Welcome to Trans-Scription

Hello blog-trotter, and welcome to my transition blog :))

Even though a multitude of blogs exist out there that deal with FTM transition, I write as an Indian, transitioning in India and dealing with Indian society, which can sometimes be very comforting, sometimes agonizingly interfering.

If this is your first visit, I suggest you start with the oldest post first - the walk-through I have slipped into the posts goes in that order and takes you through my life from toddlerhood to transition.

I also plan to include tutorials and discussions. I look to you, reader, for your opinion. If there is something you would like to share, questions you want answered or a comparison of situations, please let me know via the comments. I ask only that you do so with the understanding that I may choose not to answer - if I do so, it will certainly be for a good reason.


Monday, April 25, 2011

It's all just simple physics

Procrastination is really about inertia. When stationary, the procrastinator is loath to move; when in motion, finds it hard to stop. My appointment with the endocrinologist had that effect on me - this juggernaut had finally picked momentum - woe be unto anyone or anything that blocked my path!

10th March - Up at 6.00 and out at 8.00, I marched off to the pathology lab where I had made enquiries about my blood tests the previous day; I had been told to report on an empty stomach (12 hours fasting). I waited a long long time in queue and finally had my turn. I completed billing and waited some more till blood was drawn. Then, I darted off to the nearby hospital where I usually see my psychiatrist. After my endocrinologist visit, today was the first day he would be available for OPD consultation. I booked an appointment in 15 minutes - the doctor was to come in at 11.00 and I was 8th in queue to see him.  Raring to go and having nothing to do since it was only 9.30, I walked over to a friend's house and spilled my guts about the latest developments. We spent some time discussing what HRT would mean for me and reminiscing about 10 years ago when we each had a dream - hers, to act, and mine, of course, to transition; dreams we never thought we could achieve but knew we could not exist without somehow making happen. We both now found ourselves in places where we were starting to realize our precious, precious dreams. Time flew and, before I knew it, I was in danger of running late. I scampered!

Reaching the waiting area, I realized I was just about in time. Patient # 6 was in at the time. I awaited my turn as patiently as possible after the aerobic dash I'd made to the hospital.

My turn. By then I had managed to cool down and stop panting and sweating. I walked in, "Hi Doctor, how are you?"
Doctor, "Arre, kai re, kasa aahes tu? Yevda divsane?" (Marathi: Oh hey buddy! How are you? After so long?")
"Ho, Doctor, mi aaj concrete kaam karoon aalo." (Yes, Doctor, I've done some concrete work and come to you today.)
"Kai mhantos! Bol, kai challay?" (What are you saying! Tell me, what's going on?)

I gave him the entire update on how I had come into contact with Sampoorna right up to the endocrinologist visit two days ago. I told him in detail what transpired during the consultation and gave him the file to peruse. After reading through it, he whipped out his phone and spoke to someone, asked me when I was free next and, since I could not commit, simply informed the person on the other end of the line that he had an FTM who needed to 'get the usual tests done' to gauge readiness for medical transition. He wrote down their number in my file and left it to me to co-ordinate. Once I'd completed my evaluations and obtained the reports, I was to meet him again.

Coordinating availability and juggling a few commitments meant that I was only able to schedule the tests for the 15th of March. Doing the tests was such a colourful experience and I so badly want to share it here (I was laughing through half of it all - a very good experience); but I will have to restrict myself. Discussing the details here means that someone reading this blog will know what to expect with the tests. That means that they could potentially cheat on the tests, something that I want to prevent at any cost. Cheating on psychiatric/psychological evaluations simply because one wants their GID letter so desperately is not a good idea. Some of these tests are designed to ascertain whether the individual is in the right frame of mind to be able to handle the pressures associated with transition. I know it's frustrating, and I know it's demeaning. But trust me when I say that these guys (therapists) know what they are doing. And they don't get any sadistic pleasure in making anyone wait - they're just making you wait because they know how minds work. Come to think of it, that's their job, isn't it? Trust them. (Of course, if the therapist in question talks about changing your identity or any such nonsense, RUN!)

