My Trans Journey
As lead counsellor with GGP you might expect to hear that I have been managing my journey to HRT through our services. Well, you would be wrong. I took the decision, three years ago, to follow the NHS pathway to treatment. Here I wanted to share my experiences with you in the hope that you will see you are not alone.
July 2018: My trans journey to date
In September 2015 I visited my GP to ask for a referral to the Sheffield GIC and, despite his ignorance to the protocols, a week later my referral had been submitted. This was three months after I had qualified as a therapeutic counsellor, with a view to realising my dream of working as a female therapist.
In January 2016, I set up a private practice and advertised my services in Pink therapy. Low and behold, a month later this eager woman called me to ask if I would be interested in helping her with trans clients. Delighted, I accepted. This turned out to be my first experience of GenderGP and the wonderful Dr Helen Webberley. I will admit now, having heard the horror stories of endless waiting lists on the NHS, that I did consider my private options. It was clear that I would have been a suitable candidate for accessing the services of GenderGP, however, I was concerned there might be a conflict of interest. Keen to keep my focus and do my work to the best of my ability I decided to stick with Plan A. Some 14 months after my referral I was offered my first appointment at Sheffield. I put on my best dress and did my hair and off I went. It was December 2016. I told them my story and it was explained to me that I would have another three appointments within a six month period. At that point I would be put forward for treatment. It was an exciting time and I was happy to wait. My initial appointments went well, I thought, and I was on track for receiving the treatment I so craved. But nothing came. No letter, no appointment. Nothing. Two years passed. Then a letter arrived, it was an appointment with the voice coach. I was delighted and waiting with bated breath for more news. Maybe treatment would be quick to follow. It wasn’t. By October (some two years after my initial referral) I faltered and approached Dr Webberley for help. I needed hormones and the situation was becoming increasingly frustrating. I was living and working as the woman I have always known I was, but wasn’t able to access the treatment I needed to feel complete. I spoke to my voice coach and she did a little digging. According to my records, she said, I should have received a letter two months earlier detailing my treatment pathway. Needless to say I never received the letter. Luckily, she managed to get a copy sent to me. Back on track with the NHS, I put GenderGP on hold. As a counsellor, specialising in the treatment of gender variant patients, this insight into the experiences of those seeking treatment via the NHS was proving invaluable, so I decided to stick with it. I had first hand experience of the frustrations and I knew, that no matter how painful it was, I needed to go through the process. There are so many mixed stories out there, I had to see for myself. In December 2017, I was offered an appointment to see the psychotherapist – something which I had personally requested. On my first visit I asked when I would be able to start HRT. The response was that they would be unable to start my HRT as I was still presenting male. I calmly explained that I was living and working as female and had been doing so for the past 18 months. The response left me stunned: “Then why haven’t you changed your name by deed poll?” I explained that I hadn’t changed my name because I didn’t want to. “Well”, came the response, “you can start HRT but there will be no surgery.” I wasn’t even asking for surgery!!! It is now July, seven months later. I am still waiting. I was told last week that my GP is being sent a letter to give them the OK to start me on hormones, but at the time of writing, the letter is yet to arrive. It is now almost three years on from my referral. I want to share my journey with you so that you can see, you are not alone. I will include regular updates in the newsletter so that I can share my ups and downs – not just my frustrations with the NHS but also the things I love about it. Take my voice coach for example, she is absolutely brilliant. As a counsellor, I know that experiencing the NHS pathway can only enhance my empathy for those facing similar challenges. However, my experiences have also helped me to appreciate just how valuable services like GenderGP are for those who have already waited a life time and are ready to start their journey now, not in three years’ time.
