Find your own place in the rainbow

General Transition Progress 2006

This is a record of the general progress in my transition, including such things as deciding on my name and the procedure for transitioning on the NHS. These are the more noteworthy milestones, but more day to day events can be found in my LiveJournal: Ganimede - The Boy Inside.

Pick a year: 2004 | 2005 | 2006 | 2007


January 11, 2006: Name change on driving license

I got a response from the DVLA this morning. I'd sent my license off to have the name changed on it and didn't send the paper counterpart with it. I completely forgot that it had a paper counterpart, so I'd just sent the photocard. The accompanying letter said that all of my name change paperwork had been checked so I'm hoping that it won't take the full 15 days to get back to me this time. Once I get my license back, I'll send off my passport.

January 18, 2006: New driving license!

When I got home, I found that something had come for me in the post. It was my new driving license! There's no gender marker on it as such, it's a hidden one in the driver number. (If the holder of the licence is male, the second digit in that number is either a 0 or a 1, for a female, it's a 5 or a 2.) I had to request that that got changed as well as my name and it did. Now I can send my passport off to be changed!

January 27, 2006: Getting my passport updated

I'm also hoping I'll be able to get my passport sent off next week too. I took it in to the travel agents today to get it checked over but they said that I need the photos countersigning. I couldn't think of anyone that would fit the requirements, until I thought of Chris. He's a civil servant and has known me for quite a few years now so he's more than suitable. I texted him to ask and he's fine with it so that's one less thing to worry about. With any luck, it should only take a couple of weeks to get back to me.

January 31, 2006: Claybrook Appointment #3

I arrived in London quite early so I decided to have a wander round to pass the time before getting the tube to the Claybrook for my appointment. I don't know how, but no matter what time I leave, I seem to get there with two minutes to spare and then they keep me waiting for ten minutes. The appointment itself was fine, Dr Lenihan was nice enough even though she has a deeper voice than I do. She just asked how I was, how I was doing on T and seemed rather surprised when I said that the bleeding thing hadn't stopped yet. She said to give it one more month after my next shot and if that doesn't work, to go to every three weeks. She also wants me to get my T levels checked to see how they are doing. She asked if I wanted surgery so I said I did at some point, and she said that I'd probably be put forward for a referral at the end of this year. I asked about a hysto and she explained that I wouldn't even be considered until I'd been on T for two years so I'll just have to wait for that. That was it really. Half an hour total and I've to go back in a couple of months. Ho hum.

February 10, 2006: New Passport!

My passport just came! Special delivery too, by some bloke in a car which was kind of weird but, hey! My passport just came! It says Nathaniel Robert [lastname] and has a M on it and everything! Just 6 weeks and 2 days until I get to use it :D

February 17, 2006: T Levels

I had several things I needed to talk to my GP about, mainly things regarding T and stuff that had cropped up at my appointment at the Claybrook so I'd got an appointment for this afternoon. First off, I said that Dr Lenihan had asked me to get my T levels checked and as I already had had to schedule a blood test, I thought I might as get it all done in the one go which she agreed. Then I said that I'd been told that if the bleeding didn't stop after the shot I'd just had, I could change my dose to every three weeks instead of every four. My GP wasn't so sure about that, and pulled out the letter she'd just got from the Claybrook to check. Apparently, it wasn't so easy as all that. I need to have my peak and trough T levels measured, which means having two blood tests, one just before my shot and one a week after. So I had to set up a second blood test, and seeing as my next shot is on a Monday, I have to have the blood test early that morning and then go back later on for my shot. I can't change my cycle until after that's been done so that means more waiting and more bleeding.

I mentioned the sudden and intense itching I got round the injection site after my last shot. My GP checked her copy of the BMJ which mentioned that it was a possibility. She said to see what happens with my next shot and to take an anti-histamine and use hydrocortisone cream if it happens again. I really don't want to have to go through the severe itching again, and certainly not for months to come.

