GenderGP’s Lead Counsellor, Marianne Oakes
As a fully qualified counsellor, with a post grad diploma in Gender Sexuality and Diverse Relationships, Marianne is our most experienced counsellor in the field of transgender care. She heads up our team of specialist gender counsellors at GenderGP.
Marianne combines her own experiences as a trans woman with her affinity for others on their own gender journey. She came into this particular branch of therapy after struggling to find someone who could support her with her own transition. Marianne brings a unique insight to her practice, both from her own first hand experiences and her understanding of the impact which transition can have on families and loved ones.
She enjoys working with people of all ages, including children and their families, creating a non-judgmental space in which parents can talk openly about their own issues in relation to their child’s transition.
My child seems unhappy with their therapist, how can I investigate without encroaching on their privacy?
When talking to your child about their experiences with their therapist it is important to make it clear that you are not asking about the therapy itself. Explain from the outset that you respect your child’s privacy and that you only want to make sure that their experience is a positive one, even though what they are discussing may be hard at times.
There may be a number of reasons why your child may not be enjoying therapy, including whether or not they were involved in the decision making from the outset. If they were not involved, the relationship may well have started from a negative position, with your child feeling that you are making all of the important decisions.
Empower your child by bringing them into the conversation early on in the process. Select a few therapists that you feel have the requisite skills and allow your child the freedom to pick whoever they feel is right for them.
Whoever chose the therapist, explain that it’s ok to change to someone else, if the relationship isn’t working. At the same time, it is important for them to understand that it takes time for the relationship to develop. Make it clear that what they feel matters to you and that you want them to get the most out of the experience.
I am concerned that if my child sees a therapist they will reveal things that I do not want them to. How do I deal with this?
Firstly it is important to remember that this therapy is not about you. If you have identified a need and you feel your child would benefit from being able to talk to a professional, then you have to allow them the space – and freedom – to do this without worrying about how it might reflect on you. Unless there is a safeguarding issue, the information your child is giving to the therapist will be held in the strictest confidence. Discuss how you will approach the matter of confidentiality with both your child and the therapist at the outset, make it clear to your child that they are the client and as such they are free to discuss whatever they need to, safely.
I'm so nervous about opening up about my gender to anyone. How would it be any easier with a counsellor/therapist?
Think of a therapist as a professional friend, their job is to make you feel safe enough to open up about anything that you want to bring to the session. The fact that it is a professional agreement ensures confidentiality is paramount, you don’t have to worry about your trust being betrayed and therapists are taught never to leave the client feeling judged or dismissed – all extremely legitimate fears that may well have prevented you from opening up in the past.
I don't like my therapist but I don't know how to tell them. Can you give me any advice?
Counselling is about challenging yourself to speak the unspeakable and to recognise the difficult decisions you might have to face. There is no hiding in the therapy room and this is a factor that can lead to resentment. If you are harbouring negative feelings towards your therapist, I would strongly recommend that you explore why this might be before jumping ship. If you fail to explore this in depth, you may well find the same issues coming up time and again with therapist after therapist. It is important to remember that therapy is a long-term relationship. Before committing, make sure there is a connection. Ask yourself: do I feel I can trust this person, do they make me feel listened to and understood? What am I trying to achieve? Take time to choose the therapist that’s right for you – and if it doesn’t work out move on. Good therapists understand the importance of that connection and if it isn’t there you will not get the best out of your experience.
How do I know what gender I am? My parents say this, my friends say something else - I just don't know. Can you help me work it out?
The answer is a resounding yes! As a specialist gender therapist who has worked with many clients, each on their own very personal, very individual journeys, this is where my specific area of expertise lies – as well as my passion. This is all about you and I can help you to work out what your gender means to you and well as what you might – or might not – want to do about it. You are the expert in your life and your experience. Any good therapist will help you to feel empowered to trust yourself to make the choices that are right for you.
If you have a burning question for Marianne that you would like us to feature on the website, contact us on Twitter: @GenderGP using the hashtag #AskMarianne. The best ones will be featured on this page.
My Trans Journey
As lead counsellor with GGP you might expect to hear that I have been managing my journey to HRT through our services. Well, you would be wrong. I took the decision, three years ago, to follow the NHS pathway to treatment. Here I wanted to share my experiences with you in the hope that you will see you are not alone.
February 2021: First signs of Spring
This month I am under strict instructions to keep my update light - so I have decided to make the most of it!
Living in the north, 1000ft above sea level, it always feels that we’re slow to see the first signs of spring. But as I walked out of the house this morning I noticed the crocus pocking through, the sun was shining and I just had an enormous sense of well-being.
My mind quickly went to my wardrobe and I was delighted at the thought that it will soon be time to put away the dreary practicality of winter layers and wear something altogether prettier!
Not that long ago all I did with my wardrobe when the seasons changed was to wear a layer less or a layer more, because very little changed. I had little to no interest. It makes me laugh if I compare myself then to myself now - there are few things that give me greater pleasure than heading out on a shopping trip and finding, and wearing a new outfit. Maybe this sense of optimism is fuelled by news that the lockdown will soon be lifting and we can all get back to these small pleasures that have been so absent during these long winter months.
It feels freeing to be able to luxuriate in my clothing, to be able to wear what I want and truly be me - I guess spring is a metaphor for the sense of awakening I feel. My hormones have heightened my sensitivity to colours and materials in a away I could only have dreamed about in my earlier life.
Experience now is everything I hoped it would be and for a moment this morning, as I walked to my therapy room, I forgot about the anti trans “noise” in the news, I left lockdown behind and for the first time in a long time, I allowed myself to think about the coming months and I looked forward to enjoying my transition, as we all should be able to: a little dreamy, a little hopeful and a little better for the nice weather that will allow me to enjoy my wardrobe in all its glory.
January 2021: The ups and downs of HRT
Since beginning my medical transition I find I am more in tune than ever with my hormones, and what my body needs. As such, it didn’t take long to realise I was lacking something. I did some research, looked at my symptoms: feeling flat, tired not my usual self, and made an appointment with my GP. I wanted to discuss an increase in my Oestrogen patch or maybe even the addition of progesterone, which I have read can be beneficial to trans women.
Ironically, my wife, Vicki is also on HRT. Yet the differences between the ways in which we are both treated are stark. We are exactly the same age and we have the same needs, hormonally speaking. Yet she speaks to the doctor about her hormones and they do what they can to help, whereas I face barriers, and have to jump through hoops.
Vicki is already prescribed Progesterone as part of her hormone profile but, as a trans woman, when I approached the subject I was told it would not be possible. Why is it good for Vicki but not for me? Why is Progesterone allowed for trans women in the US but not in the UK? Why can GenderGP prescribe progesterone, in line with informed consent, but I go down the NHS route and all I find are barriers?
The truth is, healthcare professionals see me as different despite my hormonal make-up. They are afraid to trust what I tell them because they are influenced by the social discourse around trans individuals. The truth is they really don't see me as a woman, they see me as a man with female hormones, which is the fundamental issue impacting trans healthcare across the board.
No wonder, trans people feel a sense of trepidation when raising their transition with their GP. I am a few years in and still I worry about not being heard. So, rather than take the bull by the horns I ended up delaying the call to my GP, opting instead to increase my oestrogen dosage myself, using what I know based on online research and the patches I already had available.
It didn’t take long for me to feel a change, there was an almost immediate impact on my mood and over the following weeks, I began to see the physical changes, culminating in what has been the most exciting news of 2021 so far - I reached a C Cup!!!
I am not advocating for people to take their care into their own hands, but I do empathise, I know from first hand experience how helpless it feels to have to ask “permission” to make necessary changes to your hormone regime.
I know my body, I notice changes like an increase in body hair, which is non-existent at times, then I notice a coarseness on my skin and dysphoria kicks in. I know when my breasts are tender or changes in my mood, these are all indicators that my hormone levels are potentially not where they should be. A small increase in my dosage has made a massive difference.
What I really need is for my doctor to make it easy for me to broach the subject. As trans people, so often we have to take charge of our own care, tell our GP what’s happening, or in some cases - go out on a limb and navigate it alone. The dangers of self medicating are well documented, although it does sometimes feel like the only option it is vital to get help and guidance from experts and crucially access to genuine prescription medication.
From what I have read the best advice for trans healthcare is to match the hormone profile that I would have had, had I been assigned female at birth - of course that’s the best practice thinking from centres of excellence around the world. I guess it’s just another example of where the NHS has some serious catching up to do.
December 2020: Silver linings
Well it's that time of year again when we reflect on the past twelve months and consider what may lie ahead and what we hope to experience and achieve.
There’s no denying that it’s been a difficult year. It’s hard not to focus on the negative, my own personal low points include the rolling back of the GRA, the recent court ruling over the use of Puberty Blockers for under 16s, the continued ‘debate’ around trans rights...chuck in a global pandemic and the resulting loneliness and isolation so many have endured and, well, let’s just say I won’t be sad to see the back of it!
