Gender Identity Disorder

All posts tagged Gender Identity Disorder

Week 82 – Day 4 : What’s expected of me?

Published September 11, 2015 by Katier Scott

I’ve seen several posts of this ilk from people who are about to go through treatment for Gender Identity Disorder GID. They are naturally nervous about the whole process and unsure what to expect. Also, while things have improved, myth and rumour still exist. On top of there there’s the confusion of terms and what they mean, why do I use GID and not ‘trans’ related terms?

Gender Identity Disorder

So I’ll start at the ‘top’, what is Gender Identity Disorder and it’s closely related cousin, Gender Dysphoria (GD)?

GID is simply a medical condition where the brain’s gender doesn’t match that of the body. Generally this is simply the brain is gendered male, and the body female, or the other way round. But some people feel more androgynous about their gender and thus may consider themselves ‘no gender’ or maybe they switch genders depending on the situation. All this people can be considered to have GID, as their ‘Mental’ Gender Identity is in Disorder with their physical one. Current medical research points to GID occurring in the womb, during any babies development they all start as a female, regardless of the DNA, the body initial develops in a female shape. At some point in the development, hormones and other chemicals trigger the body and brain to ‘gender’. It is two separate sets of chemical signals that cause this and thus if one signal fails for some reason, then you get GID.

GID has different feelings for different people and this is one reason why gender is considered to be fluid, these days, and not simply male/female. People with severe GID may also develop GD, which is a mental condition where they are massively uncomfortable with their bodies and thus GD can trigger other conditions such as anxiety and depression. Hence while GID is absolutely NOT a mental condition, the fact it’s generally treated by Mental Health is a good thing because while the condition itself isn’t mental, it can definitely cause people to have mental health issues.

GID is treated by changing the persons physical body to match that of the gender of their brain, using hormones and surgery. For MtF it’s oestrogen and testosterone blockers, for FtM the reverse. Hormones have the effect of causing fat to be redistributed to gender appropriate parts, e.g. onto the hips on a female, body hair to become gender appropriate, I believe it changes your body odour, can help reverse Male Pattern Baldness (or cause for FtM) and causes breast growth for MtF and Beards for FtM. Surgery is considered optional but if done consists of the following :-

For Male to Female patients :

  • Vagioplasty, or the non vagina variant – i.e. the groin area is given surgery to make it physically look female, and a working vagina may be created – this is optional depending on the wishes of the patient.
  • Breast enhancement – I believe this is treated exactly as for any other female.
  • Feminine Facial reconstruction – Feminising of the face.
  • Laser/electrolysis hair removal – while not technically ‘surgery’ it is a medical procedure needed to remove beards.

For Female to Male patients

  • Penal construction – this is improving, but something that I believe is less common than Vagioplasty’s.
  • Mastectomy – this is the ‘big operation’ for men, as it makes their chest area appear for more masculine and removes the need for binders.
  • There may be other FtM medical procedures I’m not aware of, but these are the main two.

Transgender/Transexual

So that’s the medical side covered, I don’t use the terms ‘Transgender’ or ‘Transexual’ because I feel they are heavily mis-used, a bit antiquated, and harder to understand. It’s easy to explain it as a medical condition, but Transgender and Transexual can easily appear to be a fetish or similar, and that results in misunderstanding and confusion. Transgender is meant to be an overall term for all people who have some form of preference that sits outside of the ‘gender norm’, so that includes cross-dressers, transvestites, drag queens, anyone who while they consider themselves their birth gender, enjoy elements of the other gender – plus those who have GID.. confusing much? Transsexual is underused and is the term that SHOULD be used when referring to anyone with GID, but because I don’t see it used, but instead the confusing transgender term is used, I think both terms need to be assigned to history. A new term can be used for those who are ‘gender variant’ and simply use GID for those with GID. Simplez!!

Gender Clinics

OK so what are Gender Clinics looking for?

Well being a condition that, while not a ‘mental illness’ is still a ‘mental’ condition, it’s not something you can simply take a blood test and diagnose, so Gender Clinics expect to see you taking on ‘norms’ for your gender. It can feel like a box-ticking exercise, but truth be known all they are expecting you to do is live life the same as anyone else of your gender.

So to make this easy to understand I’m going to create a fictional character, I’ll use a MtF lady called Mary. Any likenesses to anyone are 100% co-incidental and everything is based on my own knowledge gained, based on my own experiences and things I’ve read or been told.

