Suzy, Drinker Of Coffee

Trans experienced and gender politics

Melanie had hers done just over two years ago, and her story of what she went through is shown here. There is also a second page, which goes into more detail on the surgical aspects. WARNING – This page contains images of the finished product about two thirds of the way down on the right (several weeks afterwards).

The second experience I found was on w3bgirl’s blog - and she’s moved around a lot over the years, starting from Chicago, and now living near Bristol. She had her work done in June, and appears to be another very satisfied user.

The third one is “Sarah’s Transition Musings” – a LiveJournal of someone who is about to undergo the same as me, by the same surgeon, in January 2007. Yesterday marks eight weeks before she has to go in. She has had her admission letter, which says a few things that I found of note. Firstly, he also asks her to bring GRP paperwork with her, so he can complete the surgical related bits. (I think this means avoiding asking your own doctor to fill in the second part – which could be a blessing in itself). Obviously you stop taking hormones six weeks before surgery (she is slowing down from eight), which most people know, as well as stopping smoking three weeks before. What I didn’t know was there is also a requirement not to take Asprin in the three weeks before, not to use hair removal cream in the two weeks before, and not to wear tight underwear in the two weeks before also. All this is to avoid you getting deep vein thrombosis (DVT), but the Asprin is apparently to avoid haemorrhaging. I think this site is probably going to be useful in the weeks and months that follow – especially as she’s planning on taking the laptop with her (and yes, you can!)

Then, I started to look down the Journal. It was somewhat interesting, lets just say. Her post from a few days earlier was of her visit to London. She had been to see a private doctor (by the name of Doctor Curtis) just off Oxford Street in London – a paid, private consultation. About this, she said “…It all works on mutual respect. Certainly he has his own ideas, and if you're unreasonable in what you want, you're not going to get it, but fundamentally he's there to help. This is a supportive environment…”

Then, she was going to help a friend with her appointment at Charing Cross Hospital.

“…my first (and likely only) experience of the NHS's flagship GIC left quite an impression on me. What I hadn't realised is that the Claybrook Centre itself isn't just home to the gender clinic. It's the mental health wing of Charing Cross hospital, and that has certain implications. Immediately by the entrance, to the left, is a glassed-off reception booth in which sit a couple of receptionists. You tell them why you're there and they tell you to take a seat in the waiting area opposite. This consists of about a dozen blue upholstered chairs arranged on three sides of the space, with a coffee table in one corner and a water dispenser (cups absent) in the other.

… Sitting there in that waiting room made me feel extremely uncomfortable, and it got me thinking that had this been where I ended up back when I started this journal, terrified and at the end of my tether, I'm not sure I'd have been able to cope with it. Even yesterday, with the confidence of a successful transition behind me, I found just being there to be very intimidating, and quite an invalidating experience. The overwhelming feeling I got from the place was that this is where you go when your mind is broken. When you can't function as a proper member of society, it's places like this where you end up and you take whatever treatment is given to you. Were I to have embarked down this treatment route, I think it would have felt like I was sitting there, glassed off from the people who work there, with the "crazy people", because that's what I am. Broken, in need of treatment. One of society's rejects. Very unfortunate, you know, thinks he's a woman. We do what we can, but some of them just don't cooperate. Suddenly a great many things became clear. I understood what the gulf between the Charing Cross GIC and Russell Reid's (later Richard Curtis') practice. It's not just the difference between the state sector and the private sector. They're starting from entirely different places. The atmosphere in the Claybrook Centre wasn't one of "this is where reasonable adults can come and discuss their issues, and work together with a doctor to get what they need", but one of, "the doctor will see you now. Behave and do as you're told." This is a mental health wing - the patients aren't the doctors' equals, or peers. They're mentally ill, and they need "fixing". In my dealings with the PCT, I must confess to having fantasies of going along there for an "evaluation", to try and get round their "must be OKed by Charing Cross" requirement. I know that won't happen, the GIC wouldn't do that and there's no way I'd get an appointment in time anyway. In these fantasies, however, I saw myself talking to one of the psychs there from a position of power, knowing that my surgery will happen on Jan 4th regardless, and all they can do is make me pay for it myself. I now realise that it wouldn't happen like that - it's not that kind of place, and to be honest, if I never set foot in there again it will be too soon. Dr Curtis' clinic is a safe space. This didn't feel like one. Eventually it was time to leave. As we did, another patient came in. He smelled very strongly of stale urine. If you're transitioning via the NHS's largest GIC, this is the pigeon hole into which you are put. Sit down there with the broken people, because you're one of them.”

You will notice there a reference to the PCT. What this appears to be is that, because this incredibly brave woman didn’t want to be seen by those at Charing Cross Hospital (instead paying for her own private doctor, and taking a little bit of the burden off their budget in any case), they are not going to pay for her surgery come January, and she’s going to have to send a cheque in for ten grand by December. Subsequently, her appeal is not to have them pay it back, but to have them change the rules. This may well be the case of “it’s not the penny, it’s the principle”. But is this case a one-off? Defiantly a case of “no”.… a few other friends have identified various problems in the running of the place.