Although it's not always easy to find the silver linings, there are some if we look hard enough. For me a high point has been my ongoing journey into womanhood. My family has come a long way this year and as a family, maybe in part because of the restricted movement, we have grown closer. It’s less difficult now to talk about things relating to my transition. I always used to be self conscious about what I said or how I said it, but now, I find myself doing this less. I also feel my family are less obviously tense when they need to discuss the practicalities of my transition.
The highlight of the year was the birth of mine and Vicki’s first grandchild Billy. His birth was a catalyst, it forced my son and I to sit down and be completely honest, urged on by the need to agree what my first grandchild will call me. For Billy, growing up in a world with a transgender member of the family is the norm, and I am certain that he won’t be the only one of his generation. While I know I am unique 😉, as we all are, I hope not to be the only Grandi to exist in the world. I consider myself incredibly lucky to be able to play an active role in his life, and I know am not the only one who will get this privilege.
So I raise my glass to you and to the hope of what 2021 will bring. I have a second grandchild coming in May so I already know that 2021 will be full of promise. My Christmas wish this year is for even more visibility for the trans community in 2021, we have come so far and with a little belief in ourselves and some help from our allies, we can go all the way.
November 2020: What a month!
What a month November has been, we’ve had the highs - with the President elect acknowledging trans people in his victory speech and Transgender Awareness Week - and the lows - TDOR gave us a moment to reflect on the ultimate devastation caused by transphobia and let’s not even mention the second lockdown...
All the while my transition has been like a freight train, rolling on regardless of what else might be going on in the world. It dawned on me that I hadn’t had a blood test in a while and I was feeling a little jaded and lack lustre so, while having my three monthly T blocker injection, I booked a blood test to ensure my levels were as they should be.
After five days of waiting for a call back I gave up and called the surgery to ask for my results. They were, I was assured, “normal”. I knew they couldn’t be normal, I had missed changing my patch the day before as I didn’t want my levels to be on the high side (naughty I know, but we do what we have to do). I asked if could I view my results online and discovered that not only were they not “normal” they were a third of what they should be (84 pmol). I rang the surgery back and said surely there had been a mistake, even if they had misgendered me, this figure was wildly incorrect.
I insisted the doctor take another look and, shocker, I have been called back for a second blood test. All I hear about is how great the NHS is when it comes to monitoring my levels and honestly, I’m not convinced.
What I have learned is that I know my body now better than ever, I know when my levels are low and I know when I need to speak up. Most people live their lives without ever questioning their hormone levels which seems crazy to me knowing how much a change impacts the way I am feeling.
I have discovered that I have an affinity with my dear wife Vicki who is using pretty much the same medication as I am. Over time, she too has learned to manage her hormone levels, the only difference is that if she would like to increase her dose, no one questions it - no blood test required - but if I want to increase mine I have to go through a huge amount of rigmarole to do so.
In more positive news, I was getting dressed in a dreamy haze one morning this week, I pulled on my jeans, slipped a jumper over my head and straightened it. I looked in the mirror with a smug smile of a cat who just got the cream. The diet is working I am feeling quite trim and my shape, oh my god, its just getting better and better. I head off to work and 4 hours in I realise, I wasn’t wearing a bra!!! How cool was that, my two little packages have grown and are pushing a C cup and they are matching my overall shape.
By the afternoon shift I had corrected my error, but I was so proud of myself, I can go braless (not that I would want to). Three years ago I was wearing breast forms worrying they would be seen or worse still, dislodge from the cup of my bra and fall out, now, I can actually go braless. Despite the obstacles the NHS services have put in front of me, this is a fantastic achievement and beyond anything I ever imagined.
October 2020: Trans visibility
I have been reflecting on events recently, the GRA, the court case against the tavistock (still awaiting an outcome) the media attacks and the damage this causes. Yet, despite all of this, as my grandparents used to say, we have never had it so good, in fact I would go one step further and say, there has never been a better time to be transgender.
I realise some people will scream at me for saying this and I truly understand why, but while things may be bad, they are bad because we are visible and THAT is a huge win for us as a minority group.
I was 12 before I found the word transvestite in a book in the school library. My only experience of transgender characters in day to day life were of a villain in a movie, a grotesque pantomime dame or a sensationalised story in the News of the World. All of this pointed to the narrative that being transgender was something to be ashamed of, not something anyone would openly own up to.
Being visible, even though it comes at a price, is incredible. It fills me with hope for a future in which we are an ordinary and accepted part of society - move along please there’s nothing to see here. I do see hints of it creeping through. Of course there is still plenty of the ‘other’, but times are changing.
I love the fact that young people are able to explore their gender, that they have access to information and education to help them put names to what they are experiencing. It is incredible that there are trans role models, people that those who are struggling can look up to and see all the potential that they have to be anything they want to be.
I never met anyone from this section of society until 2005, then it was just a glimpse, a peek behind the curtain. Now we are front and centre trans women, trans men, non binary folk, all fighting for their own voice to be heard. And heard it will be.
For me to be living my truth at the age of 58 and seeing the younger generations flourishing and getting access to care is the highlight of all my experiences to date. Never did I believe a person from my background could ever be transitioning like I am, never did I think for a minute that young people from all backgrounds would be able to access to affordable transgender healthcare. Shows how much I know!
I know that being ‘transgender’ is a hot topic, that every political party and politician is talking about us and are trying to work out what to do for the best, I know that they too are being scrutinised, that every news outlet in the country is watching to see what approach they will take, how they will deal with this latest ‘crisis’. The reality is that in time they will look back and wonder what all the fuss was about, but until then at least we are on the agenda, an item of interest, a group with a voice, which is fighting for its rights and its place in society. And we will get there, we just have to sit tight.
The Government’s own consultation showed that most people in today’s society feel empathy towards our situation, that they are accepting and just want us to get on with our lives.
For the first time in my lifetime I feel able to allow myself a little gender euphoria and I see more of that breaking through from different parts of the community including the young people we help at GenderGP. This is exactly why we keep fighting, why we keep finding a way to navigate the metaphorical bombs that are thrown in our direction. We are determined to fuel this positivity, to demonstrate that, for so many trans people, their being trans is the least interesting thing about them. Free them from the challenges that this presents, and they can get on with living a life full of opportunity and experiences - just like everyone else.
September 2020: Trans Sex Education
This month, with the focus on trans sex education, I have turned my thoughts to the topic.
In my younger days, it is a subject I could have spoken about for hours but in my older years I find it much harder. Why then and not now, you ask? Well, back then I had sex education on tap. This came in the form of a school yard full of classmates who were more than willing to share blow by blow accounts of what they knew, what they thought they knew and what they had heard from their mate Bazzer’s older brother.
Anyone who was anyone had something to share. Of course, all of this insight was based on a heteronormative view of the world (neither homosexuality nor gender variation being a thing that people were brave enough to talk about) and I soaked it all up.
Needless to say as a trans woman, I had to begin the process from scratch.
It will not come as a surprise to many of you to discover that sex education for trans people is not so easy to find. As I started to dig, I very quickly found kink and fetish sites for trans people, but there was a dearth of information about ordinary sex for people in a loving relationship (which can of course be as kinky as you like!). The perception seems to be that if we are trans then we must be into extreme sex.
But what of those among us who just want a little guidance on how to keep the fire burning in our relationships, to know how things might change, how hormones might affect our sex drive, how our sex life might evolve to allow for any dysphoria around our physical body? Where are the helpful hints and tips? Yes, there are bits and bobs for the younger generation but middle aged trans women get a raw deal!
Perhaps I am asking too much? Is there a belief that we are not and should not allow ourselves to be sexual beings? Perhaps enjoying sex is not very ladylike and if we do enjoy sex then maybe we should at least feel some shame or invalidation. But here’s the rub (pun intended)...I enjoy sex and it has always been an important part of my relationship. So how do I navigate this new part of my life while still giving my relationship the attention it deserves.
At no point have I ever been asked by any healthcare professional if I needed help nor have I been given guidance on where I might go to get help that isn’t, you guessed it...heteronormative.
Even traditional same sex relationships have access to support through their community and this is where we need to help each other, by being willing to share our own experiences as we did back in school.
As a therapist I am all about the chat. I would love it if we could begin to talk more about this most taboo of topics; real sex, for all, without the stigma.
If you have any tidbits to share and would like to send them in, please visit our Help Centre. We will share them with you as part of our sex education special. If the resource doesn’t exist, let’s create it together!
July 2020: Milestones
It’s been a double celebration this month, it was my birthday and my two year anniversary on HRT! Milestones such as this are the perfect opportunity to reflect, not only on how far I have come on my own journey, but how far we, as a community, have come in terms of achieving acceptance and understanding in the world.
If we were to believe everything we read in the media, we would be forgiven for thinking that living the life of a trans person in 2020 is a really scary concept. Yet, I keep saying to myself, there has never been a better time to be trans and I really mean this.
