Suzy, Drinker Of Coffee

Remember Remember The 7th Of November (I will...)

Regular readers of the blog will be more than aware that every 2^nd month, on a Tuesday morning, I’ve attended Sandyford, for ongoing checks. This is what they class as a “drop-in” gender clinic, for those with ongoing issues. Over the past few months, attendance there has enabled prescription of estrogen, as well as increasing it over the months – initially from one of the yellow 1.25mcg pills (I think these might be purple in America?) to four per day, and adding in an anti-androgen, to enhance the good work that the yellow ones are doing. It’s had good results in certain areas where reduction was needed, but that’s all for now. New hair coming through on my arm etc. is more like “baby” hair, the only problem there being it’s more difficult to get rid of it! So, that’s been me for most of this year.

For those of you who are not aware, the “rules” for treatment of transsexuals are laid down in a book, called the “Standards of Care”, by The World Professional Association for Transgender Health (WPATH, formerly known as the Harry Benjamin International Gender Dysphoria Association. This is not a legal document, but lays down best practice. The rules in it are flexible, and are not set in stone. To start on hormone treatment, you must first get one letter of approval from a gender psychiatrist or psychologist or similar. I did that back in March 2005, when I went to see Professor Mizra, at Carswell House in the east side of Glasgow. (This ironically enough was International Woman’s Day). That enabled me to start hormone treatment, so I was awaiting word back from Sandyford at the end of 2005. Around this time, Ninewells Genetics had been in touch with them before testing me for HD, so as a result, there was some confusion on exactly what I was waiting for, and because I was doing a circuit of every other outpatients department in Ninewells at the time, I didn’t have the chance to chase it up, until the turn of 2005/2006. I sent a letter early January, got a short notice cancellation, and it went from there (browse back to my blog). So, although Dr Carr agreed to prescribe back on Wednesday 18^th January , blood tests had to be done first, and I went back for the results on Wednesday 1^st February. After that was done, a letter had to go to my own doctor in the meantime, and then my own doctors seemed to lose the paperwork when I went back on Friday 3^rd March , so I had to go back again on Wednesday 8^th March… The guidelines also state that you need two “letters of support” before surgery, and two of the further criteria are living in your preferred gender for at least 12 months (I came out on 9^th April 2004), and being on hormones for one year (see above – date confusion!)

My initial plan for today was to ask further about the next stage of hormones, GRP paperwork, and to state my interest in referrals for assessment pre-surgery, although I would need to seek clarification of what was regarded as my start date on the existing prescription.

So, I made it there – 0800 M9 bus from Dundee (Neoplan 50141 if anyone’s logging these, with Volvo FSU 739 doing an Edinburgh duplicate). Just before getting on the bus, spoke to the new Stagecoach Strathay ops manager, Martin, whom I’d met before, and also who had left me some timetables to pick up (which I did the night before). Got into Glasgow (just a little late with roadworks), and then got First Gemini decker 32576 on the 16 up to Sandyford. All done – I arrived, and a little earlier than the previous two visits, at around 1030 (my bus ticket says 1022). Had a look – First have a “word of the day” on their all day tickets, and I wondered why today’s word was KY… until I realised my thumb was over the rest of “KYLE”…

So, I arrived. As it’s a drop-in system, when you arrive, you take a card, and that is then called out, so you can give your details to the one sat at the computer. As it doubles up as a family planning/morning-after clinic at that time of the morning, a little discretion is perhaps needed all round. So, colour coding is used – everyone else gets the yellow numbered cards, whilst we get the pink ones! (Don’t giggle, but I realise there is something in that), and mine was #30 (I think we got up to about #40 in the end). Once I got to the main desk, easily enough to get booked in, but we were advised that only two of the three doctors would be here today, as Dr Carr was away. Fair enough, so we waited… and in the end, waited a bit. I could see everyone being called, and even though they were “short staffed”, everyone seemed to be getting their time, and no-one was being chased out moments later, as may have happened elsewhere…

… So, I was seen around 1245ish, and I’d already tried to remember as much of the list as I could! It wasn’t a script – just a way of making sure I told him about the bad as well as the good. After all, they need to know everything relevant, and anything “different” to usual. Blood pressure was taken – twice – and was a little up at 130, although last time they checked me there I was 120. As regards to the way my body has tolerated the increasing estrogen and the single dose of anti-androgens, they have agreed to write to my doctor to prescribe me Provera – progestin, progesterone, whatever you want to call it, it’s the other female hormone. There was none available to take away, so for now, I await my own doctors – but they have also been asked to keep an eye on my blood pressure over the coming weeks. I can understand why.