Three days later, I received a text message asking me to pick up my evaluation results. Needless to say, I did. The interpretations spanned two pages and indicated that I was mildly anxious but very much in contact with reality. Fine by me!

22nd March - My next appointment with my psychiatrist. He glanced over the results then looked up and said, "Nothing I couldn't have told you myself. But it had to be done." He called in a ward-boy and asked for the 'certificate book' and wrote me a certificate:

"This is to certify that ____ has been under my care for the past ____, has been examined by me on ____ and is diagnosed with ____." He filled these blanks with my name, 'three years' (we checked back in the file), the date and 'Gender Identity Disorder'. To this he added, 'The patient is of sound mind and capable of making decisions regarding and undergoing Gender Re-assignment'.

And that was it. One stamp from the hospital reception, the doctor's signature and I was armed! Whether anyone liked it or not, I was jumping off!

In my next post, read what my endocrinologist has to say.

Thursday, April 07, 2011

If light were a tangible thing...

8th March - International Women's Day. This year though, I didn't go around wishing all the women in the world I knew; I had other, more exciting, things on my mind! It was after all the day of my appointment with a new endocrinologist, an endocrinologist who, I happened to know, was already administering androgen therapy to at least three other transmen amongst my circle. The possibility of impending testosterone therapy was real. For once.

I had kept ready everything I needed the previous night - bag with medical files, a bottle of water and a book to read while waiting; ample cash in my wallet; a freshly ironed shirt. I had even rolled a bandage & kept it handy for binding. The doctor had called me at 3 pm and I had to go in a little earlier to register. Registration was fairly simple: fill out a form with personal details, sign and pay up at the counter. There was a slight difference though. The form had three columns for 'gender' - male, female & other - a first for me. Although I would have loved to tick 'male', I ticked 'other' - when one is transitioning, one requires all records to be in order, irrespective of what one wishes. Then, I stood in line.

Now comes the fun part. Considering that the form has an 'other' column under 'gender', one would expect that finding it ticked once in a while would be pretty routine for the clerks at the counter, correct? Wrong! The clerk was most confused and asked me about it. I told her it was correctly marked. She asked again, lifting up the form this time and turning it towards me, and the people hovering around me trying to cut in line. People were beginning to notice. I told her again that it was properly marked but she wanted to know what to enter in her records. In other words, I'd have to explain what I meant by 'other'. Fat chance! 
Again, quite audibly, "Par aapne yahaan par 'gender' ke liye 'other' mark kiya hain. Aapne galati toh nahin ki?" ("But you have marked 'other' here, for 'gender'. You haven't made a mistake, have you?")
I am infamous for being tactless, but even I couldn't be that thick.
Scathingly, "I'm literate, aren't I? That means I've read the form and know what I've marked, doesn't it? Don't you think I'm sufficiently literate to know what it means to be ticking 'other' for 'gender'?"
Confused by the rapidity of my speech, "Huh?"
Slower this time, "If I've marked 'other' on that form, don't you think there's a reason I did that?"
Comprehension finally dawning, "Oh, sorry!"
Muttering, "That's fine." Not!
Awkward pause.
"Sir, that'll be Rs. 50/- for registration and Rs. 600/- for consultation." I paid, thanked her and proceeded towards the super-speciality OPD.

I'll admit, I did feel quite guilty about letting my temper fly. Usually, I handle situations like this pretty calmly, and much better. I guess it was nerves, and the fact that it had turned into quite a scene with a good deal of people trying to peek into the form and scanning me head-to-toe.

Super-speciality OPD. I walked up to the counter and handed over the file. It seemed like everything was in order. I was asked to wait for the doctor, who was out for lunch. After about 10 minutes, "Mr. (my last name), the doctor will see you now." Hallelujah!

