Mental health articles

OF mental health care and mentally ill

Problems of gender identity disorder

Access to sex change surgery in Britain is limited. At times of inadequate resources for health care, this type of surgery is given a low priority, and many people with gender identity disorder can fi nd it extremely diffi cult, if not impossible, to obtain this treatment from the National Health Service. Many people who choose to have surgery do so by paying privately for it, through specialist private companies such as TRANSFORM, who provide an assessment of the individual’s suitability for gender reassignment, hormone therapy, support for a year while they await surgery and try to live as someone of the opposite sex, and then surgery and post-surgery support. Simon was a 30-year-old man just beginning this process. He had been to the initial assessment and accepted as a possible ‘case’, and had begun hormone therapy at the time of the interview in which he described what led him to seek gender reassignment and the frustrations he had experienced on the way:

I am so angry. I know I have the wrong body, and no one can convince me that I am wrong. As long as I can remember, I have felt this way. I wanted breasts, to be a girl, to have a period – to get rid of my penis. I envy them so much

I have tried to go along with things, not to be as I am. It’s really pretty frightening admitting it and having to go the whole way like I want to. But it’s what I want

I married someone just to try and conform. I love her as well. Not in a physical way, though. We don’t have sex

she isn’t really a sexual person so that’s all right. That’s why I began to see her. She isn’t very attractive, but she’s a good person, so it feels good that she’s with someone like me, where sex isn’t a big deal. It doesn’t feel right, but we are good friends and we get on well. I tried to keep things a secret. I have – had – a place in my wardrobe where I keep women’s clothing. I put it on when she is at work. It feels so natural and fantastic. It’s the only time I felt I was really me, and how I wanted to be. I had a wig, make-up and stuff so I could really feel like a woman. It was secret, but she came home when I was wearing it one day, and so I had to explain some of how I feel and what I want. She knows I want to change my sex. We’re going to live together until I do, even though my body is going to change with the hormones. But she wants to live with me despite it. I don’t know what will happen and how we’ll feel in time, though  .  .  .  I wear the clothing and the wig at home all the time now, now she knows. She’s OK about it  .  .  .  I’m not a ‘trannie’ [transvestite] though, because I want more – just dressing up isn’t enough. They are just men playing at being women. I want and have always wanted to be a proper woman. It has been so frustrating getting so far. I went for an interview at Charing CrossHospital and they agreed to put me on their programme, but the local health people wouldn’t pay for it, even though I had letters from my GP and a psychiatrist saying I needed it. So I had to go to TRANSFORM. I went to see them and they agreed to give me an assessment by a psychologist, and he agreed to put me on the programme. And that was great  .  .  .  but I had no money, so I couldn’t do it straight away. I felt so low at the time  .  .  .  very depressed. I really needed it, but no one would let me get on with things. I was pretty close to suicidal  .  .  .  I thought things would never change  .  .  .  and I couldn’t tell my wife why I was so low  .  .  .  I’m still on antidepressants now  .  .  .  I think they’re the only thing keeping me going  .  .  .  I still don’t know how I’m going to pay for surgery  .  .  .  I would sell the house but that’s not fair on my wife, so I’m happy I’m on the hormones and beginning to see changes, but I can’t see how I will go the whole way  .  .  .  but I won’t be happy unless I do, because emotionally it all feels so right.

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