August 2018: My trans journey on the NHS - Month one on hormones
Tuesday 10th July 2018. After three long years on the NHS and a lifetime of waiting and dreaming, I finally picked up my first prescription for my Oestrogen patches. I was fighting back the tears as I walked out of the surgery. This was such a monumental event in my life and yet, everyone I saw, seemed too pre-occupied with their lives to even notice. Not even those closest to me seemed to understand the magnitude of this moment. I have never felt more conflicted. On the one hand I was so elated, I wanted to high five everyone I saw and on the other, I felt totally alone. To be fair, my family are going through the grief of never seeing the old me, and despite the fact I know I left a long time ago, I think hormones are putting the final nail in that coffin. I didn’t get to collect my patches until the day after. As soon as I was able, I stuck the first patch on. I don’t know if it was wishful thinking but, I swear I could feel the oestrogen running through my very being, and this feeling has not left me. The following Thursday morning I went for my T blocker injection. Another huge step in my trans journey. This was going to be the end of testosterone invading my body. I was a little nervous, what would life be like without this hormone running through my veins? I am now three weeks in to my treatment. Do I feel different? You bet I do! I am not sure how much of that is the actual treatment and how much is down to the knowledge that I am no longer being poisoned by the dreaded T but, either way, I can feel its effects. I was warned I might suffer a mini menopause, hot flushes and mood swings and they weren’t kidding! I go from feeling calm, flooded by an overall sense of wellbeing, to a sinking feeling, which starts in the pit of my stomach and overwhelms me. My patience evaporates and I feel like I need to leave immediately. The hot flushes appear from nowhere. I can be mid conversation and suddenly I feel beads of sweat around my nose and forehead and then I am hot all over. It only started like this a day or two ago, but I have never experienced anything like it. Changes to my body are slow, I have spent three weeks convincing myself that my breasts have grown or are growing. They haven’t. The only thing of note is that the skin on my hands feels softer and my body hair has slowed close to a standstill, which is fabulous. I know other changes are happening, but I am on the lowest dose of Oestrogen a girl can be on, the NHS are so cautious about these things. Having said that, I couldn’t be happier despite the negative symptoms, which, if I am honest, are of some comfort as they make me feel like things are actually changing. Of all the things I expected to happen, I never realised how confident this experience would make me. I have read and heard from many of our patients about the impact of HRT on confidence, but, just three weeks in, I am brimming with a new found confidence that I never knew I was lacking. Perhaps this is the authenticity I have heard so much about. I can’t wait to see where this journey will take me next.
September 2018: Month two on hormones
It is really difficult to say how my hormone treatment is affecting me at the moment. Physically there has been little change. I keep rubbing my skin and wondering if it is getting softer and, while some days I feel like it is, other days I feel like nothing has changed. My NHS prescription gives me the lowest does of Oestrogen combined with a really powerful Testosterone inhibitor and, in truth, I am not really sure what physical changes to expect because it is different for everyone.
Emotionally, however, there is lots going on, from the hot flushes I described in my last post, to the feeling that I want to burst in to tears at the merest thing – sad thoughts, happy thoughts everything makes me want to cry. It’s like my emotional senses are heightened and I can feel even the slightest shift. This is not a bad state to be in, quite the opposite, it tells me things are changing and this what I have truly wanted all my life.
I was called in to see my GP last week. It is unusual for them to instigate an appointment so, naturally, I was intrigued. It turned out that my GP had been reading and learning. I was informed that the surgery is obliged to change my name on my records, even without my name having been changed by deed poll (this whole area deserves its own blog post which I will write at a later date). It was a straightforward process. She was really warm and I felt like she really wanted to learn and to support me.
As we were chatting I had a revelation. She was asking if I had noticed any changes and from the deepest corner of my mind came the words: “I have lost confidence.” I had no idea where it came from but the second I had said it I knew it to be true. To be clear, I am not talking about losing confidence in my ability to do my job, or to do the ordinary daily chores, this was much more subtle. Almost like I had lost the confidence to make really simple decisions, when ordering online goods for example or confirming a meeting time and date. I even hesitated when picking a user name for social media (I went for @oakesmarianne – in case you are wondering). I seem unable to navigate these simple things in the way that I once did.