"Hello Doctor, this is (my name). We've been corresponding."
"Yes, come in and take a seat". I thanked him and did.
Doctor, "So, tell me"
"What would you like to know? I mean, I'm used to having this conversation with therapists so I know what they are interested in knowing. But from the viewpoint of an endocrinologist, what would you like to know?"
Smiling, "Right, so you identify as male but were born female? And now you want to do something about it, including taking HRT or testosterone?"
Smiling also, "Couldn't have put it better myself."
"Ok. But there are certain things we need to get done before we can start you off."
I assured him I understood.
"Alright, first of all I need to know whether you have been seeing a psychiatrist and for how long."
"Yes, I have. For definitely more than two years."
"Good. And has your psychiatrist been giving you any medication?"
"And are you on any other kind of medication? Regular medication, not like the occasional paracetamol or antibiotic course."
"Do you have any diseases?"
"Like diabetes, hypertension, thyroid trouble, PCOD?"
"No, not that I know of. But I haven't been tested."
"Any PCOD-like symptoms? Problem with frequency of periods?"
"With frequency, no."
"And what about your weight? Did you put on weight all of a sudden or have you always been heavy?"
"I've put on gradually over the years; as my activity decreased and lifestyle changed. Like for example, I sprained my ankle and put on about 4 kilos during recovery."
"Any family history of diseases like diabetes, hypertension, kidney or liver disease, etc.?"
"Maternal grandmother had diabetes; sister has a thyroid problem - sorry don't know whether hypo- or hyper-."
"That's ok." Walking up behind me, "Stretch your neck backwards and pretend you're swallowing." He placed his fingers on my throat, palpating for about a minute. "Good, let me take your pressure and weight."

He then proceeded to give me information on the various methods of administering testosterone and explained his reasons for picking the injectable form he uses. He also prepared me with what changes to expect. We discussed dosing and my intentions for surgical options. 

Then, he asked me to get a few things in order and report back to him. The first of them was a battery of tests, standard ones being a complete blood count, lipid profile, liver profile & serum testosterone level, and TSH and blood sugar (fasting and post-lunch) due to my family history of thyroid issues and diabetes. He also required psychiatric evaluations and a letter from my psychiatrist stating that I have GID and certifying me mentally fit to undergo medical transition. He was very careful to let me know that the psychiatric requirements were merely for legal purposes and was most careful to not offend. This experience was SO different from my earlier endocrinologist's appointment. I asked him what the next step would be after taking him all the reports (if they were all in order). "Writing out your prescription! The nurse on duty can administer the shot."

I know there was further discussion but I can't remember much of what happened and whether or not I thanked him before leaving - I sure hope I did!

If light were a tangible thing, I would have run forward and bear-hugged the solid block of it I could see at the end of my 10-year-long tunnel.

Friday, April 01, 2011

Dark times

Leading up to the almost present.

Jan 2011 - I set up an appointment with the endocrinologist. I am all set and raring to go when another family emergency occurs - on the same day that I am scheduled to meet the endocrinologist. The state of emergency lasts for half the month. All else goes for a toss. With the situation finally under control, my focus shifts back to self. The recent coming to a head of events on a personal front spanning the past few years (nothing to do with anything I've shared so far), the lack of a steady job for the better part of a year (a visiting lecturer-ship doesn't really count) and the lack of any headway in my transition affects me so badly that I spend days at a time holed up in my room and don't step out except to bathe, use the facilities & raid the fridge - I even take all my meals in my room, but that is something I routinely do. This goes on for weeks and my closest friends (in touch with me all the time) and even my parents (with whom I live) haven't a clue as to how depressed I am. This is not due to any lack of understanding on their part, but to my knack for putting on a happy face.

