Another visit to Your GP, Edinburgh for my second appointment with Dr Myskow. She confirmed that she’d received the psychiatric report and wanted to check that I was still happy to proceed with hormone therapy.
We discussed the regimen for injections and blood tests (although she did say that I would get a letter confirming it all so I bought a brand new notepad for nothing!) followed by a detailed chat about possible side effects and the anticipated changes as a result of the treatment. I have my next injection in six weeks time then the third one twelve weeks after that. I need to have a blood test to check testosterone levels just before the third injection then return to Edinburgh with the results. As the Nebido is a slow release depot injection the dosage is altered by changing the frequency of administration. The next appointment reviewing the blood levels will determine the intervals of my subsequent injections – usually between ten and sixteen weeks apart.
She then administered my first injection of Nebido 1000mg/4ml. It’s an oil based preparation for intramuscular administration – the solution is quite thick and took several minutes to inject. I was expecting it to hurt more than it did – just a scratch then a burning sensation. The worst part for me was having to expose my bare ass to a stranger then make excruciating small talk during the process.
The consultation was an hour long at £250 plus £150 for the testosterone injection. As an added bonus I used my Tesco credit card to pay again so extra Clubcard points! I feel so lucky to be able to start treatment privately – from my first appointment to my first injection has been exactly seven weeks which is pretty incredible.
We arrived in plenty of time for the appointment because I was super nervous. I needn’t have been nervous because Dr Yellowlees was lovely. He put me at ease almost immediately and the session was basically the abridged version of my life story to the present time with particular focus on my mental health issues. He was satisfied that my mental health problems don’t have any influence on my decision to transition and said he would be providing Dr Myskow with a supportive report within 7 to 10 days.
Saw the GP today and he’s still onboard with the shared care agreement. All he wanted was to check that I would take responsibility for the ongoing monitoring – arranging the blood tests, etc. I don’t have a problem with that at all. I explained that Edinburgh will still be overseeing the whole thing so he had an expert to ask at any point he needed them.
So everything is all go for next Thursday in Glasgow.
Got a call from the GP surgery today that has pretty much popped my bubble of elation about the Glasgow appointment. Apparently he has received the shared care agreement from Dr Myskow and he has concerns about it. He wants to see me to discuss it.
“Ok, when can I see him? March 19th. No, that’s just not quick enough – I’m going to Glasgow on March 15th I need to see him before then. Sorry there are no other appointments. Can I have a telephone appointment? No, he doesn’t do that.”
What the actual fuck? I asked him specifically if he would continue a private prescription under a shared care agreement. He was totally up for it and now he’s not sure? I can’t afford to go exclusively private – regular travel to Edinburgh, consultations, prescriptions and blood tests are just beyond me. I’ve already spent £400 on the initial consultation and committed to another £600 to go to Glasgow – all of it will be for nothing if Dr Patel pulls out of our deal.
I’m beside myself with anxiety and I feel betrayed. My dysphoria is consuming me. I’ve emailed his secretary to try and get more information since the receptionists are just stonewalling me. I’ve emailed Edinburgh for the shared care agreement to see what on earth could have freaked him out so much.
Can’t believe it! I’ve received an email today offering me an appointment with Dr Yellowlees on March 15th. I was expecting a much longer waiting time than this as Dr Myskow suggested his waitlist was at least a month long. It’s a morning appointment so we’re going up the day before and staying over instead of having to get up at stupid o’clock and stressing about getting there on time. The Priory is outside of Glasgow city centre so I’ve decided to drive up there instead of messing around with the train. We’re staying in a Premier Inn just off the motorway about 5 miles from the hospital. The room and breakfast are all booked – fingers crossed that all the snow is gone by then.
I went yesterday to see Dr Myskow in Edinburgh. I was super nervous in the morning and had a bit of a upset stomach but once we got on the train I calmed down significantly. I was incredibly grateful that we had first class tickets – quieter, more room, a table, WiFi and phone charging facilities all helped to pass the time in comfort.
The clinic is just over a mile from Edinburgh Waverley station and was a pleasant walk down Princess Street. The clinic itself seems quite small but comfortable. Dr Myskow came down to introduce herself and take me to her consulting room overlooking the river.
She asked me how I’d made the decision to transition and whereabouts I was in the process. She went through my medical history, measured my height and weight and reviewed the blood test results I’d taken with me – she complimented me on my facial hair which she said was impressive considering that my testosterone levels were significantly lower than expected. We talked about my social situation and family background and some of the experiences which have shaped my life. It was actually quite nice to talk to someone who understood how it feels and sees it as normal rather than exotic or special – the best word to describe it is validation.
