In order to ration care treat trans patients, the NHS wants shrinks to be involved. Specifically, you can't get a referral to an endocrinologist without a psychiatrist. Also, importantly, nobody wants to pay for anything unless you jump through all the proper hoops like a trained circus dog. So this morning I arose bright and early to go see a shrink.
The letter informing me of my appointment told me to go to the Queen Elizabeth Psychiatric Hospital (QEPH), which is right by school. It always struck me as highly convient, having the mental hospital right next to the Uni. I also often wonder how the queen feels about having a mental hospital named after her? There must be a great number of strange things named after her. The Queen Elizabeth Car Park. The Queen Elizabeth Strip Mall. The Queen Elizabeth Home for Rabid Puppies. Does she get any say in it? "Oh, thank you for the kind offer, but I was really holding out for a suspension bridge?" (Or can there be multiple Queen Elizabeth Bridges? Would that be too confusing? Could there be both the Queen Elizabeth Bridge and the Queen Elizabeth Suspension Bridge?) I mean, personally, I wouldn't be picky, but I have many fewer people asking to use my name for their construction projects. Nevertheless, I think I would balk at a mental hospital. What are you trying to say?
Most Brits probably have odd ideas about America. I think they imagine the shootout at the OK Corral as being highly symbolic of the country as a whole, which is not an entirely unfair assessment. Similarly, I have various stereotypes floating around in my head about the UK, many of which come from Victorian novels. High school English classes typically spend one year on American Literature and then one year on British literature. The Victorian era seems to have been a golden age of writing in England. Or, at the very least, it's the one most enshrined in American highschools. Costume dramas made by the BBC are also a major cultural import into the states. We all imagine a dark, smoky gray London with a polluted fog overhead, women in petticoats, Dickensonian beggars, murderers left and right (with Sherlock Holmes or Miss Marple on their tail) and hulking brick asylums, filled with suffering upperclass women who can't accept their station in life. Women who want to read too much. Women who want to be men.
Fortunately, I have managed to avoid being committed. I woke at an extremely early hour and managed to spill every drop of my morning coffee on the floor before I left for my appointment, alas and woe. The QEPH is in a typical largish medical building. They have automatic doors, which, unlike mental health centers in the Netherlands, are actually automatic. The reception was separated only by a normal counter, again, unlike the Netherlands which was behind glass. Maybe they think I'm crazy, but at least they don't think I'm dangerous. That was nice.
The doctor asked me when I first knew I might be trans. I should have a set answer for this by now. I should write out my official narrative and post it to my blog. Then, when somebody decides that I need to see a shrink, I can just give them the link. I don't fucking know when I first had gender issues, ok? sheesh. I really don't want to draw any kind of line anywhere. I don't want to validate all the homophobic bullshit I used to be subjected to. I don't don't want invalidate decisions of other butch women not to transition. When did I cease just being a butch woman? When I started taking hormones and told people to call me he. Not before. It happened then.
Lack of coffee, up early in the morning, strident (formerly) lesbian feminist, so very very american. I must have seemed a bit like Hillary Clinton. But, you know, if she were a bloke. I was confused by the questions and gave confusing answers. I'm pretty sure I annoyed the doctor. Nevertheless, I have successfully jumped through this hoop.
He explained that there were evaluations and waiting lists and whatnot. We don't just give out hormones on demand to people who ask for them, he explained. Why the hell not? What terrible harm would befall the commonwealth is trans people had easy access to transition? None!
Alas, this is just one hoop. This doctor is not a gender specialist. I'm to keep seeing him while I wait to see the one specialist for the region. Who is not in Birmingham. The second largest city in the UK has no gender clinic. The waiting list is apparently months long. In the mean time, I can keep taking T - and I can keep paying for it.
I am so very, very, very glad I started on hormones while I was back in the states. Sure, we're all cowboys and it's the wild west and all, but that's not all bad. The social worker in San Francisco explained that the city had no vested interest in saying no to trans people. What purpose would it serve? The city pays for it's residents to get this service if they want and need it, like the NHS pays for Brits (and foreign students). And San Francisco found it was coming out ahead when it got rid of all its hoops. People who come in for hormones also get the other health services that they need. Happier people tend to take better care of themselves and are healthier. Does it save tax money to say no to trans people? No, quite the opposite.
I left my heart in San Francisco. Sometimes, I think it's the only place in the world where anything makes any sense.
I felt good about myself when I left QEPH. I got through this round. I was treated more or less like a normal person. When I got back outside to the bike parking, somebody had left a nice, new, red mountain bike leaning on my bike. With no lock on it at all. You'd have to be crazy to leave that bike out unlocked like that! . . . oh right . . . I wish my issues weren't treated as mental health issues.
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