I spent the bulk part of my life hiding in the shadows, skulking around and going to support groups where I had to meet someone and be escorted to the venue. It was terrifying and exhilarating in equal measure. On the one hand I was risking public humiliation, if I were caught, on the other hand, the opportunity to meet other people in my position was mind blowing.
Today with so many amazing support groups available online as well as in person, we have a choice, just like any other person, on how involved we want to be and that is such an incredible feeling. Just knowing the support is there, should we need it. We are freer than we have ever been. This doesn't mean that everything is rosy in the garden, but it does mean that life for trans people has improved.
I will be honest. My hopes, in terms of what the next five years will bring, are high. The last five years have superseded anything I could have hoped for. The more we act, the more we show ourselves to be the incredible people we are and the value of everything we bring to the table, the better society will accept that we are simply a part of the rich variation that makes up our colourful, wonderful world.
June 2020: Grieving my past and embracing my future
To truly understand what it was like being trans when I was growing up it is important to remember that things were very, very different.
In 1978 there was no way I was going to university for two reasons: one, my parents couldn't afford it, and two, I just hadn’t had the sort of education needed to qualify for a place. My options were either: go to work in the local sweet factory, or serve a craft apprenticeship.
My Dad, bless him, pushed me into the building trade as a labourer at first, then a carpenter joiner. The day I went home and told my family I had secured a craft apprenticeship was a day of huge celebration, that I doubt would have been any bigger had I actually gotten into university.
Entering such a masculine environment as a closeted trans girl (which I was accutely aware of at this time), all I could do was keep my head down and work hard. After working on the bench for four years, I eventually graduated onto the building sites.
What an eye-opener that was.
I was catapulted into a world filled with drug dealers, armed robbers, wife beaters, and fraudsters. I always joke that it was like the cast of Brassic and Shameless combined. I would sit and feign interest as my colleagues regaled me - and the rest of the ‘lads’ - with weekend tales of bashing the “pakis” and “gays”, not to mention “tranny hunting”. These were all fair game for my Mancunian workmates and they did not hold back on the details.
I protected myself by being smart, I could be verbally caustic, if anyone tried to bully me or say anything negative, I would rear up and humiliate them. I would ridicule bad workmanship and lambast poor work ethic, and this seemed to put them in their place.
What I didn't do, to my shame, was stand up to their homophobic, transphobic and racist remarks - I guess it was a step too far. Knowing what I knew, my survival instincts no doubt kicked in.
All of this was taking place against the backdrop of Thatcher’s Britain, AIDS and section 28. As a trans woman, I felt completely alone, vulnerable and exposed. I remember once, heading to a trans support group in Manchester, aged 25, but travelling down past billboards comparing gay men to animals proved too much and I bottled it.
When Victoria asked me how I now feel looking back about all the missed opportunities, I can honestly say that I have no regrets. Part of me wishes I could have been a 20 something girl, enjoying life and and exploring my sexuality, but there is no doubt in my mind that doing so would have exposed me to far too great a risk. I also know that in exploring this side of myself, I would have sacrificed so much: my loving wife, two wonderful sons and their partners - who couldn't be more supportive.
What I now realise is that my life was always leading to this point. No matter how I dressed, looked or behaved, I was always female, never male. I know that now.
If someone had told me that in 2020 I would be working in a job I love as a female therapist for GenderGP, an organisation leading the charge in the transgender health care revolution, I would never have believed them. If they’d have told me I would be living my life and my truth; that I would be two years into my hormone regime; that I would have developed a B cup; that my bum would be growing and my confidence would be through the roof - I would have told them they were dreaming.
I finally feel I have reached a point where I am able to grieve my past and move forward. For me it is important to acknowledge how the times I lived through impacted me; times that didn't afford me the dignity of pride, times that forced me into hiding. Having acknowledged this gives me all the more reason to celebrate where I am now.
Today, I couldn't be more proud. Not just of myself and what I have achieved, but of my community for pushing on regardless, for continuing to fight against the odds.
So this Pride I want to say thank you to my younger self and all those that went before me who, despite the challenges, never lost faith.
Happy Pride month!
May 2020: Divorce & Transition
The subject of divorce and transition has been on my radar this month, inspired by a story I saw on Twitter, in which the trans status of one parent is being used against them in a custody battle.
For many trans women of my generation, there has always been this overwhelming fear that accepting ourselves for who we truly are can only be achieved through sacrifice.
Marriages and partnerships, careers, family, and crucially, our relationships with our children - are all potential casualties of accepting and embracing our true selves.
Nowhere does this come under the spotlight more than in the divorce courts.
Biological mothers naturally have the upper hand when it comes to being recognised as vital to the child’s wellbeing, with the father all too often taking a back seat. Throw some gender variance into the mix and the mother has enough ammunition to strip away any access to the child, should they choose to do so.
But I often wonder, where the child’s wellbeing factors in all of this.
My parents divorced in the late 1970s. My childhood involved me being pulled from pillar to post, with each parent trying to gain an advantage over the other by using me as collateral. It became a competition between the two of them and I was the prize.
The experience was traumatic. I never truly connected with my mother after the dust settled. I always sensed some bitterness in her because, having been given the choice, I chose to live with my dad. If this was indeed a competition between the two of them, she had lost, and I felt it was my fault.
As an adult, I can rationalise the fact that I was a pawn in the proceedings but, for a long time, I was devastated by what had happened.
In those cases where gender variance is cited as the cause of the relationship breaking down, it seems to me that the law is able to use it as a ‘mitigating factor’ - a reason in favour of removing a child from their parent. Surely, the focus in any divorce should be on helping the child to understand that none of it is their fault and being trans isn’t a choice. If gender variance can be used in a law court as an argument against the trans parent, how can they ever hope to get a fair hearing?
Furthermore, what impact does this display of prejudice and intolerance have on the long term relationship between the parent and the child? Surely by pinpointing the trans parent as ‘other’ the court is reinforcing a sense of shame in all those involved.
As trans men and women become more visible, we are making positive strides in gaining the recognition that, while we may not identify with the gender we were assigned at birth, our journey does not make us something to be feared. This translates into an increase in the chances of us being able to transition without all of the sacrifice and keeping some semblance of our previous life is far from impossible.
Some of us will be able to transition whilst holding on to our relationships, partners, families and children. Careers will mould around us and colleagues will accept us. We may never be accepted by everyone but we can be accepted by those who truly matter. The law must reflect this level of trans normalcy, if it does not being trans will forever put us at a disadvantage
April 2020: Lockdown
I can’t quite believe how much life has changed since last month’s update. Just four weeks ago, I was moving forward and connecting with old friends. I was feeling really positive about the future and how wonderful my social calendar was going to look!
A month later, and we are in full lockdown. Social interactions are limited and those I do have are either via video call or a shout across a garden fence. Believe me when I say it’s a challenge to sound remotely feminine or demure when shouting at the top of your lungs!
While I have kept in touch with all of my friends, there seems to be little to talk about. No stories of travel or exciting plans. We’re all in the same boat, focussing on managing the ways in which lockdown is impacting us all individually.
It will come as no surprise then, when I say that I have been concentrating on my medical transition more than usual this month. However, rather than stray into the negative - which I know all too well is so easy to do during self isolation - I have decided to focus on the positive.
I had my three monthly T blocker injection last week. My GP surgery called and booked me in - I genuinely didn’t think I would hear from them during the COVID-19 crisis, so it was a really pleasant surprise.
Even more exciting was my discovery, just before lockdown began, that changes are still happening to my body. I went on a shopping spree and bought some new bras. I was convinced that I was an A cup but it looks like this is no longer the case - I am officially heading towards a B cup!
Another area of my body where I have noticed real progress, in terms of feminisation, is the top of my legs. I always had what my wife would call “footballers legs” with very muscular thighs. When I was younger these were a blessing that got me out of trouble on more than one occasion. However, as the years have progressed, I have become increasingly aware of those areas of my body that look out of place. While no one else really notices this part of my body I had always considered them incredibly masculine - but I am delighted to say that two years after starting HRT, this is no longer the case. I love all the changes my body is going through, I feel like being myself is getting less of an effort with every passing day.
Finally, I can honestly say that writing these updates has almost become a ritual. A way of recording the changes and celebrating the fact that I am transitioning. That I am owning my life. I am a trans woman going about my business and enjoying the sun, managing the lockdown as best I can, lucky to be working when so many are not - and best of all I am doing this as myself, not as the version of myself that everyone expected me to be.
I grew up believing that only the privileged could transition. Surgery was always out of reach financially and I never believed I would be accepted by the GIC. It took time, experience, a shift in society’s view of trans people (however slow) and the support of my family to make me see that it was possible for me. With each passing month, each conversation, each interaction, I am more and more absorbed in my life, the life I feel was always mine to live.
My wish for those reading my updates is that they too can embrace themselves for who they truly are so that they can take the necessary steps along the path to help them to arrive at where they need to be and leave the old facade behind.