Way back as early as 1999, I remember coming across this webpage by Pamela Back in those days, rumours of twelve months for a letter to go on an eighteen month waiting list were actually very believable, but the hospital does state they only book a year in advance. Up to two years is still a long time for what basically amounts to an hour-long “interview”, don’t you think? When I saw that, it did make me wonder what I was letting myself in for.

Earlier than this, there was some stuff about the place written on the web, as far as I can remember i.e. going back to 1998 when I first went online. Mostly American, but Charing Cross Hospital was mentioned, and I remembered the name. Then, a few months later, I was moving to London. On my first morning in London, I was heading out to Steve’s old place in Hillingdon (211 to Hammersmith, then 72/220/283/295 to Shepherds Bush, then 207/607), and I passed the place on the 211 bus. I wondered to myself. It does look ok from the outside, but you can never judge a book by its cover (see, even then, I wanted to see the best in everyone!)

Compare that with what we have in Scotland. To friends and family, my treks from Dundee to Glasgow in the early mornings on my Tuesday off may represent a huge trek, or a massive inconvenience. Nothing could be further from the truth, maybe just because I like travelling. I can only describe with my own words, as I feel taking pictures would be intrusive. It’s in one of the terraces on Sauchiehall Street, which doesn’t look that bright from the outside – again, you never judge a book by its cover. You walk into the centre, down a spiral staircase, and you immediately wouldn’t think you were in a medical facility – at least, not one with the power to help you. The radio is on in the background, playing Q96 or Real Radio Scotland at a comfortable volume level. There is a handcrafted mural on the wall, which has “Welcome” written in many different languages. The place is in white and yellow and blues, and the design reminds you more of a leisure centre than a medical practice. The reception staff are all good, and will act with appropriate efficiency if you want to speak to a particular doctor, or if you need to be given test results by another phone number etc. There is a library there, with books on many aspects of sexuality and health. There is also a crèche, as well as a bank of Internet connected computers, and a self-help display of leaflets on most medical conditions. There is a range of books and magazines to read, as well as some magazines from Glasgow City Council etc. Everyone is there for a different reason – there a variety of counselling clinics held here, as well as the more traditional “morning after” and family planning type stuff. Once a month, on a Tuesday morning, there is also the Gender Clinic. The professional staff are really good, and will support you in what you want to do. They don’t just say what you want to hear, you can discuss many things with them. There are counselling facilities, a support group, and a second support group for friends and relatives. What I am trying to say is that they look after you really well. Some will say – “Well, isn’t that the way it should be?” Well yes – but it’s not in all cases as I’ve found out above. Sad to say, mistreatment of transpeople is still happening more than eight years after I first found out about it.

Some of you may have heard the name Charing Cross Hospital in the media etc. recently, following a case of one of the doctors there being taken to court. His name is Doctor Russell Reid, and was known to most as “Uncle Russell”. Those who’ve met him sing his praises almost equally as I do for those at Sandyford. This goes back to 2004, when the first words were spoken on the BBC’s website The most recent version is also on there , and it says…

“...Dr Reid denies serious professional misconduct. He also denies acting contrary to international guidelines relating to the care of patients with gender dysphoria. The GMC fitness to practice panel heard that Dr Reid, a leading authority on gender identity disorder, worked at the gender identity clinic of Charing Cross Hospital in west London from 1982 to 1990. The clinic deals with about 90% of all NHS work in this area of medicine. In 1990 he established a private practice in Earls Court, specialising in transsexualism. The charges cover a period from 1988 to 2003. The case has been brought by four psychiatrists who work at the Charing Cross Hospital gender identity clinics. The fifth complainant was another of his patients…

…The hearing had earlier heard that Dr Reid was known as "uncle" by his patients, but that colleagues viewed him with concern. Dr James Barrett of Charing Cross Hospital said: "It's a kind of boundary issues. I think that there is being so close to your group of patients that you have kind of lost sight of that. "I think that if you are in a position of calling your patients your nephews and nieces and being known as Uncle Russell, then there is considerable difficulty there." Dr Donald Montgomery, who was clinical director of the gender identity clinic for seven years, said he had also had concerns about Dr Reid's practice. He told the hearing: "I thought that some of the patients that Dr Reid had managed over the years had been at risk of being harmed by his early premature prescription of sex hormones without adequate assessment or a cooling off period, a period of reflection of counselling, or a second opinion from another interested professional."

