I'm now approximately two
and a half years into my transition, and so have decided to put together a
transgender survival guide to help others contemplating transitioning or
struggling with gender-related discomfort. Please feel free to share this with others.
Disclaimer: it is both rather long,
by necessity autobiographical, and aimed primarily at other female-to-male
transsexuals, though I hope it'll be helpful to other transgender people and
their friends and families. It will hopefully also be useful to those wanting to learn more about transgender issues.
What
does 'transgender' mean?
'Transgender' is an umbrella
term for a variety of experiences, from people who occasionally choose to
cross-dress for pleasure or comfort (some use the term transvestites), to
people who feel they are both male and female, neither of these, beyond gender
or who experience gender as fluid (gender-queer), through to people undergoing
social, hormonal and sometimes surgical gender reassignment or affirmation
processes (transsexuals).
When we're born, we're
assigned as 'male' or 'female' based on our genitalia (intersex people are
those born with both male and female genitals or ambiguous genitals), and it is
assumed that this decision based on these primary sex characteristics (biological) reflects the person's inner
sense of who they are, the ontological.
As we make culturally-grounded assumptions about how to treat someone and
what's considered 'typical' or 'normal' behaviour based on the biological, this
profoundly impacts the social aspects
of our lives. Most of the time, the biological and ontological match up and
there's no problem, though we may struggle with prescribed gender roles.
However, around one percent of the population experience some degree of mismatch
between the biological and ontological, which causes distress and leads to
social assumptions being made about them which don't match up to the person's
sense of their gender identity. This sense of discomfort, dysphoria, is called
Gender Identity Disorder.
Check out this TED talk by comedian Sam Killermann if you want to think more about what gender, gender
identity and gender roles are all about; it's very funny yet draws out the
complex ontological, biological and social aspects and their interplay.
What
causes gender dysphoria?
The GIRES website
is very good if you want to learn more about the causes of transgenderism.
No-one's one hundred percent sure, but it's thought to be caused by hormones in
the womb not doing their job around the eight-week point when the foetus goes
from having one sex chromosome (the mother's X) to two as the father's X or Y
kicks into action. The body develops in one way but the brain in another,
giving rise to gender dysphoria through there being a body-brain mismatch. One
legacy of it having previously been understood as a psychological problem is
that getting treatment means negotiating mental heath services.
How
do you know things don't match up?
Like a lot of transsexuals,
I realised at a young age that something wasn't right. Starting primary school
was the first time I'd been around lots of other children, and I couldn't
fathom why I was being told to dress like a girl, play with the other girls and
act in a 'girly' way. It was profoundly distressing to me, and I think it's one
of the main reasons I acted up a lot during my first months there; I didn't
have the language to express what was going on, but felt it acutely. These
feelings persisted, though being and looking incredibly tomboy-ish, and being able
to 'pass'/'be read' as a boy if I wanted to, helped a lot. I used to like
writing stories and illustrating them, and my little imaginary worlds were
exclusively male domains. My cuddly toys were also all male, and apparently
when presented with a doll on one occasion, it got banished to the wardrobe
without a second look! I shrugged off criticism from teachers for not being 'ladylike'
enough, and things weren't too bad.
However, when I hit puberty,
things changed. I went from being flat-chested to a DD cup in little under a
year, which meant I could no longer pass. Periods made me feel dirty and felt
fundamentally unnatural. As I got older, I experimented with cross-dressing in
the privacy of my bedroom, and the rush that gave me was both almost orgasmic and
very confusing. I eventually came to the conclusion that there was something
wrong with me (I had never even heard the word 'transgender' before, nor had
any idea that there are others who felt like I did), so I determined to bottle
these feelings up and repressed them deeply for a long time. In the fullness of
time, though, with the support of my now wife, my friends and my then boss, I
felt I could both acknowledge who I am really am and begin the process of
transition, so that the biological
will finally reflect the ontological,
which will in turn mean the social
reflects the ontological.
