Good news and bad news.

The bad news

My doctor is gatekeeping me. When I last saw him in late November I told him that I’d like to take the next step and send in my applications for the juridical change of gender. I needed him to sign the papers and held a short but well prepared speech about why now is a good time. But he promptly disagreed for no good reason and wants me to wait another 3-6 months. I’ve learnt from experience that it is wise to always add at the least 2 months on every time frame given to me by him, just to keep expectations realistic. As everything in Swedish healthcare freezes over summer, he was actually saying something like “Maybe in September, when I’m back from my vacation”. Almost 10 months from the day I asked him.

He claimed that “It is protocol to wait for a full year after you started on hormones before signing any papers” That is not a valid argument. Firstly, I have been in the loop long enough according to the standards this hospital normally apply. Secondly, there are no specific requirements about a certain amount of time having to pass before an adult diagnosed with GID can apply for or be granted a change of juridical gender. No details regarding time is mentioned in the national recommendations for transgender healthcare or in Swedish law.

In the material about the application it says that you should have “lived as your self- identified gender for a considerable time”. The reason why it is so vague is because time shouldn’t matter. Every applicant is judged individually on the basis of their own story and the material they choose to enclose to their case. But my doctor was stubbornly unyielding, refusing even discuss the matter and nothing I said could make him change his mind.

I very much doubt that any more information supporting or threatening my case is likely to come of further waiting. I have cooperated and done everything they asked from me. There are no more tests, no parts of my body that hasn’t been subject for careful examination, no more specialists I need to see. The most likely outcome I could see following his “Just a little longer but I won’t say how long”– strategy was that my depression might get worse. I’ve been away from school and work due to depression for a full year now. The experience of not being in control over ones life is generally a serious trigger.

Sadly I was right in my suspicions and shortly after that meeting I got a lot worse. Friends and loved ones comment on how I’m so far from my normal self, they worry about me. This last month has been a struggle, I’m not well and I realise that I might not be recovering at the rate I was hoping for.

That was the bad news.

Now here is a challenge for you: Everything you just read is either objectively or subjectively true. I feel a lot worse. The healthcare system is unfair and not working as it is supposed to. Still there are plenty of good news in this post. They just doesn’t make the bad ones go away for me. Try keeping that in mind while you read –

The good news

Luckily I have more good than bad news, so here is a list:

  • Dessert more often I’ve met a dietitian. Surprisingly she approved fully to my approach on food and eating. Instead of scolding me for eating to much, to little or to unhealthy, she helped me with exactly the things I asked for. Then she sent me home with the advice to have dessert a bit more often! She also asked me if I’d like to come back for follow-ups and to learn how I could do even better, which I gladly agreed to.
  • Back at the gym My biceps tendon seem to have healed after an injury that kept me away from my normal routine for a long time. I have been seeing a physiotherapist and done some rehab exercises. Now I’m finally back on track and it feels great!
  • Mastectomy soon The rules state that I only should have to wait 3 months from when I was first put on the waiting list for surgery. That time is due by my birthday 28/2, but in reality surgery happening sometime before summer would be great. My surgeon was not nearly as socially awkward or insensitive as I had feared. Considering my already almost flat chest and the amount of muscle tissue he has to work with, he judged me an ideal candidate for the periareolar-surgery I wanted, just as I had expected. (Advice: Don’t google it if you think you might be more squeamish than curious.)
  • Massive voice improvement I’m much more comfortable with my new voice now. I use it with confidence most of the time, except this last week when I have been down with a cold and can’t speak at all. My voice therapist is impressed by the level of voice technique I can master so far. (One could almost think I had the same university degree as she has on voice and stuff, just waiting for me around the corner.)
  • Testosterone I’ve had my forth injection and been on the treatment for 8 months exactly today. The fresh results from testing my hormone levels reveal that I’m still a bit lower on testosterone than I should be. From now on I’ll be getting my injections with only 10 weeks in between, not 12. I really like what the hormones are doing already, so that is good news.
  • Flexibility Just before it was time for my injection I needed to leave town with short notice. I had to ask if I could get it a few days earlier and it was a relief to discover that it was no trouble at all re-scheduling it! Timing is very important when it comes to hormone treatment. If I miss one injection or if I get it to late, I might get my period back. Suddenly being fertile again when you thought you were not could mess things up a lot.
  • A major revelation Lastly but perhaps most importantly, I’ve recently had a major revelation about the nature of the gender dysforia I’ve been experiencing my entire life. I see so much clearly now how it has been affecting me. Given some time and work, I think this will be a breakthrough unlocking experiences and enabling positive emotions I’ve never had access to before. It could change everything. I know I’m cryptic, but be sure that I’ll get back to this later.


