Experiences of trans and gender diverse young people

I think a very honest, hey, Tavistock has a fuck tonne—sorry, a lot of referrals right now, look chances are you are not gonna get any appointments at all like you are an adult and so it might be time to start kicking in with those coping mechanisms early, because not in a bad way but, unless you were like rich and your parents fully supported you and there was no way that if you were referred to Tavistock, you would be seen in like the next year and a half or even that like. I think just being told, look, you need to start kicking in some really healthy coping mechanisms now, because chances are, if you don’t do that, you like you will be in a horrific state by the time you get any response from Tavistock. And, to be honest, it’s been radio silence from Tavistock since I, as long as I remember and I don’t blame them for that. They are absolutely swamped with referrals. It’s not like, I don’t hold anything bitter to that. It’s not their fault. I think if there was information on like, hey, we know this can’t be a long term solution but coping mechanisms, you know, help yourself because chances are you won’t be able to see a professional for a very long time. I think if that was made clear earlier, that might be better. I feel like it’s a really grim response and it shouldn’t be like that. It’s the kind of thing that you have to bear in mind. Unless the NHS suddenly gets a lot of money and Tavistock and other trans clinics become like a huge priority, that’s not gonna change for a long time, so, yeah.

It was hard and then also it felt kind of helpless, like because I couldn’t see the Tavistock cos obviously I was on the waiting list, so I couldn’t see them, and then as soon as I got to the Tavi appointments I still had to wait like, I had to have multiple assessment sessions before I could even get on blockers, and before I was even like on blockers a lot of like the main things that defines a male puberty had already like happened or finished, like voice breaking, getting taller, and things like that.

Like I said we got to, once we got referred, we got a letter back from the Tavistock saying that we were on the waiting list and it was, I think it said nine to twelve months we were waiting for. And it was just kind of like helplessness, especially like after a few months, when I’d started going through puberty a lot more, it was like there’s literally nothing I can do, I just have to wait for an appointment. And then we got, I don’t, we didn’t get lucky, but like we were on it for nine months when the waiting list was like up to twelve months, so I suppose we got the better side of things, but still, we were still waiting for a really long time and lots of changes to my body was happening that are irreversible, and that blockers can’t take back.

I think hormone blockers are good for trans youth, but I think they could be better if the wait and the effort to get them is a lot shorter, because I basically was going through puberty whilst I was waiting to get the puberty blockers, so it was, it seemed really dumb and unnecessary and like I experienced a lot of the things that in the first place I was trying to stop, and I didn’t get to stop them.

It's ridiculous. And it's disgusting. I understand there has to be a wait, a wait, for a while. And I understand that, you know, they can't just rush and see everyone immediately. And when you get there I understand they have to do assessments and they have to do assessments and checks to make sure you are making the right decision and stuff. But, it's too much. And I understand, the idea of the six months assessment I think is when the waiting list was so short, someone could come out as trans, get referred, a month later, they could go and talk. So, of course they do a six months assessment and then possibly another six month assessment. So that person would be forced to live as their, you know, their true gender for a certain amount of time and make sure they were comfortable with it. But now that the waiting list is two years long, by the time someone's got to the top of the list, they've already been living as their assigned gender, not their assigned, their true gender for two years and they don't need an assessment anymore, because, you know, not for more than a couple of weeks or a few questionnaires. You know, they've already been doing it for two years. I think it's, it it's too long of a wait.

And especially with being moved to the adult list. If you're moved off the child list, all that happens is you get moved to the bottom of the adult list. There is no separate thing. There's no, well, this adult's been waiting six months, but you've been waiting two years so you go above. It's nothing like that. It's just, sorry, bottom of the list, pretty much. Unless you've already had your assessment done in which they only move you up by about six months. I’m like, it's ridiculous. There are people who have been waiting, who will get to the top of the adult list and they've been waiting four years which is what they're trying to do for me. The NHS clinics are trying to do for me and they've been waiting four years. Some trans people aren't gonna live through four years of this or they're just not gonna make it, the stress, you know, people who already have mental health problems as well, you know, and then have this on top of them. They won't, either they won't make it or they'll develop more problems, you know, the number of trans people especially trans men who develop eating disorders because they're trying to help their body in some way, because they're, you know, desperately don't want to be viewed as, as female and they just can't wait any longer. You know, you get people self-medicating which causes health problems and they die from self-medicating and stuff and it's, the wait is horrible.