My story is not unusual;
while some children do experience the kind of confusion I did when younger but
things settle down as they get older, for me the discomfort stayed and it's
only through transitioning that I've found any relief. Others begin to
experience gender dysphoria in adolescence and others in adulthood. For some
people, their feelings can be relieved through things like binding their
breasts or selecting hair styles and clothes that give them a more androgynous appearance,
For others, hormone treatment alone does the trick, and some may opt for
surgery but no hormones; others like me go for both. It's important to stress
that everyone is different, and pushing people down a route that isn't for them
is wrong.
If you want to learn more
about gender dysphoria and hear some other people's experiences, check out this page from
the NHS website. There's also an excellent series in the Guardian by Juliet Jacques,
who is a male-to-female transsexual, and it details her story from starting out
to recovering from her surgery.
Could
you not have just had counselling?
Nope! This has been tried in
the past and caused a great deal of damage to many people. I did have some
counselling around three years ago, but that was to help me deal with my fears
about coming out as transgender and how people would react. There are world standards of care for transgender people which make it
very clear that the best way to help transgender people relieve their gender
dysphoria and feel comfortable in their bodies is by offering options for
changing outward appearance in some form, perhaps as mentioned above through
clothing and other external choices, or perhaps by hormones and/or surgery if
that is right for that individual.
What
did you do about it, then?
Well, not having the
faintest idea where to start, I did some asking about among my friends in the
LGBT community (before I came out as a transsexual man, I identified as a
lesbian) and came across a local trans activist called Delia. We had lunch and
she talked me through what was involved in the process of transitioning and the
good and bad things about how the NHS handles it all. This did scare me
somewhat, as many people have had bad experiences of the NHS, but I think has
made me a lot more realistic about what the process involves and what I wanted
to get out of it.
I decided to tell the outgoing boss of my team at work, on
the basis that if he reacted badly, he was leaving anyway! As it turned out, he
was great and suggested that his successor would be a great person to support
me. I then spoke with the equalities person in HR, and between the three of us,
we put together a plan to 'manage' my coming out. Around that time, I decided
on a new name, Karl, and began to use it with my partner and certain close
friends. In February 2012, I began negotiating the NHS 'care pathway', and came
out at work and changed my name by Deed Poll a month later.
What
about negotiating the NHS pathway?
The NHS refers to the
treatment options as a 'care pathway', which sadly still strikes me as a bit of
a misnomer, as the early stages at least seemed more diagnostic than caring. The
first step was going to see my GP and asking to be referred to the local mental
health team for an assessment. I think the need for a local assessment might
vary from place to place. I'm also not sure whether for younger trans people,
the first stop would necessarily be the local Child and Adolescent Mental
Health team. Either way, I was pretty scared before my GP appointment, and
wasn't sure how he would react to me; others have had bad experiences at the
hands of GPs who don't understand trans issues or have shown blatant prejudice
(if this happens to you, insist on your right to see another doctor). While he
admitted that, like the majority of GPs, he'd never met a trans person before,
he was supportive but needed telling what to do.
This highlights one of the
problems I've found with the NHS - you have to be an expert patient. I went
into the surgery that day - by the way, book a double appointment - armed with useful
leaflets I got from the GIRES website,
which explained what 'transsexual' means, what treatments I needed and what my
GP needed to do to ensure the funding was put into place for these. Things have
improved considerably in England in the last couple of years, in that the money
now comes from NHS England, rather than the local Primary Care Trust, meaning
someone transitioning is no longer tired down to one area while they go through
treatment, which takes a number of years. Anyway, this meant I could give him
some bedtime reading to do, and not have to worry about chasing up funding
myself.
One thing the NHS isn't very
good about is helping with the practicalities of everyday life in the
intervening period before treatment starts. As there is a requirement (the 'real
life experience') to live in one's preferred gender role for at least six
months to a year before beginning hormone treatment for adults (see below for a
note on teenagers and hormone blockers), this can create problems. I mentioned
earlier that periods were very distressing for me; I asked for female
contraceptive injections that would stop (or at least notably reduce) my
periods at that same appointment. Annoyingly, I got passed onto a female GP who
couldn't get her head around things and gave me a lecture on safe sex (despite
my saying I have a long-term female partner), but I got them nonetheless. I
needed to be the one asking for this; my GP wouldn't have thought to suggest
it.
