For the past couple years, I have been talking with Dr. Lewis about my gender identity. I also discussed it at length with whatever-her-name-was at CAMHS.
I have never, not once in my life, felt anything close to a positive emotion when thinking about the idea of being ‘a man’ or ‘masculine’. At the very best, I have felt a numb and inert helplessness, and at the worst I have felt as though it would be easier if I died.
When I was younger, I was not really aware of what society calls gender. It was not an intuitive concept to me, probably because I’m autistic or something, but I don’t remember ever really being aware that people expected me to conform to this male mold. I do, however, clearly remember times where I (unknowingly) did things that did not fit this mold, and people judged me for reasons I did not understand.
When I was in year 2 or 3 - around that age, I don’t remember - there was some sort of school disco that we went to. Each classroom had things you could buy and things to do. You stayed in the main hall as I went in to the year 6 classroom with the few pounds you had given me and I went to a brightly coloured stall with a woman behind it who was painting nails. I asked to get mine in a red glittery colour. A few minutes later I came out to the hall and excitedly showed you my pretty new nails. I remember you looked upset and told me that it wasn’t normal for a boy to do that. I didn’t understand.
I remember that in primary school I sometimes would think how the names of some of my female classmates were so much nicer than mine, and I wish I had one like theirs. As strange of a thing that is to do.
Remember how I absolutely hated P.E.? The one subject where students were seperated by gender? As you know, it only got worse as time went on and I became more aware of what I ‘was’ to people, and what I ‘had’ to be. In year 7, I wished that in P.E. and swimming lessons I could instead be grouped with the girls.
As puberty started and went on, I felt that numb feeling the as the very things I hated the concept of being slowly became hard-baked into my appearance.
It was when I was 14 that everything started to set in for me. I realised what it was that was making me feel so horrible, and I finally understood the gist of society’s concept of gender. I knew that I could absolutely not go on living my whole life that way, and that something had to change.
I didn’t know what a transgender person was until late 2020, but the moment I learned what it meant to be transgender, I knew that I was. Descriptions of how transgender people felt growing up matched perfectly with my experience.
I knew that I wanted to be a woman, and I still know it. My judgment has not wavered for a single moment since.
It was around this time, mid 2021,that I bought that cheap skirt from Amazon. It wasn’t much, but upon wearing it I felt instantly relieved of so much weight that was bearing down on me, and I finally felt like myself. It was as if I had been holding my breath for 14 years, and finally was able to again.
This wonderful feeling is known as gender euphoria. It is the opposite of what is called gender dysphoria or gender incongruence. It really is like nothing else. It is a complete happiness. It’s the feeling you get when you are finally able to exist. Just exist. For that is something that I have not been able to do for the large majority of my life. Even when happy, there’s this deep sense of primal wrongness in your chest, and it just doesn’t go away. Unless you get to exist.
At the BRIT School, I didn’t hear the name that was given to me at birth once. I didn’t hear the word he once, nor him. Instead, I was she. It was a place where I could exist, to some extent.
There are others like me in my class, at least six I can think of off the top of my head, and each of them would corroborate these experiences.
Over the course of my time with Doctor Lewis, she gained an understanding of my experience and diagnosed me with the aforementioned gender dysphoria. Along with that, I was referred to Tavistock & Portman Gender Identify Clinic. I’ve been on the Tavistock waiting list for nearly a year now.
Now, with the backstory over, we are here. Stick with me.
The Tavistock waitlist is extremely long, with some estimates placing it at twenty years long, despite the NHS’ very own guidelines stating no person should have to wait longer than 18 weeks for an appointment. People die on this list. People kill themselves because they simply cannot endure the wait.
I will not allow that to happen to me.
There are, of course, private gender clinics. Some popular ones include GenderCare and the Northern Gender Network. These are, however, really expensive.
Let’s go through what these clinics do.
First, at an ‘initial assessment’, the doctor will determine whether or not you require their care. Then, there’ll be a couple more appointments where they just gather more info on you. Eventually, if they feel you are trans enough by some mysterious metric, They may prescribe you Hormone Replacement Therapy (HRT).
This typically comes in the form of a duotherapy - two medications are prescribed. This will be an Estrogen, commonly Estradiol Valerate if taken orally, and an Anti-androgen, commonly Cyproterone Acetate.
The Estrogen, which occurs naturally as the female sex hormone, serves as a replacement to Testosterone. The Anti-androgen serves to supress the body’s production of Testosterone or to make the body less sensitive to Testosterone. Cyproterone Acetate does a bit of both.
Along with these medications, you receive blood tests (Once per 3 months in the first year, 2-3 times a year afterwards) to keep track of your estrogen and testosterone levels. You also generally receive an initial test of liver function, as Cyproterone Acetate can, usually in high doses, rarely cause liver issues due to a rare side effect of increasing the number of liver enzymes present. This has only been reported to happen in very high dosages of the medicine (>100-300mg /day) when it is used as a prostate cancer treatment. The typical dosage for Hormone Replacement Therapy is 6 to 12.5mg /day, a level at which the risk profile is not to worry about.
