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.

Complaint to the BBC re Transgender Kids programme

    The BBC is a respected national broadcaster with a long record of balanced reporting and quality programming. If something comes up on the Beeb the chances are you can trust it, a reputation it has won over many decades of cherished independence from government through its unique trust status.

    Sadly though, even the BBC sometimes falls short of its usually impeccable standards. Yesterday they aired a programme: "Transgender Kids: Who Knows Best?", which presented a very one-sided view of the treatment of transgender young people drawing largely from the input of the discredited Canadian Dr. Kenneth Zucker. I was not going to watch it because I thought it might be too triggery, but I decided this morning I had to catch it on iPlayer because sticking one's head in the sand is never the best option.

    It does not, I am afraid to say, make inspiring viewing. I saw a very one-sided portrayal of transgender medicine for young people which presented Zucker as an expert beyond reproach and failed completely to feature the professionals who work with young transgender people here in the United Kingdom. The BBC has failed, and they have done so badly.

    For what good it will do, I have submitted a complaint, which you can find below. If you saw the programme and found it objectionable I suggest you do the same, and if you haven't seen it and live in the UK I suggest you find it on iPlayer and give it a look. it's too important to ignore. Handy details about making a complaint have been collated by UK Trans Info if you wish to complain as well, perhaps we can make this one of those shows with so many complaints that the BBC have to make amends.

Here's the text of my complaint. Write your own, don't copy mine word-for-word.

This programme relied heavily on the input of Dr. Kenneth Zucker, a discredited doctor from Canada who was removed from his post due to his use of conversion therapy methods which caused untold damage to his patients. It presented him as a foremost expert in his field, which given that he has been so comprehensively discredited is hardly accurate today, and it glossed over the excesses of his clinic's work. 

It did not feature the providers of gender clinic services to trans children here in the UK such as the Tavistock Clinic, nor did it feature the work of support organisations who are active in the field such as Mermaids, Gendered Intelligence, or GIRES. The majority of the example patients featured in it were not from the UK, and the view it gave of how youngsters with gender dysphoria should be treated was in sharp contrast to either that of the professional bodies in the field, WPATH, or the NHS. 

It treated adult activists in the transgender community as dangerous meddlers in the treatment of others when in fact they are the survivors of exactly the kind of abuse that doctors like Zucker practice, and which the programme promoted. 

This programme was nothing short of an outright attack on a vulnerable and marginalised minority, and in particular on members of that minority who are too young to speak for themselves. Transgender people have a significantly higher incidence of suicide than the general population, and because of attitudes like those presented as mainstream by the programme that suicide figure is increased. People kill themselves because of the views the BBC is promoting with programmes like this one. 

The BBC should present an abject apology for this dangerous and objectionable piece of programming, and immediately take steps to rectify it by presenting the views of real experts in the field from the United Kingdom, who do not have episodes like Zucker's in their pasts.

Edit: This isn't the first time...

The Year Of Teh Tranz

    2015, if you believe the Chattering Classes, has been the Year of Transgender.
    By which they mean, there are some famous and very gender-conforming people they can safely talk about without straying too far from of their comfort zone. From Caitlyn Jenner through a host of TV shows sporting token one-dimensional transgender characters to Eddie Redmayne in The Danish Girl, the transgender narrative has been packaged up in Cellophane like a Barbie doll, something for daytime telly and newspaper colour supplements.
    The trouble is, it's a very synthetic transgender narrative. Transition is instantaneous and successful, and transgender people are achingly cisnormative. Nobody ever has problems accessing healthcare, and nobody faces discrimination in their employment or personal life. The transgender drinking game has never been played so often.
    It's not been all bad this year though. It's taken about four decades, but the world has finally realised that the ravings of radical feminism on the subject of transgender people are hate speech. Germaine Greer and her ilk have finally become persona non grata, and in particular her resorting to ever more hate speech upon receiving that news has propelled those views more firmly into the cold.
    Meanwhile though the reality of life for the unseen majority of transgender people who don't have their own reality TV show or write for the Guardian remains pretty bleak. Poverty, violence, employment discrimination, awful access to appropriate healthcare, the list goes on. If you happen to be a transgender person who isn't white-skinned it gets about ten times worse, the list of casualties read out on Transgender Day of Remembrance drives this point home.
    So while it's great that we are less often the target of Richard Littlejohn style tabloid hate speech or the butt of Little Britain style offencive comedy, don't make the mistake of thinking we've made it because we've moved to being daytime television sensations. There is still plenty of work to be done, and progress is not being aided by publicity-seeking starlets, celebrity transitioners or attention-grabbing journalists.

On gender recognition

"It's perfectly legal to be gay, but only if we put you on this secret government list of gay people".