Mary is somewhat of a recluse, she’s nervous about going at ‘as Mary’ in public, and when she does tends to have just had a shave roughly brush her slightly receding hair, and put on gender neutral clothes with no effort to try to ‘feminise’ her appearance through things like fake boobs. She is also unemployed and if she does go out as Mary to social settings it is with Transgender groups or to LGBT venues.

The Gender Clinic aren’t happy they are seeing Mary actually taking on a female gender role in a form that makes them happy she actually has GID. So they request she tries to get a job, or voluntary work, and works on her appearance through the use of fake breasts, more feminine clothing – they also suggest she sees someone for make-up tips – NOTE: Makeup doesn’t have to be much, I often go to appointments just with foundation on, but you need something to hide beard shadow. Mary hasn’t changed her name or documents either, so they also request she does so through a deed poll and presents them at the next appointment.

They talk and find out that Mary used to enjoy walking, but hasn’t done this for a while so they suggest she finds a walking group and joins them.

All the gender clinic are asking is for her to start actually living and socialising as a woman, contrast that to my first appointment. I arrived, dressed in jeans and a female cut top, wearing simple make-up and a wig (as I have male pattern baldness). I was socialising at the local open Mic and had both a job, and was doing voluntary work. At my second appointment, 6 months later, they put me on Hormones, and this blog was born.

I wasn’t doing anything ‘clever’ or special, I was simply getting on with life and doing things I enjoyed with people who fast became friends. That’s all a Gender Clinic wants to see, you living your life in a role typical for your gender. Gender Clinic’s have never asked me to do anything, because they’ve always been happy that I was doing that. I also transitioned before I got to the gender clinic. As soon as I moved out from my ex-wife, I immediately switched genders, changed my name as quickly as possible and all associated documents. My new bank account was in female gender and I presented as female immediately, and non-stop since. This meant when I got to the Gender Clinic in July 2013, I had already being living as myself for three years, so they really didn’t have any issues.

Contrast that to Mary, or even someone who turns up (for example) presenting Male, then Changes to Female when at the Gender Clinic, and you can see the contrast. Now don’t get me wrong, everyone’s situation is different, we have different levels of support (I’ve been super lucky in that my family has always been supportive and my best friend at Uni has stuck with me throughout) – friends may or may not stick with you, but ultimately everyone has control of what they do.

It is incredibly tough, my transition since moving out has been a long journey, but at least I’ve had support. But if your married, having kids, unsupportive family – it’s incredibly tough, and takes a strong person to make the switch.. but ultimately at some point you have to say ‘enough’s enough’ this is what I am, and I need to live that way. If you can do that before arriving at a Gender Clinic it’ll make things a lot smoother, but certainly isn’t essential.

Week 78 – Day 7 : Oh dear.. oh dear..

Published August 16, 2015 by Katier Scott

This weeks blog was triggered by this photo that one of my friends shared on facebook. The photo can be found here and on the face of it looks innocent.. until you read the text. The photo was posted by a proud father who’s son, Beau, was born with a condition called Fibular Hemimelia which resulted in him having to have both his feet amputated.

Obviously that has caused Beau’s life to be not as straightforward as for anyone with feet, and he seems to face adversity strongly and with a brave face. But when you read a bit deeper you realise that Beau is facing many problems, all be it caused by a different problem, that anyone with Gender Identity Disorder (GID) faces.. so it was very unfortunate that Jason chose to blight what could have been a wonderful ‘I’m proud about my son’ post by roundly being critical about Caitlyn Jenner getting a reward for Courage.

Not only did Jason question the award, but he refused to refer to Jenner as anything other than Male and using her former name. In doing so he instantly showed by Jenner’s award was so deserved,  by choosing to be so public with her transition Jenner immediately opened herself to criticism, transphobia (as displayed by Jason) and bullying.

All people who are born with disorders, or who develop them in life, which cause them to be different from the ‘crowd’ face very similar adversity, including acceptance, discrimination, bullying, harassment, fear and just the general struggle to try to broadly fit into the crowd. In that respect Beau is no different to Caitlyn, or as Beau is a child, any of the many children and young people struggling with conditions, be it GID,  Fibular Hemimelia, Deafness or any other condition.

Both this blog, and the work Caitlyn is doing through being so public in her transition is simply trying to educate, and sadly it’s not an easy job. As Jason proves, you’d think someone who’s son is facing so much adversity might actually empathise with someone who has GID, but I guess because it’s not a physical ‘disorder’ then he doesn’t belive it exists.. so I’ll leave a few thoughts.