March 2020: Reconnecting
When I started my transition I left a lot of old friends behind. As many transgender people will know, the fear of rejection can be so overwhelming that all too often, rather than tackle the issue head on, and risk a negative response, we remove the threat by walking away. I suppose it gives us a sense of control. It also means that those people who were once close to us do not get a say in the matter. While we are busy protecting ourselves, we kick them to the curb and they are left wondering what they have done to deserve such treatment.
This month was a huge milestone for me. I met up with one such a friend, with whom I had lost touch. She hadn’t ever met the real me and I had no idea how it would go.
We arranged to meet and the day finally arrived. She sat me down in the middle of Costa Coffee and I waited for the scene that I had played out in my head, to unfold. She would tell me how great I looked, we would discuss my transition. She would show me just how supportive she was going to be as a friend and we would move on.
So it began: "Before we go any further I need to get something off my chest..."
This was not the tone I was expecting.
She proceeded to tell me how much my disappearance from her life had left her feeling bereft. That she was so angry with me but that she didn’t have anywhere to take her anger because I had disappeared. That she had missed our friendship and my family, that she had been worried about Vicki and she had felt frozen out.
In short - it wasn’t all about me.
I was stunned into silence for a moment (anyone who knows me well will know that’s not easy), but for the first time I was blown out of my bubble - something I hadn’t realised I needed until that moment. My friend owned all of her feelings, despite understanding and having empathy for why I had done what I had done, she couldn’t take any comfort from it - she just felt abandoned.
Over the course of the next three hours, we had a great chat. She was curious, not about hormones and surgeries, as I would have expected, but about the family, little William (my new grandchild), how Vicki and I were doing and how the counselling was going.
If I said we didn't reference my gender identity then I would be lying, but it was all done in the context of ‘catching up’ as old friends who had missed each other dearly and desperately wanted to carry on where they had left off.
The afternoon was magnificent in its ordinariness. My friend made me feel connected back to my former life, she smashed down barriers with her, "now look here" attitude, and the love and care I felt was mind blowingly refreshing.
I have spent a lifetime believing people won't like this version of me, that they simply won't understand, but this friend truly saw me: the person and I, maybe for the first time in my life, was able to see how my actions had impacted her.
It truly hurts me to know I could have caused so much pain to someone so dear, however, I also know, I had to remove myself from my old life to truly find myself. And I have found myself.
This friend showed me true class and social awareness beyond anything I could have ever hoped to experience, and I can't thank her enough. I hope that she isn’t the exception to the rule and that in time, I might be able to reconnect with other people from my past.
Whatever happens, it all seems that little bit more achievable now that I have my very own Holly Willoughby on my side.
We want to hear from you!
What you are doing to ease the burden during social distancing? If you have any ideas, stories, pictures and videos you want to share, please email them over to Aby@GenderGP.com and we will get them up on our social media channels.
February 2020: Coming Out
I have been more reflective than usual this month, mainly due to attending the funeral of the last of my dad’s siblings. I never told my parents that I was trans and I often wonder what they would have thought, had they known. My parents were lovely people but they were from a different time.
I always feel humbled when I hear stories of people coming out to their parents and being accepted, and yes, I will admit, there is a pang of jealousy that I was not able to have that conversation. But I also hear just as many stories from people who came out, only to be rejected.
Of course, I will never know and it does leave me feeling a little lost at times. While it is too late for me to do anything practical about the fact, I do try my best to live my life on my terms, free of regret.
After the funeral, I spoke to my father in law about my transition. We’ve only spoken about it twice since I started living full time. We plan visits very strategically so that I only see them when I am dressed as conservatively as possible and if they drop by unannounced, conversations tend to happen through the wall, so as not to ‘shock’.
This time we talked openly, the conversation lubricated by half a bottle of whiskey. I understood more about his fears, the fear that the things we used to do together would have to stop, that I would change.
It led to me wondering whether I need to officially ‘come out’ to my wider friends and family and invite them to ask any questions that they may have. This isn’t something I ever felt the need to do. My wife always knew that I was trans and while I did talk to my kids and a select few, once I made the conscious decision to go ‘full time’, I never sat everyone down to tell them what was happening.
Instead, I made a decision to move forward with my life and transition and I made the necessary changes to facilitate this process. I was a carpenter by trade, which didn’t fit with who I now was, so I went back to college. I became comfortable, created a new circle of friends and I left parts of my old life behind.
For some people, I simply disappeared off their radar, for others, there were whispers of what had happened. Peppered with truths and no doubt a great degree of twitching curtains and liberal use of artistic license.
This has created a strange dynamic in which family and friends have told each other but I do not know what they know, or even who it is that knows! As the majority of these people have not been told directly by me, they will have heard the news via someone else, who heard it from someone else, resulting in who knows what mutation of the truth.
This leaves me feeling incredibly uneasy and out of control. Something which, I am increasingly inclined to take back. But how best to do that?
Watching Philip Schofield’s revelation about his sexuality recently I longed for my very own Holly Willoughby. Someone who knows me, who is connected to my network and who can pave the way with those contacts with whom I have lost touch. Someone who can state my case, address misconceptions, remind people that I am still me, just a different version. Asking those close to me to do this is out of the question, they are coming to terms with their own feelings on the subject and I know talking about me behind my back would feel disloyal, make them question their own perceptions.
The funeral definitely made me think I could start to tackle this beast. Perhaps I am ready to open my door, to be less guarded, to answer those burning questions myself, address any misconceptions. All in the knowledge that not everyone will accept me. However, even though I have a pretty good idea of who would best be left alone, how can I be sure if I don't give them the chance?
January 2020: Optimism
I am feeling particularly optimistic as we enter into this new decade. I have been discharged from the PorterBrook GIC in Sheffield, and if I am honest, it’s a bit of a relief. They outright refuse to acknowledge my transition and only address my correspondence to my male name, using male pronouns.
The stupidity of this never fails to amaze me, particularly when all other healthcare professionals I see, including my GP, dental practice and chemist have all managed to update my records to reflect my preferred name and pronouns. How is it that the one place that should ‘get it’ flatly refuses to comply with my wishes? It beggars belief.
The #epicfail on the part of the GIC aside, I am loving my transition. I wore a pair of my old jeans over christmas to do some work (I didn't want to spoil my new ladies’ jeans) and I was delighted to find that they didn't fit me! It appears that my bum DOES look big in this and I genuinely couldn’t be happier!
These tiny changes creep up on me, month by month. All of a sudden after checking and rechecking only to find there’s no change, you relax into a routine of taking your hormones. Months pass and then one day here you are - more rounded, more feminine. The results are so affirming but so slow, whatever the media would have us believe.
In other news, I received an olive branch from a couple of family members over Christmas who had taken particular care in selecting the gifts that they kindly gave to me. It felt like a true sign of acceptance for who I am now. These are small but hugely important steps for all of us.
It never ceases to amaze me how ongoing the process of coming out, of feeling truly accepted, can be. You tell one family member and in the best case scenario they come around only for the next person you are brave enough to tell to have a bad reaction. Remember that every battle won - no matter how small - is a huge victory in the path towards authenticity.
Saving the best till last...Vicki and I became grandparents last week. The eagerly anticipated arrival of our grandson was the most incredibly exciting start to the New Year. I have spent much time over the past nine months agonising over the role I will play and how he will see me - not to mention what I will be called (which is still the subject of much discussion). In spite of this, I am not afraid. Everything feels so positive. Like it has slotted into place with his happy and safe arrival. My role is clear. My name...well that’s for another edition of the newsletter ?
December 2019: Peace
As we move into December and we start the countdown to 2020, I wanted to take a moment to reflect. It has been eighteen months since I started diarising my experiences on HRT. I am always acutely aware that those who read this will be at different stages on their journey. Some may have yet to start, others may be mirroring my experiences and, of course, there will be those who are far ahead.
My aim is not to tell you what your life will be like on HRT, I cannot speak for anyone but myself. However, I do hope that by being open and honest, I might share some learnings and bring some comfort to those who may feel nervous about what a future on HRT looks like.
Back to this month’s update...
Eighteen months down the line, the changes are very visible and emotionally I am at peace with myself, perhaps for the first time in my life. This feeling of contentment has crept up on me, it appeared when I wasn't looking. Before HRT, there wasn't a minute that went by when I didn't think about my gender, and it really did stop me from feeling completely free to move forward with my life for a long time.
I kept myself busy to silence my thoughts. I have historically worked long hours and taken on more hobbies and activities than was honestly necessary or perhaps healthy, just to keep me from thinking about my gender.
But the last couple of months have been different.
It hit me one day, after going about my normal morning routine. I suddenly realised I hadn't been thinking about my gender. I had just been going about my day in the same way that someone would, if gender was never an issue. It was a revelation - particularly given my day job!
I will confess, the realisation left me with mixed emotions. On the one hand it was really nice to feel at one with myself, ‘ordinary’ if you will, then I realised with some sense of indignation that perhaps I don’t want to feel ‘ordinary’.
