Posts Tagged ‘medical transition’

So this post is going to be kind of cryptic, because I really, really don’t want to ID the people involved. Partly because it’s nobody else’s business, partly because I’ve picked up on something I’m sure was not what was meant.

Someone I know came out as trans recently. They’ve been questioning for ages, but finally hit that ‘ohhh’ moment where it kind of clicks into place. Even more recently (duh) they have got themselves on the waiting list for a gender identity clinic.

(These are specialist clinics where you go to get access to transition treatment, known simply as GICs.)

This person announced the new development, and happily lots of people clustered round to offer hugs and support. (Woo!) The waiting list at their ‘local’ clinic is about a year. So, in a year, they’ll get to actually see somebody about it all.

(There’s about seven GICs in the entire country so local is putting it very, very, very loosely. As a comparison, Houston is local to Dallas compared to, say, New York City.)

But one remark stuck out to me.

One comment fucking hurt.


And I am sure this is not what the commenter meant, and I’m sure they are genuine in their support for this mutual friend.

But my God, did I want to shake them and scream in their face.

Their comment (and I will not directly quote because, as I said, I really don’t want to ID them) was that the waiting list is needed.

As in, for the patient to figure it all out before they get there.

As in, it’s a good thing the first appointment is twelve months away, because this mutual friend will need that time to get it all sorted out in their head anyway.

Even worse, this was not the only comment along these lines. Others include the wait will be beneficial and after all, it’s a big change.


I mean, you do realise that’s a middle finger salute to the hundreds of people who’ve been psychologically tortured by the waiting lists in for UK GICs, right?

You do realise that many of us have bankrupted ourselves going private because we won’t receive any actual help within two years, minimum?

You do realise that people have committed suicide waiting for treatment here, right?

You do fucking realise that it takes seven years to transition on the NHS, right?

So no.



Absolutely fucking not.

No-no-no-no-no. Do not, do not, excuse the torture of patients on those waiting lists for years because hey, they need time to figure it out.

Okay, firstly?

Most people going to a GIC already figured it out.

Like seriously, this is not an early step. Most people have already been talking to therapists for years. Most people already have a good idea of what they need to feel better, to be okay again. Most people are going to the GIC because they think (wrongly, actually) that this is the only damn way to access treatment.

And those who don’t? The first person you see in a GIC is a psychiatrist. And guess what their job is? To help you figure it out. To make sure you’re set on this, you’re not going to regret anything, that you’re giving yourself the best shot at happiness and health again.

Some GICs are actually famous for stalling you at the psychiatrist stage. Some psychiatrists are so binary-blind and focused that you have to be super hyper feminine or masculine to get what you need (because obvs no trans woman ever likes wearing football strips, and no trans man has ever thought their toenails look awesome painted blue). A friend’s girlfriend was stuck for two years at the psychiatrist level, not even allowing her access to hormone therapy, because she didn’t experience dysphoria from her deep, manly voice.

Can you imagine waiting for a physiotherapist for two years because you need time to figure out your knee pain hurts? Can you imagine waiting four years to see an endocrinologist about your pre-diabetes? Can you imagine being told, ‘Yes, you may have an appointment with the severe depression counsellor, but her waiting list is two and a half years and we can’t offer you any support while you wait to be seen, but it’s alright, you need time to figure out if this is affecting you.’


Do not fucking tells trans people that their torture on waiting lists is okay.

And you think I’m exaggerating by torture?

This is what being on a GIC waiting list entails:


You are left to rot. There is no support. There is no communication. There is exactly nothing waiting to help you while you wait to be helped. You are left to hurt and cry and die.


You can’t admit you have mental health needs, like anxiety or depression, because that endangers your treatment. You can’t admit even to your GP that you’re struggling, because they might tell the GIC, or might even refuse to help you because you’re the GIC’s problem now. You have to sit there, in silence, waiting and waiting and waiting and waiting, to be helped with something you probably already know to be true.

