modest in the scheme of private medicine. Enough for a significant belt-tightening for a couple of months, not enough to bankrupt me.
    What makes it different is the access. I had arranged both appointments two and three weeks in advance, by email on my mobile phone, over the course of a half hour walk in the countryside with my friend R. A quick online payment for each, and I was good to go.
    Going to each necessitated a train to London, and since I was there for a day I arranged to meet friends both times. A visit to Tim Hunkin's arcade in Holborn with the first set of friends, then a week later a rather nice cafe with friend 2. She felt she had to warn me it was very discreetly a kink cafe, but as I pointed out: "I Googled it".
    The two clinics were slightly different, one was at the private equivalent of a GP's surgery, the other at a very flashy clinic whose main business was plastic surgery. And immediately upon sitting down in the waiting room it became obvious the main difference between the private and the NHS sector. It may seem an obvious thing to say, but for the first time in my life I was sitting among those transitioners for whom transition is something that can be bought rather than something that is a drawn-out process. I'm used to the GIC waiting room crowd, a mixture of fresh-out-of-the-closet first timers and people who've been in the system for years. The emphasis there is on Real Life Experience, living in role, and due to the delays in the system the patients haven't got much else to do but get on with it. So while the first time MtFs in an NHS GIC waiting room are a little overdone on the presentation front, most of them are in jeans and trainers, lived-in everyday clothes from whatever they are doing with their lives.
    By contrast the private waiting rooms, especially the latter one, were full of high-speed transitioners anxious to get to their goal in as little time as possible. I hesitate to go into detail because it's not really appropriate, but if I say the tone was probably more Sparkle than Trans Pride Brighton you may get my meaning. I have little doubt that within very little time all of those people I saw will have had their visit to the surgeon and consider themselves fully transitioned, but will they really have socialised in the same way as the girl who's been full-time going through the process at an NHS GIC for three or four years and is only just receiving her first surgical referral? I worry that maybe they won't have.
    Both doctors were professional and straightforward, and since I had all the paperwork necessary to prove both my HRT and my time living in role I received an assent from each of them. A few weeks for the paperwork to be processed, and there they are. Back into the system. No idea when my time will come, and when it does I'll probably be rather circumspect about it online because blow-by-blow GRS accounts can be triggery as hell, but at least now I know my day will come. One day.

Monday, 17 April 2017

Complaining: it works sometimes.

   A few weeks ago I made a complaint to the BBC, after a regrettable Radio 4 report about a trans woman prisoner in which she was repeatedly misgendered. I received a reply, which I missed at the time because it went into my spam folder.
Many thanks for contacting us about PM, as broadcast on 21 March 2017.
Thanks for raising with us the pronoun we used during the item on a transgender prisoner being moved to a women's prison - we took this to the editor and those involved in the story.
You're right about the pronoun use during the item. We always seek to use the correct wording, but unfortunately that didn't happen here.
It was an oversight, for which we apologise.
We value the time you've taken to point this out and do seek to use the correct wording.
   So there we are, a straight apology. Most likely not just because of me, but because Trans Media Watch got on their case about it. But without a load of people complaining, we wouldn't be there.

   So keep complaining when you see or hear this kind of rubbish. Sometimes, it works.