We then discussed the GRP paperwork, and he explained that although those who’d applied had been relatively successful, those who were successful were those who had already been through surgery (and this is a point they’d apparently stuck on, but it wasn’t in the paperwork). Interestingly enough, that brought me onto my next set of questions. First things first, I stated my “interest” in surgery, and asked first of all who they refer to for the initial letters of referral. He then questioned if I meant the surgeons that they used, and I said “both”. (Well, it was the next question on the list!) There are two surgeons they would refer to – one, based in Edinburgh, who does more of a cosmetic job. Another one, based in Brighton [yes, England], does the more detailed, in-depth (bad joke, I’m sorry!) job. I’d actually read quite a good story about his work a while ago – probably early 2005 – but the site is long gone (I’m sure I put my story of what else I found at the same time in the blog before, at the time), but I didn’t let on. I remembered it was somewhere in the South of England, but as ever I’d not remembered where (well, it was more than 18 months ago I read it, so I am sure I can be excused this time!)

I then asked who he would refer to, for me to see, before getting a “letter of support” (sorry, I know it’s technically a transport industry term – used to describe the approval of a local authority to an operators change at short notice, and usually ended with “We fully support this application” – but there is no formal term for it, as far as I know, and not over here). This is the bit that sort of surprised me. The original letter from Professor Mizra from March 2005 would be one, and they can supply the second – meaning that I don’t have to go through two “interviews”, they can refer straight to the surgeon concerned. I then got onto the issue of dates, and then I asked exactly what would be the date as to when he would consider me as commencing on the estrogen – all things considered. This also surprised me a little more, and he explained that the referral is less built up on the time that I’d been taking the stuff, and more based on the time I’ve been living in my correct gender – i.e. as I’ve now been living this way for 31 months, it’s well in excess of the 12 month minimum. So, he’s scribbling all this down, and I then ask if he feels the time could be right to refer now? Yes, he did! The surgeon in question was to be coming up to Glasgow to see prospective patients in January at some point, but that looks like the date for that may be not happening, or subject to change.. I said I’ve been down to Brighton before, so didn’t object to going down there, or him coming north – whichever comes first. So, I return there again at the beginning of February (no drop in during January usually), and if I’ve not heard by then, hopefully I would when I came back.

As I walked out – 1315 (1.15pm!), I was very happy with my lot for the day – but then I did question who’d write first, the surgeon or my own doctor? Time will tell, and if they both turn up on the same day, I’ll call it a draw! So, that was that…

… and instead of saying “oh, that’ll happen way off in the future”, I can now say “it will be happening soon”… but obviously don’t ask yet – we’ll just take it to be late summer/early autumn (fall) 2007, or possibly even winter 2007/2008.. The “window of opportunity” is most defiantly open, and I’ve asked all what I had to, with the bonus of not having to find, then go to, two totally separate and different medical facilities, and explain them my life story. Again. (and no, I can’t just print out this blog!) I don’t know about you, but I know when I go somewhere, it’s better knowing that someone has already outlined the basics to them, rather than starting again with a blank sheet. There are still a large number of formalities to go through, but we can come to those at the time. As for the distance, I’ll come to that later. As for what will happen to everything I’m doing at the moment up here, plans have been underway for some time! That, and I’ve known I wanted this since I was a little girl – well, I wasn’t quite on the outside, but you know what I mean – inside, the mind is always right. I feel ready now to make the decision, and I have done so. Now, preparing as a physical person, as well as preparing everything locally, work etc. can all take place over the coming months. I shall see to everything, and then it will be time. Surgery to reconstruct the lower part of my body is not the be all and end all – lets make that quite clear. It only changes one thing, and 99% of people in this world will not be able to tell the difference. As I said back at the beginning, this is the long haul for the short drop, but I’m getting there.