I went private for my surgery, because I was refused ‘permission’ (no, seriously, that’s how this treatment works) to undertake transition in the order I needed it. I am still financially unstable thanks to that. I then flat-out told the GIC I would not sit and die on their waiting lists—because I would have done—and was allowed to seek hormone therapy without their involvement. (Like, you know, I should have been able to do anyway, like any other patient with a hormone problem in the whole country.) I still had to wait six months from surgery to getting that very first shot—and in those six months, I attempted suicide twice, and had three mental breakdowns.

All whilst going to work (I can’t afford not to), keeping my mouth shut (I couldn’t afford to have the possibility of help taken away from me) and pretending I was completely fine.

And that was just six months.

I knew I was trans before I ever told a single medical professional. And I am not remotely unusual. So for someone to have asked for a GIC referral—hey, guess what! They probably already know!

And if they don’t, they’ll have all the time in the world once they’re at the GIC to figure it out with the help of the psychiatrist!


Those of us who do know are being fucking tortured in this limbo between the GP and the GIC, held on ice and terrified to admit to needing more than a vague promise of an appointment maybe 12 months, 18 months, 2 years, 3, FOUR YEARS if you’re unlucky enough to live near Leeds.

And why is this bad?

Because who fucking cares about trans people suffering and dying on these lists? They can get seen eventually. It’s not cancer. They’ll be fiiiiiine.

They need.

The time.

To figure.

It out.

Yeah. That’s why.

Trans people are dumped off as whogivesafuck citizens because hey, it’s all in our heads and we need time to sort it all out first. So it’s okay to do that to us. It’s okay to make us wait years to even see a psychiatrist (never mind, by the way, that actual medical transition is going to take you years on top of that because you’ll spend the first six months just proving you’re not batshit or a special snowflake to the psychiatrist) because heeeey, we need that time.


We had that time. We had that time all the way running up to booking a GP’s appointment to get referred to a GIC in the first place. What do most of us need by the time we ask to go to the GIC?

Help. To. Transition.

And it’s comments like this that enable that torture. Because some people have not got it down 100% before they hit the psychiatrist’s office, all of us must be tortured on these waiting lists, and killed. All of us don’t know what we want, and must be forced to explain it over and over and over, and live months and years longer in the wrong bodies, with the wrong faces, in the wrong voices. And that wait, that lack of the system’s ability to help, is killing us.

And if you don’t believe me?

Come and meet me sometime. Come to a con, come to a pride parade, hell, rock up in my town and ask to share a coffee.

And I’ll show you the scars. I’ll show you the road outside my GP surgery. And I’ll show you the bridge over the railway line, where I sat for three hours wondering if I could make it six months until a doctor would deign to see me. I will show you the space in my bathroom where the pills used to be, that I had ready to go on the day they authorised my access to hormones.

Because if they hadn’t, that very day, I would have gone home and made a third attempt.

We don’t need time anymore.

We need a solution.


Work in Progress

Posted: April 27, 2016 in Uncategorized
Tags: ,

So it’s six weeks since my first T shot, and I’ve just had another.

In six measly weeks:

  • I’ve lost the upper ranges in my voice, and am speaking much more quietly than before. My colleagues and my boss have all remarked that I sound ‘gravelly’ or like I have a sore throat.
  • I had to shave my upper lip before work about four days ago. Haven’t since, but then, I hadn’t before
  • There has been a lot of growth in the downstairs department, to the point where I can just about cup myself, if you know what I mean.
  • Been a lot of growth in the fuzziness downstairs too. FYI, a beard trimmer has multiple uses.
  • I am basically a teenage boy right: ridiculous amount of energy, and eating my own body weight in food every day.
  • I’ve been hitting the gym every day and doing workouts that usually would leave my muscles crying and me curled up in a ball on the floor. It’s not happening. I don’t look any different yet, but I feel like for the lack of heart failure and death that occurs after a 10k run.


Work in progress, guys. Work in progress.

I hit the finish line.

I mean, I’m not finished, but I’m over the line. Today I had a nurse pull my boxers down and give me my first testosterone shot.

Which means in under a year, I transitioned.

In April 2015, I came out and socially transitioned. In November 2015, I had my top surgery. And in March 2016, I started HRT. And as HRT is a lifetime of injections…I am done.

In eleven months.

