Feb. 4th, 2009

mschatelaine: (Default)
I don't fit in the box. That's fine with me, but the medical powers that be apparently don't approve. Apparently they will come down with a heavy hand on any doctor who doesn't follow a rigid set of guidelines in dealing with transgender patients.

Apparently the Charing Cross Centre (I think) in London is very prescriptive about what a transgender patient should do and how they should behave, and their view of gender roles and behaviour is narrow and conservative. Patients can get treatment denied for turning up wearing trousers rather than a skirt, for example.

More importantly, this big important clinic says that hormones should not be prescribed until after a patient has been living at least three months in their transgender role, and is going by their transgender name full-time. And they must supply proof of this. This role having been conservatively defined by the clinic as noted above.

They also have a tendency to accuse doctors who don't toe their line of malpractice and one has been struck off recently for not following these guidelines exactly.

I mention all this because my counsellor informed me of it all this afternoon, as well as informing me that there is a change in the management of the gender unit that I go to and the head of the unit is much more inclined than the previous one to this clinic's views.

Now I don't argue with the existence of guidelines and oversight. They are there to prevent errors and there are people who really shouldn't be allowed in their current state of mind to make the kind of irreversible decisions that gender reassignment requires. But I have had a psych evaluation and I'm fine and in command of my own decisions.

There is also a fear of the gutter press in the NHS establishment and this is another consideration that my doctor has mentioned to me more than once, and intimated that it is more of a concern to his bosses. I personally view that attitude as caving in to an attack on my civil rights of privacy and freedom from discrimination, but that's an argument for another time.

I'm allowed to stay on the level of hormones that I am currently following, but I predict that I will have this 'discussion' at every session. If that is the case I am going to have to figure out what to do. I am tending to consider all of this information as unfair pressure to follow a path that I'm not currently and for good reasons prepared to follow.

I don't want to live full-time as a woman. I don't feel desperately enough out of place in my current life that I would wreck it to change sex. And that is what I would have to do. I'd lose my career, and a large part of my family, both of which are important to me. I'd keep some family contacts and most of my friends, for which I'm eternally grateful, but still.

But the British medical establishment doesn't have a box labelled with what I need: you can be a man or a woman, and by their rules or don't play. I told the doctor that most of my female friends would consider that clinic's view of their gender role as an affront, and he agreed, but he has been going out on a limb to allow me to go as far as I have.

I'm not going to be railroaded. I'm not. But I'm not sure how to make the system fulfil my needs, and just as importantly how to get it to stop putting pressure on me that could become damaging. It's clearly only set up to cater for cases that require the full gender reassignment intervention. It isn't set up to consider any kind of flexibility outside that, for fear of accusations of malpractice.

But I have been made more happy than I was by being allowed to grow breasts. My hips and thighs are widening too, which pleases me. My blood pressure is significantly lower when I am cross-dressed, and that is now my normal mode in the house; I change when I get home from work. I intend to continue with hormone treatments but I may never transition; be transgendered, either gender at need or in between. I may have to find support outside the NHS - does anyone have any information about where to ask?

Apart from that everything's going swimmingly. I'm going to start going out more often, which will go some way to making the doctor happier too. It's extra work to do makeup and put on a wig and padding and corsetry, but when I do it nobody bats an eye in the shops which is exactly what I'm after. I couldn't get away with going out the way I am in the house, which is still all female clothes including underwear, because I still have too masculine a shape, and I have to wear makeup to feminise my face. And of course the wig.

But my bust is still growing to reasonably fill a 38A in fact rather than by wishful thinking. If you know to look when I'm not wearing a bra it's noticeable and a padded bra does wonders. I'm dieting and exercising to reduce the masculine belly and hoping it won't retard my hips too much.

In the rest of my life, I went back to fiddle lessons this evening and got on fine. And I'm getting a consistent note out of the wooden flute I bought a couple of weeks ago. I'm planning to build a harp this year too - it's like a kit car: you buy a kit of parts pre-cut and finish and assemble them yourself. Later on I might start building them from scratch, but I'd need a workshop space to cut and drill the wood.

There, now, woodwork, that's hardly a typical feminine activity, is it? In the words of Amanda Palmer, fuck that shit.


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