    If I ever need to explain UK gender recognition certificates to a Muggle, that's how I do it. There is usually a shocked moment of incomprehension, then the penny drops that something they considered to be a perfectly reasonable identification requirement is in fact a bit sinister, not to mention rather unnecessary. I don't think there's a gay person alive who'd be happy to be put on a government-held secret list of gay people, and when put in those terms it becomes rather unreasonable to expect the same of a transgender person.

    They're funny things, gender recognition certificates. You have to jump through a lot of hoops to get the evidence for one, pay a rather steep fee, then convince a panel of cis people that you're trans enough to require one. All for a bit of paper that it's a criminal offence for someone to ask to see, the right to a reprint of your birth certificate with your correct gender on it, and your name on that secret government list of transgender people. And the idea was that it also put you in the right jail if you commit a crime, though that last point's taken a bit of a battering this week. The trans woman without one who was sent to a men's jail came out for her appeal and then went straight back to a women's jail. Yes, the subject of my last post didn't get let off on appeal, common sense prevailed, and she's back on her diet of porridge. Girl porridge.

    So we're left with a new birth certificate as the main prize. And if that's one which some people among our community consider to be a big one, then good for them. I just can't say I'm one of them.

    What gender recognition certificates really do has very little to do with us. They exist as just one more Thing To Appease the Panicking Cis People Who Can't Handle the Idea of Trans People. If we bend over backwards to appease them, we're rewarded with a dog biscuit, oops, I mean shiny bit of paper. 

    Sorry, I'm all done with sit-up-and-beg tail-wagging, I want to get on with my life.

    Funnily enough, there exists a fabled land in which gender recognition is as simple as deciding how you want to be recognised. No panels, no secret government lists.

    Where is this place? The Irish Republic, a short ferry ride to the west. Has the world stopped turning on the Emerald Isle since they passed this enlightened law? Have cats married dogs? Hardly. Instead they're just getting on with their lives, just like we should be.

    Wish it could happen here in the UK? You could always petition the Government about it...

Finally listening

    Every now and then as you observe the trans community's path through the world, you become aware that a watershed moment has been passed. A few years ago we had one when we held a vigil outside the offices of the Daily Mail following the death of Lucy Meadowes, bashing us in the way they had became something tabloids couldn't do without censure.
    And the last few weeks. The Parliamentary Women & Equalities Committee holding a wide-ranging enquiry into transgender affairs, and the noted feminist Germaine Greer facing the threat of a no-platforming at Cardiff University over her views on trans people. When she angrily pulled out of the event and launched an astonishing hate-speech diatribe on the matter there was none of the chorus of defence from feminist worthies we've come to expect, instead she finds herself a pariah, damaged goods.

    It's almost as though a switch has been flipped, and people are finally listening.

    Of course, it's not all plain sailing. One of the absurdities of the gender recognition system is laid bare as a trans woman sentenced to twelve weeks for assault finds herself heading for a male prison because she doesn't have a gender recognition certificate. After tens of thousands of signatures on a petition the latest news is that she's likely to be granted an appeal. The word is that she may escape a custodial sentence and have some form of community punishment instead. The Ministry of Justice is so anxious to dodge the prospect of a trans woman in a female jail without a gender recognition certificate that they're prepared to forgo the sentence altogether. Good news for her, but isn't the point of equality that we should be treated the same in all situations as anyone else? Shouldn't she just serve the time in a women's jail? I'm not sure "Embarrass the MoJ as a trans woman criminal, get let off" is a message I want to come out of this.

    Still, at least people are expressing outrage. A decade ago they'd have been a metaphorical pitchfork waving mob yelling "Burn her!".

    I await the Women & Equalities report with interest. I'm not holding too much hope though, as a friend once said to me: "Politicians take our rights away, we get them back in the courts".

Not my trans-inclusive space

    I had an interesting conversation with a friend earlier. I needed to talk about some things and I am extremely grateful to her for listening and offering her advice. The thing that made me think enough to write here though was incidental to our conversation.
    She invited me to a local womens group meeting. Which sounded rather interesting. However she cautioned me that as a trans person pre transition I'd be thrown out if I turned up without presenting female. Fair enough I thought, it's not as if presenting female isn't something I want to do.
    On my walk back home though I was thinking about the exchange. I have to admit I found myself not entirely comfortable with it. Both the exclusionary nature of the space, and the implied threat of what might happen were I not to meet some imaginary standard of femininity. It was not the intention of my friend who is a very nice person indeed to present the meeting in a bad light, but thinking about it I decided on my walk that perhaps it wasn't for me. There is something ever-so-slightly ridiculous about the idea that to a trans-inclusive gathering I am acceptable wearing a bit of lipstick, some not very large breastforms and a pair of slightly better-cut jeans while I'm not acceptable without the makeup or forms, and wearing some baggier jeans. Because after years of mild anti-androgens, beard lasering and hairstyling that's really the sum of the differences left between the two versions of me. I'm afraid even at my scruffiest I'm not what you'd call a blokey bloke any more.
    I appreciate that writing about this conclusion in a public space might not win me any friends. I hope it doesn't lose me my friend mentioned above, should she happen to read it. And I'll probably get a few angry comments from people who will maybe bring their preconceptions to the table without necessarily reading what I've written. It's not as though they shouldn't have a women-only space and it's certainly not as though I'd dream of trying to crash any meeting that wouldn't have me in a particular form. But I feel a space that wishes to be trans-inclusive should spend a while thinking what "trans-inclusive" really means, rather than saying "We'll include you if we think you look like we want you to".
    Maybe it's just me but I think only accepting people who look a certain way has been used to justify too many bad things over the years, so count me out.
   