Luckily, I have an overdeveloped sense of introspection - which comes in handy as a counsellor! So I spent some time unpicking my feelings and talking them through with close friends. Part of me was afraid that I would come across as ungrateful, like I was in some way looking for ‘drama’, but I quickly realised that isn’t the case.
Instead, as strange as it may sound, I think I have been missing the internal conflict that, until this latest revelation, I have lived with all my life. Be that conflict about which clothes I could wear or even what I might say in the event that I needed to stand up for my rights, as a trans woman. It seems that I have lived in this constant state of inner turmoil for so long that “fight” has become my normal.
Accepting this new - much improved state - requires a little adjustment and I realise that recognising it for what it is, is the hard part.
Now I almost have to start again. Embrace my new ordinary and build an authentic life, safe in the knowledge that my secret is out, I am on the right path and all those people whose opinions matter to me are part of my life.
I believe where I am on my journey to womanhood was always my destiny, like it was preordained. No research will ever be able to prove this and, unless you have ever felt how I feel, you will never know or truly understand.
For the record, I am under no illusion. I know that this does not mean that the battle is over. I know that not everyone will see me as I wish to be seen but I do recognise that how I see myself is just as important.
October 2019: Reflecting
I have been reflecting on my voice recently. I have had 12 sessions of voice therapy and I can, when I feel the need, soften it to what might be a more traditional female tone and manner. But while this softer, more recognisably feminine voice may help to prevent my being misgenderd, as a counsellor, it feels more genuine to use my natural voice.
In this role everything I say, as well as my tone and the sentiment with which it is said, has to be real. Voice is crucial to delivering an authentic, empathic session. Each patient is trusting me with their deepest darkest thoughts and fears and my response is to be as genuine with them as I possibly can. This includes using my real voice, and despite the fact that it feels at odds with how I look, I am learning to accept it for what it is: part of who I am.
My acceptance of my voice has not happened overnight. It has been a long process which has, I have no doubt, been helped by the training sessions I had. The training took in to account my relationship with my voice, that it was a part of my identity and that, for both myself and those close to me, it is an endearing quality.
Nothing demonstrated this better to me than my colleagues at GenderGP who were always puzzled that I wanted to change my voice. I was regularly told how lovely and warm It was. It was interesting to me that my natural voice did not make me any less of a woman, in their eyes at the very least.
Despite this, I still have to answer the phone to clients who are often surprised by my natural voice. And it does become an issue when I have to make calls to order a takeaway or a product, even to complain. I won’t lie, navigating the associated awkwardness can be distressing. A feeling I know many of the trans women I see in the therapy room know all too well. One client recently said to me that their voice was the main reason they couldn't move forward.
When I am established in a conversation or a friendship it becomes easy and relaxed, it’s just getting to this point that can be so difficult. I empathise with all those trans men and women who's voice really does invalidate everything they are trying to do in relation to their gender expression and identity.
I do think age has probably got a role to play in my relationship with my voice. If I was younger I feel I might be more minded to change, if I worked in a role where public speaking was a requirement, my voice would no doubt be more of a fixation.
What I can say with certainty is that, so far on my journey, my voice has not held me back or restricted my ability to function as a woman. My voice coach said something really interesting as part of the preamble to my therapy sessions, she said:
“If changing your voice is important it will be effortless, if its something you think you need to do without true conviction it will be impossible.”
An interesting insight.
In other news, as regular readers of my blog will know, I am on the NHS pathway for my gender care. I am due a meeting with the nurse and I have no clue if this will happen, as far as the GP is concerned it has been radio silence. This brings it to six months since I heard from them. Not a peep. I don’t even know if I have been discharged or if I am still under their care. It is worrying.
I have not had my bloods checked since my medication was increased, I have no idea if my levels are correct or not. It’s fine for me, having a strong will and a good support network around me, but for someone in a more vulnerable position, this would be highly distressing and could impact negatively on their mental and emotional wellbeing. I have my injection in two weeks, I will book my blood tests then and organise my own care, as usual!
Finally, I have sore tits, I mean, 14 months or more in to HRT and I still wince when I catch them, if I don't wear a bra its hell!!! Don't misunderstand, I love they are still developing and growing, it would be nicer if they didn't hurt quite so much. Or, do breasts hurt, is this all part of my learning process, a forever painful chest?
Other than that, I am loving my life! Ups and downs and all. My winter wardrobe is now coming out so all the knits and thick tights to choose from, I love the changing of the seasons in a way I never did a few years back. Now, I get excited buy the opportunity to wear something different and colourful and just lovely. Come the spring it will all start again!
Love, Marianne x
September 2019: Family
I would love to start this month’s update by telling you what a sterling job the NHS is doing in regards to my healthcare but, unfortunately, I can't! I was supposed to have a doctor’s appointment in July/August to discuss my ongoing care. I was expecting to be discharged, as I am not in the process of seeking surgeries at this stage.
We are nearly at the end of September and I still haven’t heard anything. I guess I shouldn’t be surprised, communication from the NHS in relation to anything regarding my transition has never been hugely forthcoming. I even had to proactively approach my GP to get an update on the HRT situation, after reading the comms which went out from my colleagues at GenderGP. Needless to say, my GP was unable to shed any light.
In other news this month, I am increasingly hearing in my therapy room from parents of gender variant children who are being actively discouraged from supporting their kids. The message seems to be that affirmation is damaging. This is at odds with research which confirms that supporting gender variant children leads to better mental health outcomes, but who knows what politics are at play.
It is heartbreaking to see parents afraid of helping their own children for fear of the reprisals. I will be honest, despite being a professional counsellor in this field, I often feel unable to offer any glimmer of hope that this rhetoric will stop anytime soon. I can say from my own first hand experience of seeing the young patients that come through the GenderGP appraisal pathway, that the relief I see, when a patient’s needs are taken seriously, is palpable.
My role within the family faced an unexpected challenge this month when my youngest son decided to embark on the massive project of building a timber-framed garage, incorporating a recording studio and gymnasium - not for the faint hearted!
Before I trained as a counsellor I was a carpenter and joiner by trade, so I knew I would be expected to muck in.
In the past, before HRT, this would have triggered my dysphoria and led to questions about where I fit as a parent, how my family sees me and whether they truly accept me for who I am. I would have been anxious about whether the project would invalidate my gender identity somehow. I am delighted to report that this was not the case. In this instance, using a combination of my brains and my sons ability, we are now 60% of the way there. It has been a great bonding exercise which has proven to me that my place in their lives has not diminished in any way because I have transitioned.
In spite of my family’s unwavering support, I know we can all feel disorientated by the changes in our relationship, and it is so important to recognise this and to try and navigate a path through together. Having said that, now that I have shown quite how comfortable I am helping in this way, I expect more projects will follow!
August 2019: A Friend Request
On Sunday evening I was sat strumming my guitar learning a new song, I was deep in thought, enjoying a little me time. Out of the corner of my eye I saw the screen on my phone light up. At first I ignored it but, as always, curiosity got the better of me. I set down my guitar and picked up my phone. Staring back at me was a friend request from an old colleague and family friend. Someone who knew me when my true gender identity was still a well kept secret.
I have lost touch with many of the people from my old life, partly due to my new life - and career - being so full and busy but also, I admit, partly out of the fear of rejection. Over recent years I have built a new life with new friends who know me as the woman I truly am, people who never knew me before. This has been incredibly liberating but, leaving people behind has not been without its sadness.
With this simple friend request, my past life had now firmly stepped in to my new life.
I sat and stared at the screen. Had she sent the friend request by mistake? Why now, after all this time? Was I ready to open this can of worms? There was no denying it: I was having a mini meltdown. One minute I was strumming a relaxing melody on my guitar, next I was filled with angst. Do I accept, and open myself up to who knows what kind of judgement, or do I simply ignore it and go back to my guitar?
This would be such a simple choice for so many people, but for me, it was a moment I will never forget. What do those old friends, that I did not bring along on my journey, feel about my transition - did I even want to know?
This needed more time, more research, more reflection. So I did what any respectable person in this situation would do: I Facebook stalked her. As I started to explore my old friend’s wider friendship group, it immediately became clear that it contained at least 50 people who I had left behind: work colleagues and friends. I knew that in pressing “accept” I would be revealing the truth to a significant number of people who had once meant something to me. Could I really do it?
I pressed 'accept' and waited, with baited breath. I knew Facebook would encourage me to say 'Hi' on messenger, but also it would encourage her to do the same. Would she? How long would it take? The wait was excruciating. I could see she was online, what was she waiting for?
Feeling powerless I did the only thing I could. I took charge. I sent a simple message: ‘Hi'. Her reply was instant: 'don't be nervous, we love you and admire you, it’s your life and we support you, be proud and enjoy your life'.
I started to breathe again not even realising I had been holding my breath.