ADHD? Epilepsy? ASD?

Yep all exist, but are ‘invisible’ conditions and so does GID.. but there’s a way of flipping round GID and realising it ‘can’ exist and that is the fact there is a ‘physical’ problem that can easily result in Gender Dysphoria (which is when GID is actually causing mental problems as the person really isn’t comfortable with their body), that condition is ‘Intersexed’.

Intersexed is when the physical genitals of a person are of BOTH genders, the chances are the brain, however, is of one or the other gender, and worse, often surgery is performed early on to make the baby a single gender.. get it wrong and that child instantly has in effect Gender Identity Disorder and almost certainly will be Dysphoric..

So if things can go wrong obviously with the physical make-up of a body, and we know the brain must be gendered in some way, otherwise you wouldn’t have female and male characteristics in the way people act, and we know Mental Health conditions exist – there is absolutely no reason what-so-ever why Gender Identity Disorder can’t exist!

The fact of the matter is, of course, that is does exist – but because it’s totally invisible it’s easy to dismiss it at something it isn’t – however it’s a proven medical condition and researchers even are pretty sure how it happens.

For those who are still with me, when you are developing in the womb everyone starts off female. It’s actually chemical/hormonal triggers that cause a female body to change gender to male, at the same time, other chemicals will trigger the gender change in the brain to whatever it should be. So for a female, the only chemical trigger is to ‘set’ the brain, in a male two triggers go off, one for the body, one of the brain. If any of those triggers, for whatever reason, don’t go off properly, that’s how Gender Identity Disorder happens.

Now I should add, that I have absolutely no issue with the concept that some people have that gender is just a fluid, natural, flexible entity. The point I’m making above, however, is the strict medical definition, however if you see gender variance as natural that’s absolutely fine. But when educating, or informing, working on something tangible such as above, should make it a whole lot easier to understand.

Week 75 – Day 4 : ‘Hearts not Parts’

Published July 23, 2015 by Katier Scott

You might recall, back in April, me talking about the loss of a 15 year old, young Roller Derby player, Sam Taub, a loss that effected me quite strongly simply because I connected with him in a way I never expected. More recently the Roller Derby community lost another of their youngsters when a 14 year old skater lost her fight with Depression – both these incidents saddened me, we shouldn’t be loosing young people with bright futures, at this age. We shouldn’t have to be fighting against discrimination and we need to look after our young people – when I qualify as a Mental Health Nurse in around 3-4 years time, I most definitely would like to work to help these people who should be getting every bit of support they need.

But the reason Sam’s story has resurfaced was a fantastic speech by Caitlyn Jenner. Now I’m not someone who particularly follows celebrities, especially when it comes to their lifes especially, let them live them. But Jenner has come out very publicly, and, having listened to her speech I realise she’s using her celebrity to raise awareness, she’s clearly someone who’s grounded and understands the problems people with GD and/or GID face, alongside those who identify somewhere under the Transgender umbrella. During her speech, which was for a well deserved courage award, Jenner mentioned three people, two by name, one of whom was Sam.

This unsurprisingly raised awareness of what happened back in April as many news outlet’s who may have missed the initial story, or ran it at a low profile, suddenly started digging and the result has been a series of fantastically supportive articles in which the result is I so want to fly to Detroit and give Sam’s Dad, Geoff Taub a huge hug. For someone who must be still struggling with the loss of his son, the quotes have been from a very brave and tough person. I already had a lot of respect for Geoff after comments he’d made in response to articles in the Roller Derby community, but his recent quotes are of a very brave person.

One quote really hit home, however. I’d seen Geoff mention it before, but in light of conversations I’ve had with people recently the quote, which was made by Sam Taub when he first told his dad who he really was. Sam said, Dad, “it’s Hearts not Parts” and today really hit home for me.

I am having my little battle with the Gender Clinic to sort out surgery, it’s a battle that appears to be on the home stretch but it’s unlikely I’ll have surgery for another year.. but while I was there chatting to the receptionist I told her how, for me, this whole GIC journey was purely about fixing the ‘parts’ – but ultimately for me it’s what my Heart (well brain) said, I didn’t feel I was transitioning, I transitioned the day I moved into my new flat after splitting with my ex. From that day on my life has been lived as ‘hearts, not parts’ – the parts cause me issues, things like changing rooms primarily are still an issue, however ultimately it’s sorting a few minor things – I live my life as me, what my heart says, not what my ‘parts’ are.