Getting through the local
psychiatric assessment was pretty straightforward; I got grilled on my
childhood and past relationships, as well as how the people around me were
handling things. I think it helped that I come from an academic background and
had already been grilled by supportive people with a knowledge of the issues,
so I knew what was coming and didn't feel intimidated by the doctors. This
highlights another issue: being educated and middle-class really helped when
dealing with certain medical professionals. An acquaintance of mine, who found
it harder to express what he was feeling, got quite a bumpy ride from the same
people. One tip, therefore, would be to talk over how you feel with people you
can trust and work out what you want to get across beforehand, so you can be clear
and articulate. Be ready to be asked about some difficult things, and for it to
feel like being put through the mill if the conservation goes to places you
normally keep closed off; exercise judgment in what you say, and be gentle to
yourself.
Eight months later, I
finally got my first appointment at the gender clinic. Where you get sent will
depend on where you live; I got sent to Charing Cross, which deals with London
and surrounding areas. There is a useful list of the different clinics on the NHS website. Two psychiatrists have to agree on a diagnosis and the
appropriateness of treatment, as well as one meeting the real-life experience
requirements, to allow hormone treatment to commence. The questions were the
same, but the tone was different. It came across as someone with a checklist
and an agenda, and at times I felt pushed into simplifying my story and
omitting certain things. For me, it's one of the problems with this model of
treatment; the gender clinic staff are the gatekeepers of further treatment,
and the resulting power dynamic, together with time constraints on the staff,
can create tensions that might hinder honest conversations. I got past these
hurdles, and started taking testosterone gel in September, and was referred for
chest surgery at the same time.
Word of warning: Charing
Cross have the worst administration of any organisation I've ever dealt with! I
was supposed to take one 50mg sachet of Testogel each day, but was initially
told once a week thanks to a clerical error, which is a bit of a difference -
I'd wondered why it wasn't doing anything! I've also had to do a lot of chasing
up if I've needed anything from them, such as help getting my hormone balance
right. They also don't seem to have discovered the 21st century and e-mail
seems quite beyond them!
How
did you handle coming out at work?
As I've already outlined, my
coming out at work was helped by having a supportive boss and HR department. Having
already come out as gay, I was acutely aware of the differences; in one sense,
nothing changed when I announced I had fallen in love with a woman and being
attracted to women was part of who I am. This time, my name and the pronouns
I'd be asking people to use would change, along with my appearance to some
extent, though I'd long since given up any pretence to feminine dressing and
wore a suit and tie to work. I was also nervous because people have been
hounded out of jobs, and unemployment among transgender people is historically
higher than among the general populous. Having the support, therefore, was crucial to
my sense of well-being during this time.
I work for Santander, and
the equalities person from HR hadn't met a transgender person before, so once
again I found myself having to be the expert. This guide for employers from
Stonewall Scotland was particularly helpful. Again, though, what made this a good experience was
the willingness of others to listen to my story and do their research to figure
out how they could help me negotiate coming out. It was a pretty rocky time as
my partner and family struggled to accept what was happening, and my boss
really went above and beyond the call of duty in supporting me and keeping me
on the rails during that time. When I'd seen my GP and felt ready, my boss was
with me when I told my team, and then she told the rest of the department on my
behalf so I didn't have to, which made it a lot less daunting prospect. HR had
already sorted things so I could have a new e-mail address with my new name,
and when I'd done the Deed Pool, I formally changed my details on the payroll,
with my bank and other companies.
What
about people in schools, youth groups and so on?Again, Stonewall Scotland have some great resources for schools which provide advice on how to support transgender students, and there is a useful guide on the GIRES site for youth group leaders on making their group trans-friendly. There are also organisations like Gendered Intelligence which offer workshops for schools, resource-sharing sites like Schools Out, and many LGBT youth groups around the country. In my experiences and sadly that of countless others, being different in any way can make school a thoroughly shitty experience, and while I've not always got on too well with trans support groups, they can be a lifeline for both the person themselves and their families. It may well be worth having a trawl online and seeing what you can find, and there are some suggestions below. There is a Home Office guide on dealing with transphobic bullying that schools can access easily and should be putting to practice.