And you know, I think that the Tavistock especially don't understand just how awful it is to wake up every day in a body that is wrong. How awful dysphoria is. How awful it feels to be misgendered. How awful it feels to be trans when all, when you know 100% for certain all you want is your hormones. And they seem to think that, ''Oh you think that you're it's gonna magically fix your problems.'' No, we don't think it's gonna magically fix our problems. I think it's gonna magically get rid of half of my dysphoria, because I'll have the hormones and I think they don't, they don't get just how awful it is to wait that long and then just be moved. And then, you know, when you get there and it's a six months assessment, it's ridiculous. They need to take into account that now the wait is a very long time and therefore when people get there, suddenly going through ''We're gonna do a six months assessment and are you sure you want hormones?'' All of that is just, it's offensive that they do that when you get there, so.

It’s a long dreaded wait [Laughs]. I am on it as of now and I don’t even know when it’s gonna end. I’ve been on waiting lists before. I’ve had braces and since had them off. Hence my beautiful glowing teeth now. That was a wait of like a good year or so and even that felt like forever especially ‘cos I was like must have been 14 at the time. But this one, I’m cognisant of the fact that it must be about two and a half years long by now. I remember like I last checked the website probably about four months ago or so and they said like, we’re now taking patients who signed up in 2016 and it’s like [Laughs] Mmm… I wasn’t even out in 2016. And especially as like a person and I am 17 and I am on the cusp of adulthood. I very much aware before I complete this waiting list and I’m gonna have to be switched again to the adult services. At that point, it’s like, why am I waiting this long?

The wait list for the Tavistock clinic is obviously a lot longer because it’s all children from the whole country whereas with the adult ones it’s like is everyone from [county] as opposed to everyone, especially teenagers who are the most like at risk and vulnerable group in terms of needing HRT, certainly on the one with the most pressure and social media or whatever. But so whilst my current wait is like two and a half years, I don’t know if it’ll actually be that long and there’s kind of confusion and when are they gonna transfer me over and what is my actual waiting time? They’ve not got in contact with me yet. I just know that I am on the list. But I’ve not actually like received any information so it’s been a very, very confusing experience and I’m just like, I’m figuring, right now that it’s like it’s so far away that it’ll just, it’ll happen when it happens. I just might suddenly get a letter one day and I’ll stop paying. And that’s my understanding of it currently. But I’m very like aware of the fact that it’s a massive issue and have been for a long time because I was like, [intake of breath] oh, it’s a long wait and I’m gonna have to go private [Laughs]. That was like, that was, that was a huge concern for me.

I was just hoping generally for some sort of support with dealing with any sort of issues I was having with my gender and then also being given some sort of route to hormones, presumably because of the gap because of the gap between when I was referred and when I actually got there, I was almost 17 when I got there so they effectively told me as soon as I got there. We are not going to prescribe you anything. Because you’re too old and we’ll need to have stuff sorted out by adult services, which yeah. So, going in and just thinking well, I would like hormones from whoever will give me hormones. So, I think this might be a potential route to that because I’d had friends who had been through the process with GIDS before, but because that was quite a while ago and because how the process works is incredibly opaque and people who have been through it don’t know how it works. They don’t tell you how it works. The website doesn't tell you how it works. None of it is very clear at all. I didn’t really know what to expect, but by that point, because of my experiences with the counsellor, the GP, the pastoral support team at my school and the counsellor at CAMHS, my expectations for talking to somebody else were very, very, very low.

I thought that I would have some understanding at least of how to get hormone treatment. Whether that was going to be through GIDS or through adult services, I wasn’t completely sure because there just wasn’t. I felt I might have more of an understanding which I guess I did by them saying, no, you’re not getting anything from us. But, even then, not really. And then I thought seeing a psychologist for appointments all these times, I might get some kind of support in some way. But I didn’t, it was basically just a series of appointments where I was interrogated by this guy a bunch of times and it was just uncomfortable and didn’t feel beneficial to me whatsoever.