Feb 2011 - The financial situation has really tightened - my whole focus shifts entirely to getting a job, a futile venture. Personally, I am dealing with things, conditioning myself to bounce back up like I always have. I haven't listened to music for a few months now; towards the end of Jan, I had cancelled on a musical night featuring the works of Jack Johnson, one of my all-time favourite artists, and only now know why.

early March 2011 -  No job yet. Time is flying by. I reason that I may as well see the endocrinologist - HRT isn't as expensive, and there's really no point waiting. I send him an email and am called for an appointment on the 8th. Still no music, but I am doing better. I anticipate that I will soon be my old self again. Fingers crossed for the appointment.

Next, a full-bodied article on the appointment, and what happens subsequently. Keep reading!

Aimless wandering...and happenstance!

Now began a completely lopsided period of my life. I had a specific, yet vague task: "find people who have undergone transition in India and obtain references and the protocol they have followed." Easy enough, if one knows where to look; next to impossible if one is out of the loop of things because, as a rule, information of this nature is not advertised.

I was also being assigned tasks of increasing responsibility at the work-place, tasks that were above the scope of my designation and required me to apply and train myself with inordinate dedication. Add to that the extended evening, night and sometimes even mixed (3-day evening, 2-day morning) shifts and my brain chemistry was so messed up that it was now reading sunlight as a cue to fall asleep. Plus the coffee addiction - my only vice - and the associated daily withdrawal (few hours after drinking coffee, withdrawal begins) were killing me.

Vague tasks that required a gargantuan effort on the part of a procrastinator who is also a perfectionist took an obvious back-seat. Then there was pressing family/friend emergency after emergency that always took precedence. And the procrastinator was only too happy for an excuse to not have to draw up and execute an elaborate action plan. Time passed. The procrastinator did not.

Months after, I gave up my job and some transitory stimulus pushed me to renew my search on the internet. I found a reference to a gender clinic run by the Sitaram Bhartia Institute of Science and Research, New Delhi, on a website. Not knowing the reputation of the institute, and knowing no one I could ask, I remained sceptical - I tend to be wary of anything that seems too good to be true. Note the devious ingenuity with which the procrastinator's brain comes up with perfectly plausible 'reasons' to evade tasks. Consequently, the tab remained open in my browser for weeks but I did not follow up.

Then, an unexpected turn of events caused me to rush to Delhi for a couple of days. It was very short notice, but I took a chance. While still in Mumbai, I placed a call to the hospital and found out that appointments to the gender clinic are usually booked up to two months in advance. I had less than a week. I explained the situation and was given numbers of the psychiatrists associated with the clinic to ask them if they would make an exception. Needless to say, my calls went unanswered. To date I am ashamed that in my desperation to get an appointment I placed in excess of 20 unanswered calls to each of the numbers. Almost absent-mindedly checking the website, I came across the email addresses of the doctors in question. I emailed them and one answered - she agreed to see me and told me how to go about setting up the special appointment she was granting me.

During my meeting with her, we discussed my readiness, the protocol, where I could have HRT and get my procedures done, and how feasible it would be for me to be a long-distance patient of the clinic. I then returned to Mumbai.

A day or two later, she sent me an introductory email to Satya, the founder of Sampoorna, a trans Indian group. Satya, very promptly, sent me an invitation to the first Indian Trans Healthcare Meet, conducted by Sampoorna in collaboration with the Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai, which I attended (23rd Oct, 2010 - I remember for it was one friend's birthday and another had just been discharged from hospital). And just like that, I  was a member of the group. After the meet was over, the attendees had dispersed and the group members had had refreshments, we rose to leave when two of the transguys from the group excused themselves and headed over to the pharmacy in the hospital - to buy their doses of testosterone! It was so matter-of-fact. "Hey hold on a minute, we'll just buy our testosterone and be back". I was happy for them, no doubt. But I was insanely envious - I ached to walk in those shoes.