How
do you change your name?
I used Deed Poll, which is
one of two options; the other is to make a statutory declaration. People have
gone for cheaper options and been fine, but I used the site linked to on the
Passport Office website. It cost me £50, and involved sending for the form online, getting it
signed and witnessed and then sending it back to get the final certificate. I've
had no problems with using it to get a new passport (along with a letter from
my GP saying the change is permanent and my gender identity is stable), or
updating bank accounts, National Insurance and tax details, and so on. To
change the gender marker on some paperwork (such as getting a new birth
certificate) requires a Gender Recognition Certificate - see below.
Coping
with everyday life: Friends and family
Telling friends and family
is one of the most difficult bits of the journey in my opinion. As I've already
hinted, it was hard for my now wife to come to terms with, as much as anything
else because it created questions of identity for her: can she still be a
lesbian if she's with a man? (Answer: of course!) My parents seemed alright at
first and then exploded later when the reality hit them. Over time, things have
got better, and in their own (unique) way my mum and dad now are great about it
all, but they still find it a struggle. Some of my relationships with other family
members have become strained, as they won't use Karl and misgender (refer to me
as female) me constantly. That hurts like crazy.
Thankfully, things have been
much more positive in terms of my friends; a couple of people did walk away,
but everyone else has been really supportive, which has made such a difference.
At our wedding last year, people I hadn't seen since I started transitioning
came, and their acceptance of me just as I am was one of the things that made
it such a special day. Work being safe has also helped, and I've not had any
problems making new friends, in both professional and other settings, as a
result of my transition.
One thing I hadn't expected was
that some people, notably my partner, expressed a sense of grief when I started
transitioning. They felt they were losing someone they cared about, and I found
that incomprehensible at first, because for me it was a liberating experience. Having
to be honest with each other and deal with painful stuff, as well as find
language for what we were both experiencing, has brought my partner and I
closer together, but has been very hard, with lots of tears shed along the way.
It doesn't help that the NHS process focuses on the person, but there's not so
much there for partners and family, especially if formal support groups aren't your
bag. Thus, finding someone your partner/parents/other family/friends can talk
to, who isn't you(!) about their feelings is important, in helping them come to
terms with what, after all, is a big change.
On a related note, one thing I've learnt really helps is having people about with a bit of knowledge of the issues who are willing to listen, ask the hard questions and give hugs when they're needed. For me, one of those key people has been my minister at church, who is also a GP and has supported trans people before. She both helped me get to the point where I was ready to transition and dealt with curious questions from people in the churches I worship and lead worship in, meaning this part of my life (being a Methodist local preacher) has been able to continue perfectly happily since coming out. In addition, she led a naming ceremony for me in church when I wanted to reaffirm my commitment to God but use my new name, whereas when I was confirmed and first made that commitment, it was in my old name.
Coping
with everyday life: Language and pronouns
Getting the language right
is something that is very important, but can be hard for people. It takes time
for people to change to using 'he', 'him', 'his' and so on, when they've been
used to the female versions. Other people prefer 'they' or other neutral terms,
and that seems to be quite beyond a lot of people to get right! One of the
hardest things I found in the pre-hormones period was trying to live as a man
but still sounding and looking female. It meant that even after binding my
breasts and wearing a suit and tie, people got it wrong. Places that were very
keen to affirm and welcome gay people were the worst - I think they assumed I
was a butch lesbian! It's irritating, but you have to be patient with people,
as it's very rarely borne from maliciousness. Now my voice has broken, things
are a lot better, but it does take time for people to adapt to new language. Check
out this TED guide for more on use of language.