In my experience I got told that I’d be sent a letter at some point for a second appointment and it could be in about three months and so I waited the next three months and had another appointment and I think for me a lot of what GIDS was talking because I was sort of 16 and a bit when I got seen by GIDS they weren’t going to, I was probably actually closer to 17, they weren’t going to actually offer me any, they weren’t gonna put me on hormones or anything because their process for that would have actually taken longer than me just waiting and going straight into adult services at 18 and being given hormones through adult services because obviously with young people, like children and young people you have to be a lot more careful around giving hormones and whatever and so they advised and I agreed that actually it would make more sense for me to just like wait and go to adult services and get the medical support there. But they continued to give me appointments so I was able to like talk about my experiences with gender kind of a little bit more like therapy than actually anything like medically, like to medically transition. At the time it was really frustrating but looking back I think it was really useful to have that space to just explore like what I wanted even if I was like slightly altering my experiences for them. And they also talked to me about like what options I had in terms of like hormones and surgery which was really good to have those conversations so when I did go into adult services I was able to just be like this is what I want, these are the options I know that I’ve got like give me these things please. And just going in knowing exactly what I wanted and needed.

When I started, like I said they were just getting to know me, and that went on for the first three, I’d say, that I was just sat there explaining for about two hours. And then we kind of went on about the struggles and like school and how that went on, and them kind of little details, and then towards the end of me talking to them, because they were leaving for some reason I was getting someone else, then I’ve got someone else now, I kind of felt like we weren’t really getting anywhere and I feel like you felt like that too, and I wasn’t really like hearing the questions very well, and I wasn’t, I felt like I, we were kind of not going anywhere. So when they left, and I got this new woman, who I’m working with now, she’s lovely, she kind of gets on with it, and I feel like we’re kind of getting somewhere. Obviously not at the fastest pace cos we can’t really at the moment, cos it’s kind of like a waiting game until I’m older, so I can get the testosterone, but yeah she’s, it still feels like we’re getting somewhere in what we’re talking about and we’re talking about and helping me with my anxiety as well which is quite good.

When you first go in there, they just make you feel comfortable, and yeah, you go in and they just like let you say what you want to say. They’re not, you’re not going in with a set plan, they’re just going in and if anything’s happened, from last time they saw you, they’ll just be like, “So what’s going on with you?” And check, like check in first and then if I didn’t’ have anything in particular to talk to them about, then they can be like, “Well I think it might be smart to talk about this, and go deeper into this,” and so it’s kind of up to you, but then they’ll always have like a back-up plan to like, “Well I think it actually might help maybe if we done this, and try stuff out.”

I felt like towards the end they were kind of asking me a question, and saying, “Well we know this about you, so how do you feel about this? Cos obviously this is what you’re going through.” And then like it would go on for like maybe a minute and then they’d just like sit there, look at me, and I’d kind of be like, “Which one do you want me to answer?” or “How do I respond to that?” and stuff like that. So I think maybe if I’d had the confidence to be like, “I don’t think I understand that,” and stuff like that, but I think nothing else I would have really changed cos it really helped me get through.

I think it was good, because obviously the people that I was working with before were lovely, and they really helped me get through it, but I think [name]’s, who’s the person I’m working with now, she’s also a lovely woman, and she kind of goes about things in a different way, and I think it’s good because I had them two different types of approaches to what I was trying to handle, and I think they both really helped.

It was exciting, obviously, I knew already that there was like an assessment process, so you had to take before you get blockers, because we’d researched into that. But anyway we met the therapist and the person that was with them, because you have to have two people usually to do therapy. You have your main therapist and then you have someone else with them, so we met them both. Obviously, introductions, told them what I wanted to get from the Tavistock which was blockers initially, and then they said that as the assessment process went on we would have one to one sessions with the, I would have a session with one of them, and then my parents would talk with the other one. It was mainly just like a, “Here’s what’s going to happen in the future.” We didn’t really accomplish much then. And then the appointments are monthly.

And so, what was it like for you on that first appointment?

It was exciting, cos it was like finally after nine months I get to see these people, and then, yeah it was kind of exciting. But then it was also like disappointing because we didn’t really achieve much and they were like, “Oh you can do it in four to six appointments, before you can even like start thinking about blockers.” Or something like that. Which obviously there’s an appointment every month it was going to be at least another third of a year before I even get any chance of getting blockers. So, we kind of left feeling like, [puff of air], like, it is like defeated because you know it was all this big excitement like finally get to see someone who can help, and then they’re just like, “Well you know we can help in like four or six months, we’ll see you next month.”

Okay. So what happens after that?