Tuesday, 28 March 2017

Detouring the slow train

    If you are stuck in an interminable waiting list - no, if you are stuck in a holding pattern simply to be on the waiting list, what would you do if someone offered you a shortcut?
    Readers of this blog will know that I'm on the slow train when it comes to transition, nearly 4 years full time and 7 years in the system, but discharged from the GIC because after 18 months fighting awful treatment by my then employer I wasn't ready to go forward for surgery. Having sought re-admission to a GIC I've subsequently found out that it's likely to be 18 months before I see anyone and then another year before I have my referral letters, so getting on for 3 more years to surgery. Naturally I'm about as pissed off and dejected as it's possible to get. Knowing that with 4 years behind you you've made a far better job of a social transition than many of those who overtook you in their race for surgery doesn't help when you're left in the wilderness.
    So back to the question, if someone offered you a shortcut, would you take it? And if that someone was your doctor, your GP, especially would you take it? Hell yeah!
    I'm not going to go into the gory details, but there is something I can do that will save me a lot of waiting, which my GP tells me will let me back into the system by a different route. It's not some magic fix for those at the start of the process who are desperate to go faster so don't bother asking, instead it's for the rare and unusual cases like me who are stuck, but stuck very near the end of the medical road.
    It does however involve a short detour into the private sector, seeing a different set of doctors, and forking out a moderate amount of cash. Not new car levels of cash, or even slightly new car levels of cash, but let's say decent quality older car levels of cash. Cash I can afford, but would prefer not to waste.
    It's risky, in that it depends on my GP's say-so. If he decides to forget the path he laid out for me, then it's wasted money. Wait the 3 years, or fork out new car levels of cash for private surgery. Which I could raise if I perform financial back-flips, but would prefer not to.
    In Hollywood films there seems often to be a mysterious plot twist in which a choice is offered to the protagonist through which they can continue their boring life or enter a course of excitement and danger. Looks as though that just happened to me.
   

Wednesday, 22 March 2017

Another day, another BBC complaint

     Another day, another BBC complaint. This time a story on Radio 4 about a convicted rapist who transitioned in jail. An unpleasant person, but a regrettable slip in broadcasting standards.

Yesterday the PM programme carried a piece about a rapist who has transitioned from male to female while in jail. She has completed entirely the medical process and obtained a gender recognition certificate, so she is both physically and legally female. Yet your report persistently referred to her as "He" and as "Him", and did not acknowledge at all that she is now a woman.
This is highly offensive to all transgender people because when it happens so blatantly on as respected a national broadcaster as the BBC it devalues their claim to their gender. The person in question is an extremely unpleasant criminal, yet her unpleasantness does not mean that the BBC should legitimise misgendering of transgender people. The vast majority of other transgender people who are not criminals will suffer when transphobes will use the BBC's legitimising to justify misgendering them.
Your reporters let their distaste for the individual concerned cloud their judgement when it comes to your organisation's diversity commitments towards a vulnerable minority. Their report came perilously close to hate speech, she is an unpleasant person because she is a convicted rapist and not because she is transgender. This represents a regrettable dip in standards from the BBC and from Radio 4, a station that already seems to have a problem when it comes to transgender people.
She has become a woman, and her pronouns are she and her. Please do not forget that.
I doubt it'll get anywhere. But somebody has to.

Saturday, 18 February 2017

Breaking down those walls of stone

    If someone had told me I'd see over forty transgender people in a room expressing something approaching agreement, I'd never have believed it. We are by our nature a very diverse grouping, you might say a broad church. You could safely expect an argument over whether the sky is blue on a clear day.
     But yesterday it was something of a surprise to see just that. Stonewall, the national LGBT campaigning charity, were holding one of a series of consultations on a document intended to lay out their trans strategy now that they are embracing the T in LGBT.
    Stonewall, you see, are an organisation with a bit of a problematic history in these matters. In the past, they have quite happily pretended to be LGBT when in fact they were more LGB, or a bit more accurately, LG. If you're being brutally honest, LG. Even LGGGGGGGGGGG, some people will tell you, such was the attitude of the coterie of middle aged gay men that once held sway at its helm. They'd take money on an LGBT ticket and even talk to politicians on that front too, but when it came to the crunch they'd throw us under the bus every time. Thus you'd see its name sometimes written as "Sonewall", because there's no T in it, or even occasionally "Sonewa", because at times there could be precious little L either. Not an organisation that had much trust from within our community
    A couple of years ago against this backdrop along came a new Stonewall director, Ruth Hunt. She immediately set about refocusing Stonewall to be genuinely LGBT, and to facilitate this she had the organisation recruit a trans steering committee. This committee put together the draft document, and yesterday's event was one of a series in which they placed it before the trans community.
    It was a document into which a lot of effort had been put, and it shows how much they have changed. In front of us we had a well-thought-out enunciation of trans rights and experiences, both as they are and as they should be. And here we come to the agreement between the attendees, while there was plenty to tweak around the edges the tone of the document was as far as I could see universally approved.
    Since I was there wearing my trade union hat I made a few suggestions on workplace rights. I always feel as though I've said too much or even made a fool of myself at these occasions, let's hope I made a valid contribution. We'll see the completed document in the coming weeks, and then its contents will be the subject of Stonewall's campaigns on our behalf.
    A long day involving a sprint across London between connecting Tube stations to get back home for another engagement in the evening meant I couldn't afford to hang around and socialise. My fellow attendees were a diverse bunch among whom was my friend Paula, and there could have been a lot to chat about had I had the time.
    I'm still beset by the crushing onslaught of my recent GD relapse, which isn't ideal when you're in the icily polite loneliness of a packed British commuter train. A self-important middle aged lawyer kept trying to invade my space with his elbow, then fell asleep and toppled onto me. I proceeded to invade his space with my elbow, placing him upright and awake in no uncertain terms.
    Before my evening engagement, an online conference for one of my current part-time employers, I went to the toilet in their office building. In the mirror, despite all the annoying stuff, I saw an image I liked.
    Pictures of me are not common, so it was the first time I'd been tempted to take a selfie in many years. It shows how far I've come, even if in some ways I'm no further forward.