Satya and I met solo, to get to know each other, now that I  was in  the group. We discussed options for me, a future for the group and just hung out. It was a refreshing change to have an intellectual conversation in which I wasn't holding back on anything. I attended the next group meet where one of the members demonstrated how to self-administer an intra-muscular injection. I was more than ready to begin. Satya sent me an email introduction to the endocrinologist who has been treating most of our FTMs (as of this moment, I'm not sure about the MTFs - will check and update). Unfortunately for me, a few other things cropped up preventing me from making an appointment with the doctor.

In the interim, I received an invitation to attend an LBT conference in Kolkata, India, conducted by Sappho for Equality (Dec, 2010). After a lot of rumination, I agreed to go. Understand that, up until now, I had never intended to do more than transition, write a blog about it and then move on with my life. Attending the conference changed that. I had always been of the opinion that instead of Indians migrating to 'greener pastures' we need to stay here and avail of, and contribute to, the verdure here, and I realized that queer rights, finally, was where I could work towards making the difference I always spoke about.

The wearing (and scuffing) of shoes & the painful stubbing of toes

Personally, this is the time that my family (mother and sister) started addressing me by my chosen name and with male pronouns. With my father, it wasn't as easy. He needed to see my psychiatrist twice himself and was still not convinced. He was under the impression that because I was 'anatomically and functionally a perfect woman' if I was administered female hormones, I would begin to 'feel like a woman' (yeah, I know!).

I went back to the psychiatrist a few times, taking him, on his instructions, literature from WPATH and various letter templates. Then, I began to get frustrated - it seemed like I was just going around in circles. All the 'homework' he was giving me, and that I was religiously doing, was going nowhere. My visits to him were very infrequent - not from lack of fervour but simply because I am a major procrastinator (Emperor of Procrastination, an ex-girlfriend once called me) - and he didn't call me for follow-ups, either; I'd just randomly get up and go. I was worried that my being inconsistent would give him the idea that I was suffering from psychosis and that every time I had an 'attack' I would get up thinking 'I want a sex change'. If he ever had that idea, he never let on. He didn't give me any tests or ask me any probing questions about my emotional well-being and, instead, kept conversations casual and brief. Don't get me wrong - he's not a bad guy, and is a good therapist - I'm just telling you the approach he took. I think he may have been trying to to test my patience and resilience for clinical purposes.

During one of these visits, he suggested I go to a government hospital and have the psychiatry department there give me a 'GID diagnosis' to tread on the side of safety, legally speaking. Since my mother wasn't in the country, my father accompanied me (I must have been 22). At this stage, my father had perfunctorily accepted my identity and gender expression, addressing me by my chosen name and using male pronouns though slipping up all the time.

We went; the head of department wasn't in - he's a famous psychiatrist in Mumbai. The senior psychiatrist present instructed the intern to take my case history. On realizing that I was a 'GID patient' they asked me if I would mind other psychiatrists from the department sitting in on the session as they didn't get that many 'GID cases'- they made a visible effort to not give offence. As a science student, I understand academic curiosity and the interest in studying new or rare phenomena; and I understood it then. I was, am and always will be generous about being used as a trans-textbook; if some good can come out of relevant people interacting with me, I will do it - for science and for the transpersons out there. I gave my permission and explained my reasons. They sent word out to a few associates; then suddenly it was decided against. I asked what happened and assured them I had no objections to being studied but they seemed to want not to implicate themselves.

So began the painful task of giving the intern my case history. This was a story I had repeated so often to therapists in the past that I was beyond sick of it. I laboured through. At one point I was asked how I felt about myself (why I wanted SRS) to which the expected answer I saw as so clich├ęd and overused that I could just not bring my self to articulate it. The intern tried to nudge me on, "Would it be correct to say that you feel like a man trapped in a woman's body?"
Disinterestedly, "Yeah"
"No, no, if that is the case, you must say it. I can't write it down if you don't say the words yourself; and if I don't write it down, we can't supply the diagnosis as GID." 
The poor girl. She could see from my appearance that I was definitely gender incongruent. She wanted genuinely to help. And she was crossing a few boundaries in trying to do so. I steeled myself and tried my level best to keep the sarcasm out of my voice, "I feel like a man in a woman's body." She finished taking my case history and we went to the senior psychiatrist.