The only other thing I needed to mention was that if I stay on the four weekly dosage, I'll be away for the shot after the next one. It's due on April 3 and I'll be in San Francisco so I wasn't sure what to do about that. Dr King checked her diary, asked when I'd be back and said that I could have it on April 7. I don't really want to have to have it that late, I don't want to have it late at all. The entire appointment seemed to be a complete waste of time. I don't think I got anywhere, if anything, it's now got worse. I'm still going to be bleeding for the next two months, that's on top of recovering from surgery, I'm going to have one shot several days late and I've got two blood tests to look forward to. One of them is on my birthday, the same day as my next shot so I'm going to be spending that day going backwards and forwards to the surgery. Just great.

February 23, 2006: Bloody hell

I've got a letter from the Claybrook telling me I have an appointment with an endocrinologist on April 24th. It's only 3 weeks after I come home from San Francisco, so I hope I'm going to be fit enough to travel down to London. I don't want to put it off though, especially as it's looking like it's going to be nearly May before I stand any chance of getting my dosage changed. I hope I can hold it together long enough because the whole thing is turning into a fucking farce. I might has well not had T for the past three months for all the good it's done. Maybe I should see if I can get in touch with Dr Lenihan and find out what the hell is going on and explain the situation to her. I don't know. I just don't know anymore.

March 28, 2006: Chest Surgery

The big day arrives! My chest surgery took place at 9.00am this morning and all the details about it are in my surgery diary. Details about the entire trip to San Francisco are in my LiveJournal.

April 21, 2006: Doctor's Appointment

I had a check up today with my GP to make sure everything was going okay after my surgery. She happened to ask if I'd told anyone at the Claybrook that I was having surgery but I said that although I hadn't, I had an appointment with an endo the following Monday so I could mention it then. She said she thought that was a good idea. Straight away, she pulled my records up on the computer and looked through the letters from the Claybrook. She asked when I'd started on T and if I was still bleeding. She then said that Dr Green had written that if I was still bleeding after 4 months on T, I could change to having my shot every 3 weeks. There was no problem with my T levels so she decided this alteration was fine. I found it highly amusing that the very mention of the endo brought about this sudden change of mind when only a month ago she said there was no need.

April 24, 2006: Endocrinologist Appointment

I had an appointment at the endocrinologist at the Claybrook Centre at 12.00 today. I arrived at the train station in plenty of time to catch my train down but there were problems on the line way up north somewhere which held it up. I was told the best way to get down to London was via Manchester but it wouldn't get me there till 1pm. I called the Claybrook to explain the situation but was told that the endo had a jam packed schedule and wouldn't be able to fit me in if I arrived after my appointment. I had to say that I wouldn't be able to make it so it's going to be reschuled. I was rather annoyed, I was hoping that I'd get some good news about self injecting or using some other form of T that would take out the need to go to my GP's every few weeks.

May 9, 2006: Claybrook Appointment #4

I'd missed the appointment with the endocrinologist due to problems with the trains so I hoped that I wouldn't have any trouble getting down to London today. Thankfully, I didn't; I actually got to Euston ten minutes early! It really doesn't matter what time I start to head off to the Claybrook though, I only ever just make it by the skin of my teeth. This time I set off at 2.30 and still only just made it in time. I wasn't looking forward to telling Dr Lenihan that I'd had my top surgery privately, I didn't think it would go down very well.

Dr Lenihan started off by asking how I was doing on T, whether the bleeding had stopped so I told her the whole situation with my GP - how she was adamant I was staying on a 4 weekly cycle until she found out I had an appointment with an endocrinologist and that suddenly made her okay a change to every 3 weeks instead. After that, Dr Lenihan said something about putting me forward for top surgery so I had to say then that I'd already had it. She said that she was wondering because it didn't look like I needed anything. I just said that the opportunity to go privately had come up so I'd taken it. She asked who the surgeon was and then said that he'd gone against the SOC because I'd not completed my one year Real Life Experience. This did not impress her at all, she made it sound like it was a serious offence. She asked why I'd decided to have my surgery so early, making it sound like I was either incapable or just not allowed to make this kind of decision. I think it really threw her though, she wasn't at all sure what to do now. Finally she said that my hormones still need sorting out so I should make sure I see the endo. Then I'll have one more appointment with her to check how things are going and then probably be discharged. Yay, no more trips down to London for 20 minute appointments! What a relief.