And yet…thousands of trans people in this country go years without being able to do it. Transitioning can take a decade or more — and that’s for ‘straightforward’ cases. If you’re non-binary, it may be longer. If you have other health issues, mental or physical, it may be longer. And as I’ve learned this last year, if you play by the NHS rules, it will be longer.

On a totally different note (maybe), the LGBT fiction community is up in arms at the minute. And it all boils down to erasure. Many LGBT people feel erased, marginalised and hurt in that community. Which is appalling and crazy and I’m one of them.

Because this is the consequence of erasure: waiting a decade to get help, and all the time, that help act like they’re doing you a favour. In fact, that’s very much a mirror image of the LGBT fiction community’s sad state at the moment. Ignore the LBT and any other orientation, for that matter, and when they complain, tell them they’re ungrateful.

In my battle to get hormone treatment, I was told I had to be seen on the first Friday of the month only, because that’s when the transgender clinic is. When I asked why I couldn’t have a Thursday like any other patient, nobody could answer me.

I was told I couldn’t be treated by my GP because of the guidelines. When I asked which guidelines, nobody could answer me.

I was told I couldn’t have surgery before hormone treatment. When I asked why, nobody could answer me.

And nobody can answer because…nobody’s actually got an answer. But because nobody has challenged this and forced them to change what they’re doing and how they’re thinking, we continue to wait and suffer and die in silence.

Yes, die.

I would have died if I had not been given my injection today. Because the other option would have been wait until mid-June, maybe even July. And I would not have made it. I would have killed myself, and I would have died because the system is constantly and systematically ignoring us.

If you like me, or my books, or heck, even the concept of a human being behind these posts, then for god’s sake stop pretending that sticking a rainbow flag on your profile picture and reading gay men getting it on makes you an ally. It doesn’t. And we need allies. We can’t change these systems, we can’t fight this oppression, completely on our own. We need to stand up and fight them, and you need to stand with us. You need to do something. You need to talk about these issues, you need to call out bigotry, you need to share stories, you need to donate to charities, you need to sign petitions. You need to act.

But if you call yourself an ally and all you ever did was read gay men screwing, then you’re no ally of mine.




(But I am a man now! Woohoo!)

#hormonewar 2.0

Posted: February 29, 2016 in Uncategorized
Tags: ,

So today I got a reply from the consultant’s office. So much for the call back.

Firstly, completely skated over the reason I am angry — that I have been separated from all the ‘normal’ patients and can only be seen one day a month because I’m transgender. Nope, that’s still all totally acceptable in their eyes. We’ll just ignore that part,  shall we?

Secondly, I will be ‘kept in mind’ if there’s cancellations. Yeah, okay, sure. Given your staff couldn’t be bothered to ring me back after typing up this letter (and it’s a paragraph long, by the way), I very much doubt you will do anything of the sort.

Thirdly, and this is the bit that really hacks me off…

“One possible solution would be if your GP were prepared to start you on testosterone treatment in advance of you attending clinic on the basis that I will be seeing you shortly and can discuss ongoing hormone treatment with you at that point in time.”



Right, so…my next GP appointment is in March. I will not see this consultant until June. So potentially, I could be on T for three months before I even see the so-called specialist whose so-called expertise is supposedly ‘required’ to get hormone treatment IN THE FIRST PLACE.

And given I first approached the gender services about how to get testosterone in DECEMBER, had that been said then instead of referring me to him just to be referred right back to my GP, I could be celebrating three months on T now.

So let’s just summarise that, folks.

The doctor who has quite probably never met a trans patient in his life (the GP) has treated me with the respect.

The doctor whose expertise is in trans patients has treated me like dirt, delayed my treatment for months unnecessarily and based entirely on my status and not on my patient needs, is passing my care knowing back to a doctor with no expertise in this area of medicine whatsoever, and is still refusing to see me within the timeframe set out by the NHS.

This is not fucking over.


Posted: February 23, 2016 in Uncategorized
Tags: ,

So right now my transition priority is starting HRT: hormone replacement therapy.