Wednesday, 15 February 2017

What a difference a few years makes

    So yesterday morning, there I was in my doctor's waiting room. I've gone back seven years, asking to be referred to a gender clinic again. Only of course it's rather a different situation, I'm asking to be referred back to the clinic. Not the same clinic, in the intervening years another one has opened up a lot closer to home.
    Into the doctor's office, and explain why I was there. Discuss where I am in the process and where I want to be, and that I need to be referred with my referral stating very clearly that I'm there only to get surgical referrals, I have served my time.
    The difference between now and seven years ago was this. Back then my GP, a different one from today, had that rabbit-in-the-headlights look. Transgender people were something of an unknown to him. Yesterday, completely different. I went in expecting to have to explain the whole process, and was pleasantly surprised to find this GP fully clued-up. We're coming out of the woodwork in huge numbers, and of course the professionals have had to learn about us. It would be difficult to explain to a cis person how positive this is, but it's evidence of an inexorable process. A decade or so ago you would never have met a transgender person in an average small British market town, now we're part of things. The dinosaurs in the media who still have a go at us on a regular basis can't fight that, when their readers all know people like us it becomes ever more difficult to demonise us.
    It'll be quite a few months before I get an appointment, and thereafter there will be more delay as I traverse the final few hurdles. But I'll get there.
    One thing's for certain though, I'll heed the advice a friend gave me quite a few years ago. Transition, she said, doesn't end with any particular medical procedure. It never ends, and there is always more to learn.
 

Wednesday, 25 January 2017

BBC Transgender Kids programme: the second salvo.

    After the BBC transgender kids documentary a few weeks ago I made a complaint, and received a standard cut-and-paste response that was breathtaking in its lack of saying anything other than they were blameless.
    Though it's likely to be a futile effort, I've made a response, which I've pasted below.
Your response to my earlier complaint did not even try to address the subject of the complaint, instead it was a content-free cut-and-paste form response full of meaningless platitudes and bogus half-truths.
You did not address my question as to why the programme failed completely to engage with the UK medical establishment. Perhaps it is because in the time since the broadcast the various medical bodies involved have come together and issued a statement condemning utterly the practices put forward in the programme, and you knew that they would not have supported the view you were trying to put forward.
You maintain the pretence that the programme presented a balanced argument, while in practice a simple analysis with a stopwatch reveals a huge time advantage to the views of Zucker and his supporters.
You justify the programme by saying that you had input from opponents of Zucker, and from families with transgender children. Why is it then that the activists and families involved are now saying that the producer of this programme misled them as to its content? Surely that is against whatever rules you are supposed to abide by.
Continuing to pretend that this programme was without fault is putting the BBC on the wrong side of history. Trying to ignore the objections of the transgender community will not make us go away and will not help you. We are the victims and survivors of abuse like that practiced by doctors such as the ones you featured, and we will not stand idly by and see it put onto a new generation. Transgender youth support organisations are already reporting an upsurge in hate incidents as a result of this programme, when the first young trans person has committed suicide because of it what are you going to say to the transgender community then? You can count on it, we won't let you get away with a cut-and-paste answer.
    These things are an exercise in postbag size and in capturing their resources. When they get a large number of complaints, they are forced to take notice, and the aim of our community was to make this one of the most complained about shows of the year. It is likely that my reply will be printed and filed, but will effectively go in the round file. However it's worth doing, because if enough of us follow suit it adds to that complaint volume figure and causes their complaints department to have to work extra hard. We'll see what the coming weeks and months bring on this front, the BBC can be rest assured they haven't seen the last of us.