One benefit of the Sandyford’s "edge of city centre" location is the easy of access to public transport – well, lots of buses! The First Glasgow 16/18 42/42A go past often enough, but two sides of the building (albeit the opposite sides of the road) are used for layover stands for Service 57 journeys, adding at least another six per hour. Arriva & DJ services 17 also go past, as well as the fact there is STILL a panel up promoting Henderson Travel Service 49/149 (although this was applied by the finding SPT ) – complete with sticker advising that this service would be withdrawn in Summer 2005! Anyway, I crossed the road, waited patiently for the driver to prepare the bus for service, and then got on First Scania 61682 on the 57, towards the heart of the city centre i.e. food, timetables and shops! The bus was more or less empty all the way down, largely due to the fact the driver stayed in the outside lane… and I rang the bell at my stop (Jamaica Street), and he looked back and yelled “You wannin aff here?” I nodded, and he slowed down, and stopped the bus… now I thought that is what the bell was for? I went into the Travel Centre, picked up what was new, and then went over to the Blue Lagoon for a pizza supper, especially as I’d not had one for a few months… just as soon as my pizza hit the fat, a text in from the West End Poet (I’d sent him one as I left Sandyford), saying that he’d be in town. I wasn’t sure if I was meeting him or not, as he’s been off work ill, but I gave him a call, and we arranged to meet around a few corners. I munched what I could of the pizza (and in fact, couldn’t stomach any more of it anyway!), before I waited – and then got another text, and I realised I was one further street up to go! We met for coffee, and he explained what had been happening, and why he’d been feeing so ill – not that the doctors seemed to know. They put it down to the flu! (sounds like previous diagnosis of “stress”!)

He also told me how everyone else had been saying “you look very pale”… so I didn’t say it again, but he still looked a little under the weather. I know how frustrating that can be – especially when a few weeks ago, they were saying to me “are you sure you are well enough to come back to work…” He also advised me on the rumours going around while he had been off, and told me that he understands everyone is enjoying scrapping over his shifts for overtime! Friendly colleagues eh?

So, at 1515, he had to dash, so I had a wander through the St Enoch centre for a bit. I was booked on the 1700 bus back, by this point I still had 85 minutes left, in the rain. I know… there’s a web café in St Vincent Street… the keyboard was barely working, but I put in £1 which gave me up to 1630 – just enough time to send a message that special someone in my life, and tell him all my good news. Now, he was thrilled to hear about Part One i.e. the hormones, but when I told him about Part Two i.e. the surgery, he was somewhat lost for words! Needless to say, he’s very excited about all this too! I left, walked around to George Square to catch any bus heading to the bus station – and a 240 drove past me, but the 262 behind had to stop, because someone wanted off! Oh well, glad 61601 rescued me, or I could have been there for some time. Sorry, but if someone stands at the right stop, with hand out, on the road, you cant really drive past! Anyway, got to the bus station in enough time, and 1700 departure for Dundee was Volvo L100 WCM (actually newer but on an older registration plate) on the M8, which got me back to Dundee for 1920ish.

I got in, got online, and caught Jay just before he went into a meeting… and he was glad I got home safe. That’s the thing I was thinking about – out of all these Dundee – Glasgow trips, someone out there has been looking after me. Maybe “god doesn’t make mistakes” (quote: my mother), but in my Dundee – Glasgow medical trip series, we’ve had a northbound truck driver in front start smoking, we’ve had an RTA which caused me to be late (the day I said I’d be about 15 mins down, and turned up bang on 15 minutes late), various other issues with coach changes etc. – I’ve always got there and back safely. Anyway, as I am sure you can imagine, he’d been thinking a bit, and was rather happy for me. Questions about when etc. all this can be done, so I used the (fully working) keyboard, to tell him as much as I could, and as much as I currently know. Since then I’ve told a few friends – now for the last few weeks, I’ve had the “battle of good and evil” from friends as to whether or not to go for progesterone or not. Yes, it causes body development, but it also is the hormone behind genetic women getting pmt/pms. We shall see how I get on. Having said all that, no-one has suggested otherwise to the surgery referral…

… so, the end draws to another day, another 170+ mile round trip, and another stage in the rebuilding of my life. Thanks to everyone for your words & thoughts so far.

posted by Suzy Scott @ 23:59