Estradiol Valerate is prescribed at a rate of 2-3mg/day. Any health risks associated with taking it should not alarm you, because this very drug is naturally in your body at a higher level than this HRT dosage can provide to someone born male. Just to be comprehensive, though, risks include Blood clotting of various degrees, Breast Cancer, and Benign tumour growth.
Again, the risk of someone on HRT having any of these symptoms is lower than the risk you having these symptoms by virtue of existing in a female body.
The effects of HRT are slow, taking many years to complete, and most are entirely reversible. Effects include:
Body fat redistribution - android/male body fat patterns change to gynoid/female body fat patterns. This means more fat on the arms, legs, face, etc and less on the stomach and surrounding the internal organs (visceral fat)
Breast growth, just like in female puberty. Because it literally is female puberty.
Softer and more sensitive skin
Stronger emotions, happier happies, sadder sads.
Period-like symptoms, Of course I do not mean bleeding. I mean a monthly cycle of emotions and cramping, just like in someone born female.
Infertility With a significantly lower testosterone level comes the halt of sperm production, and commonly erectile dysfunction. I don’t care. Honestly, both pluses for me.
Libido changes Blah blah, less male-like sexual experience more female-like sexual experience.
Less body hair
Male pattern baldness stopped/slowed/partially reversed
So, that’s the rundown on what happens when you either wait 20 years or pay a private doctor a preposterously high amount of money.
Some parents feel as though their child ‘dies’ in some way. You know, like “oh my baby has gone on this medication and it has killed who they once were!”. I trust you to be more reasonable than this. Whatever medicine I take does not change who I am or who I have been. I would still be your child. There is no reason to feel grief-stricken.
Anyway, here is the plan. I do not mean to sound assertive, but this is happening. I assure you that I am 100% certain of the safety of the following, and it is a common route for trans people in the UK and worldwide. A couple of the trans people in my class at BRIT are already doing this. I have weighed the options for years, and this is the best possible route that doesn’t require you to go to private appointments which cost hundreds of pounds.
So,
There is, of course, a large community of transgender people around the world. In the face of systems designed against us, the community has developed a large list of safe ways to go about transitioning, these methods are trusted by thousands in the UK alone. The most common method of attaining HRT without being rich or waiting decades is through online vendors, specifically ones that are tried, tested, and trusted by the community. Through informed and practical use of these vendors, taking the medication in accordance with medical organisation’s recommended dosages, and by monitoring results in the standard way, transition is entirely safe, with the exception of risks that are inherent to the medicines taken. If you skipped above, read that for the risks.
Surveys suggest that 31% of transgender people in London have got their HRT through these means. That’s at least over 14,000 people in London alone.
Note: These are pharmaceutical grade medications produced by legitimate pharmaceutical companies that are licensed and subject to regulation. Their quality is no different to the medicines you get from the pharmacy at the green.
As you know, I saw Dr. Mehta today (Sept. 26 ‘24). I explained all of what I am planning to her, and we discussed the risks. Her professional advice was, as expected, to not do it, but this is standard NHS advice and protocol dictates that this is all they can say in terms of whether you should or should not do it. Afterwards, she said that she believes I am capable of making the decision and that she is glad I am well informed, the only caveat being of course that the NHS is not responsible for anything. That’s all obvious.
We discussed the risk profiles for the medicine as well as monitoring. She did not object to any of my assessments. Her only major concern, outside of the legally required ‘do not do this’, was the risk of blood clotting from orally administered estrogens. I am aware of this, and am weighing oral administration vs sublingual administration.
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The current price for the very duotherapy described above from retailers trusted within the community (I know that one of the people in my BRIT class are on this exact regiment) is as follows:
this is the one thing on earth that i would get a job to fund if I must
These will all be taken as tablets. No needles.
This is a life-saving treatment. I honestly, truly, do not know how I could bare to live if I were to go on as I have.
As you read this, 20x28 2mg tablets of Estradiol Valerate and 2x50 50mg tablets of Cyproterone Acetate are in shipment to me. Be assured of the legality of this.
Love you x
As great as getting to the end of this NHS waiting list would be, The NHS’ transgender healthcare is still severely lacking, and does not at all follow the global standards of care. (SOC 8). Oh, and that’s if they don’t weasel their way out of providing care to trans people, as they have many times before, by getting permission from the courts to ignore their very own constitutional doctrine.
GenderGP is an international trans healthcare service that is based on a subscription. I decided to not go with them due to the countless horror stories from people who have gone with them. Additionally, they display a high degree of carelessness, providing poor regimens, not reviewing blood tests, and failing to follow clinical guidelines.