I'm hopeless at misgendering

    I mentioned in my last post that I'd been to a panel discussion on transgender politics and being a better ally. There's one thing brought up during the evening that has been dwelling on me for a few days so I think deserves a moment's contemplation.
    The subject in hand was misgendering, and the audience discussion turned to one of calling it out. Unsurprising given that many of them were politically motivated students, they live to a large extent in a culture in which calling out provides a means of garnering kudos. Different causes from those of my student days, but plus ça change!
    I felt that something had been missed, namely that not all misgendering is malicious. People slip up, it's only natural. I'd be the first to hold my hands up here, I dread  the moments in which my brain tells me something automatically and I say the wrong thing. For me the danger comes when meeting transmen at the start of their transition before their T kicks in, my damn brain has so often had a "she" hovering about to be said without thinking.
    So if someone misgenders a trans person by all means tell them so, but hold on a minute before breaking out the big guns. There are two things to ask here: Did they do it deliberately, and how did they react afterwards? If they purposefully emphasised an inappropriate *HE* or *SHE* and responded with anger when politely corrected, then let them have it! But if they went red-faced and said something like "Oh shit, I got that wrong, didn't I, sorry", then smile and move on, next time they'll remember and get it right. It's never appropriate to make a scene unnecessarily, it doesn't make us any friends.

Dodgy docs and fail hashtags

    I can't say the last few days have been good for the cause of transgender medicine here in the UK. You see, the papers have picked up a story that's been rumbling along quietly for a while now, that of the General Medical Council investigating Dr. Richard Curtis, prominent trans man as well as the go-to doctor for private treatment of our condition. As I understand it there's the usual crowd of regretters claiming that they never wanted to transition really, and blaming their doctor.
    The news coverage has been predictably depressing. Short on news but long on sensationalism and outright transphobia, it's as though the Leveson Inquiry never happened. The trans community, seeing the whole debacle as something of a witch hunt against one of their own and reminiscent of the circumstances surrounding the departure of Dr. Russell Reid a decade ago, have reacted with anger. There's a hashtag on Twitter, #TransDocFail, which is full of the staggering ineptitudes and failures of duty of care felt daily by transgender people in the medical system here in the UK. It's depressing stuff, but it needs to be said as a response to the rather obvious misinformation on the subject.
    The trouble is, I'm not entirely comfortable with the battle lines here. I think there are serious shortcomings with the way transgender people receive medical help here in the UK and I've been happy to write about them here ad infinitum over the last few years, but my personal experience of the GIC system has been mostly pretty good. I've been unimpressed a couple of times by psychiatrists modifying their responses to me because of my background and occupation, but the fact is my course through the system has been exactly as advertised. And on the other side, I'm not entirely at ease with the haste with which some people I know have passed through the private system. The screwed-up ones in my experience tend overwhelmingly to have transitioned very quickly through the private route, and I can't help thinking less than eighteen months from hairy panty wearer to post-op is just a little irresponsible on the part of an attending doctor.
    So rather than black-and-white I see grey on both sides. Overwhelmingly though I see the most fault in the relative scarcity of professionals involved in our field and their concentration in a fairly small number of places. I can't help thinking that the best way to fix the #TransDocFail would be not to go after individual doctors or clinics but to broaden the availability of treatment over many more centres.
    Transgender medicine is not rocket science, surely it can't be that difficult to make it better!

