I went to the Tavistock as a young person - AMA

[MAW1993]

I attended the Tavistock from 2008 to 2011, beginning when I was about 15. I made this post because I saw the many questions people asked on a previous AMA. Unfortunately, the OP was uncomfortable answering some of them, and I felt there may be a need for an AMA with someone who can be more open.

Do you think you have any form of neurodivergence op?

Thanks for sharing your thoughts it's really interesting 😊

You're brilliant OP x

Why did you think you are trans and not a lesbian OP? If that's not a stupid question.

I believe that medical staff of any background should be allowed to treat female patients, providing that it is with the consent of that patient.

I think patients should be entitled to refuse care for any reason, but I don't think they are entitled to the details of a healthcare worker's personal life in order to do so.

The thought of a system in which patients can demand this should be concerning to everyone, not just trans people. Do you think people should be expected to disclose all aspects of their personal life to their workplace? Or do you think trans people, and trans people alone, are not entitled to a private life?

No I will not tell my boss or colleagues, and I don't feel there is anything more unethical about that then not telling them my sexuality, political views, or ethnic background.

I have to be honest, I'm not sure. I think it is something I would have to put more thought into were I to have children in the future.

Thank you for your honesty.

Re: the medical care thing...

How can girls elect not to be intimately examined by a man if they are mislead into thinking they are female. Or if they can see they are a man, but are being required to pretend they can't see this because it's "mean"?

Firstly, thank you for being so open and honest and very articulate with your responses. I am really pleased that you're happy now you are living as your true self.
I do have a couple of questions too!

1. When you were young and distressed about having female genitalia, did you also look in a mirror and see a male rather than a female looking back at you? And if so, did this cause you confusion?
2. When you look in the mirror today, do you see a passable male looking back at you? Would I have a clue if I were stood in front of you, say?

I only ask this, because I have 2 trans friends, both m to f, who still say they see some male traits when they look at themselves (even though they have fully transitioned now and have been for a few years). I'm just wondering if that's a difference between m to f and vice versa... As male characteristics are stronger than female. Hope you understand what I mean, it's in my head but I can't word it properly! I have to say, your mum sounds amazing! And your dad has come through too. You can understand how they would feel, it's a kind of grief, losing a daughter and gaining a son. I honestly hope you find a loving partner and are able to adopt in the future. 🤗

The problem is they can't refuse care on the basis that you are female if they're not aware of that. If I wanted female only care when I gave birth for example I wouldn't want to be assigned a midwife who was a transwoman just because people believed (or were too polite to say) that someone wasn't female.

I think you are entitled to some privacy of course, you shouldn't have to tell everyone you see. But at the same time your boss should be aware IMO so if they know that a person has asked for care from someone male they can ensure someone else sees that patient rather than you.

Yes I think this is where it falls down, and it's interesting thst OP is a trans man. It would be interesting to see how many trans women feel the same way. Women are more likely I would have thought to feel uncomfortable with a male medical professional, and trans women rarely 'pass' as women. So if trans people don't have to declare their trans status ( at least in certain situations, like provision of medical care) then you are relying on them to behave in a way that respects the rights of others in the way the OP seems to want to.

In terms of transracial, I have only seen a few examples, but from what I have seen people have referred to a desire to be of a different culture or community. I know some people choose to transition because of similar reasons, but to be honest this is not something I feel I understand because my personal experience is so different.

With body integrity disorder I feel there is a lot more similarity compared to my experience. By that, I mean people feeling overwhelming distress by the presence of a limb, for example, seems much the same as how I feel about my biological sex. As such, I have always felt a lot of empathy when I have read about people with this condition.

I do have to be honest though that my knowledge on how this can be treated is limited. However, if there are non-invasive treatment options with therapeutic effect I think they should be attempted first. I also think people with sex dysphoria should try non-invasive options first; if it is possible to live happily as your biological sex that is a better option than medically transitioning, which is an inherently arduous and difficult process.

Your last point is a very interesting one OP. To be honest this is what I hope for my child, as I am fearful about the risks of testosterone. But because of all the debate about trans, there’s a bit of me feels it is somehow wrong to want her to stay in a female body. It is very interesting to hear you, with your experience, put this view forward. I also think that with any other aspect of oneself that you’re unhappy with, it seems better to learn to live with it somehow than to cancel or change it - if that’s not too simplistic here.

What do you think op?

If someone specified male only care, how would you avoid treating them without outing yourself to your colleagues?

Thank you for your openness and honesty in sharing your experience and views. I am sorry that expert clinicians could not find a way to discuss and explore your feelings with you. I wondered if you thought this could have happened if you had been accompanied by someone else, a designated appropriate adult maybe, rather than your mother? Should that be offered? Or do you think nothing would have helped, you just couldn’t talk about it?

Thanks for your response. I do also feel like there is more of a similarity with body integrity disorder. It sounds very distressing.

I'm not sure my feelings have ever been out of line with reality. I do not believe I am biologically male, I have just always wished that were the case.