My GP had an obvious explanation: “That may be because you no longer have any Testosterone in your body.” Then the penny dropped. I had been so focussed on looking for the changes that my Oestrogen might bring, that I completely failed to consider how my lack of Testosterone might affect me.
I came away feeling really up-beat, that was until I went to book my blood test only to discover that it would be a four week wait! One step forward, two steps back!
October 2018: My hormone journey continues unabated
I reached the first three month milestone and my blood tests revealed that, while my Oestrogen levels were certainly moving in the right direction, they were still low, so my GP upped my dosage.
As a result my skin has softened and, thankfully, my hot flushes have all but stopped. Emotionally I feel far more grounded and I am filled with a sense of contentment. You know when you are running for the train and you manage to jump on just as it is about to leave the station, but you can’t quite relax until you are sure you are on the right train, heading in the right direction? Only then can you start preparing for the rest of the journey. That’s how I feel. As for the other physical changes, frustratingly I am feeling all the pain and none of the gain. My chest area has a dull sensitivity, a bit like I have been punched on each nipple and they are bruised and sore. Even a cuddle from my wife can really hurt. But there’s very little growth. In spite of this I keep checking every day and just knowing changes are afoot is really comforting. I have an appointment at the GIC later in October to speak to a clinician. I honestly don’t know who they are or what they do. Like all things NHS, it seems to be shrouded in mystery. I assume they will ask how I am doing. I am doing really well, so hopefully the appointment will be a formality. I will report back! On a happy note, in spite of the fact that my first prescription was made out in my male name (nope, I haven’t changed it officially, this will be the subject of a separate blog) the doctor sent my second prescription in my female name – without me having to complain! This was a really nice touch. It can be draining having to keep repeating the same stories and explanations over and over so, just to have this little but significant detail sorted without me raising it, was a positive step in the right direction.
November 2018: This month saw the arrival of two small but life-affirming packages...
While I would love to share my latest news in a calm and orderly fashion, it is impossible. This month saw the arrival of two small but life-affirming packages, in the shape of my very own breasts and I couldn’t me more delighted. I am still suffering with growing pains which has made the wearing of breast forms impossible. This has left me with a dilemma: how do I go from wearing breast forms, which have for so long given me the female form I needed to feel safe, to having my own breasts – certainly small but increasing in size as the hormones weave their magic – without leaving myself vulnerable.
I needn’t have worried, I arrived at an ‘A’ cup very quickly, a small ‘A’ cup granted, but enough for me work with. I purchased a bra and was able to enhance my natural assets with the help of some (what we girls in the know call) ‘chicken fillets’. Searching the rails for ‘A’ cups was an eye opener as I also discovered I could wear bras a couple of sizes up and feel very comfortable boosted by the extra size which they comfortably provided.
It was a hugely emotional moment for me. Buying a bra for my own chest felt like a milestone that had seemed unachievable just a few weeks ago. My mother used to tell me, ‘good things come in small packages’, now I realise what she was talking about.
Who knows what size my breasts will finally settle at. To be honest, right now I don’t really care. All that truly matters is that I am overjoyed with my developing body, a sensation which I have no doubt has been experienced by countless trans women before me.
I promise not to give you all a cup by cup commentary each month, but what I do want to say is that in time, change does happen and dreams can be realised.
In other news, I had a clinic appointment with the nurse at the GIC. I spent the hour telling her about…you guessed it, how I am loving the changes HRT has brought. A few other highlights include: slower body hair growth and softer skin, oh and did I mention my breasts are growing!
December 2018 - Let's talk body hair!
We’ve reached December and I can’t believe it’s now six months since my hormone journey began. December has brought with it new revelations, specifically in relation to my body hair and skin.
The latter is significantly softer and my sense of touch has become heightened. It’s almost as if it was slightly fuzzy before, but now I am really feeling everything, from a soft breeze on my face, to the warm heat of my duvet and the feel of the driving wheel in my hands. One down side to all of this is that I am really feeling the cold so I am constantly reaching for an extra jumper or to turn up the heating!!