Sunday, 22 January 2017

Freight train

    I'm told that this is something that comes eventually to most of us in this sphere, the point at which your transition comes to a head and it hits you like a freight train that you need to move, and quickly. After a year or two settling down and reinventing myself following the turmoil of my first year after going full-time, it came to me. Going back seven years, losing the ability to sleep, hit again by wave after wave of dysphoria as though I was still hidden in the closet.

    Yes, it's taken a few months, but the anti-androgens have hit with a vengance. All the good stuff is accelerating, building on all the estradiol patches of the previous year or so with much nicer skin, less body hair and a pleasing resumption of breast growth. But I didn't expect to be hit in this way, and to be honest I'm rather embarrassed about it. I've always pursued a "Better slow and right than quick and wrong" approach to transition, and it has stood me in good stead. It's allowed me to build a successful life as a woman unencumbered by other considerations, and I strongly believe it's given me an advantage in that I have less baggage than some contemporaries I've observed.

    So I'd always taken a view that some time in the future when I was ready I'd go forward and talk to the medics about surgery, but there was no point in pushing it if things might go awry. I imagined it would probably be another year maybe, and I'd get on with my life. It therefore feels a little silly to be reduced to a gibbering eejit by it all, I didn't think I was like that!

    Normal service will be resumed. I've made an appointment to go back and talk about it all, then no doubt I'll see psychs and all sorts again before one day taking a trip to Brighton, or West London. It'll be a couple of years, plenty of time to regain my composure.

    I feel as though I have gone back a year or two though, I thought I'd mostly dealt with this kind of dysphoria. That's weird!

Tuesday, 17 January 2017

The BBC respond to the transgender kids complaint

   I've had a response to my complaint over the trans kids documentary. Well, when I say "response", I really mean "Cut and paste a pretty meaningless response which says in effect 'we did nothing wrong'.".
Thanks for contacting us regarding ‘Transgender Kids: Who Knows Best?’ broadcast on the 12 January.

We understand you had concerns with the programme.

With a rise in the number of children being referred to gender clinics, this programme sensitively presented different views from experts and parents on gender dysphoria in children.
For more than thirty years Dr Kenneth Zucker ran Canada's biggest child gender clinic and was considered a recognised authority on childhood gender dysphoria until he lost his job. He believes he was fired for challenging the gender affirmative approach.

This documentary examined Zucker's methods, but it also included significant contributions from his critics and supporters of gender affirmation, including transgender activists in Canada and leading medical experts as well as parents with differing experiences of gender dysphoria and gender reassignment.

Thanks again for contacting us with your views.

Kind Regards

BBC Complaints Team
    I feel as though I'm repeating a trade union speech I gave at a Pride a couple of years ago when I say that we're the last minority they think they can legitimately have a go at. You can't take a pop at ethnic minorities any more, Jewish people are off limits, gay people can't be touched, and women are beyond reproach. But transgender people? Hey, yeah, come on and weigh in, nobody will touch you for that!

    It can't continue, we can't let it.

    Last Saturday I was lucky enough to see Helen Belcher from Trans Media Watch speak to Swindon Transgender Group. She covered several aspects of her work as both a trans campaigner and parliamentary candidate, but as you'd imagine the documentary occupied a significant proportion of the time. It's safe to say that the transgender community will not let this one rest at merely a meaningless email response, and that awkward questions will be asked and BBC executives will be held to account.

    When I say I may soon be spending an evening standing on a pavement in Central London, it's not what you think. Last time we had a demo on this theme, it got results.