I am on several trans facebook groups. One is for activists, and discusses trans in the media. Another is a support group, and there are two strong themes there- how long the poster has to wait for my psychiatric referral, and how wonderful it is to have their operation at last. Often people give daily updates when they are in hospital: they are so happy! You would see your GP and say “I am trans.” You want NHS psychiatric referrals to confirm this, because that is the way to get hormones and surgery; anyone can change their name and clothes. You see a psychiatrist locally, who refers you to a specialist gender clinic. Before you see the gender clinic, you are certain of what you want. You are trans, and you need a medically supervised transition. Your friends online, and perhaps IRL too, tell you that is what they want and how wonderful it is finally to have it.
You have the idea transition is the answer to your problems, and then you join trans groups which confirm that. All you hear is confirmation, and the idea that true trans folk need Gender Confirmation Surgery is still strong even if we also hear that not all trans folk have it.
Problems with dilation come up now and again, but not enough to convince pre-op people that there are serious difficulties.
You see a psychiatrist and say you know you are trans, and have known this for years, or for all your life. Ideally that psychiatrist would explore with you- who are you, really? Why do you want this? What is it in you that you call “trans” or “female” or “feminine”? But you see them for an hour once every six months, and that is impossible in the time available. It needs a depth and direction of psychotherapy they are not equipped to offer, even if you were in a place to participate in it.
There are also psychiatrists who will see patients privately. Mine used hormones as a diagnostic tool: he would prescribe them to every patient who consulted him. He said fantasists would balk at taking them, and never come again. I feel desperate people would know that this was what they were supposed to do, and take the hormones.
I, being desperate, knew this was what I was supposed to want and took the hormones. If you transition, they help you pass.
I transitioned in April 2002 at work. I thought, even though I don’t know if in five years I will be trying to live as a man, I need to do this now. I did not want The Operation immediately. I found I wanted it more and more as time went on. I had it in February 2004. In Autumn 2003 I was depressed, and my GP gave me more and more Citalopram. In February I ceased being depressed, and remained not depressed though the GP steadily reduced the anti-depressant. I thought that was proof that the operation was right for me.
And now I say I was poisoned and mutilated, the operation is a sham, a con, we want it because of social pressure and minimal medical intervention confirms we can have it because we really want it. There is no place for a psychiatrist to probe beneath the desire for the operation, even if they wanted to. We resent the delay, and resent the “gatekeepers” who might stop us having the operation we want. I did.
This is the way to happiness and acceptance! I knew I was not a man, I repeatedly curled in a ball on the floor weeping “I am not a man, I am not a man, I am not a man, I am not….” At the Sibyls we talked of it. We knew transition was terribly difficult, and we might not make a go of it, but there was no question that it was the difficulty stopping me, not any doubt that “I am trans therefore transition including surgery is right for me”.
How could I refuse the way to happiness and acceptance? I knew I wanted it, at a time when I was unclear about wanting anything else.
The social pressure is still there. There are a variety of messages- here I read Gender non-conforming kids – such as boys who like dolls or girls who hate dresses – aren’t trans. Trans people feel a disconnect between the person they’re seen as and expected to be and the person they actually are. What neat boxes! Why should anyone imagine they really knew which box fitted them?
I was poisoned and mutilated. Transgender medical care did not protect me from that. It could not.
Self-discovery while presenting male would have been difficult. Transition without hormones would too. I would not have passed as well. The operation removed my depression, and meant I could swim and wear trousers comfortably. It was good for me, and so this second-best, good enough is so enduring. We know what we want, and are desperate to get it.