For a transman, that basically means taking testosterone for the rest of my life. As male hormones do their thing more-or-less irrespective of whether or not you have a bunch of female hormones floating around, the testosterone will slowly stop the production of female hormones, and take over. Then I go through puberty again, with the random hair, voice breaking, and acne. Not fun, but once it all settles down, boom. Hello, passing, no more periods, and finally being able to get on with my life.


Now, as I have ranted and raved before, gender identity clinics are the slowest motherfuckers on the planet. They get zero fundings, have zero staff, and thousands upon thousands of people churning through a ridiculously slow and backward-ass system. The people in the clinics are generally trying to help you, although asshats still exist, but they’re crippled by their own system.


Way back at the end of December, I called my local clinic. The pathway on the NHS is very much real life experience to hormones to surgery to more surgery to discharge, takes up to ten years to complete, is extremely rigid, and the waiting list to even begin was three and a half years. I rang them to explain I’ve been diagnosed, so I don’t need that, I’ve had all the surgery I plan on having, so I don’t need that. I literally need hormones. And once prescribing my hormones has been safely passed back to my GP, I will wave goodbye to gender clinics forever.


Simple, right?


At first, yes. The clinic sent me a letter to explain to my GP what to do, as GPs frankly haven’t got the first clue. My GP read it, said, “Right, I’ll do that then,” and sent it to the endocrinology department that the clinic recommended, and–




Four weeks later of hearing nothing, I rang the hospital. “Oh!” said the receptionist. “I can’t find you on our system!” You’re fucking kidding me. Actually no, several rustling noises later, she unearths my referral and says, “Oh I see, it’s from the gender clinic.” No it isn’t, it’s from my GP. “You’ll have to go the monthly clinic, the next available appointment is in June.”


June. Six months after the referral was sent. Well over the 18 week target to start treatment. I’m not even going to see the consultant until the 19th week, and given that apparently he can only see transgender patients once a month at a special clinic (instead of, I don’t know, seeing us and treating us like regular patients), it’ll be July or August before I get my first hormone shot.


In this exchange, mostly done through gritted teeth, I learned the following:

  • It’s okay to separate transgender referrals from cisgender referrals and stuff all the transgender patients into once-a-month clinics, as opposed to letting them have regular appointments like everybody else.
  • It’s okay to breach your rights as a patient — 18 weeks doesn’t matter, because your other option (going through the GIC) is worse.
  • It’s fine for staff to not actually read your referral and have no idea where it’s coming from, because hey, you’re only a transgender person, it’s not like you have a real thing needing real treatment.


Unfortunately for the staff at this particular endocrinology department, I managed to go from referring myself to a psychiatrist to having surgery in six months, something that usually takes year. I am not going down that easily.

So it’s not Sunday, and normal service will resume next week.

However, it is now 2016!

I actually made goals for 2016, something I haven’t done in a long time. And one of them was to start hormone treatment. Only that’s going to be way harder than writing it on a piece of paper and going ‘hey, I can totally do that.’

The thing is, hormone treatment is usually the third step, after diagnosis and social transition. But for me, it’s the last step. I have no plans at the moment to have bottom surgery, and I’ve already been diagnosed, socially transitioned, and had top surgery.

Unfortunately, NHS services really do presume that anyone accessing a gender clinic hasn’t made any steps whatsoever, so the information that’s out there is useless when it comes to how flexible they’re prepared to be. The Laurels in Exeter had all the flexibility of a plank. I hadn’t heard awesome things about Leeds either. And Nottingham was to be avoided at all costs.

I live near Leeds now, so I sent them an email detailing the situation. Imagine my surprise when I was called back the same day by the Leeds Mental Health Team! (Seriously, for the non-Brits here, NHS efficiency is an oxymoron.) Well, the first lovely fact of that phonecall:

It will currently take you three and a half years to get your first appointment at the gender clinic after being referred.

Seriously, three and a half years.

On top of that, by the way, it takes four months to be diagnosed, up to two years of social transition before an eighteen month hormone treatment plan and, two years later, surgery. That’s just under TEN YEARS to transition on the NHS right now, from that very first referral made by your GP.

Oh, and if you want help in that time? Call a hotline, NHS has no resources for you.

Ten fucking years.