Let’s talk body hair, I used to shave my body four times a week. I was never very hairy, but what I did have was persistent and very coarse. I won’t lie, hair removal was always a chore. Now, after five months on HRT, I only really need to shave my body once a week and when I do, the hair is a lot softer and hardly noticeable. This means, even to the touch, I feel a smoothness I haven’t experienced before.
My facial hair is still there, in spite of some sessions of laser hair removal, but the growth has slowed substantially. Now, if I remove it in the morning, come midnight I am still confident and smooth. This is a huge change for me as, in the past, my stubble would grow as the day progressed. As this exacerbated my gender dysphoria, trips out had to be organised to accommodate the growth. The softer skin on my face has made shaving (it feels horrible to even type the word!) much easier with no rash and no cuts, just smooth clean skin.
When I started sharing my journey, via this blog, I was really nervous. I had no idea how people would react. Being a therapeutic counsellor, however, I could also see the need for me to lay myself bare so that anyone who wished to follow my journey, and maybe get some insight, could do so.
The truth is, everyone has been really lovely and positive and they have thanked me for sharing my personal perspective in such detail. It has been a humbling experience.
As individuals, we are unique and the hormones will affect us all in a unique way. My experience to date, in terms of physical changes, has been very subtle and nuanced rather than the huge transformational shift I was expecting. What has surprised me is the extent of the emotional changes I have experienced and willingly embraced.
I hope everyone can enjoy Christmas and look forward to the new year with hope in their hearts. Please stay strong and I will keep you all updated on my progress in 2019. Happy Christmas xx
January 2019 - New Year New You?
This month it’s the inevitable diet issue!My muscle mass is turning in to fat. This hasn’t been as disturbing as I thought it might be as I am acutely aware that if I want fat redistribution, first I need the fat to redistribute! I am also experiencing cellulite, which is a bit of a shock as I have been lucky enough never to have experienced it before. The realisation that more physical changes were afoot dawned on me on a recent family holiday to Centre Parcs. We had hired bikes and were cycling around the complex. I love to cycle and it is not something that has ever been a struggle for me in the past. But all that has changed. I got on my bike and assumed the position. As started to pedal I noticed that my legs were sluggish and each rotation felt like like wading through glue. It took almost an hour of this for me to realise what was going on – the muscles that once made this activity so easy have lost their strength, the power has simply gone. I knew this was coming, but knowing and experiencing things are very different! Not that it was an unwanted side effect – for me each of these changes are like a little surprise, reminding me of this wonderful journey I am experiencing. On the fat redistribution front, my stomach has started moving south and my bum feels fuller. When I stand on the scales I am no heavier but I can see the extra weight I am carrying. This has spurred me on to take more interest in my weight, so the post Christmas diet and new year exercise regime have now begun in earnest. Over more recent years I had stopped exercising as doing so built muscle very quickly, muscle that wasn’t very feminine and did not help my dysphoria. Now, six months into my hormone treatment I feel I don’t need to worry, fingers crossed I will loose a few pounds without loosing shape where I need it most. One really positive effect of all this has been that I keep getting complimented on my skin. One old family friend asked me how I manage to have such lovely skin, I was delighted to reveal my secret, it’s all down to my hormones. My life has changed in so many ways purely because of HRT. Yes, I am now having to work harder to maintain a body that is reasonably fit, but that is all I have wanted throughout the years. I can now engage with my friends who have had a lifetime of maintenance in this way, I can talk about dieting or keep fit, and these are some of the things that allow me to connect with my new world. To sit, if only in a small way, with my female experience, to be seen and received as the woman I am.
February 2019: Settling down
My Oestrogen levels have settled down and while changes are still happening they are slow and subtle. Initially I was desperate to see big changes happen fast but I have come to terms with the idea that, when it comes to hormones, nothing happens overnight.