Everything I've worked to avoid

    This morning's hot link in the world of trans people, in the UK at least, is this: "My Husband's Sex Change". A piece in the Guardian from the ex-wife of a now-transitioned transwoman about the process of change from the husband and father she once knew to the transitioner from whom she separated.
    Some of the language isn't what I'd prefer to see - "Sex change", how delightfully 1970s - but the Guardian lives up to its reputation for serious journalism by not sensationlising the story and using the words of the woman herself.
    It makes rather depressing reading to be honest. Of course it's only the partner's view, but she does not come across as quite so vitriolic as many I have encountered in her situation and it is possible to read between the lines.
    And I'm afraid her husband - "Tom" as he is described in the piece - comes across as a bit of a selfish arse. Read the piece and judge for yourselves, but I came away from it both angry and sad. Sad for her and her children, and angry that we have yet another depiction of us as selfish to contend with.
    Sometimes I have people within this sphere expressing bewilderment at my path. Reading the piece, maybe they'll understand. Not hiding anything and making sure my wife knows the trans community as I do means that while our relationship still has its turbulent moments we're still together and there is no deceit.
   One of the saddest parts of the trans experience is meeting people crippled by what they have lost. If that ever happens to me I never want to feel I didn't do my utmost to avoid that loss.

About two years.

    Just from curiosity I took a look back on this blog at what I was up to at this time last year. Bin-diving to save R's possessions. That was fun. Then a further hop, to this time two years ago.
    A question: "How long have I got?". Meaning of course: "How long before I can't take all this any more and can't go on any longer as a bloke?".
    You learn stuff, given enough time.
    I've learned that it's not a black and white thing. You can always hang on just that little bit longer, I've been doing it continuously for the last few years. And while I feel sadly a lot closer to the edge than I was a couple of years ago I've also had a couple of extra years practice at making it go just that little bit longer.
    All the same though, I can't help thinking that my answer back then was "About two years".
    Ah well, another year chalked up. My answer this time next year may or may not be "About three years", but I know for now I have to hang on.
    Just that little bit longer.

On the edge

    There has been something missing here of late.  Regular readers might have noticed their reading material has strayed into the mundanity of rural life and random political rants. This is a transgender  person's blog, so where's the tranny content, damnit!
    The answer's a bit complex. On a simple level I do not wish to simply churn out an endless transition diary or scorecard of the glamorous and exciting transgender lifestyle, whatever that is. In my view the best offerings from this sphere are those from bloggers who happen to be transgender, rather than those from transgender bloggers which can get rather stale.
    But on a more complex level there are issues that need to be confronted, yet that it is difficult to talk about. Things that involve my wife, for example. I feel that while I can talk about myself in specific terms it is unfair on her to talk about her in the same way in a forum on which she can not speak for herself.
    So what can I talk about. Guilt, I guess. All the walls, roadblocks and barriers behind which I've spent most of my life hiding have now fallen away. My wife has made it pretty clear that we'd both be better off were I to move forward. I can do it too, I'm confident in the world presenting as female. I shock myself with how well I manage at it. I don't have to deal with wigs or trowel on the makeup, I have an employer with whom I could transition tomorrow and nobody would bat an eyelid and I live in a place that's about as good as it gets to be transgender.
    Yet I'm hanging back from the edge of the abyss, scared even to peer over it.I've really tried these last few years to hang in there, to manage this condition and find a way to be the husband she deserves, and to move forward would be a betrayal, a failure and a waste of all that emotional investment.
    Some people write endless screeds justifying why they should transition. Maybe they need to convince themselves it's the right thing for them to do. I guess I've known for years it was the right thing to do and I've done the opposite, trying to convince myself that it's the wrong thing for me to do. That was a big waste of time, wasn't it.
    In January, I'll be seeing my specialist at the GIC again. By May I'll have been with them for a couple of years and they'll discharge me if there's nothing more they can do for me. So I have a few months in which I have to make up my mind. If I want to transition under their care then January is the time at which I have to start. Not the end of the world, for theirs is not the only path through this mess, but a pretty stark choice nevertheless.
    You see, if you are going to transition it has to be for the right reasons. I've seen enough people doing it for all the wrong reasons, caught up in the pink cloud, and I have no wish to emulate them. The pink cloud has long ago departed for me, but I need to have better justification than avoidance of a delay in the medical pathway. There is more at stake than just my path here.
    So there we go. I'm standing on the edge. I don't need pushing from either direction and surprisingly thanks to the help of my counselor and others things are pretty good all round, but I can no longer dodge the decision. I'm beginning to think it'll probably be a yes, but that's by no means certain.
    Strangely enough, that admission in itself brings a feeling of relief. Unexpected, that.

DIY endocrinology, now available on the NHS

    A friend recently mentioned that she has decided to take a short-cut, to self-medicate with estrogen rather than submit to the interminable wait for hormones through official channels.
    It's her choice, and on reflection I don't think it would be mine. Though I'd be happy if I could secure a hormone prescription before going full-time I'm at peace with the notion of an RLE requirement if that's what it comes to for me because I subscribe to the view that living as a woman is more important than  accessing any particular treatment. But she's at an advanced stage of desperation and who am I to judge her decision. I've made my views clear enough in the past on the whole sorry mess of self-medding becoming the de facto route into hormone therapy.
    Something she said made me take notice though, something I'd heard the same thing from others but had never before considered the implications. Her doctor is happy to give her regular blood tests to allow her hormone levels to be monitored, but is not prepared to give her any advice or referral based on those tests.