I went up to Russell Square where I met up with a friend. We got drinks and doughnuts from Tesco's and took them over to the square to eat. We just sat and talked for a while, enjoying the occasional sun when it decided to show its face. It was nice to finally sit and relax, my chest was a bit sore from the weight of my backpack although the worst bit was at the sides where the straps rubbed against the incisions. I'd spent all day walking holding them away from my body which was not the most comfortable thing to do.

May 24, 2006: Appointment Rescheduling

Two weeks ago, I got a letter giving me a rescheduled appointment for the endocrinologist on July 3rd at 11.30am. I rang the Claybrook to say that 11.30am was too early, but got told it was either that or wait till September. This morning I got a letter saying that my appointment had been rescheduled anyway. It's now on July 18 at 10.30am. There is no way I can make that. I'm going to have to reply and ask if they can give me one at a more reasonable hour, i.e. one that doesn't involve me getting up at 5am. I'm seriously glad I'd not bought my tickets, that would have been more money wasted. It's great when I get advance notice so I can get cheap train tickets but not if I then run the risk of having my appointment rescheduled without warning.

June 6, 2006: Charing Cross letter

Yesterday I got a copy of a letter from Dr Lenihan at Charing Cross to my GP about my last appointment. Here's an excerpt:

"Mr [lastname] had a private bilateral mastectomy carried out in San Francisco by Dr Brownstein on 28th March 2006. There was no psychiatric/psychological endorsement for this surgery. Dr Brownstein requested a therapist letter and your patient said he was unable to supply one, and used a GP letter endorsing change of name and a passport which apparently was accepted. This surgery would not have been endorsed from Charing Cross Gender Identity Clinic because it is not in accordance with the Harry Benjamin guidelines for transgender care, which specify a minimum of one year's 'Real Life Experience' prior to any gender reassignment surgery. 'Real Life Experience' at Charing Cross GIC is two years, but we do consider bilateral mastectomy after one year. Your patient had only been 5 months into his reassigned gender role and was only 3 months into his 'Real Life Experience' when he had the bilateral mastectomy.
"It was discussed with your patient that there is a conflict in care from him having sought private treatment whilst in an NHS programme for gender reassignment, without an endorsement or discussion with his NHS consultants. What is particularly a concern in your patient's case is how quickly the surgery was carried out following the start of the 'Real Life Experience', in breach of clinical guidelines."
There is so much wrong in the whole letter, never mind that excerpt, that it's untrue. Firstly, as far as I'm aware the current version of the SOC does not specify any Real Life Experience at all. The previous version did but obviously, that's been superseded by the current version. Apparently Dr Lenihan/Charing Cross are not aware of this. Secondly, I did not say I'd used a GP letter and a passport instead of a therapist letter for Dr Brownstein, I said the only paperwork I had from anyone was the letter to get my name changed on my driving licence/passport. Thirdly, I'd love to know where they got figures from about how long I've been in my reassigned gender role and my Real Life Experience. I've been living as male since the end of September 2004 which by my reckoning was 18 months by March this year. In addition, there's the fact that at no time at all was I told the RLE at Charing Cross was two years or even that I was undergoing it!

Apparently they're going to discharge me after I've got my T sorted out with the endocrinologist. I'm a little concerned because they seem to be under the impression that I don't want a hysterectomy (another thing they've got wrong) and I don't know how I'll go about getting that if they discharge me. I'm just going to have to write a letter to ask about that and to correct all the mistakes they've made. I have a feeling they're not going to take too kindly to it.

June 12, 2006: Six months on T

Doesn't time fly? Tomorrow will be exactly 6 months since I started on T. So how will I celebrate this milestone? By having my next shot, that's how! And maybe having chocolate or something.

June 17, 2006: Anniversary of a name

It's now a whole year since I legally changed my name to Nathaniel Robert. A whole year, I can't believe it. It's gone so fast but it also feels like so much longer, like I've had this name for more than just 12 months. When I think about how long it took me to find it and how many names I tried, how I wondered if I'd ever find the right name. I finally did though, and I'm still so glad I chose this name.

July 3, 2006: Another Claybrook appointment?

I recently got a letter from Dr Lenihan saying that as I'd had my surgery privately at the same time as being under NHS care I was being discharged from the Claybrook. It's been a good two weeks since I posted it off and I've not had any reply yet. Imagine my surprise to get a letter telling me of an appointment with Dr Lenihan! I can't help but wonder what this appointment is for - I can't have a hysto until I've been on T two years so unless it's just a general 'how are you doing?' I can't see what else there is to talk about - and if it's because of my letter. Anyway, I had to cancel it, it's on September 5th and I'll be in Boston then. Ha.