Her kind words washed over me. And in an instant I realised how much I had missed my old friends. Then, inevitably, came the guilt and the shame. Why hadn’t I trusted them? Why didn't I hang around to see how they felt?
The answer was as clear as day: I’d had to disappear. I had needed time to explore my knew life without fear. Carrying my old life with me would have made it so much harder, a balancing act, trying to be authentic while trying to keep everyone happy, for fear of losing them.
I realise this is a sacrifice that so many of my trans brothers and sisters have to make. And I know how devastating it can be.
Allies, I know that sometimes you may not know what to say, or even if there is any point. I know you may even feel hurt, that someone you considered a friend didn’t feel able to share their story. The truth is that so often we have such little confidence that we will be accepted for who we are, that we feel we have lost you anyway.
So I want to say thank you to my old friend and to those brave allies who care enough to reach out and embrace their trans friends. To accept them for who they are. It means the world.
All it took was one simple “friend request” to open up a whole new chapter in my life. I don’t feel like hiding anymore. I feel I can open myself up to those who want to be part of my life. I also know that this will not be everyone, and I am at peace with that. Yet another realisation which I might not have come to without the help of my old friends.
July 2019: My first year on HRT
I said to Aby, the wonderful lady who takes my words and makes them readable, that I wanted the July update to be special. Not only is it 12 months since I began taking HRT, but July also happens to be the month I celebrate turning 57. As if that wasn’t enough, I have also found out I am going to become a grandparent. A life changing moment if ever there was one.
As you will know, if you read my blog on a regular basis, I am a pretty reflective person under normal circumstances, but this is a whole new level!
This baby will be born into a world where I am Marianne. I won’t ever have to be anyone other than my authentic self and that is such an incredible feeling.
They say the first step is the hardest, but while my HRT journey only began a year ago, the path towards being who I am now has been a long one filled with highs and lows.
I grew up in very hostile times for LGBT people, I know things seem bad now but they pale in comparison. At least today we are visible and while we often end up with our noses bloodied – for the most part this is metaphorical.
I have been married for 36 years to a wonderful woman. I confessed my secret before we got married and somehow she stuck by me. While I know I am incredibly lucky to have found someone who would love me for who I am, it has not always been moonlight and roses. The responsibilities that go with being a parent and a partner can challenge the resolve of the best of us, add gender dysphoria into the mix and the pressure can, at times, be overwhelming.
My gender variance has also put my two children on this rollercoaster ride but, despite everything, we continue to be a close-knit family. My eldest now runs the family business by default, not because he ever wanted to, but when it became impossible for me to continue in that role, he stepped up and took over at a moment’s notice.
My second son moved out of the family home shortly after I came out to him – a devastating moment for me. But just as quickly he moved back, having understood that this was not something I was able to change.
Being accepted by my incredible family has given me the support and strength that I know so many people in my position lack and my heart goes out to them.
Yet, despite all of the of the positive reinforcement I have, being trans still has its challenges. As I write this I am on holiday. My family has gone to the swimming pool but just don’t feel able to join them, it feels a step too far at this time. HRT or not, this is a SLOW process. Maybe one day when my grandchild is old enough to go swimming I will join in, perhaps in the role of official towel monitor – I look forward to those ordinary moments.
As a trans woman there are lots of small challenges like this, which I face on a daily basis. Internally I am the strong confident one, who flags down the waiter and asks for the bill or jumps out of the car to fill the car with petrol, but then I catch myself and make my excuses. Somehow, I’m not quite there yet.
But I have come so far and I wouldn’t change a thing. I still pinch myself when I think of how it might never have happened, had I lived in the not so distant past. That I wouldn’t have been able to be myself – it would be unthinkable.
So as I celebrate my first year on HRT I raise a glass to all those who are on this journey, whatever point they may be at. To the wonderful patients at GenderGP and beyond, to the incredible team I work with. I also celebrate this first year with Helen and Mike Webberley, they have given so many people like me hope despite the challenges they continue to face.
Thank you for your love and support over this last year and here’s to a bright new future.
June 2019: Gender Euphoria
*Warning* this post is influenced by a rush of Gender Euphoria which some may feel is currently out of reach for them. For the record, this is not my day to day state of being. I also fully understand that, for some, the idea of ever feeling this confident may seem impossible. But I want to send a very clear message: don’t lose hope. This is what it can feel like on a REALLY good day xx
This month I am reaping the rewards of dieting. It has been a long time coming but, ten months on HRT and my old male muscle was turning to fat, and not attractive fat either! I needed to take drastic action. I know many of my clients work hard to lose weight before starting HRT, I always thought this was a little over cautious - now I realise they may well have had the right idea!
People talk a lot about fat redistribution, mine was certainly redistributing but not as I had expected - or hoped! Having put myself on a strict diet, I am a stone lighter and I can visibly see the curves that were hidden. I realise it is not a massive amount of weight, but for me, even losing a stone has made a huge difference. My clothes fit better, hang better, I feel better, emotionally this has been a fantastic exercise. My dysphoria when looking at my body in the mirror has halved.
I will confess, part of not losing weight and something that held me back, was fear. I was really worried that if I lost weight, my feminine curves would disappear and I would feel deflated. However I am delighted to report that nothing could be further from the truth - as I write this I am smiling like the cat who got the cream. For the first time in my life, I like my body, not just the curves, but the way I feel, my God it feels so good.
My HRT journey so far is not only life changing, it is life making. It feels like someone has switched my experience setting to High Definition, life is full technicolour.
Transition is about looking after ourselves as a whole. If I had put off my diet for another month, I know June’s update may well have been a little flatter. Having to write my updates motivates me in to action - I have had no chocolate for five weeks now, anyone who knows me will know that that is a huge challenge in and of itself!
But of course these things are never all plain sailing. My two best assets have sadly taken a hit, and some of what I have gained in size has reduced. I won’t lie, this does feel like a tiny step backwards, but I am sure they will make a welcome return, eventually.
As I type this I am looking at my complexion, I would have to say I feel like I am glowing, which is something I would never have said in the past, so, on to next month. Perhaps I should be organising a one year HRT party, I really can’t believe how far I have come!
May 2019: Peace
This last month has been full of ups and downs, trying to figure out what has changed, what am I achieving and what I want. I say this because I am being asked about surgery at the GIC in Sheffield.
However, I am getting on so well in many ways, I have achieved so much that I feel I need time to adjust to my life for now. The thought of having time off work, and recuperating and healing feels like it would just be too much.
In many ways I feel guilty because I feel pressure from my trans friends who would love to be in my position and would love the opportunity to progress in their physical transition. But equally, I feel more settled than I have ever felt, content that I am finally a woman and seeing the world for the first time as such. I do not feel a sense of urgency when it comes to having surgery and while I do worry that others will judge me, it’s incredibly important for me to do things on my own terms - as it is for us all.
I will be honest, my experience as a trans woman and the stories of my friends and the people I have met on my journey have led to a lack of trust in the NHS which is also influencing my decision. I am nervous about the approach that will be taken, I am concerned that they will tell me what I should or should not do, that I have to fit their model of what it is to be trans.
I finally feel I have a measure of control over my body, my gender and I want to cling to that as long as I can. I do not want to be judged by others in terms of whether I fit their criteria, or not. What I need now is time to be me. To enjoy my newfound femininity. I will take the next steps as and when I feel ready.
A large part of this is thanks to the changes I have already seen in my body since I started on HRT. My breasts have grown and I now fill an A cup, this means everything to me. Seeing evidence of change is so reassuring. Alongside this growth the other noticeable change is my skin, which continues to soften and my hair growth which has slowed to the point where I only have to shave every two weeks. Bring on the summer, I can’t wait to be able to bear a bit more flesh with a lot more confidence!