Dr Montgomery, who admitted under cross-questioning that he "did not like Dr Reid", said there had been occasions where Dr Reid had referred patients for genital reassignment surgery without a second opinion or without patients completing a period of eligible real life experience. He said this "put patients at risk of psychological and social damage.".. “

Now, to those not in the know, this person must sound like an animal. There are five cases, of which two appear to be on less shaky ground than the others. The Guardian did have a Q&A into the story, including a bit more detail on all the charges. “Dr Reid admits prescribing Patient D hormones against the advice of a second opinion provided by another psychiatrist. Patient D was later sectioned and, after a diagnosis and treatment for manic depression, no longer wanted to change sex. Patient E alleges that Dr Reid suggested that he work as an escort to fund his gender reassignment. Patients B and C now regret changing sex; the former has returned to living as a man and the latter now feels trapped between genders.”

Of course, not everyone falls into “one or the other”, and over such a long period of time, some might say this could happen. If you are being honest in what you tell them, and you don’t have malicious intent, then you have nothing to fear by seeking treatment. The case was brought by some of his colleagues – “Four doctors from the Charing Cross gender clinic - James Barrett, Richard Green, Donald Montgomery and Stuart Lorimer - forwarded complaints on behalf on patients B, C, D and E.”

“The gay and transgender rights activist Peter Tatchell claimed the hearing was a "battle between the conservative medical establishment and a radical pioneering doctor who has brought fulfilment to dozens of previously troubled patients". Within the transsexual community there is a split between those who see the inquiry as an attempt by Charing Cross hospital to corner the market in gender identity disorders, and those who feel Dr Reid has been too quick to offer treatment to some patients.”

The case is adjourned now until February 2007, but in the meantime, those who have appreciated what he has done for them, have stepped up their campaigns. This includes a blog, with the ability for those who support him to leave appropriate comments. In just under a month, the blog has had well over 300 comments from satisfied users of his service. All you have to do is to read through some at random, and you can see how happy some of them are to have been listened to, and treated correctly. Again, you might think “Isn’t that be how it should be?” Most defiantly. Those who feel misdiagnosed do have a case, and I’m not trying to say they should be overlooked. They also have a right to have their voices heard. Back in 2004, several trans websites were saying that this person appeared to be the only person at Charing Cross who actually cared about his patients. That’s the difference. Yes, it’s just a job. In any walk of life, there are people who just turn up, and there are others who are genuinely interested in what they do.

Then I thought “why have I ended up with all the luck” ? I actually said to myself “Can’t I share some of my luck with them?” Obviously not (you know I've always liked to share!)

The majority of transpeople are not weird or scary, but on average, up to 50% of transpeople try self-harm or suicide. This includes people before they transition, as well as some who don’t think that they could. Part of this is caused by reading stories like that – and hoping you won’t end up a wreck. A lot of people find it hard to talk about, as I did at first. Eventually I was able to talk. Maybe I got away from the south quick enough, meaning I am one of the luckier ones perhaps. I always look for the good in people, but all the good stuff written about CXH is from years gone by – nothing at all recent, except all the stuff that’s been written in Dr Reid’s defence. Sad but true. There are some nice people in the world of gender dysphoria, not all are private practitioners. Look around, ask other people who’ve had experiences. We are the ones that have the experience of the service – not those who create them, set the budgets, make the rules.

We feel wonderful when someone listens to us, supports us, helps us. Sometimes they may see it as “just doing their job”. To us, it’s a lot more than that. From my calls in the “day job” , just showing someone how to put in their user name, or resetting their password, can mean a huge amount to them. I’ve had kisses blow down the phone, “thank you so much”, the whole lot. I’ve also had customers wanting more than they can have, or maybe even more than they can handle. The point is, I have a memory too. People may not always remember what you said, but people will always remember how you made them feel.

Right, I’m going to bed!

p.s. Charing Cross Hospital is one of the “oddities” in London, as it’s no-where near Charing Cross railway station (for trains to the south and south east), as well as Charing Cross underground station. Charing Cross underground was formed when the Jubilee Line opened, and basically a new tunnel was created between eh Trafalgar Square station on the Bakerloo Line, and the Strand station of the Northern Line, and adding in the Jubilee Line. When the Jubilee Line extension opened in 1999, the Charing Cross bit was formally abandoned, with concrete placed over the entrance. Trains would sometimes use the old Charing Cross as a turn-around, but de-training (tipping everyone out) at Green Park. One driver came in once with “Charing Cross” on the display screens, but we had to tip everyone out at Green Park, as there is no physical way of getting out of Charing Cross from a Jubilee Line train now…

… but I digress. One of our new start Station Assistants was doing his first day on the gateline at Green Park, and someone made an enquiry to him. Message then came over our radio’s “What station is it for the Tower of London?” Just about everyone yelled “Tower Hill” at him. We then kept an eye on him, and he got a second enquiry, but did not use the radio. We approached him “Oh yeah, I done that one myself…” “Where did they want to go?” “Charing Cross Hospital?” “Where did you send them to?” “Charing Cross???”… and then the look on his face was a picture… put it this way, that’s not the answer in “The Knowledge” book that we all got. The only way you could use Charing Cross station for the hospital is if you got out and took a number 9 bus almost end to end, and then still had a walk at the other side...

posted by Suzy Scott @ 01:33