However, in terms of attempts to come to terms with that rather than transition, there were things that I tried and that was part of the discussions I had with medical staff and therapists. Personally, I tried living as a butch and openly lesbian girl/woman. Although it felt better than my attempts to conform to traditional femininity, which were prompted by bullying, it didn't do anything to address the feelings I had in relation to my sex.

The therapist I saw at Tavistock did try to engage in that kind of exploration, but I found her approach very humiliating and invasive. For example, she asked me if I had had any kind of sex, and when I said no she asked me what kind I would like. I said I wouldn't like any, but her argument was that I couldn't know whether I would like being a woman unless I had sex. My mum did ultimately shut that down, as I wasn't yet 16 and so she didn't think it was appropriate, but I still vividly remember how she made me feel to this day. Another exercise she had me do was to look in the mirror, point out the feminine characteristics of my body, and to say positive things about them. I didn't want to acknowledge things like the growth of my breasts or my female genitals, and I didn't feel there was anything positive about that, so I mostly ended up freezing and not saying anything. She did try to elicit why it was I had so much distress about my sex at times, but I've never really known the answer, and I no longer felt comfortable having discussions with her.

Overall I found the whole experience there deeply traumatic and embarrassing, especially as they insisted my mother was in the room during the sessions. The last appointment I went to the woman was particularly pushy and I ended up crying. That was what resulted in me not going back, and my mum arranged for me to see a private doctor when I was 17. I had 3 appointments with him over a year, and after that and the second opinion I needed from a psychiatrist, I was given testosterone as I was 18 by that point.

However, I had a really positive experience with a social worker who provided me one to one support through CAMHs. She supported me for quite a few years until a little after my 18th birthday. She was the first person I confided in. She was always really kind and accepting, and she did ask about things like whether I had a boyfriend/girlfriend etc. but in a sensitive manner. If I wasn't ready to talk about it yet, she would leave it and come back to it another time. She helped me to explore my options, and to think about whether I could be happy living as a gender non-conforming woman. However, she wasn't a specialist in the area and so she had been the one to suggest I be referred to the Tavistock clinic.

Yes I am very fortunate to have lots of wonderful friends, both male and female. I can't say that I feel I know anything specifically about men, that I didn't know when I was younger.

However, I did notice differences in the way that I was treated after people began to perceive me as male.

You are right that it is hard to differentiate for me really, as I have been perceived as male for almost all of my adult life.

Thanks for the interesting thread, OP.

Why do you want the phalloplasty? (As far as I'm aware the techniques used are not very advanced yet and so the results are not very good.) Do you worry you might suffer complications or have regrets about that aspect specifically?

Do you think you could ever get to the root of wanting rid of your female parts?

How much therapy did you have to explore this hatred of women's bits.

Do other women's bits repulse you?

If it's just your own bits then why are you replacing them with man fake bits if you think it's just a hatred of your female parts.

I don't know to be honest, but I do remember feeling that something was very wrong in relation to my genitals before I can recall being aware of the specific physical differences between boys and girls.

When I first transitioned I would go to long lengths to try and avoid needing the toilet outside the house. I knew I couldn't go into the women's without causing alarm or raising difficult questions, but also didn't feel safe using the men's. When I was at sixth form college there was a disabled toilet in a quiet location that the staff said I could use and that was a good solution for me.

These days its a lot easier as there are a lot of single stall bathrooms, so I just use them. However, when there isn't one available I wait for a quiet time and then use the men's.

Thank you, that's very kind of you.

I feel very divided over it. I really crave love and connection with another person. However, I also feel horror at the thought of being touched sexually in any way. I know there are a few people who could accept that, but then I feel very scared about the prospect of disclosure.

I think people have a right to know about someone's biological sex before commencing a romantic relationship with them. However, I have been outed before and it ruined the life I had started to build. I had to leave my work and start up again in a new area. It was done by someone I trusted very much, and wanted to begin a relationship with, and as such I have a terrible fear about disclosing to anyone again.

I told myself it wasn't an option after all that happened, and I've never had any kind of romantic relationship except for briefly having a girlfriend when I was 16. I tried using dating apps where I could be open without risking it being leaked, but I found the only people who messaged me were men, who I am not attracted to, and they were very creepy and demeaning as well.

I hope I will be able to accept my body enough after phalloplasty to reopen that part of my life. I still worry about how I will navigate the disclosure process and risk of betrayal though. I understand if it's not the right thing for someone, I just don't understand why people think it's ok to tell the world something they know is deeply personal and that I struggled to even tell them.

I do agree there is probably some underlying cause. But I don't know what that cause is - whether it was some kind of exposure in utero, an experience I had as young child, my environment etc.

My mum personally believes it's something biological or some kind of miswiring during development, because it has been so pervasive throughout my life. I think that's a possibility also, but I don't think anyone will ever know for sure.

You should write a book, OP. You are so erudite and straight with your replies - you sound wonderful, a credit to your mother (as us old fogeys like to say). Best of luck with your studies x

What's your view on the use of wording such as 'chest feeding' and 'people with wombs', 'people who menstruate'.