Shrink Wrapped

This morning I went to see a shrink.

I walked into the empty reception area and, through what seemed like bullet proof glass, told the receptionist I had an appointment, handing him through a slit the letter I’d been sent to confirm it.

He looked it up down, tapped some keys on his computer, scratched his head, sat back in his chair and read the letter again, a look of consternation crossing his already mardy face.

He thrust it back through the aperture and without looking up mumbled “Take a seat.”

A few minutes later another man popped up in the glass cage and sat next to him.

They had a little confab and both shook their heads.

This second man came out to the water cooler next to where I was sitting.

I looked up at him and smiled as he ambled by.

He snarled.

Wow, I thought, these two are the grumpiest patient care people I have ever seen.

Having been looking for employment the past couple of months I would happily do it better.

I took out my iPad to read while I waited.

I heard a door opening and looking up was surprised to see the area full of people waiting for appointments, in varying degrees of distress.

We all looked over, like meerkats.

A woman called out a man’s name.

We looked around but no-one got up.

She said the name again, louder.

With dread and horror as I realized it was my old name, the name I had when I was a man.

I closed my eyes hoping she’d figure out the error and get it right, or would just give up after which, letting enough time pass so no-one made a connection, I could get up quietly and leave.

She said it for a third time, this time loud enough that people on the street turned their heads.

I opened my eyes, steeled myself, stood up and walked the gauntlet over to her.

“That’s not my name” I hissed as she fumbled with the combination lock on the door.

I could feel all eyes burning into the back of my head, my mouth so dry it literally felt like there was a sock in it.

I’d rather have walked on hot coals back to that water cooler.

She was mortified too, poor thing, trying to apologize as she finally punched in the correct sequence of numbers and we both fell through the doorway in relief.

We entered a little cubicle where she and another young woman quizzed me.

It was clear they were in training and more than a little out of their depth, but I smiled and we carried on.

“How did you do at school?”

The words Eleven Plus, Grammar, and GCE gave them cause for concern, as if I was speaking gibberish.

“Do you ever feel like you are a famous person?”

I mentioned this to a friend after and she said, “Did you just tell them you were in The Passions?”

“Do you ever feel like people are talking about you behind your back?”

Not the best time to mention the receptionists I figured, so kept mum.

After fifteen minutes trying to catch me out they told me to wait in reception while they spoke with the head honcho, then they’d give me their assessment.

Cautiously I opened the door and was relieved to find it again empty, and the receptionists replaced, presumably their shifts over rather than turfed out for their narrow mindedness callousness.

With barely enough time to regain my composure I was called back in, this time to a spacious office where sat a man, mid forties, leaning back in his chair behind a large desk, the two students seated to one side looking very down in the mouth.

I feared the worst.

“Do you know why you’re here?” he asked, eyes piercing my skull.

I glanced over at the girls hoping for a clue but their heads were bowed, looking at their trembling hands.

“Well” he continued, “I am a psychiatrist and your GP has asked me to assess your mental health before referring you on to hospital.”

I expected the door to open and men in white coats strap me into a straight jacket.

“I’m not sure why they sent you here as Charing Cross have their own psychiatrists, but as far as we’re concerned you clearly have no mental health issues so I see no reason why you cannot be treated for gender reassignment on the NHS and I’ll be writing to your GP in the next week or two informing them of this. Goodbye.”

I know.

Two weeks to write a letter!

The girls showed me out in silence.

I concluded they must’ve had a dressing down for using the wrong name and putting me into an awfully embarrassing situation which I thought particularly unfair seeing as it was most likely his error.

It was a kind of surreal and not altogether pleasant experience, my first and hopefully last encounter with the NHS mental health department.

In the UK one can have gender reassignment on the National Health Service but there are a number of hoops to jump through.

The psych eval was number two, the first being to register with a GP, a family doctor.

Step three is referral to a Gender Clinic for primary care such as hormone therapy, and for me this will be Charing Cross hospital.

To qualify for this one has to live full time in one’s chosen gender for a period of one year.

This is cruel as it is the hormones that give the confidence and body shape to do that successfully.

These hormones are Estradiol, estrogen, the female hormone, forms the breasts, redistributes fat, alters body shape, and Spironolactone, an androgen blocker, stops the production of testosterone.