August 10, 2006: Endocrinologist Appointment Date #4

I got a letter today with my appointment date for the endocrinologist at the Claybrook.
Monday, February 19, 2007 at 2.00pm.
*sigh* Well, at least it's not 10 o'clock in the morning like the last three they sent me. I might actually be able to make this one.

August 21, 2006: GP Appointment

I had an appointment with my GP this morning to discuss my T levels which I had taken at the request of the endocrinologist at the Claybrook Centre. I started off by telling her that I'd finally got my appointment through but that it wasn't until February next year. She asked if I had any burning issues that I needed to discuss with him, to which I replied the fact that I was still bleeding was quite a concern. She remembered then that I'd had the blood tests and pulled up the results. She said that my peak level was at the top of the male range at 35 (I have no idea what the scale is but it goes from 10 to 35) so that's fine and there's nowhere further for it to go. I asked what my trough level was, because she didn't appear to be interested in that, so she pulled that result up and said it was 11.3. Again, she said that was fine as it was in the normal male range and it was levelling out (?!) so there wasn't really anything that needed to be done. Despite the fact that I'm still bleeding after being on T for 8 months.

I'm a little concerned that there's still a huge drop between my peak and trough level. It has changed since last time my T levels were checked - on a four weekly shot cycle, my peak was 23 and my trough was 6.8. My trough level now still seems really low, and it is a huge drop from 35 down to 11.3 in the space of two weeks. I have no idea how my GP can think that is 'levelling out', it seems fairly obvious to me that there shouldn't be such a drastic difference and that's why I'm still doing the icky bleeding thing. I don't know whether changing to a weekly shot would be better, or if moving to something like the gel or the patches would help give a more regular dose. I guess I'll have to wait and see what the endocrinologist says in six months time.

October 4, 2006: Claybrook Appointment #5

Last time I went to see Dr Lenihan at the Claybrook, she said that she was going to discharge me but that as I needed to get my hormones sorted out, she wouldn't action it until I'd seen the endocrinologist and it was all taken care of. I then got a letter telling me I had an appointment on October 3rd. I spent all of last week trying to make contact by phone to make sure that I really had to go down because it seemed a bit odd but all I achieved was a game of phone tag. I'd not got train tickets so I ended up booking seats on instead because it's cheaper. The only problem is that it's a really long trip down, 6 hours each way, so I had to get up at 6.00am.

I got to the Claybrook at 3.10 which is the earliest I've ever arrived for an appointment - previously, it didn't seem to matter how early I set off, I'd always arrive on the last minute! I didn't have to wait long before Dr Lenihan called me in. The first thing she asked was if I'd called to arrange the appointment so I said no. Then she asked if it was my GP which it wasn't as far as I knew. She then said it wasn't her so she had no idea why I was there. Great. A 6-7 hour bus ride and you have no idea why I'm even here. She thought it must have been the admin staff getting confused because I'd not been discharged yet but I had no further appointment so they'd taken it upon themselves to arrange one. Grrr.

She said that we should use the time productively so she started asking about a hysterectomy as I'd said previously that I wanted one. She said I need to have been living as male for 2 years before I can be referred but as my documentation dates from June 2005, I can be referred as early as June next year. She also made a note for my next appointment not to be before 8 months time and it'll be with Dr Lorimer who will then be my second referral for the hysterectomy (I need two referrals so she will be the first). I don't really want to have more surgery and I'm not looking forward to the hysterectomy at all but I'm of the opinion that if the female internal bits could be a problem at a later date, it's best to get them removed as early as possible so as not to have that happen. Also, it'll mean a lowered dose of T afterwards which puts less strain on your liver so that has got to be a good thing. I just don't want to have any more surgery really.

All of that took about ten minutes and then I left. That's got to be a record for the Claybrook really, a 7 hour bus ride for a 10 minute appointment. I can't wait till I don't need to bother going there any more.

December 13 2006: One year - Click here for a photo.

Exactly this time last year, I had my very first shot of T. I can't believe it's been a whole year already.