My appointment with the psychiatrist seemed like a very long wait. I would have been seen sooner but the psychiatrist who was assigned my case felt she didn’t have enough experience within the relevant areas and passed my case on. Eventually, the appointment came around and in February 2011, I went for my very first appointment to discuss my gender issues. I don’t mind saying I was terrified, not because I was worried that I was making the wrong decision, but because I was worried they may not take me seriously or, even worse, that they may not be able to help me. Having to talk about such personal things was going to be a huge challenge for me as I had kept many of those feelings hidden away from everyone. My partner came with me and waited in the car and I took my first big steps towards my new future.
The appointment was everything I had expected and was quite daunting. The questions were fired at me over the course of an hour-long appointment and I had to recall information from my childhood, about my parents, siblings, teenage years and relationships. I was asked to explain how I felt about my gender and identity. I felt myself second-guessing how he was trying to analyse me and did feel quite a bit of anxiety about the outcome of that appointment. I remember really clearly at one point, when I was talking about how my chest was the most difficult element of my life, describing trying to conceal it. This was a daily battle and one of the things I needed to change more than anything. He began to suggest I had a body dysmorphic illness but without any reference to the gender. This was the only time I got a little agitated as I made it extremely clear this was not the case; I didn’t feel female, I didn’t look or act female and I no longer wanted to be known or seen as female. By the end of the appointment, he advised me his diagnosis was Gender Identity Disorder and was referring me to a specialist clinic in Charing Cross. He also advised he would write to the local Primary Care Trust to fund referral and surgery. I came out of the appointment feeling really excited that I had made such a hugestep forward – however, the realisation of vocalising my life and feelings hit me really hard.
About a week later, the psychiatrist sent a letter to my GP which was essentially a copy of the referral letters for Charing Cross and for the PCT . About a month after that, I received my first letter from Charing Cross detailing my first appointment. My excitement for this unfortunately was very short-lived as the letter that followed was from the North Lancashire PCT, advising that the panel had refused the funding for my referral or surgery. I felt crushed and couldn’t believe people who didn’t even know me could take away this chance that I had been given. Within the letter was a great deal of well-written jargon surrounding policies and the procedure followed when considering funding. I was advised that I could appeal and after speaking to my partner and a very close friend, summoned the strength to fight the decision.
The fifteen-page appeal document took us a few weeks to put together and it was accompanied by a letter from my partner and best friend, both supporting my request for help with my GID diagnosis. Within the application I stated the following:
Policy Number 7: 2.2
The PCT recognises that assessment with a view to possible gender reassignment surgery is the appropriate medical strategy for some patients with gender identity disorder illness. Other patients are best managed by techniques leading to psychological adjustment without surgical intervention.
I pointed out to the PCT that I had been offered neither of these things; after the decision to decline my funding was made in July 2011, I saw my GP who advised that I would have to wait another two years before re-applying. In the meantime, no alternative help was being offered, which I found both shocking and terrifying. I went on to explain that I failed to see how the PCT could justify not even giving an initial assessment from Charing Cross. At that point I had received only one assessment from a psychiatrist in which I spoke about my life for a short time for him to build up a picture and brief report. I stated that each person suffering from GID who applies for funding and support is an individual case. Each person is striving for different things – whether that individual wants to change one thing or several things, their suffering remains the same. I then pointed out another of their ‘policies’, which stated that documentation exceeding three years must be in place to consider funding. This had been raised as a main issue for declining the funding. I pointed out that I had suffered with GID for more than 15 years – a detail they had clearly chosen to ignore.
The appeal was sent off and the appeal panel met a few months later to review my case. It wasn’t long after this meeting that I received the letter I had been dreaming of. As a result of my appeal, the PCT had reconsidered the initial referral and decided that assessment at the Gender Identity Clinic in London would be funded in order to get a specialist opinion. Not only this but as a result of many of the points I raised in my appeal, the many policies used as a decision-making tool for funding, were being re-written. Words used within the polices were being reviewed in order for the polices to be ‘fairly’ applied. Although it went on to state that funding for surgery would need to be applied for again nearer the time it was required, I didn’t care.
To me this meant one thing; I would now finally be able to get specialist help on my journey to change my gender and the appointment I had received to go to London in November 2011 at Charing Cross would now take place.