April 2019: Reflecting
I am in a reflective mood as I write my update this month. A friend has sadly passed away. She was the wife of a good friend and not just a supportive partner, but a champion and advocate for the transgender community. I mention this because, when I look back on my transition, there are many people whose stories and experiences have made things that little bit easier. Not just for me, but for Vicki, my wife. Other couples before us, blazed a trail so that we could feel a sense of hope that, not only can a relationship survive when one partner is transgender, but the relationship can flourish and thrive. It was through events organised by the Beaumont society that we first met other couples in a similar situation. From there we made lots of friends, arranged private events and social gatherings. The age range tended to be older, and it wasn’t a cheap exercise: ‘specialist’ weekends away in hotels and meals out, and yet it was worth it. Being with other couples and hearing how they had survived not only any transition they may have gone through, but the associated stresses was truly empowering. We also witnessed the dark side, a really good friend passed away a few years ago from alcohol abuse, she was a kindly old lady, a picture book grandmother and we never knew how much she drank. It was heartbreaking to learn that the strain of her situation had driven her to this untimely and painful end. When I hear the hate, or read the 'debate’ around trans women and their rights, I think of the ripples of pain that are caused and which extend far beyond the individuals in question. When trans people are publicly vilified, mocked and denied their very existence it hurts their partners, their children, their parents and anyone who chooses to lend their support. I am so grateful for the support of each and every person who stands as an ally - without you we would endure the pain of this experience far worse than we already do. Since being on HRT, my ability to keep my feelings under lock and key appears to have gone out of the window. In the past, I would never have complained (at least not openly) about how people treated me and I certainly wouldn't have called a friend to moan and groan about life. I feel so much, sometimes it’s impossible to keep it in. I feel truly lucky to have one or two people with whom I can share some of these feelings, without being judged. Being more open to emotion and more sensitive to everything and everyone around me is a new experience, a side effect of my transition that no one warned me about. Yes I knew it was likely that I would cry more, but this is much more subtle. It is a feeling that seeps in to every part of my day. On the one hand it leaves me open to wonderful experiences that are beyond anything that I could ever have imagined, but it also means I am a little less robust, a little less hardened to dealing with any negative influences that come my way. I can be needy, fretful and vulnerable, especially if I am dealing with something new. Sometimes, I just need to talk, to let it all out. My friends don't need to do or say much, they just need to be there. We talk a lot at GenderGP about support, about the importance of listening and hearing those who are struggling on their journey. This does not mean box ticking and chin-stroking but patience and understanding, born out of empathy: everything is new and I liken the process to relearning how to use my senses. It is truly wonderful if a little disorientating.
February 2019: Settling down
My Oestrogen levels have settled down and while changes are still happening they are slow and subtle. Initially I was desperate to see big changes happen fast but I have come to terms with the idea that, when it comes to hormones, nothing happens overnight.
I still look at my breasts every morning and evening, in fact every chance I get. It is difficult to describe the way it feels to finally have something I never dreamed possible, although growth still continues to be very painful!
My breast development has taught me two really important things:
1. Among all the changes brought about by HRT, my breast development has been the most significant in terms of the impact on my emotional wellbeing. My breasts are the undeniable proof (size at this stage really doesn't count), that my body is gaining the secondary sex characteristics of my gender identity. This is beyond anything I could have imagined before starting HRT. 2. I can't imagine being a young trans teen and going through this process if my breasts were not a welcome addition, such is the significance of this area of our body. The dysphoria it could potentially cause would be unimaginable. It is no wonder that trans boys choose to wear binders and long for top surgery.
In February, I had an appointment with the GIC and we talked about surgery - bottom surgery. I am not yet ready to think about this, I don't know why, but life is ok for now, my place on my journey is settled, my dysphoria is, for now, manageable.
I know for some this could never be the case at any time, but, my career is going well, I am connecting with my community and most importantly my family in a way I never truly thought possible and, for now at least, this feels enough.
The doctor explained that I am ready to be discharged. If I do choose to go down the surgical route, I will see someone within three months and surgery would be within 18 months.
I can't tell you how comforting this was to hear, my fear was that I would be forced on to the operating table before I was psychologically ready. Before making this step I really need to speak to more people who have undergone different procedures to see what it is that I want. It may involve having surgery privately, who knows.
January 2019 - New Year New You?
This month it’s the inevitable diet issue!My muscle mass is turning in to fat. This hasn’t been as disturbing as I thought it might be as I am acutely aware that if I want fat redistribution, first I need the fat to redistribute! I am also experiencing cellulite, which is a bit of a shock as I have been lucky enough never to have experienced it before. The realisation that more physical changes were afoot dawned on me on a recent family holiday to Centre Parcs. We had hired bikes and were cycling around the complex. I love to cycle and it is not something that has ever been a struggle for me in the past. But all that has changed. I got on my bike and assumed the position. As started to pedal I noticed that my legs were sluggish and each rotation felt like like wading through glue. It took almost an hour of this for me to realise what was going on - the muscles that once made this activity so easy have lost their strength, the power has simply gone. I knew this was coming, but knowing and experiencing things are very different! Not that it was an unwanted side effect - for me each of these changes are like a little surprise, reminding me of this wonderful journey I am experiencing. On the fat redistribution front, my stomach has started moving south and my bum feels fuller. When I stand on the scales I am no heavier but I can see the extra weight I am carrying. This has spurred me on to take more interest in my weight, so the post Christmas diet and new year exercise regime have now begun in earnest. Over more recent years I had stopped exercising as doing so built muscle very quickly, muscle that wasn't very feminine and did not help my dysphoria. Now, six months into my hormone treatment I feel I don't need to worry, fingers crossed I will loose a few pounds without loosing shape where I need it most. One really positive effect of all this has been that I keep getting complimented on my skin. One old family friend asked me how I manage to have such lovely skin, I was delighted to reveal my secret, it’s all down to my hormones. My life has changed in so many ways purely because of HRT. Yes, I am now having to work harder to maintain a body that is reasonably fit, but that is all I have wanted throughout the years. I can now engage with my friends who have had a lifetime of maintenance in this way, I can talk about dieting or keep fit, and these are some of the things that allow me to connect with my new world. To sit, if only in a small way, with my female experience, to be seen and received as the woman I am.
December 2018 - Let's talk body hair!
We’ve reached December and I can’t believe it’s now six months since my hormone journey began. December has brought with it new revelations, specifically in relation to my body hair and skin.
The latter is significantly softer and my sense of touch has become heightened. It’s almost as if it was slightly fuzzy before, but now I am really feeling everything, from a soft breeze on my face, to the warm heat of my duvet and the feel of the driving wheel in my hands. One down side to all of this is that I am really feeling the cold so I am constantly reaching for an extra jumper or to turn up the heating!!
Let’s talk body hair, I used to shave my body four times a week. I was never very hairy, but what I did have was persistent and very coarse. I won’t lie, hair removal was always a chore. Now, after five months on HRT, I only really need to shave my body once a week and when I do, the hair is a lot softer and hardly noticeable. This means, even to the touch, I feel a smoothness I haven’t experienced before.
My facial hair is still there, in spite of some sessions of laser hair removal, but the growth has slowed substantially. Now, if I remove it in the morning, come midnight I am still confident and smooth. This is a huge change for me as, in the past, my stubble would grow as the day progressed. As this exacerbated my gender dysphoria, trips out had to be organised to accommodate the growth. The softer skin on my face has made shaving (it feels horrible to even type the word!) much easier with no rash and no cuts, just smooth clean skin.
When I started sharing my journey, via this blog, I was really nervous. I had no idea how people would react. Being a therapeutic counsellor, however, I could also see the need for me to lay myself bare so that anyone who wished to follow my journey, and maybe get some insight, could do so.
The truth is, everyone has been really lovely and positive and they have thanked me for sharing my personal perspective in such detail. It has been a humbling experience.
As individuals, we are unique and the hormones will affect us all in a unique way. My experience to date, in terms of physical changes, has been very subtle and nuanced rather than the huge transformational shift I was expecting. What has surprised me is the extent of the emotional changes I have experienced and willingly embraced.
I hope everyone can enjoy Christmas and look forward to the new year with hope in their hearts. Please stay strong and I will keep you all updated on my progress in 2019. Happy Christmas xx
November 2018: This month saw the arrival of two small but life-affirming packages...
While I would love to share my latest news in a calm and orderly fashion, it is impossible. This month saw the arrival of two small but life-affirming packages, in the shape of my very own breasts and I couldn’t me more delighted. I am still suffering with growing pains which has made the wearing of breast forms impossible. This has left me with a dilemma: how do I go from wearing breast forms, which have for so long given me the female form I needed to feel safe, to having my own breasts - certainly small but increasing in size as the hormones weave their magic - without leaving myself vulnerable.
I needn't have worried, I arrived at an 'A' cup very quickly, a small 'A' cup granted, but enough for me work with. I purchased a bra and was able to enhance my natural assets with the help of some (what we girls in the know call) 'chicken fillets'. Searching the rails for ‘A’ cups was an eye opener as I also discovered I could wear bras a couple of sizes up and feel very comfortable boosted by the extra size which they comfortably provided.
It was a hugely emotional moment for me. Buying a bra for my own chest felt like a milestone that had seemed unachievable just a few weeks ago. My mother used to tell me, 'good things come in small packages', now I realise what she was talking about.
Who knows what size my breasts will finally settle at. To be honest, right now I don’t really care. All that truly matters is that I am overjoyed with my developing body, a sensation which I have no doubt has been experienced by countless trans women before me.
I promise not to give you all a cup by cup commentary each month, but what I do want to say is that in time, change does happen and dreams can be realised.
In other news, I had a clinic appointment with the nurse at the GIC. I spent the hour telling her about...you guessed it, how I am loving the changes HRT has brought. A few other highlights include: slower body hair growth and softer skin, oh and did I mention my breasts are growing!
October 2018: My hormone journey continues unabated
I reached the first three month milestone and my blood tests revealed that, while my Oestrogen levels were certainly moving in the right direction, they were still low, so my GP upped my dosage.