Thankfully, the clinic lady was actually helpful to me. She outright admitted that going through the clinic wouldn’t be ideal for me, and offered to write a letter to my GP telling him to refer me directly to either a local endocrinologist, or one in Harrogate who has worked with their patients before. Cut out the clinic entirely, and crack on with the hormone treatment separately from the gender services.

And the waiting list for an endocrinologist right now? About two months.

Three and a half years versus two months, I know what I’m going to try.

So seriously, if you’re a trans person needing something a bit different from the gender services, call them! They will try and help you get around the problem. And if they don’t? Complain the fuck out of it. It’s only by complaining we’re going to change the system, because three and a half years to wait for treatment is longer than people waiting for a cosmetic boob job on the NHS. It’s absurd.



(happy new year!!)

It’s four weeks today since I had my top surgery.

I meant to post more, but I moved house and lost internet in those four weeks, so now I’m back! And four weeks to the day seems a pretty good place to give an update.

So: the surgeon removed 1.5kg of breast tissue. Pick up that in sugar bags next time you’re in the supermarket and imagine how much my poor skin was holding together. I wore a compression binder for a week, which canes on the ribs. It’s seriously quite painful because it’s 24/7. But there was no pain on the surgery site — just my poor shoulders and ribs, unable to move and being squished. The idea is to basically get the nipples to ‘stick’ back on, and it worked beautifully. One of my nipples has lost its scab now so it looks like it will for the rest of my life, more or less, and the otherone is nearly finished.

I have complete mobility again after four weeks: I can hold things above my head, I can drive, I can run for a bus, I can cook and liIMG_2804ft boxes and all that nice stuff. I had pretty heavy bruises on the left (I’m left-handed, so likely caused by needing to use that arm more than the other one) and being driven home was not fun at all. However, they discharged me with paracetamol for mild pain and codeine for heavy pain, and in the following week I only took the codeine once, on the second night. After that, it was all uphill.

I’m still a fortnight away from being allowed to soak in the bath, swim or sunbathe, but it’s the middle of winter, so I’m not bothered. Putting heavy jackets on is still a bit sore. Sensation-wise, I have a tingling sometimes around the nipple areas, and the skin under each arm is totally and completely numb. I nearly fainted when the surgeon took the staples out, it felt so weird. Didn’t hurt at all, but my brain had no clue why the hell my muscles and ribs could feel pressure but my skin couldn’t, and my brain always wigs out a bit when things like that happen. My skin on my upper chest also has the oddest feeling like it’s been burned a while ago when I’m wearing cotton work shirts — for those of you who’ve had tattoos, it’s almost exactly that same burning feeling left behind when you’ve had some intense colouring or shading done on a small patch of skin. There’s a couple of pinches in the stitching under my right arm that may need tidying up in a few months, but I’m waiting to see what more healing, hormones and weightlifting do. It may sort it out, it may not. I’m rubbing bio-oil into the scarring twice a day to help it heal nicely and without leaving a big mess, and it seems to be working fine so far.

Most importantly: I am fucking flat. I am totally flat. I put a t-shirt on and I look like a guy. I’m wearing a man’s shirt at work, and I look the part. I don’t feel horrible buttoning it up. I was lying in bed with the laptop on my stomach the other day, looking down my chest towards it, and the contours of it even now — when four weeks of inactivity have taken their toll on my muscles, and the scars are still raised and red — I feel amazing. It’s going to be a while before I can get back to weightlifting and working out again, and when I do, I’m going to feel even better…but right now is pretty fucking awesome as is.

More updates will come as time passes. If I don’t get back to y’all beforehand — Merry Christmas!

Matt x

Okay so it’s six and a half, shut up.

Basically, I feel fucking awesome.

This is a little selfie shot to show you what I had to lose. A pair of very big and heavy boobs. My surgeon told me afterwards that each breast alone weighWP_20151118_22_14_23_Proed 700-800 grams. That’s 1.5kg I just lost in four hours — fastest diet ever. And I only weighed 54kg to start with.

They knocked me out at about 12pm, and the next thing I knew, I was back in my room sans breasts. Fine by me, not remembering being intubated is an excellent thing.