How to talk about my past is
another question that arises: should I be open, or just not say anything that
could give away that I'm a transsexual? It's a complex question, with
implications for people around me too, which I've not fully resolved yet. For
example, can I talk about childhood or teenage experiences that I wouldn't have
had if I hadn't been assigned female at birth? I think each person has to make
their own mind up on this one, and so far I've chosen to be open most of the
time. However, there are situations where that can make life awkward, and I
don't know what I'll do beforehand. As an example, I was asked while on a
church placement about when I got married and whether it was in church. I
really didn't want to go into the complexities and avoided the question, but
other times have told the person what the deal is, so it depends on the
situation. Perhaps ask me again in a year's time on this one!
It helps that my
relationship has survived the process, so I've not got the complexities of
dating to deal with. The only thing I would say is that I'd hope that, if
something happens and I end up single again, I wouldn't want to have sex with
someone I couldn't trust to tell I'm transgender. If they couldn't handle that
or insisted upon thinking of me as a woman, I'd be out of there!
Coping
with everyday life: Binding breasts safelyI started binding my breasts after coming out, mostly because I was worried about how to do so safely. I'd met people who use elastic that binds so tightly it restricts breathing and causes pain, which is obviously not good. I'd also come across full upper body binders, which given I'm a tad on the larger side seemed a recipe for sweating and discomfort. In the end, I settled on sports bra-style chest binders from a company called Peecock Products, which had to be shipped over here and cost around £30, but which when worn with a bra underneath provided a good degree of binding and gave me a much flatter chest, but still left the area below my breasts free to breathe. They didn't work for me without a bra; my breasts fell out! One of the disadvantages of wearing this was that the bottom curls up sometimes, and can crease shirts and other tops. They do show through some clothes, but I reckon just look like you're wearing a vest.
The important thing with
binding is to do it safely. I met a trans man who bound his breasts day and
night for years, and did so that tightly that he hyperventilated when he took
the elastic off, because his lungs weren't used to so much air! As a general
rule, if you're struggling to breathe or in pain, you're binding too tightly.
Once I got used to the new binders, I found them really liberating, as having a
much flatter (though there's only so much you can do with DD cups!) chest gave
me the confidence to use the gents' toilets rather than the disabled loo, and
to feel confident challenging people about using the wrong pronouns. Binding
reduces breast size over time, so one's chest appears less feminine as a
result, though having squashy breasts might be off-putting for some people. The
downside is that even with ones that don't cover the whole chest, they do trap
a lot of heat and can be very sweaty and itchy in summer.
Coping with everyday life: Toilets and other gendered spaces
Negotiating gendered spaces can be tricky at first, especially in the period before starting hormone treatment. I'd never considered how difficult going to the toilet could be before beginning transition. One thing to make clear is that you're entitled to use the toilets of your preferred gender or the disabled facilities as you feel comfortable; if someone tells you it's illegal then they don't know what they're talking about. In my experience, I didn't feel confident to use the gents at first, so I used the disabled loos wherever I could. This was hard in some places like some pubs, as it required having a RADAR key and I didn't want to have to explain to the people behind the bar why I wanted to use that toilet and not one of the others. It meant knowing where I could go that was nearby, or simply avoiding certain places. As time went on, I got more confident and started to use the gents regularly at work, and later in public places that felt safe.
Over time, this has got
easier as I have been binding for a while and my breasts have shrunk, my
appearance is more masculine and my voice has broken. However, changing rooms
haven't yet become any easier, as when I take off my clothes I still have a
female-appearing body, meaning using the gents is out, but the hormones have
made me rather hairy, and especially with a deep voice, it means I can no
longer just use the women's changing rooms and keep quiet about my gender
identity. When looking for a gym to join, therefore, checking out the disabled
facilities was important, as was letting the staff know the situation and that
I would need to use these. I mention this as my gym has a notice on the door of
the disabled changing room telling people it's just for wheelchair users, so it
helps if they are aware in case, as has happened to me once, someone takes
offence to you apparently breaking the rules!