Now, the senior, the intern and I were sitting together. The intern was supposed to narrate the case history to the senior and then the session was to begin. 
The girl began, "blah blah blah...she feels like a .."
Grr. "Sorry to interrupt, but please use male pronouns."
"I understand your need, but I can't; by protocol, we have to use the pronouns of the gender you were assigned at birth."
Bristling mildly, "The gender I was assigned at birth was male. My sex is female. Don't get the two confused."
"Yes, but I still can't.."
Senior psychiatrist, "It's ok, it's ok. Whatever makes the patient comfortable."
The patient. Right. Deeeeep breath; it doesn't matter.

So the case history was given. Questions were asked. I can't remember very many. One, however, stuck. 
"Are you attracted to men or women and do you have a girlfriend?" 
RELEVANCE!?! With superficial calm, "Since you asked, I am attracted to women; I don't currently have a girlfriend but I have had two in the past. But, there are transpersons out there who identify as homosexual - they are attracted to members of their desired sex."
"No, patients with those characters are not considered GID; they are pseudo(something I can't remember)."
Grr. But it was not for me to attempt to correct whatever Devonian textbook they were referring to - it wouldn't work, and it would hinder my getting a GID diagnosis on paper. I let it pass.

The diagnosis was given, the paperwork filed. Time to leave. I went to the waiting area where my father was sitting, visibly agitated. Apparently, while I was busy trying to reason with nincompoops (albeit well-intentioned ones),  my father had spoken with an associate nincompoop - well, maybe not so bad, but I really want to vent some spleen here. Will get back to telling the unbiased truth now. So my father spoke with an associate who told him all about Gender Identity Disorder. But my father, with his unparalleled selective-listening skills, was only ever able to register the word 'disorder'. Then followed a long argument over why when bipolar disorder can be controlled by medication, gender identity 'disorder' cannot. The point about female hormones came up again. My father also took offence to the fact that the whole department was buzzing about the 'GID case that has come in' - like the response to a circus freak. Attempting to reason with him at this juncture was pointless; he would not understand 'academic curiosity'. We went home.

I followed up with my psychiatrist after a while and reported the task complete. He said we could now take the next step and referred me to an endocrinologist. I met the man but I seemed to know more than he did about cross-sex HRT. He also didn't seem to be in solidarity with transpersons. He agreed to 'treat' me but I wouldn't have been surprised to know I was his first trans patient. I made my decision. Attempting to commence androgen therapy with him would have been like asking local club cricketers to play for the national team and expect them to bring home the cup. I thanked him and left.

During my next appointment with my psychiatrist, he asked for a protocol to follow for transition. I reminded him about the WPATH literature I had given him but he said he needed a protocol that had been followed by doctors in India. He said that if we were unable to find any protocol, we would then go about formulating our own, based on the WPATH Standards of Care. I tried to tell him that each person is master of his or her own transition but try telling a medical professional or a scientist (myself included) to attempt a procedure without a protocol!

Thus began my unsuccessful and stagnating search for people who have undergone transition in India or resources for gender clinics or doctors here.

The picking up of socks

I'll skip back to a little after I had started working, and binding, say about 3.5 years ago.

I had gone to the local surgical store looking for safer, more comfortable and more effective alternatives to binding by crepe bandage. I happened to know they stocked all sorts of Vissco® products (rehabilitation aids and medical & mobility supports) and had some hope. From my internet research about various kinds of binders, I knew that the easy, delicate way to get what I wanted was to ask for a 'male gynaecomastia vest'. The clerk had never heard of one before. Great. I went home.

