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26 Nov 24 - Gender Clinic assessment part two

The gender assessment is a two part meeting. We had a little over an hour last week and the second part is a week later. Dr J emailed to say she had extended the room booking to ensure we had time to complete it. Maybe she is saying I talk too much! 

I asked as I was leaving last week whether I could come as Nicola to the next session and she said if I was comfortable doing so, I could. 

I had to go into work first and do a meeting, so needed to be male for that and then change. There was the slight challenge of getting from the office loos to the car park without outing myself, so I kept trousers on with the skirt hitched up under my coat, and used a scarf to cover the low neckline of my top. Then, once in the car, I pulled the skirt down and trousers off, and swapped shoes. It was a bit stressful but I think I got out without anyone seeing. 

Traffic into town was then very slow which added to my feeling of stress, as I would then need to park in a public car park, get out and walk to the clinic. It’s only a five minute walk but I had to cross one of the main commuter roads into town and stand waiting for the lights in full view of anyone who drove past. Once off the main road I felt more relaxed. There were a few people about who probably clocked me but that was fine. 

When I got to the clinic, I had to wait in reception and there were a few other people there, all men and very definitely cis men who were not waiting for a gender clinic but one of the other services. That was also fine. 

When Dr J came to get me, she called me Nicola and asked how I felt being dressed female.  I said that I felt normal being female with her but walking across town I had been a bit nervous. 

She said that she had sought out the documentary A Change of Sex (on All4 apparently) and had found it interesting but sad, and very much of its time. I said that she was a whole lot nicer than Julia’s psychiatrist who was just mean. 

We then talked about sex and relationships in adult life, or rather lack of sex, and what that might mean. Had I actually found it convenient for my own feelings about masculine sex to be with someone who didn’t want it either? I said that I love all the intimacy and cuddling and exploring the female body, but “didn’t want to be thrusting my penis into someone” which she repeated back later on in the conversation. We talked about me not being gay but that many people assumed I was. She seemed surprised that I had never been to a gay bar or engaged with any kind of queer scene. We talked about the trans community that I had found online and how I compared myself to their experiences, and things I had read, including about Blanchard. She seemed genuinely annoyed by the continued existence of the autogynephilia theory which she views as harmful and outdated. 

We then talked about work and social life and how I felt like an outsider everywhere because I didn’t fit in with nor want to be part of the male groups, but nor could I really be part of the female groups either because I am still “other” to them. 

She then talked about how I cope and manage my gender issues and that I seem to have developed good coping mechanisms and can live my life functioning normally despite this. I agreed that I am generally fine and it doesn’t cause me problems and that if she said that I could never transition, I would be able to continue to do so. She said she worries for people like me who can cope without transitioning, and have successful lives who risk losing a lot. 

Anyway to the conclusion: I show strong indications of gender incongruence, but less so dysphoria. She has found no reason not to allow me to proceed to a referral for hormones should I wish to do so. Interesting that she expressed it in the negative, “no reason not to”, although that is probably how it works. 

She said that although I don’t show many signs of strong dysphoria now, she thinks that this will hit me harder when I transition and the incongruence increases. 

She recommended an endocrinologist who is happy to allow patients to give hormones a try even if not already socially transitioned and I can see how I feel and then decide whether to continue or stop after a few months. 

She also recommended I start laser hair removal sooner rather than later as it works better pre-hormones. And voice therapy. 

This is all positive and she reassured me that I “am trans enough” to transition but that she worries for me about the impact on my life. 

I can read the subtext here. I can if I want but she doesn’t think I should given that I can cope well without, but she can’t actually say that. 

She wished me luck and that was that. Report to follow in a week or so. 

I had changed in a hurry and hadn’t seen myself until I went to the loo to change back and saw myself in the long mirror there. I was suddenly struck by how female I actually look. 

This process has been good and it has been amazing to be able to talk about this with someone. It has clarified a couple of major things: I am trans but not strongly dysphoric, which is what I expected I suppose. It does still leave the big question of what to do with this information and that is still all down to me. 

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