Entering the system

Yesterday evening I got an unexpected text message stating that I was welcome for a first meeting at the clinic responsible for the investigation process preceding a formal medical diagnosis as suffering from transsexualism. I’ll be there tomorrow morning, at 10. That is great news but with less than 48 hours notice. I was like “YES!! Already?! Or, I mean… I’ve been waiting forever!”

The meeting tomorrow is the first step in a lengthy process of investigation where a team of medical specialists decide if I match the formal diagnosis requirements. If they think I do, that will eventually give me access to the state-sponsored medical transition care and ultimately allow me to change my registered gender. I expect the process all in all to take 2-3 years, but it could take longer depending on things like my health during the process, the resources of the hospital where I live, how well I get along with my team and what sort of medical care I’d like.

For tomorrow, my goal is to give a short but coherent presentation of myself and my thoughts on why I want to transition, why I need to change my registered gender. I’ll also try to make sure that they’ll use the right name and pronoun and preferably acknowledge how far I’ve already gotten in my transitioning. I’ve done so much already and I really want that to be recognised. I guess this is only a first screening meeting but hopefully they’ll see that I’m ready to move on in the process into the first phase of medical transitioning, called “Real Life Experience”, stretching usually over a full year.

Real Life Experience¬†is a test of sorts, it is all about proving that you are comfortable in expressing your gender identity. For me, it would mean just that I’ll keep living the way I do, as a guy. I haven’t got any “coming out”-stuff to do and I’ve already been out for about 9 months. Mostly it is not until the end of the Real Life Experience-period that you get a diagnosis and some surgery may be “unlocked” as a possibility.

But during the Real Life Experience-period it is common for female-to-male transsexuals like myself to start on testosterone treatment, and that is what I’m really after now. Hormone therapy would boost huge bodily changes and it would make my life so much easier. Most importantly it would make my voice go darker and make my period stop. Testosterone would also make my muscles grow larger and I’ll probably loose most of the few “female”curves I’ve got today. Other effects are less welcome, but I think I’m ready to deal with them.

Yet, all that is in a far future. First things first. Tomorrow will be the first step in my medical transitioning, entering the system. I am so ready for this. Wish me luck!

You know that you are a transgender guy when…

…Friends who are moving or arranging a party kindly wait for you to arrive to let you carry the really heavy stuff – in the pure purpose to help cultivate both your male ego, your back and biceps.

…You find yourself discussing different ways to do a mastectomy (breast removal) with no less than four different transgenderd people on a week flat, considering loss of sensitivity, re-positioning of the nipple and the risk for visible scars. (Amount of pain experienced or expected was never mentioned.)

…Tired cis-genderd guys follow you blindly into the changing room at the gym, looking at you rather than the sign on the door and therefore ending up in the ladies locker room. Embarrassment.

…Tired cis-genderd girls stop and blink in a mix of confusion and awkvardness when you meet them in the door to the ladies changing room at the gym, seemingly questioning which one of you who are not supposed to be there. Embarrassment.

…You feel awkward and embarrassed about NOT having a rolled up sock tucked down in your trousers, because you forgot to do your packing routine when dressing in the morning.