    That's right. We do endocrinology here, but you? You're on your own!

    It's understandable I guess, they stray into a huge legal quagmire if they offer official support for strictly unofficial use of medication. Sure, they are qualified and experienced to give advice on basic endocrinology even if they aren't world-class experts -  they do it every time a natal woman comes in for HRT, to name but one of many endocrine issues they face - but they need the endocrinology in question to be under their control to be able to do it properly. In offering the blood tests they're going out on a limb somewhat, doing the best they possibly can for their patient without exposing themselves to malpractice claims. Can't blame them for that.
    This is not a good situation though, because even though it provides the requisite information it still means the patient relies on DIY endocrinology. You'll probably have heard the DIY endocrinology line somewhere in this sphere, that endocrinologists just use a trial and error process to get the levels right and it's so simple anyone could do it. How dangerous a half-truth can be.
    I can't help thinking yet again that the whole situation is an unholy mess. A lot of transgender people seen to end up self-medding through necessity and though the medical profession frown on it they provide just enough help to facilitate it. But not enough help to enable the patient to do it in complete safety.
    Yet again I wish there could be a grown-up conversation on the subject. I see other clandestine medicine being provided without question - to drug addicts, or to teenagers needing contraception - and I can't help thinking that if it's legally safe for those kind of services to be provided then there must be a way for it to be so for endocrine advice to be given to a self-medder. I wonder whether the atmosphere of reluctance to do so comes from fear within the medical profession of a perceived rather than genuine legal threat.
    After all, there are people facing real medical issues because of this, and isn't fixing that what a doctor does? Can you be nicked for simply practicing your profession in that situation?

Advice to a young person

    I'm a moderator of a mailing list for transgender people in my part of the world. Today, I had a membership request from somebody self-describing as a young person with transgender feelings.
    We all want to help someone like that. We went through that, and it was awful. But we can't, because of course such a person is a vulnerable young person who really shouldn't be talking to people they don't know on the Internet. Child protection laws aside, it would be irresponsible of us to admit someone in that position, so the group has an age policy of 18 years old and over.
    Here's the mail I sent. I hope I hit the right note.

Hi
  Thanks for joining our group. I'm Jenny, group moderator.
I'm mailing you directly because you mention you're a young person.
Having grown up having to hide gender dysphoria I guess I know
something of what you are going through and I know just how confusing
and dreadful it all is. I think we'd all be very anxious to help
anyone in your situation to ensure you don't have to go through what
we had to.
However, because you say you're a young person we have to proceed
with caution before I can approve your membership. There are all sorts
of child protection laws to stop Internet predators and all kinds of
dodgy people who might take advantage of young people, and as well as
being highly irresponsible we'd probably be breaking some of them if
you are under 18. Though we're all pretty normal people we are after
all people you've never met, and I don't think any of us have the
background checks that for example teachers have.
So I guess I have to ask some slightly difficult questions.

First of all, are you 18 years old or older? If so, welcome aboard,
how can we help you?

If you are under 18, are you out to your parent or guardian? If you
are, we'd be only too happy to provide you with whatever support we
can, but only through them. Don't worry if you aren't out to your
parents, we understand that only too well. I was in my 30s before I
came out of the closet.

If you're under 18 and still in the closet then don't worry! We can't
help you directly for the reasons I outlined above, but there is an
organisation just for you. It's called Mermaids, and you can find it
at http://www.mermaidsuk.org.uk/index.html

The Mermaids support page is here:
http://www.mermaidsuk.org.uk/New%20Mermaids/support.htm

And their Yahoo group for transgender young people is here:
http://groups.yahoo.com/group/mermaids_uk/

I hope the above is of some help to you. I feel rather crap for having
to proceed with caution in this way for someone who needs the help I
wish I'd had when I was younger, but I hope the Mermaids people can
help you.

If I can leave you with a few words for a trans person at the start of
their journey, here goes:

(1)You are not alone. You'll find men and women like you are
everywhere, getting on with their lives and doing fantastic things.
You do that too.

(2)There are as many routes through all this as there are trans
people. There is no single path you have to take if you don't want to
or aren't quite ready. Choose the way you want to go and do it in your
own time. Being young you have the luxury of time to get it right. You
don't have to transition at all, but if that's what you end up doing
it's better slow and right than fast and wrong.