I still look at my breasts every morning and evening, in fact every chance I get. It is difficult to describe the way it feels to finally have something I never dreamed possible, although growth still continues to be very painful!
My breast development has taught me two really important things:
1. Among all the changes brought about by HRT, my breast development has been the most significant in terms of the impact on my emotional wellbeing. My breasts are the undeniable proof (size at this stage really doesn’t count), that my body is gaining the secondary sex characteristics of my gender identity. This is beyond anything I could have imagined before starting HRT. 2. I can’t imagine being a young trans teen and going through this process if my breasts were not a welcome addition, such is the significance of this area of our body. The dysphoria it could potentially cause would be unimaginable. It is no wonder that trans boys choose to wear binders and long for top surgery.
In February, I had an appointment with the GIC and we talked about surgery – bottom surgery. I am not yet ready to think about this, I don’t know why, but life is ok for now, my place on my journey is settled, my dysphoria is, for now, manageable.
I know for some this could never be the case at any time, but, my career is going well, I am connecting with my community and most importantly my family in a way I never truly thought possible and, for now at least, this feels enough.
The doctor explained that I am ready to be discharged. If I do choose to go down the surgical route, I will see someone within three months and surgery would be within 18 months.
I can’t tell you how comforting this was to hear, my fear was that I would be forced on to the operating table before I was psychologically ready. Before making this step I really need to speak to more people who have undergone different procedures to see what it is that I want. It may involve having surgery privately, who knows.
April 2019: Reflecting
I am in a reflective mood as I write my update this month. A friend has sadly passed away. She was the wife of a good friend and not just a supportive partner, but a champion and advocate for the transgender community. I mention this because, when I look back on my transition, there are many people whose stories and experiences have made things that little bit easier. Not just for me, but for Vicki, my wife. Other couples before us, blazed a trail so that we could feel a sense of hope that, not only can a relationship survive when one partner is transgender, but the relationship can flourish and thrive. It was through events organised by the Beaumont society that we first met other couples in a similar situation. From there we made lots of friends, arranged private events and social gatherings. The age range tended to be older, and it wasn’t a cheap exercise: ‘specialist’ weekends away in hotels and meals out, and yet it was worth it. Being with other couples and hearing how they had survived not only any transition they may have gone through, but the associated stresses was truly empowering. We also witnessed the dark side, a really good friend passed away a few years ago from alcohol abuse, she was a kindly old lady, a picture book grandmother and we never knew how much she drank. It was heartbreaking to learn that the strain of her situation had driven her to this untimely and painful end. When I hear the hate, or read the ‘debate’ around trans women and their rights, I think of the ripples of pain that are caused and which extend far beyond the individuals in question. When trans people are publicly vilified, mocked and denied their very existence it hurts their partners, their children, their parents and anyone who chooses to lend their support. I am so grateful for the support of each and every person who stands as an ally – without you we would endure the pain of this experience far worse than we already do. Since being on HRT, my ability to keep my feelings under lock and key appears to have gone out of the window. In the past, I would never have complained (at least not openly) about how people treated me and I certainly wouldn’t have called a friend to moan and groan about life. I feel so much, sometimes it’s impossible to keep it in. I feel truly lucky to have one or two people with whom I can share some of these feelings, without being judged. Being more open to emotion and more sensitive to everything and everyone around me is a new experience, a side effect of my transition that no one warned me about. Yes I knew it was likely that I would cry more, but this is much more subtle. It is a feeling that seeps in to every part of my day. On the one hand it leaves me open to wonderful experiences that are beyond anything that I could ever have imagined, but it also means I am a little less robust, a little less hardened to dealing with any negative influences that come my way. I can be needy, fretful and vulnerable, especially if I am dealing with something new. Sometimes, I just need to talk, to let it all out. My friends don’t need to do or say much, they just need to be there. We talk a lot at GenderGP about support, about the importance of listening and hearing those who are struggling on their journey. This does not mean box ticking and chin-stroking but patience and understanding, born out of empathy: everything is new and I liken the process to relearning how to use my senses. It is truly wonderful if a little disorientating.