As a result my skin has softened and, thankfully, my hot flushes have all but stopped. Emotionally I feel far more grounded and I am filled with a sense of contentment. You know when you are running for the train and you manage to jump on just as it is about to leave the station, but you can’t quite relax until you are sure you are on the right train, heading in the right direction? Only then can you start preparing for the rest of the journey. That’s how I feel. As for the other physical changes, frustratingly I am feeling all the pain and none of the gain. My chest area has a dull sensitivity, a bit like I have been punched on each nipple and they are bruised and sore. Even a cuddle from my wife can really hurt. But there’s very little growth. In spite of this I keep checking every day and just knowing changes are afoot is really comforting. I have an appointment at the GIC later in October to speak to a clinician. I honestly don't know who they are or what they do. Like all things NHS, it seems to be shrouded in mystery. I assume they will ask how I am doing. I am doing really well, so hopefully the appointment will be a formality. I will report back! On a happy note, in spite of the fact that my first prescription was made out in my male name (nope, I haven't changed it officially, this will be the subject of a separate blog) the doctor sent my second prescription in my female name - without me having to complain! This was a really nice touch. It can be draining having to keep repeating the same stories and explanations over and over so, just to have this little but significant detail sorted without me raising it, was a positive step in the right direction.
September 2018: Month two on hormones
It is really difficult to say how my hormone treatment is affecting me at the moment. Physically there has been little change. I keep rubbing my skin and wondering if it is getting softer and, while some days I feel like it is, other days I feel like nothing has changed. My NHS prescription gives me the lowest does of Oestrogen combined with a really powerful Testosterone inhibitor and, in truth, I am not really sure what physical changes to expect because it is different for everyone.
Emotionally, however, there is lots going on, from the hot flushes I described in my last post, to the feeling that I want to burst in to tears at the merest thing - sad thoughts, happy thoughts everything makes me want to cry. It’s like my emotional senses are heightened and I can feel even the slightest shift. This is not a bad state to be in, quite the opposite, it tells me things are changing and this what I have truly wanted all my life.
I was called in to see my GP last week. It is unusual for them to instigate an appointment so, naturally, I was intrigued. It turned out that my GP had been reading and learning. I was informed that the surgery is obliged to change my name on my records, even without my name having been changed by deed poll (this whole area deserves its own blog post which I will write at a later date). It was a straightforward process. She was really warm and I felt like she really wanted to learn and to support me.
As we were chatting I had a revelation. She was asking if I had noticed any changes and from the deepest corner of my mind came the words: “I have lost confidence.” I had no idea where it came from but the second I had said it I knew it to be true. To be clear, I am not talking about losing confidence in my ability to do my job, or to do the ordinary daily chores, this was much more subtle. Almost like I had lost the confidence to make really simple decisions, when ordering online goods for example or confirming a meeting time and date. I even hesitated when picking a user name for social media (I went for @oakesmarianne - in case you are wondering). I seem unable to navigate these simple things in the way that I once did.
My GP had an obvious explanation: “That may be because you no longer have any Testosterone in your body.” Then the penny dropped. I had been so focussed on looking for the changes that my Oestrogen might bring, that I completely failed to consider how my lack of Testosterone might affect me.
I came away feeling really up-beat, that was until I went to book my blood test only to discover that it would be a four week wait! One step forward, two steps back!
August 2018: My trans journey on the NHS - Month one on hormones
Tuesday 10th July 2018. After three long years on the NHS and a lifetime of waiting and dreaming, I finally picked up my first prescription for my Oestrogen patches. I was fighting back the tears as I walked out of the surgery. This was such a monumental event in my life and yet, everyone I saw, seemed too pre-occupied with their lives to even notice. Not even those closest to me seemed to understand the magnitude of this moment. I have never felt more conflicted. On the one hand I was so elated, I wanted to high five everyone I saw and on the other, I felt totally alone. To be fair, my family are going through the grief of never seeing the old me, and despite the fact I know I left a long time ago, I think hormones are putting the final nail in that coffin. I didn't get to collect my patches until the day after. As soon as I was able, I stuck the first patch on. I don't know if it was wishful thinking but, I swear I could feel the oestrogen running through my very being, and this feeling has not left me. The following Thursday morning I went for my T blocker injection. Another huge step in my trans journey. This was going to be the end of testosterone invading my body. I was a little nervous, what would life be like without this hormone running through my veins? I am now three weeks in to my treatment. Do I feel different? You bet I do! I am not sure how much of that is the actual treatment and how much is down to the knowledge that I am no longer being poisoned by the dreaded T but, either way, I can feel its effects. I was warned I might suffer a mini menopause, hot flushes and mood swings and they weren’t kidding! I go from feeling calm, flooded by an overall sense of wellbeing, to a sinking feeling, which starts in the pit of my stomach and overwhelms me. My patience evaporates and I feel like I need to leave immediately. The hot flushes appear from nowhere. I can be mid conversation and suddenly I feel beads of sweat around my nose and forehead and then I am hot all over. It only started like this a day or two ago, but I have never experienced anything like it. Changes to my body are slow, I have spent three weeks convincing myself that my breasts have grown or are growing. They haven’t. The only thing of note is that the skin on my hands feels softer and my body hair has slowed close to a standstill, which is fabulous. I know other changes are happening, but I am on the lowest dose of Oestrogen a girl can be on, the NHS are so cautious about these things. Having said that, I couldn’t be happier despite the negative symptoms, which, if I am honest, are of some comfort as they make me feel like things are actually changing. Of all the things I expected to happen, I never realised how confident this experience would make me. I have read and heard from many of our patients about the impact of HRT on confidence, but, just three weeks in, I am brimming with a new found confidence that I never knew I was lacking. Perhaps this is the authenticity I have heard so much about. I can’t wait to see where this journey will take me next.
July 2018: My trans journey to date
In September 2015 I visited my GP to ask for a referral to the Sheffield GIC and, despite his ignorance to the protocols, a week later my referral had been submitted. This was three months after I had qualified as a therapeutic counsellor, with a view to realising my dream of working as a female therapist.
In January 2016, I set up a private practice and advertised my services in Pink therapy. Low and behold, a month later this eager woman called me to ask if I would be interested in helping her with trans clients. Delighted, I accepted. This turned out to be my first experience of GenderGP and the wonderful Dr Helen Webberley. I will admit now, having heard the horror stories of endless waiting lists on the NHS, that I did consider my private options. It was clear that I would have been a suitable candidate for accessing the services of GenderGP, however, I was concerned there might be a conflict of interest. Keen to keep my focus and do my work to the best of my ability I decided to stick with Plan A. Some 14 months after my referral I was offered my first appointment at Sheffield. I put on my best dress and did my hair and off I went. It was December 2016. I told them my story and it was explained to me that I would have another three appointments within a six month period. At that point I would be put forward for treatment. It was an exciting time and I was happy to wait. My initial appointments went well, I thought, and I was on track for receiving the treatment I so craved. But nothing came. No letter, no appointment. Nothing. Two years passed. Then a letter arrived, it was an appointment with the voice coach. I was delighted and waiting with bated breath for more news. Maybe treatment would be quick to follow. It wasn’t. By October (some two years after my initial referral) I faltered and approached Dr Webberley for help. I needed hormones and the situation was becoming increasingly frustrating. I was living and working as the woman I have always known I was, but wasn’t able to access the treatment I needed to feel complete. I spoke to my voice coach and she did a little digging. According to my records, she said, I should have received a letter two months earlier detailing my treatment pathway. Needless to say I never received the letter. Luckily, she managed to get a copy sent to me. Back on track with the NHS, I put GenderGP on hold. As a counsellor, specialising in the treatment of gender variant patients, this insight into the experiences of those seeking treatment via the NHS was proving invaluable, so I decided to stick with it. I had first hand experience of the frustrations and I knew, that no matter how painful it was, I needed to go through the process. There are so many mixed stories out there, I had to see for myself. In December 2017, I was offered an appointment to see the psychotherapist - something which I had personally requested. On my first visit I asked when I would be able to start HRT. The response was that they would be unable to start my HRT as I was still presenting male. I calmly explained that I was living and working as female and had been doing so for the past 18 months. The response left me stunned: “Then why haven't you changed your name by deed poll?” I explained that I hadn’t changed my name because I didn’t want to. “Well”, came the response, “you can start HRT but there will be no surgery.” I wasn't even asking for surgery!!! It is now July, seven months later. I am still waiting. I was told last week that my GP is being sent a letter to give them the OK to start me on hormones, but at the time of writing, the letter is yet to arrive. It is now almost three years on from my referral. I want to share my journey with you so that you can see, you are not alone. I will include regular updates in the newsletter so that I can share my ups and downs - not just my frustrations with the NHS but also the things I love about it. Take my voice coach for example, she is absolutely brilliant. As a counsellor, I know that experiencing the NHS pathway can only enhance my empathy for those facing similar challenges. However, my experiences have also helped me to appreciate just how valuable services like GenderGP are for those who have already waited a life time and are ready to start their journey now, not in three years’ time.