Transition – Explanation for the Uninitiated (Page 1)
Transitioning – the pain and the joy of being true to oneself
So, what is this ‘transitioning’ that all transsexual people talk about – and ultimately have to go through to become true to ourselves?
It is the time which really starts when we finally accept who we are and instead of fighting against it like most of us have done, finally accept ourselves and start to do something about it. Every person’s transition is unique to themselves, but with many common strands shared with other ‘groups’. Some might have struggled with gender dysphoria from a very young age (typically 3 to 5 years old), whilst for others it did not start until puberty. For some people, they suddenly became aware of it much later in life (in their 40’s).
Once the point of self acceptance has been reached, the very first steps towards transitioning can be started, This often means either going for counselling or going directly to your doctor to discuss your gender identity problems. NHS England published an interim protocol in July 2013 which stipulates that the GP should refer their patient directly to one of the six NHS GIC’s (Gender Identity Clinic) in England. The NHS has a number of articles about trans health and treatments which are well worth having a look at. Here in the South West we are fortunate to have the Laurels clinic in Exeter, which is one of the best in the country – if not the best. Under the new NHS protocols you, the patient, can decide on which clinic to go to, so please do your homework as some clinics have much longer waiting lists to get that first appointment than others (varies between 2 months and 18 months according to anecdotal evidence). A little later in 2013 the Royal College of Psychiatrists published their report “Good practice guidelines for the Assessment and Treatment of Adults with Gender Dysphoria” which advanced our case for better and more inclusive treatment.
Once you start attending a GIC, you will have several discussions with their staff, initially you might be seen by a clinical psychologist and then by a psychiatrist – but all clinics are different in how they operate, Once they have been able to diagnose you as having gender dysphoria, then you will be given the option to start taking cross-sex hormone therapy (i.e. taking hormones of the sex opposite to your birth sex). Hormone therapy is rarely started until you have been under the care of a GIC for around 6 months (but can be sooner depending on circumstances). The effectiveness of cross-sex hormone treatment can be very variable (but is generally more effective the fewer number of years you have been exposed to the hormones of your birth gender) and remember that, say in the case of male to female transsexuals, it can take 3 or 4 years before you see the full effect of the treatment – natal females don’t suddenly go from girls with no breast tissue to a size 34D overnight, it normally takes several years. For female to male transsexuals, again it can take a number of months before the hair starts growing on your face, natal boys don’t suddenly start sprouting a full beard growth the moment testosterone starts coursing through their bodies. The voice breaking takes place over a shorter period of time, but it can still take a few months during which time you will go through an awkward phase as the voice box enlarges to enable you to achieve that deep booming voice that men have.
Transitioning can be a very emotionally demanding – at times you will be on an extreme high, but other times you will be very depressed – but remember, this is normal and it affects all teenagers the same and in effect (unless you have been on puberty blockers to prevent an unwanted puberty) then you will go through a second puberty and all the awkwardness which that entails, but this time the puberty that you desperately always wanted to go through. Nevertheless, for M2F’s, you will feel weepy and tearful at the very slightest thing, other times you will feel as if you can accomplish anything. F2M’s have said that they become much more aggressive in their behaviour and if something upsets them they are far more likely to want to go and punch somebody on the nose instead of dissolving in tears.
Society can be very judgemental about things that they do not understand and transphobia (fear and aggressive behaviour towards transgender people) can be very hard to understand and deal with, especially at the start of transition. If you ever have to face a transphobic attack, please contact the police. If it is just a verbal comment, make a mental note of what the person/people look(s) like, what they are wearing and then ring the police on 101. If the person is threatening violence or physical attack or if you perceive that it could turn dangerous, try and get yourself out of harms way as quickly as possibly and then ring 999. You should do the latter even if you only suspect that it could turn nasty.
Many transsexual people risk losing their job after transitioning (even in this day and age), their partners, their children, their family, their friends, their home and many other things when they come out to people. It is getting better though – starting with the Gender Recognition Act (GRA) 2004 and since then the Equality Act 2010 which included gender reassignment as a protected characteristic group and more recently the Public Sector Equality Duty (PSED) 2011 which mandated public sector companies to have a good equality framework in place to protect both their staff, and the public that they serve (and that includes you as a transgender person), from discriminatory practices, then things have improved further.. If you are working for a company and are planning to transition, then one of the first things to do is to go and have a discussion with the Human Resources (HR) manager at your place of employment about what your plans are – they should be able to put practices into effect to safeguard you, if they are unsure of their legal requirements in this respect, please contact one of the LGBT organisations which does advocacy work with companies (Intercom Trust can do this for you if you live in the South West).
Lead up to living full time:
During your lead up to start living full time in your preferred gender role, it is helpful for you to start transitioning to living in that gender role part time. It can be a very frightening time, yet exhilarating time for many as they go out and face the world for the first time as who they truly believe themselves to be and there will be many slip-ups and mistakes made. Some of these will be extremely funny – and others, less so. This is where making contact with local groups like Transfigurations and others can help you prepare you for either manhood or womanhood – it gives you a safe space in which to experiment, to receive advice from others who are on the same road as yourself (often only slightly ahead of you) and from others who have lived their lives as their true selves for many years in their acquired gender. GIRES has a database of transgender groups in the UK from which you should be able to find a support group in your own local area. There are also many online groups which you can join and make friends and get good support as well:-
1. Transfigurations own forums which you can access by clicking here
2. The Gender Society (mainly UK based)
3. Gender Trust (whilst not a support group in itself, it gives links to many trans organisations in the UK)
4. Susan’s Place (mainly US but with a good mix of UK and others)
5. Laura’s Playground (mainly US but with a good mix of UK and others)
– and for younger people and their families (who often need support as well) there is
6. Mermaids – a UK based charity working with transgender children and their families (see links page and also the Trans Youth page).
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