mschatelaine: (Default)
[personal profile] mschatelaine
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.

Date: 2009-02-05 08:23 am (UTC)
julesjones: (Default)
From: [personal profile] julesjones
[hug]

One of the afper trans people ran into this attitude a few years ago when he was in much the same mental place as you regarding gender identity, and of course when he vented about it on afp, a lot of the cis-women *did* take serious offence at the clinic's idea that wearing trousers (and various other things) was so unfeminine as to make anyone who did them obviously really mentally a man. But afp has rather broader ideas of gender identity than does the tabloid press. :-(

For reference, I think the last time I wore a skirt was before I started the new job last July, and I'm a cis-woman with an extremely firm female gender identity. I just don't feel like conforming to Victorian concepts of what that gender identity ought to be interested in.

Date: 2009-02-06 11:10 pm (UTC)
From: [identity profile] ms-chatelaine.livejournal.com
[hug, thanks]

I like skirts and dresses, don't get me wrong and most of what I'm looking for is to be able to fit them more naturally than I do right now. It's the all-or-nothing attitude that I'm objecting to most of all and the increasing pressure to accept the whole package no matter how inappropriate and damaging, if I want any help at all. The alternative is psychological treatment, which the new head of the clinic is in favour of. I don't need to be cured, thank you, there is nothing wrong with me that can't be made better by society letting me do what I want.

Out of interest, how did that other trans person move on, do you know?

Date: 2009-02-05 09:58 am (UTC)
From: [identity profile] sha-d.livejournal.com
I don't know enough about the system to be able to help, but that does sound daft to me.

I'm female, I mainly wear trousers (it's drafty in glasgow.) I'm not good at woodwork, but am happy with DIY.

These criteria seem daft. I remember hearing something from the 50s about women being sent home from work for wearing trousers, maybe their guidelines have remnants from then?

Do you want to learn to knit? have some knitting in the waiting room, that'll earn you some points on their tick box system. you might even like it ;o)


Date: 2009-02-05 10:11 am (UTC)
From: [identity profile] unblinkered.livejournal.com
I'm all for knitting in public! *g*

As for their definition of female behaviour....I could tile before I could knit and noone I know is going to accuse me of not being a woman or lack of femininity. Sheesh. And the skirt thing is just ludicrous.

Don't let the system bully you. You seem to be confident and happy with what you're doing just now and that *should* be the main criteria.

I'll ask around about alternatives to the NHS.

Date: 2009-02-06 11:37 pm (UTC)
From: [identity profile] ms-chatelaine.livejournal.com
Thank you, I think that should be the main criteria too, and my doctor initially led me to believe that that was how he felt. "Functional in the gender you choose," was his ideal as I recall. Problem is that the system is being hellish narrow about the definition of gender, and requiring me to make a choice but not letting the choice be "all of the above".

And I think reading this that I misrepresent him a little. I think he'd like to be able to support me but he's putting himself in professional jeopardy by doing it as it is. And he said so.

However, I do think that it shows a lack of character to be putting pressure on a potentially vulnerable patient to conform by making an appeal like that. I do know that the last time he tried to put that kind of pressure on me, last May, I was very upset and quite angry. I felt that I was being pushed into a position that was wrong for me by someone who was supposed to be helping me. Now I'm just angry, even more so because I realise now just how wrong it was of him to try pressuring me then when I was still vulnerable.

I also realise now that he wouldn't have needed to try that tactic back then and I am actually stronger than I was.

But knitting isn't me, thanks, I'm not really interested in the things you can make with it. Although I could use a new Arran sweater; My mother made the one I have when she was having my brother and he's 28 this year. I'll think about that.

But I'm really looking forward to making a harp, even if it's half-made for me already. And I found a woodworking charity that has a workshop near where I work. I don't doubt that they'll let me use the facilities for a donation, and there'll be a wealth of experience there to learn from, so maybe the one after my next one will be all my own work.

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