I felt pretty rough initially. My reactions to drugs is to feel sick, and the normal blood loss of surgery drops my already perfectly normal blood pressure down into the dizziness and fainting category. I nearly fainted just lying down and had to have a fan on all night. The night nurse kept annoying me too. At the 2am observations, she said ‘you’re not very responsive.’ No shit, lady! Trying to sleep here!

I basically slept, only punctuated by nurses coming to check on me, from that 4pm realisation I’d been returned to the ward until 7am the next morning. At once I woke up at 7am and had breakfast, I felt surprisingly good.

This is the state of play at 9am when the surgeon came back and they cracked open my chest binder to check for bleeding or oozing. There was a bit of gunkiness on the left, so that had to be changed, but not before I snapped a fuzzy selfie. I felt pretty human, albeit sitting up was a big no-no. Sharp, burning pain where I presume the incisions had run under the breasts. Not comfortable at all.

But it was mostly discomfort, not pain, exactly. I needed the drugs more to get my chest muscles to relax and allow me to move around. I was sicWP_20151120_08_21_19_Prok only once, ironically half an hour before I was discharged and in response to my body’s chronically poor ability to swallow chalky tablets.

Then at 11am, we were outta there! The drive home was similarly uncomfortable, but still didn’t really hurt. I was given paracetamol for normal times, and codeine for if it got really bad. Six days on from the surgery, I’ve only taken codeine four times, and two of those still in the hospital. (And my tattooist will tell you I’m a pussy when it comes to pain.)

That said, it’s not all awesomesauce. Lying down to go to sleep wasn’t happening even four days later, though honestly that was more the compression binder I had to wear 24/7. It felt like it was squashing my ribs. Typing this, I have a vague throbbing in my left breast not unlike what can happen when you run without a decent bra, or when your period is fast approaching. I struggle opening the heavy doors at Boots, but it’s discomfort rather than ‘ohshitthathurts!’ and I get a stinging sensation around my nipples occasionally.

This was the situation at 10.30am when I was up and moving and getting ready to go home, and it’s pretty much the situation now. I’ve been wearing a compression binder ever since. My surgeon crudely put it as ‘getting everything to stick back on’ (mostly the nipple grafts) and by god do you know about it when you’ve been wearing a tight binder 24/7, asleep and awake, for a week. Plus I can’t shower because the dressing absolutely much stay dry, so it’s been bWP_20151120_08_47_43_Proaby wipe sponge baths for indecently long. Tomorrow, the dressing comes off. And hopefully, stays off. And I can go home and shower.

I went home Friday, and spent most of Saturday just lying in the armchair in the living room watching TV. But Sunday evening, I managed to put a t-shirt on over my head, and went to the theatre for a mate’s birthday. (I slept for eleven hours afterwards, but hey, still counts.) On Monday, I went for a mile-long wander round the shops and had lunch in a cafe. Getting back to normal daily life was pretty quick and easy, and aside from push/pull patheticness and a tendency to hunch over like an old man to protect my chest, things were pretty good.

I also had a bit of an emotional moment when I put that t-shirt on. My frame looks so much more masculine, in one fell swoop. I’m too flat to be female. It’s so obvious that there’s nothing left, even with the dressing and the binder, and I couldn’t be more pleased about it.

Bring on tomorrow and the banishment of this itchy binder!



Surgery Day

Posted: November 19, 2015 in Uncategorized
Tags: ,

It’s the day!

It’s 6.30am in Brighton and in 45 minutes I have to be at the hospital. My surgery window is anywhere between 8am and 11.30am. (And honestly, I’m so tired they may not need anaesthetic! Who invented 6.30am?)

Basically they will knock me out, do the deed, wake me up in the afternoon to check I’m sound, then leave me to sleep it off until Friday morning when they kick me out. So this is it!

My bra is in the bin, which I am obscenely happy about. But I am a bit grumpy this morning, thanks to the rule of nil by mouth since midnight, not even fluids since 5am. I want an OJ, damnit.

My hospital bag is finally ready, as of last night, and I go armed with things to do. I won’t however have my laptop as it’s too heavy to pick up afterwards, so this is the last you’ll hear from me until probably Friday.