Good luck :)

Jenny

Please help my friend Rebecca

    My friend Rebecca is nearing the end of her diploma course, and she needs your help. As part of her research project she is researching the perception of some of the language and terminology you'll find in the DSM (Diagnostic and Statistical Manual). That's the document most of the world's medical profession look to for guidance on our diagnosis and treatment, so it's quite an important and interesting area of study.
    To gather the data for her research she's created an online survey, and she would be very grateful if as many of you could complete it as possible.

    You can find it here, at http://www.surveymonkey.com/s/LPMK35P.

    I'm sure she would also be grateful to any of you who could spread the survey to the widest possible audience, so if any of you are social media users please consider sharing it with your followers.

The fanny-wavers

(I deleted this post by mistake, this is a copy retrieved from Google Cache. Unfortunately I lost the comments that came with the post, sorry commenters!)

    An acquaintance of mine surprised me a few months ago, she disappeared off to London to have her GRS. Why a surprise? She'd never said anything about her medical history and I'd never asked her, so from her demeanour I just assumed she'd transitioned much longer ago than in fact she had.

    Good luck to her, as far as I am aware her recovery has gone very well.

    There is a significant group of transwomen though who leave you in no doubt by referring to their GRS in practically their first breath on meeting you. Whether they are fresh off the plane from Thailand or twenty years down the line, it's their only opening topic of conversation.
    I have to say, I find this to be rather wearing. It's Too Much Information, I simply don't want to know unless the conversation turns to GRS independently, in which case it's valuable to have another first-hand view. If I meet a woman it's usually safe for me to assume she has a vagina by myself, nothing needs to be said, it's unimportant. Natal women don't tell you they have a vagina on first meeting, at least if they are not the kind of natal woman who stands on street corners wearing little more than their underwear.
    I wonder sometimes whether I'm not reading the situation properly. On many such occasions the chances are I'm presenting as the scruffy bloke, so am I in fact being propositioned? After all, why else would a woman want to remind a bloke she has a (presumably available) vagina on first meeting? I was always very poor at picking up on such cues when I was younger, so maybe nothing seems to have changed. Since I'm happily married and in general the people who tell me they have a vagina are not my type anyway, perhaps I should prepare answers that let these ladies down gently while making it clear that I'm not available for sex.
    Sometimes though the conversation descends into the farcical. One such lady felt it necessary to inform me unprompted that she experienced ejaculation, something of which she seemed inordinately proud. I felt that saying "Why what a coincidence, so do I!" would not be appropriate under the circumstances.

It's all about the looks, innit.

    It's very unfortunate, but we live in a society obsessed with beauty. The goldfish-like attention spans of the media-sated are directly proportional to the bimbo-esque qualities of the dolly-birds piped into their living-rooms. The only place for the less beautiful lies in freak-show programmes, the Undateables, My big fat gypsy wedding, Super-size vs. Super-skinny. Or My transsexual summer.
    It was very interesting last year to listen to reactions from people outside the trans bubble to the MtF participants in MTS based on their looks. There were four MtFs on the programme, and to paraphrase the unflattering descriptions from outside the bubble: one was seen as pretty, another pretty but used far too much makeup, the next had a disastrous wig and the last was seen as still having something of the bloke about her. The last woman was furthest along the path of transition, yet it was sobering to hear people unconsciously refer to her as "him". Not through malice, just thoughtlessness and ignorance.
    Pretty strong stuff. And I think it's time we all admitted it, we all looked at their appearances too, whether we judged them by it or not. The phrase beloved of comedians "You were all thinking it, weren't you!" springs to mind.
    I'm writing this because I've observed a reaction somewhere else in the trans community to one of our number. I'm not going to go into detail because it would be unfair on her, but she's very talented at what she does. She's also pretty, I believe she was lucky enough to be able to transition young. I find it unfortunate that I am seeing praise being heaped on her from within the bubble for being pretty, rather than being clever or doing what she does.
    If we don't liberate ourselves from the beauty obsession, what hope have we for those outside the bubble?   

That's the trouble with partners of transvestites...