In the US, where I lived from 2002 until recently, hormones are prescribed immediately after registering with a clinic and being assessed by a psychiatrist, something I did in 2009, and for which of course I had to stump up cash.

No, Obamacare doesn’t cover it, though it is now tax deductible.

Fortunately because I had been on hormones over there for nearly four years my GP over here prescribed them straight off the bat.

Lucky.

The final step, the one I am most keen to complete, is SRS or GRS, sex/gender reassignment surgery, turning my bits around, a procedure that would cost me upwards of thirty grand in the US.

I’m no medical tourist, before you reach for your green pen.

I’ve paid taxes and national insurance here for over thirty years and do so now.

SRS for many but not all transgender people, is the final stage, the last piece of the jigsaw.

After years of hormones, the gradual reshaping of the body and mind, after laser or electrolysis hair removal, after voice training, after trachea shaving, comes the vagina.

Those of a nervous disposition look away now - for male to female surgery the glans of the penis, the head, is turned into a clitoris, the penis itself turned inside out to form the vagina, the testicles removed, the labia formed, and the urethra repositioned.

We’re talking major surgery.

Not everybody chooses to have it.

Some people do not want to have to go through the pain, discomfort, and the three months minimum recovery.

Some simply cannot afford it.

I have had done and paid for everything so far, including the trachea shave, where an incision is made under the chin and the trachea, the Adam’s apple cartilage, is shaved to reduce or remove its prominence, feminizing the neck.

It’s a long journey, a gender journey, and one not to be taken lightly.

Yes, it has been wonderful, calming, life affirming, to be able to at last admit to myself who I truly am and, most importantly, to feel good about it.

But there are pitfalls, should you, reader, be thinking about choosing this path.

It is not uncommon to find that the thing that makes you feel complete makes other people run for the hills, or want to beat you to a pulp.

Within the blink of an eye home, job, friends, can all disappear.

I’ve been lucky in that most of my friends have stuck with me.

Not all though, and not all those who’ve stuck around have found it easy.

It must be quite a thing to have a friend you’ve known for 30 years seemingly out of the blue declare themselves female and start wearing dresses and make up in public.

After the initial shock and embarrassment most folks come around.

Those that don’t, well were they really friends?

I travel a lot as a touring sound mixer, and in early transition found myself in some tricky situations, with my name change papers in one hand, and my old passport in the other, trying to get into, for example, Russia.

The thing is to stand your ground, be open, sincere, smiling just enough, not too much that you look insane, or more than they already think you are.

In Japan one time the immigration official looked at me, a woman, looked at my passport, a man, put a hand to his forehead, exhaled deeply, and waved me on, shaking his head.

In China I had five men in uniform all looking at my face, then my passport, up and down, up and down for 20 minutes, jut-jawed, grimacing, then begrudgingly letting me pass. 

I walked through with all the dignity I could muster.

One thing it’s worth bearing in mind at these situations, should you ever find yourself there, is to remember that sometimes the straightest looking people cross dress.

Oh yes, it’s a lot more common than you’d think.

Most who transition do so later in life, when it is hardest.

When the skeleton has formed, the voice dropped, the beard thick, the head bald, all the will and pills in the world may not produce the effects society deems appropriate.

The best time for anyone to change gender is before puberty, and thankfully that is beginning to happen now.

When I was eight years old I would go to sleep every night hoping I would wake up a girl, and cry every morning.

This was the nineteen sixties, when homosexuality was illegal, men were men and women were terrified.

Just the other day I saw an article in a national newspaper about a happy heterosexual couple who had both changed gender.

We’ve come a long way since I was eight.

But there are people who would’ve looked at that happy couple and called them freaks, or worse, much worse.

We can have two happy people who don’t fit into a warped nonsensical bigoted hateful view of humanity or two miserable people who do.

I ‘pass’.
This really helps, as no gang of uncouth youths have tried to hospitalise me.

But I am now a middle aged woman which presents me with a whole new slew of discrimination, not least that I am failing to get work.

A friend who is still struggling a bit said to me recently “I don’t understand why anybody would chose to be a middle aged woman.”

There’s nothing I can do about being middle aged.

Gender is not black and white.

It’s a rainbow.

Fortunately I am a citizen of a country that recognizes my condition as something essential to treat, that will do so for free at point of need, and will allow me to become my gender of choice legally whether I have had SRS or not.

Now, gis a job.

Julia Brightly

August 22, 2013