After that appointment, well at the end of the appointment told them other dates that we could do, and then they told us that it was going to be monthly, and we went to monthly sessions where basically they, I had a one-to-one session with my therapist, basically he asked me questions like: “What’s my main source of dysphoria?” Do I have a gender dysphoria? Where do I see myself in X amount of years? It was just like questions about sexuality, gender dysphoria, like gender identity, some of the questions seemed a bit dumb because we started talking about like, “Oh what’s your sexuality?” And it was like, “Does this matter? I just want blockers, like why are we talking about this insignificant stuff?” it’s like, the assessment process seems really long and most of it’s like pretty pointless, especially someone like me who came to block, to the Tavistock with a clear idea of what I want, had wanted. Cos a lot of people come not really knowing a lot of information, but we came like, “I want blockers, I’m this, that and the other,” but we still had to go through everything that everyone else does even though most of it we’d already accomplished.

They give you quite a lot of social support so if you’re having trouble with like CAMHS and school in my experience they were able to intervene and establish meetings with the school and CAMHS. They were even willing to come to my school and get, organise people from CAMHS to come to my school to have like a team to talk about me and my like plan, my mental health plan and stuff like that and how to support me best. So even if you’re not looking to transition or do anything medical, they’re there to help with the social stuff as well.

I can’t actually remember much but I know in the post that they sent a lot of questionnaires that I had to fill in, I filled in on the train there and it was actually, I think they were just going through the questionnaires and asking me what I wanted and they asked lots of questions to my mum and they wanted to know about my ASD diagnosis because that’s like the link there and generally about my mental health. It was kind of more of a, how my wellbeing was rather than any like transition-related things.

I think at the next appointment it was kind of like transition goals, like what I wanted. I said that I wanted like hormones and then top surgery. Fertility was brought up quite early and I was like, “I’m just like fifteen, I don’t really want to think about it and if I did, I don’t want kids but,” and they talked me through the process of getting hormone blockers if I wanted it and the whole process put me off as well rather as well as the, not just the process of the whole year of being on them but the whole process of getting them was quite invasive what they put you through so I didn’t want to do that and they just asked me how I was doing, generally how I was getting on and really trying to like yeah, I did get a diagnosis at that point as well of gender dysphoria because it was around that time there was the change wasn’t there with the thing, so I was diagnosed at some point. I can’t remember when, but I was and eventually because I didn’t want blockers from them and I was doing okay, they referred me to the adult services.

I didn't receive anything from GIDS, the whole time I was on the waiting list. They were supposed to call me when I reached 17½ to tell me about my options and whether I was meant to move. I only called them a month ago to ask them what's going on after my GP said, ''Yeah, if you're gonna go privately you should call them and asked what's happening at GIDS.'' So I called and I found out ''Oh yeah, we, when you reach 17½ we'll call you.'' And I'm like, ''I didn't receive a call.'' ''No, when you reach 17 ½.'' It's two months till my birthday. you know, I've passed 17½. It's like, ''Oh you can't have been on the waiting list for that long.'' I've been on the waiting list for two years, I received nothing, no letter, no update. I had to call, I had to ask and then when I did ask at one point back in April or whatever I was told, ''Oh you've only got a couple of months left.'' And that was wrong as well. So, nothing, I got nothing. No support from them. And anything, the only support I got was, I happened to be in CAMHS at the time. So I was spoke about it briefly. But I had so many other things I wanted to talk about CAMHS. I didn't really get support. So other than my best friends being the most supportive friends you could ever ask for and all telling me how you look so masculine and all of that. That's the only support I got. Nothing from GIDS absolutely nothing from GIDS.

I found it really easy I know that when you get referred from GIDS to adult services you don’t get put on the normal waiting list so it’s not like you’re going to end up waiting then like two years again before you get another appointment. So I essentially got fast tracked into adult services because they have to do continuity of care or at least that was my experience of it when this happened three years ago. And so it was, it was really easy and then I was given like I had the crossover appointment where they just sort of shared the information and I was able to ask any questions that I needed to ask with someone that I already knew there and then I was just seen by adult services from that point which all, well it worked out okay for me.

Well, when I got my first GIDS appointment I guess we spent like a lot of the sessions talking about like what gender means. And only recently, actually, we started talking about interventions and like other than social kind of transitioning and because I'm in like a weird like twilight or like limbo situation where I'm a year from adult services. And when, which means it'll be a year before I can probably get my hormones. And usually, in the past, they said, if I came into GIDS earlier then I would have to be on like a year of hormone blockers and then I would get testosterone. But because I've already gone through puberty, hormone blockers wouldn't do anything. So, I'm like, I was in a position to choose to go on hormone blockers and basically not do much or not go on hormone blockers and then go to adult services and get testosterone. So I'm kind of just like chilling and waiting for my, getting like an appointment at an adult service.