    "That's the trouble with partners of transvestites, they can be such a problem".
    I looked at the speaker, slightly shocked. Dawn, our host, widened her eyes in disbelief. I wasn't that bothered at being called a transvestite even though we were talking about my progress through the GIC. That was par for the course from this particular source. But calling my wife 'a problem'? She was extremely lucky that my wife wasn't there to hear it
    I should have expected it. Not many years ago the speaker was a bloke in his mid fifties. Older then me, with wife and grown-up kids. Since then she's transitioned and reinvented herself with a rather preposterous back-story ignoring a hilarious number of inconvenient truths. Now she's married again, to an inoffensive transvestite who she's banned from dressing. The hypocrisy meter is on overload.
    Quite simply she's the most deluded trans person I've ever met, and that's from a pretty strong field.
    Hers is probably the most blatant example I've encountered, but I've noticed a consistency among a significant section of our community in forgetting where they came from.It's simple and self-evident: if you are an MtF trans woman then you too once had a life as a bloke, and probably a depressed one at that. No shame there, after all, you've escaped him, well done!
    The reaction of such people to those among our community who still have something of the depressed bloke about them is very telling. People who are secure in their own skin do not react in such a way. I'm thinking in particular of another acquaintance, a rather pretty early-40s transwoman with a slight, feminine build who is paranoid about those around her outing her to the extent that she outs herself by drawing too much attention her way.
    It's funny, I have another acquaintance who is a full-time TV I would judge to have something similar to the sexuality of a gay man - tried hormones, but I suspect gave them up when her bits stopped working. My two acquaintances above are a lot more at ease with her than they are with me, it's possible that people like me remind them too much of where they came from.
    How people behave is up to them. But I have evolved a very short fuse on these matters. It's easy to damage a trans person pre-transition, we're a vulnerable bunch. I'm happy to be friendly and supportive to anyone I meet in this community, but if I'm likely to be damaged by their actions then I'll drop them like a hot potato and make it very clear why I have done so. My store of second chances is exhausted.

Self-medding: time for a grown-up conversation

    "If I was starting transition now, and knew what I know now, I would self medicate. Absolutely no question".
    I read this quote a while back, referring to the practice of self-administering hormone treatment without any prescription. It came from someone well-known in this sphere whose stance I respect a lot. And it struck me, how unusual it is to see someone saying something like that in public, online for all to see.
    You see, what normally happens if someone mentions self-medding on the internet is this: they are drowned out by a chorus of people anxious to point out that it's generally frowned upon, all sorts of nasty things can happen to you if you do it, it's illegal, it'll affect your future treatment, etc. etc. If the mention happens on a moderated forum or mailing list there's a good chance it'll be deleted too, because We Don't Encourage That Sort Of Thing.

    Y'know what? We know.

    We all know self-medding is a risky business, we don't need to be told again and again. What we do need within this community is the chance to talk about it in the open, because stifling any attempt to do so is stopping a conversation  in this community that both we and our medical practitioners need to have.
    My local psychiatrist surprised me a while back when he told me that as many as 80% of his patients self med with hormones they've bought from the Internet. I knew a few people who were open about it, but never realised it extended to that many of us.
    So, just out of curiosity, I asked a few friends. Got some funny looks, but assured them it was only for intellectual interest. My wife would not thank me for self-medding and I don't want to lose my fertility just yet, those are pretty good reasons not to do it if there weren't plenty of others.
    I was reminded of a 1950s British film in which one of the protagonists - a terribly respectable middle-aged lady author - goes into a seedy pub to try to buy a Mickey Finn to incapacitate her blackmailer. She ends up trying to buy one from a man who turns out to be a policeman, saving herself only by claiming to be researching for a book. "Pssst - Where can I buy some Estrogen?".
    If you ask people why they self-med, it always comes down to the gatekeepers. The medical profession don't make it easy for us to get our hands on the hormones for many very good reasons. Aside from the need for safety under medical supervision there are some people who seek hormones for whom they are an extremely unsuitable treatment. There are many arguments passionately made as to how the doctors could speed up their service and how their attitudes could be updated, but why they work the way they do is entirely understandable and in the best interests of their patients as they see them.
    The trouble is, in doing this it seems from this viewpoint that the gatekeepers encourage self-medding. This isn't a tacit encouragement, but it happens in two ways. By raising the barrier to legitimate prescription they increase the incentive to simply bypass them. Thus they simply never see a great swathe of non-transitioning self-medders who don't need their other services. Then when they do encounter someone who self-meds their concern is to get them onto a safely prescribed dose as soon as possible so they forgo the usual RLE test before a prescription is issued. This encourages people at the start of transition to self-med while on the waiting list. I have more than one friend who has done just that, and I believe the quote at the start of this piece referred to it as well. Why spend an uncomfortable period as a bloke in a dress when you can hit the ground running?
    This relaxation of the RLE requirement has a rather iniquitous parallel. Those patients who self-med are rewarded with a fast-track, yet those patients who present to NHS clinics having obtained legitimate hormones by private prescription seem to be required to come off them and serve the full RLE without hormones. I have personally encountered more than one person who has experienced this, as well as a couple of well-publicised people in the blogosphere. The dichotomy between a reward for dodgy hormones and a punishment for legitimate hormones is startling.
    (Edit: Following clarification of the legal position in the UK, removed paragraph relating to dire punishments for those importing hormones. My source turned out to be wrong. It seems it's illegal to import testosterone in some circumstances but not estrogen. Well, those of us on the MtF side of the fence know testosterone is the dangerous one! :) )
    I wonder if I'm alone in thinking the situation I've outlined above is a bit of a mess. A mess without clear fault or solution at that. It's difficult to fault desperate people for self-medding, equally you can't blame doctors for doing their job, however frustrating it might seem at times. But if it's a mess without a solution, one thing definitely makes it more of a mess. The self-censorship within our community whenever the subject comes up isn't helping anyone.
    I'll repeat the point I made in the title of this piece: it's time for a grown-up conversation about self-medding.

