So what’s my take on what just happened? I think there’s a much bigger political dimension – which I will write up later over on the political blog.
However, this feels like an obsession by some parts of the medical (psych?) profession with control and dogma: prescribing according to guidelines and not the needs of the patient. Sure: I see the need for a lead consultant, and therefore would not mind losing my private specialist.
But this prescriptive, inflexible approach to history-taking and rule-setting? Let’s NLP some of this. First off., I arrive looking good, wearing some of my nicer clothes . Hair is neat and tidy. Make-up is good. Nail polish, sadly, not quite up to scratch (sic!) – but it will do.
All this takes time and effort. Did he notice? Nope. No pleasantries. No “hair looks good”. Nothing. Would a female consultant have done better – or not? Because there is a double point to this. I’m being assessed and one of the things being thrown into the scales is one tiny trivial item legislatively – the deed poll. Whereas the fact that I took time to dress, to look good, is not commented, not recognised.
(Also unrecognised: the fact that i walk through london this way!)
Instead, its quickly on to the verbal history-taking which, let’s be honest, if I wanted to screw with their system, I could have learnt by rote.
The clothes? The look? The work that goes daily into my self-presentation? The fact that, because I am still some way from that Holy Grail of “passing”, all of the above means I walk through life now the centre of comments, sniggers, and occasionally far far worse…no comment.
But if – perish the thought – I prove “resistant” to some petty abstract little legalistic rule that they have made up for purposes of back-covering, why: that might be enough to bar me from hormones.
Well, bully for them – and I do mean bully.
I come away with my faith in the system (and my belief in all the re-assurances that the system has improved) quite shattered. I am dealing with a bunch of control freaks who either have no comprehension of what they are dealing with or…and I sincerely hpe this is not the case…know all too well.
Because if they understand what it is to be trans, then they would understand that the line is being drawn in the wrong place. Hormones should be, need to be, easy. The cost is not great. There’s a long run-in before effects become irreversible. They minimise distress.
Sure: I’ll go along with surgery being harder to access on the NHS, given the step-change in resource and consequence that it entails. But not hormones.
No. In a sane and idealised world, we would get beyond this psychiatric nonsense for the early stages. I should be assessed on basis of my understanding of the issues and ability to take responsibility for my decisions. There shouldn’t even be a question mark over hormones.
The fact that there is suggests that much of this process is about control – and little else.