Wish me luck, guys!

#boobwar is over

Surgery Countdown

Posted: October 18, 2015 in Uncategorized
Tags: ,

So tomorrow is exactly one month until my top surgery.

There’s a lot of stuff happened I could have talked about this week: mental health, what it’s like to not fit in to a community that likes to brag about how much it includes the LGBT, having a sense of humour about who you are, and so on and so forth. But they’re all pretty thorny issues, I’ve had a bad day, so I’m not going to talk about anything that’s going to piss me off or upset me.

So, surgery!

On 19th November, I will having top surgery. In layman’s terms, a surgeon is going to remove my breasts, put my nipples back where they would be if I were biologically male, sew me up, and send me on my way. Several pounds lighter, given that I have a massive rack.

I will be posting quite a bit around surgery day itself to keep you guys posted with a real blow-by-blow of what it’s like to undergo that procedure, but let’s start here with some background.

1) I am having to undergo this privately. For those of you in the US, that’s like ‘duhhhh.’ But in the UK, typically medical care is via the NHS, which is free at the point of use. The problem is that the NHS has serious financial problems right now and, even if it didn’t, frankly doesn’t much care about transgender patients and tailoring their treatment to the individual. In short, the NHS will pretty much refuse to give anyone any surgery before hormone treatment. As that isn’t what I needed, I went private.

2) So basically, I’ve been saving up £6,000 for this surgery. My bank balance is going to be a paralysed heap on the floor next month.

3) On 10th November, I will be heading to hospital for my pre-operative consultation. This is basically the bit in the medical dramas where the doctor draws on you with a sharpie. See, top surgery is done a whole bunch of ways, depending on the size of the breasts and the aims of the patient. Some people really want to keep as much sensation in the nipples as possible, so the surgeon will have to find a way of doing it to avoid as much as of the nipple resize and regrafting as possible. Others, like me, have looking naturally male top of the list and to hell with nipple sensation. So for me, the surgeon can use techniques that would render my nipples literally senseless and it wouldn’t bother me at all, as long as I can go topless at the beach and nobody looks twice.

4) On the same day, the hospital want to run a whole bunch of tests. Basically to make sure I’m fit to undergo surgery. I have to fill in a questionnaire the size of a stottie cake to bring to them, then they get to make me look like a heroin junkie with all the blood samples they’re going to take.

5) If all is well, I come back on the 19th. It’s nil by mouth for the evening and night of the 18th, then I have to show up first thing in the morning and get checked in. At some point, an anaesthetist will attack me with a mask, and then I will (ideally) wake up some time later sans boobs.

6) I will leave the following morning (20th). I know some American surgeons are all ‘you have to demonstrate you can eat and put a t-shirt on over your shirt’ but this surgeon hasn’t specified anything I have to do in order to be signed out.

7) I lounge around generally feeling knackered for a week.

8) On the 26th, I return to hospital for a post-operative check-up. By this point, swelling should have gone down and the early results should be obvious.

After that, I can get on with my normal life, albeit given that I currently wear 30F or 28G bras, my equilibrium will be a bit off for a couple of days, the car seatbelts are going to be shady as fuck for weeks, especially going over speedbumps where currently it’s like “Ma’am, please remain in your assigned seat,” in my shirt, and I will probably be mega confused the first few times I shower and reach to put on a bra again afterwards that I no longer need.

A few things will be different for a while, such as:

1) No driving for a week or three. It’s difficult to lift the arms afterwards, and nobody’s power steering is that good.

2) I’ll be taking pain medication and arnica to counteract bruising and swelling for a while.

3) I’ll have to wear a binder for a while afterwards too, to help healing and minimise scarring.

4) No swimming or working out for ages. Which is going to be a bummer, as I’ve worked super hard bulking out for this surgery to give the guy something to work with.

But that’s the boiled down version of what’s happening in like…four weeks. I’m also moving house in that time, so I’m going to have to pack a hospital bag super early, move, hope I lose nothing, arrange the new house in time to be useable when I’m released, and — of course — take entertainment.

Because lying around unable to work out, go to my day job, or roam is going to be fucking dull.