May 2019: Peace
This last month has been full of ups and downs, trying to figure out what has changed, what am I achieving and what I want. I say this because I am being asked about surgery at the GIC in Sheffield.
However, I am getting on so well in many ways, I have achieved so much that I feel I need time to adjust to my life for now. The thought of having time off work, and recuperating and healing feels like it would just be too much.
In many ways I feel guilty because I feel pressure from my trans friends who would love to be in my position and would love the opportunity to progress in their physical transition. But equally, I feel more settled than I have ever felt, content that I am finally a woman and seeing the world for the first time as such. I do not feel a sense of urgency when it comes to having surgery and while I do worry that others will judge me, it’s incredibly important for me to do things on my own terms – as it is for us all.
I will be honest, my experience as a trans woman and the stories of my friends and the people I have met on my journey have led to a lack of trust in the NHS which is also influencing my decision. I am nervous about the approach that will be taken, I am concerned that they will tell me what I should or should not do, that I have to fit their model of what it is to be trans.
I finally feel I have a measure of control over my body, my gender and I want to cling to that as long as I can. I do not want to be judged by others in terms of whether I fit their criteria, or not. What I need now is time to be me. To enjoy my newfound femininity. I will take the next steps as and when I feel ready.
A large part of this is thanks to the changes I have already seen in my body since I started on HRT. My breasts have grown and I now fill an A cup, this means everything to me. Seeing evidence of change is so reassuring. Alongside this growth the other noticeable change is my skin, which continues to soften and my hair growth which has slowed to the point where I only have to shave every two weeks. Bring on the summer, I can’t wait to be able to bear a bit more flesh with a lot more confidence!
June 2019: Gender Euphoria
*Warning* this post is influenced by a rush of Gender Euphoria which some may feel is currently out of reach for them. For the record, this is not my day to day state of being. I also fully understand that, for some, the idea of ever feeling this confident may seem impossible. But I want to send a very clear message: don’t lose hope. This is what it can feel like on a REALLY good day xx
This month I am reaping the rewards of dieting. It has been a long time coming but, ten months on HRT and my old male muscle was turning to fat, and not attractive fat either! I needed to take drastic action. I know many of my clients work hard to lose weight before starting HRT, I always thought this was a little over cautious – now I realise they may well have had the right idea!
People talk a lot about fat redistribution, mine was certainly redistributing but not as I had expected – or hoped! Having put myself on a strict diet, I am a stone lighter and I can visibly see the curves that were hidden. I realise it is not a massive amount of weight, but for me, even losing a stone has made a huge difference. My clothes fit better, hang better, I feel better, emotionally this has been a fantastic exercise. My dysphoria when looking at my body in the mirror has halved.
I will confess, part of not losing weight and something that held me back, was fear. I was really worried that if I lost weight, my feminine curves would disappear and I would feel deflated. However I am delighted to report that nothing could be further from the truth – as I write this I am smiling like the cat who got the cream. For the first time in my life, I like my body, not just the curves, but the way I feel, my God it feels so good.
My HRT journey so far is not only life changing, it is life making. It feels like someone has switched my experience setting to High Definition, life is full technicolour.
Transition is about looking after ourselves as a whole. If I had put off my diet for another month, I know June’s update may well have been a little flatter. Having to write my updates motivates me in to action – I have had no chocolate for five weeks now, anyone who knows me will know that that is a huge challenge in and of itself!
But of course these things are never all plain sailing. My two best assets have sadly taken a hit, and some of what I have gained in size has reduced. I won’t lie, this does feel like a tiny step backwards, but I am sure they will make a welcome return, eventually.
As I type this I am looking at my complexion, I would have to say I feel like I am glowing, which is something I would never have said in the past, so, on to next month. Perhaps I should be organising a one year HRT party, I really can’t believe how far I have come!