They say getting to a GIC is a long road...

    In a couple of weeks I'll be off up to London again, this time to see the GIC counselor. For me that means about an hour on the train, followed by about an hour's walk across the park and through Kensington. I'll be back home by lunchtime, back in work for the afternoon.
    Note, I'm not complaining about my journey. Because mildly annoying though it is, compared to some of the patients I'll be sharing the waiting room with it's quite short. For me the GIC is almost local by comparison, even though my train ticket has just cost me about thirty quid.
    The NHS can be a little unexpected in its organisation at times. For most ailments that need more than a GP's input you'll be taken to a local general hospital for treatment. You'll be seeing a specialist in your condition, but in the same building there will be specialists in all conceivable medical disciplines. Oncologists, ENT specialists, heart specialists, urologists, the list is endless. Including unsurprisingly, psychiatrists like my local psych who referred me to the GIC and endocrinologists like the one who keeps a yearly eye on the blood of all my local trans friends.
    Some ailments, gender dysphoria among them, are seen as specialist beyond the limits of what the general hospital can offer. For these you'll be referred to a specialist regional clinic like the GIC. Each local healthcare trust has a contract with a GIC, and sends its gender dysphoric patients to that GIC.
    So far so good, you say. But here's where the unexpected part creeps in. There is nothing that dictates which GIC your healthcare trust has a contract with, so while you might expect to be sent to the nearest one in fact which one you are sent to depends on the postcode lottery of who your trust decided to contract. Thus while I only have to travel an hour for my appointment the lady sitting next to me in the waiting room might have come from the far north-west of Wales, and had to spend the night in London to make her appointment.

    Just to satisfy my curiosity I created a map of the UK showing the location of the main GICs overlaid on population data from the Guardian Datalog. It's not comprehensive as there are some small-scale single-practitioner operations I omitted, but it gives a pretty clear idea of the distribution of services for gender dysphoric people across the country. (Please tell me if there are any I have missed!)
    Straight away you can see that the distribution of GICs is not even. Exeter, Glasgow and Norwich have clinics because they serve far-flung points of the country, but does the concentration of GICs from the north-east Midlands through Yorkshire to the north-east of England really represent an unusually high regional demand in those regions? That a huge swathe of territory including Birmingham, the Midlands, the north-west, the west of England, and Wales have no GIC services seems to go against the overwhelming evidence that there are just as many trans people in those parts as there are in the well-supplied north-east.
    Does it really have to be this way? I sense this situation evolved because years ago there were relatively few of us who weren't suffering in the closet. The chances of a local psych or endo having any experience of us was nil, so it made sense to centralise the facilities. But is that still the case? I know my local psych and endo have both seen a large number of trans patients and I doubt my city is significantly different from any other of equivalent size. It makes sense for me to take an hour's train ride to the GIC, but for the patient from North Wales would they not be better served by seeing a more local trans-experienced psych or endo rather than spending a fortune and traveling hundreds of miles to see one in London? I can't help thinking someone's missing the rather obvious here.

Trans Conversation Bingo!

    So there we were. Last night, in a Chinese restaurant. My wife and I, our friend B, and about twenty varying trans people of all hues. A local gathering, nothing special.
    The conversation at various points in the evening was sadly predictable. Cars. Bikes. Aircraft. You know, Girly stuff. I'm sure as the owner of a Wreck I've been just as guilty as anyone on that front at times, but this was getting out of hand.
    B and I started playing Trans Conversation Bingo. Collect the set of predictable conversation topics and win!
    At some point, someone suggested it would make a neat mobile phone application, and on that thought I sat down this morning and set to work with the ever-flexible jQuery Mobile.
    You can try the result below. Follow the link in your browser, or scan the QR code into the browser on your internet connected mobile phone. And score the next trans get-together you attend, after all it could be your turn to triumphantly shout "Bingo!".

    It should work on most modern smartphone platforms as well as desktop browsers. You'll need Javascript, and server-side rendering browsers such as Opera Mini might make a meal of it, but give it a go and see how you get on. Just remember one thing though: this is a joke application, don't take it too seriously.

    Try the application at this link: http://goo.gl/uhxYp or scan the QR code on the left.