What really moved me, and it’s so sad to hear it still happening, is the story of another trans person who recently mentioned they were having to live as their wrong gender. Speaking to them, despite the trans-person being an adult (gender withheld for maximum anonymity), their parents were clearly not from the Geoff Taub mould of parenting. They can’t seperate the ‘parts’ from the ‘heart’ and worse, are worried about the ‘appearance’ of having a trans-person as their child. I’ve been fortunate, my parents, and family, have all been hugely supportive, heart is what matters, and the fact I’m much more happy, living a much more fulfilling life, and am hugely fortunate – means they are very happy for me.. it’s about Hearts, not Parts, folks.

Which brings me to this blog and my book, I really hope people who might not understand, read it and realise that life is very much about heart, about loving your kids, helping them and supporting them – not about the parts. It’s tough, many supportive parents have mentioned how they went through a grieving process, it needs patience on the part of the person who is living as their correct gender, and sadly as Sam shows, it’s not always enough – but we need to love and care for our kids, show it doesn’t matter what Gender they really are, what their sexuality they are and that they need to be taken seriously and given the treatment and support they need. They don’t need to be forced to live as the wrong gender, have their things thrown out, be forced to undergo degrading and pointless ‘curative therapy’ as happened to  Leelah Alcorn.

All our young people need love, support, and access to the right services in a supportive environment, we are losing too many of our young people, and it shouldn’t be happening. Remember folks, it’s Hearts not Parts, give all your kids all the support they need, be compassionate, caring and supportive – and allow them access to all the services they need and deserve. It’s not their fault they are GD/GID, Depressed, Gay, or whatever else, give them all the love and support they deserve.

Week 68 : Day 6 – Successful complaint

Published June 13, 2015 by Katier Scott

I’ll cut to the chase, I won.. well won is probably strong but my complain against Porterbrook clinic was successful, although interestingly the major point of my complain was successful due to a point I didn’t make!!

I had a formal apology for them mis-handling my transfer from CHX as they shouldn’t have re-assessed me, this they admint ‘probably’ delayed my moving onto T-blockers, although it didn’t effect my Hormones. Hopefully this has raised their awareness of the issue at the very least and any future transfers don’t have this delay in their treatment.

The second point I made was centred about delays in my second opinion appointment for surgery and again they agreed that Porterbrook was at fault, although not exactly on the grounds I gave them. I guess this might have been because part of my complaint was surrounding future delays, rather than actual delays. They said that agreed that there are actual delays and that’s good, but also, and more importantly, have put in place a plan to limit any future delays.

Essentially they told me that Porterbrook, being one of the smaller clinics in the UK, discusses all patients in meetings with all consultants, so even if you don’t see a particular consultant apparently they can’t be considered to be ‘independent’ for the purposes of clinical referrals for surgery. The fact they can do it for hormones (which also needs two referrals in effect) does make this slightly strange, however, and if any medical professionals who read this would like to comment I’m all ears.

However it turns out that currently Porterbrook only do referrals for surgery every 3 months, which means my first referral won’t go through until this month, 4 months (or near enough 18 weeks) since I had been on hormones for 12 months and thus falling outside the 18 week NHS contract. As part of a procedure update this week be reduced to a month for future patients, so that’ll help them, but for me the big ‘win’ is that they are going to contact all gender clinics and arrange an appointment as soon as possible. Obviously if this comes back as anything more than a few weeks I’ll be carrying on with the complaint as, because I’m currently on the treatment path, and it’s a single appointment for second opinion, it shouldn’t be subject to any waiting times commonly suffered by people waiting for their first appointments.

So while it’s not the end of the story, it shows complaints DO work and are worth doing, in the right situation. If you are going to complain I would look at two things. Firstly as to whether the complaint is sensible, if your complaining about waiting for your initial appointment, then it’s probably be better to be proactive and try to find somewhere with a shorter wait time. Secondly make sure you understand the grounds for your complaint and make sure you refer to the regulations, procedures and guidelines the NHS works to when making your complaint.

Saying ‘XYZ gender clinic is crap with horrible delays’ isn’t likely to get far, but make it a proper, well written, complaint with clear aims at what your trying to achieve through the complaint. Refer to the aforementioned procedures, include a run down of your life and treatment to the point, and  connect the dots so it’s clear what the basis of your complaint is. Also suggest solutions, and make them sensible, I suggested three, and Porterbrook came up with a 4th, if the timings for the 4th are ok, then that’s great, if not, then I can just go back to my suggestions and fight harder.