This was the first big step I had taken after coming out. I had had only the nerve to ask that one question. Well, I told myself, so you took the first next step, but you can't just sit on that - you've got to try again. Okay, self, I'll try again.

A week later, I went back. This time the proprietor was in as well. Good, I thought, he speaks English and he knows his stuff; let me try asking him. I started, "Do you stock gynaecomastia vests?"
Damn. "Do you stock any form of chest compression garments?"
"Do you mean an elastic belt?"
"Something like that...but more like a vest...and a bit more discreet. Something that a man with gynaecomastia would require"
"I'm think I know what you're describing but we don't stock anything like that."
"But we my wife runs a physiotherapy clinic 6 shops away where we also take orders for various support garments. Try there."
Bingo! "Thank you!"

I went to the physiotherapy clinic but the lady in question was out for lunch. I took her number from the assistant and went home. As usual, I procrastinated calling for a few days. Eventually, I called and took an appointment. Appointment day. I walked in with a pounding heart. She sat me down and I explained my requirements. This time, since she needed to know exactly what the garment was being made for in order to make it correctly, I braved it and told her. She seemed more personally curious than professionally. I overlooked it. I had to take off my shirt but had a muscle tee on inside, over my binding. The measurements seemed never-ending. We discussed the exact properties of the materials to be used, etc. Apparently, the details were to be sent overseas and the garment would be shipped back. Also, I could only be provided with an estimate after she consulted the manufacturer. I left precise instructions on calling me - under no circumstances was I to be called on my home phone (I live with my parents and I had not yet told them that I was taking any steps) - and left.

When the call finally came, it came, predictably, on my home phone and my mother answered. She was pretty matter-of-fact when she gave me the message and I began instinctively to start slipping my mother tid-bits as to what I was doing. I called the clinic - it would cost me about Rs. 2500/- for one garment. And she couldn't guarantee the outcome. Sigh. Anything would be better that having to use crepe bandage indefinitely. I asked her to place an order for a single garment. Shortly thereafter, my father met the surgical store proprietor and was asked why 'his daughter was interested in living like a man' - he seemed to have a lot of the details I had shared with his wife. Apparently, patient confidentiality takes a back-sheet to pillow talk. I never went back. They never called me either.

At around this time I was also busy learning my new job. I used to have dreams about mainframe password-resets and when my alarm rang I'd snooze it like anybody else, the ever so slight difference being that in that groggy state between dreaming and waking I'd be under the impression I was doing something in mainframes, not snoozing my alarm. I was also attending college for practice at lab-work. It was crazy. Binding was still a new science and summer was 8 months away. I was already chafing everyday, the binding coming loose. I was utterly miserable and desperate to have my chest reconstruction before summer, and hell, began.

I had to do something about it. Hadn't I taken up a job because I wanted to transition? Wasn't I now earning a salary? What then was I waiting for?! According to all the WPATH (I knew it then as HBIGDA) references and documents I had read, I was to see two mental health professionals for a minimum of two years each before I could attempt any kind of medical transition. It worked perfectly for me - in that two-year period I would be able to set aside some funds as well. The thing to do  now was to pick a therapist. I started close to home - the nearby general hospital's Psychiatry Outpatient Department - and fixed up an appointment with a psychiatrist I had heard a bit about.

My first appointment with my therapist - I walked in, determined not to have to fight my case to convince yet another healthcare provider of the authenticity of GID or my identity. The first words spoken in that office that day were mine, "Doctor, what is your take on GID?". Direct. No mincing words.
"What do you mean take on GID?"
"What are your thoughts on GID? Do you support transpersons?"
"I have no 'thoughts' on GID. GID exists and it is not something that can be 'treated' in the way that psychiatric illnesses are treated. We can only support the person and enable them if they want to transition."
I had no defences left. "Doctor, I gender identify as male and I want to transition." It was the beginning of a new chapter in my life.


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