Coping
with everyday life: ShoppingOne situation that can become more difficult when transitioning is shopping, not least because there's another changing room situation to negotiate, and while some stores have gender-neutral changing rooms, many don't and that can cause problems. Once, I was shopping for a new shirt and got told I couldn't use the men's changing rooms, so reluctantly went to the women's section. They told me they wouldn't let me in with a man's shirt. H&M lost £30 worth of custom that day! My worst experience was in BHS in Milton Keynes; I went into try on some short-sleeve summer shirts for the office, and after my experience in H&M decided to use the women's changing rooms. The women minding them reported me to security as a potential shoplifter, and I was then followed around the store! Again, as time has gone on, things have got better, partly because I 'pass' more readily and partly because we've found shops that are more transgender-friendly. House of Fraser, Marks and Spencer's and Hawes and Curtis in Milton Keynes have been great for clothes, and Schuh and Doc Martens for shoes.
Another issue that arises
for me is to do with sizes. I'm 5ft 2 and have proportionally short arms and
small feet! This means I have to get shirt and jacket sleeves shortened, and
because most places stock men's shoes from size six upwards and I'm a size
five, I buy gender-neutral shoes like Doc Martens. I did try junior shoes, but
they looked like they were for kids, so wouldn't really work on a thirty-year
old! Finding a place that will do clothes adjustments can really help,
especially if like me you work in a professional occupation and are expected to
dress smartly. Learning what your size is when you start transitioning can be
tricky; be willing to do a certain amount of trial and error until you get it
right, and don't be afraid to ask for things in smaller sizes if you need them.
Coping
with everyday life: Getting hassled
Sadly, being perceived as
'different' in some sense can put one at risk of harassment when out and about,
and as transgender people challenge people's often rigid ideas about what is
socially acceptable for males and females, simply by being ourselves and not hiding
away, we often come in for more than our fair share of hassle, particularly
trans women. I think my experience hasn't been too bad partly because I've
often been viewed as simply a butch woman, and there's far more freedom for
women to appear masculine then men to appear feminine in our society, something
I think it is bond up with misogyny, homophobia and transphobia intersecting.
However, I've nonetheless had to develop a thick skin.
Just to tell one story to
illustrate: I was out for a lunchtime walk in Regent's Park, which is near
work, a few weeks ago and wearing a suit and tie. I thought I looked pretty
dapper for what it's worth, and was just enjoying my stroll. There are some benches
by the lake, and that day they were full of French school kids. The children on
the first bench pointed at me, laughed and started loudly speculating about my
gender, which encouraged all the rest to do the same. One lad openly stared
open-mouthed at me, and then nudged his friend and got him to do the same. I
felt like a zoo exhibit! I've also had abuse (both homophobic and transphobic)
shouted at me, been threatened and pushed about, chased and spat at, and one
guy tried to punch me in a pub toilet. Thankfully he was drunk and he missed,
but it was scary.
If you do experience
harassment - verbally, physically or sexually - then please do report it rather than suffer in silence. Most councils have hate crime officers, and the
police do want to help in my experience. It may help to get to know officers
working with the LGBT community, as they've had specialist training in things
like transgender issues. In Milton Keynes, we've built up good links with
Thames Valley Police, and they've sent officers along to community events such
as Pride and the Transgender Day of Remembrance. Employers also have a duty
under the 2010 Equality Act to deal with discrimination against transgender
people, and it is illegal to fire somebody for intending to, going through or
having been through gender reassignment; it's worth getting to know your rights.
What
about teenagers and hormone blockers?
Hormone blockers can be very
useful for teenagers, in that they can stall the process of puberty and give
the young person breathing space to work out what (if any) treatment they want
to have as they get older. If you want to learn more, check out this guide on the GIRES website, or have a look at my previous blog post on the subject. Additionally, there is a great TED talk by Norman Spack, who has helped young trans people for years, which is about
hormone blockers.
What
happens when you take testosterone?