She explained the process which she insists on (and mirrors that of GICs) – the initial appointment with her followed by a second assessment by a psychiatrist. Once those assessments have been completed I can arrange a follow up appointment with her and assuming that all is well she would administer my first testosterone injection. She recommended that I see Dr Yellowlees in Glasgow for the psychiatric opinion and is arranging a referral to him. The appointment was about an hour long and cost £250.
Initially I was disappointed that I had to see a psychiatrist (incurring extra expense and adding another delay in getting a prescription) but that was because I was expecting to see a GP with an interest in gender dysphoria to start a bridging prescription. What I didn’t realise is that Dr Myskow, before retiring into private practice, was the clinical lead of the East Lothian gender identity clinic and as such was/is one of Scotland’s foremost experts on the issue. The result of this is that when the assessments have been completed I will have an official diagnosis which starts the countdown for a gender recognition certificate and can potentially look at getting top surgery in 12-18 months time.
The doctors surgery rearranged my appointment with Kim to Dr Patel because she didn’t feel confident prescribing the hormones. Had the appointment with him this morning and he’s reluctant to initiate the bridging prescription. He’s had a meeting with the community pharmacist and is happy with the idea of a bridging prescription but doesn’t feel comfortable starting it because he doesn’t feel confident prescribing off licence without having more expertise. Apparently he’s contacted Leeds GIC but they’ve been less than helpful. I was disappointed but not entirely surprised.
I mentioned the possibility of getting the prescription initiated privately through a gender specialist if he was willing to enter in a shared care agreement and continue the prescription. He had no problem with that and seemed visibly relieved. I’ve booked in to see Dr Myskow in Edinburgh. I can’t believe I’ve managed to get an appointment on February 19th – I was expecting to wait a lot longer for an appointment. I’ll need at least two appointments to secure a prescription and the cost is more than other private clinics such as Gender Care but since their waiting list is months rather than weeks I’m happy to pay the extra.
I’ve booked the day off work and booked the train tickets so now all I’ve got to do is wait…
As soon as I had my change of name deed notarised I dashed around to the GP surgery to register my new name. The receptionist gave me the forms to fill out and took photocopies of the deed. Everything to seemed to go swimmingly and it was satisfying to complete the form as Mr Jonathan Brindle.
I’ve just checked my Emis app to see if it’s been updated with the new details. It has sort of – Mx Jonathan Brindle. Mx? What fuckery is this? I’m all super pissy about it because I’ve looked it up on Wiki and it isn’t a typo it’s an actual title for people who identify as non-binary. Don’t get me wrong, if you identify as non-binary and want to use a weird title then knock yourself out but I don’t. I am a man, I am Mr Jonathan Brindle not some unspecified inbetweener. Of course it’s stupid o’clock at night and I’m all wound up – someone is hijacking my identity and dictating who I am. Chris suggests journalling to channel my frustration and I also post on the Facebook group.
Ok, ok, time to calm down. I’ve had some replies on the group and apparently this is a common thing. I’ve learned that NHS numbers are gender specific to enable targeted screening programmes for things such as cervical smear tests and the like, so Mx is the best that can be done for me because the system won’t allow Mr. I will need a new NHS number issuing to change gender on my medical records. The doctor can apply on my behalf and it should be a simple enough thing to do but I’m holding back at the moment because I don’t want to interfere with any referrals that are carrying my current NHS number – I’d be upset to lose my place in a treatment queue just because I want to be a Mr not a Mx.
Early December 2017, my wife and I went to the GP surgery, she wanted to come with me to demonstrate that she was 100% behind my decision. We spoke to the nurse practitioner Kim. She asked how she could help and I told her that I wanted treatment for gender reassignment. She was surprised but I felt only because she’d never come across a transgender person before. She asked how long I’d felt that way and I replied over 30 years. I know some people have to justify themselves and answer questions like “How do you know?” and “Are you sure?” but she seemed completely accepting of it without further probing. Maybe that’s the benefit of being an older person – I’ve had half a lifetime to be sure! I explained that I hadn’t done anything about it before because I married a woman who married a woman and I wasn’t prepared to throw that away if Chris had been anything less than completely onboard.
She admitted she didn’t know what to do next and I briefly explained what was required (referrals to the Gender Identity Clinic and a referral to an endocrinologist for a bridging prescription of testosterone) and where to find the necessary information (the NHS website and the WPATH treatment guidelines). At this moment in time the waiting lists for my local gender clinic are in excess of a year and I was keen to stress the importance of a bridging prescription to get treatment underway.
She assured us she couldn’t see any reason why the practice wouldn’t support me through the transition and said she was going to set the medical receptionist the task of researching the processes involved. Wow, that’s a massive relief and I guess one of the first hurdles towards treatment because there’s no way I’d be able to afford the entire process privately.