After negotiating my way
through the NHS system, I eventually started taking Testogel at 50mg once a
day. I began in December 2013 and have noticed significant changes, despite
transitioning with gel being slower than injections. I'm scared of needles and didn't
want the aggression after an injection and the gloom in the run-up to the next
one. The most notable change is that my voice has broken, and after going
through a phase of being squeaky, has settled down to a nice, deep tone. It
does crack and squeak still while singing, so someone concerned about this
might want to do voice exercises like singers do a little more diligently than
I did! This has been really liberating for me, as now I don't get misgendered
over the phone or anywhere near as often in person, and I feel more confident
in handling gendered spaces and social situations.
Other changes have thus far
included development of muscle mass, particularly in my legs and shoulders,
increased stamina, growth of body hair on my legs, arms, back, chest and
shoulders, the beginnings of facial hair, being more (but not hugely more)
short-tempered, increased sex drive and an enlarged and more sensitive clitoris,
increased sweating and spots. I think my face looks more masculine, and my skin
is a bit tighter around there. The spots have been easy to deal with, but the
sweating harder. I occasionally get hot flushes, and feel like a teenage boy
crossed with a menopausal woman! My periods had stopped but have recently
restarted, which has been quite distressing, so it evidentially takes time to get
the level of testosterone right. One thing that hasn't happened is that I
haven't suddenly become really aggressive, something I was worried about beforehand;
I'm still just a weedy mathematician!
Overall, I have found taking
hormones to be a good experience, though one thing that has taken a bit of
getting used to is how my sexual orientation has shifted. I'd now say I'm
bisexual but still much prefer women to men. I'd heard this could happen, but
it's taken me a while to get used to it. Taking hormones does mean needing
regular blood tests, as cholesterol levels can shoot up, and increased red
blood cell count can cause problems, among other issues. I dread these, as it's
not easy to get blood out of me. I'm told I have bendy veins! Hormones are
something I'll need for the rest of my life, as without them, certain
characteristics (such as facial appearance) will begin to regress, and because I'll need them to maintain a healthy
body when I've had my hysterectomy - see below.
If you want to know more
about how the hormones work and what the risks are, check out this NHS guide.
What surgical options are there?
I have decided to have what's commonly called 'upper surgery', which means having my breasts removed and a male-appearing chest constructed in their place. As I noted earlier, I've been stuck with DD cup breasts since around twelve years old, which has been a source of great distress to me. Even if the world around me was more tolerant of gender variance, I'd still have to look at them every time I take my clothes off. I'm really looking forward to the surgery (hopefully in October 2014) and have been working hard to lose weight so I can get good results from it and recover more quickly.
I've elected not to have any lower surgery (penis construction) because to my mind, the dangers outweigh the benefits by quite a way. I'm told around 5% of trans men opt for this treatment, which involves using arm tissue to construct a phallus. I will need to have a hysterectomy, though, as otherwise the thickened womb lining caused by the testosterone can give rise to problems, and there's an increased cervical cancer risk. I'm quite nervous about that operation, to be honest, but at least it means I'll never have another period.
If you want to know more
about what it's like to go through chest surgery, check out this Guardian article by a trans man called Fred McConnell,
or the ever-helpful GIRES website again,
which also talks about options for lower surgery.
What
is a Gender Recognition Certificate?
The Gender Recognition Act
2004 allows someone who has transitioned to obtain a new birth certificate with
their new name and the correct gender. It also affords the person extra legal
protections, and it is illegal for someone to 'out' someone as having a gender
history. To obtain this, one has to have lived in one's preferred gender for at
least two years and have changed appearance sufficiently. It has implications
for marital status: someone in a civil partnership will have to transfer to a
marriage before obtaining a Gender Recognition Certificate (GRC). Everyone will
have to have written confirmation from the partner, sworn before a solicitor, that
they are happy to remain married. This is called the spousal veto, and has the
potential to cause issues when nasty break-ups occur...
For more information on the
Gender Recognition Act, check out this guide to the process of obtaining a GRC.
Where
can I go for support and advice?
There are various websites
worth checking out if you want further help and advice. One very good list has
been compiled by Juilet Jacques in the Guardian.
There is also a new book called 'Trans Bodies, Trans Selves' which may be worth a read, and there's an associated website to check out. Finally, there are local groups out there, so have a hunt around the internet and ask about.
