I think a lot of people have a lot of stereotypes and generalisations about the gender binary. I think for a lot of trans people it makes them question their interests and their expression. I second-guessed myself a lot growing up because I… There were a lot of things I liked that were stereotypically boyish that I was very much into, and still am into. I think there is room for everyone to like what they like, express themselves however they want. I think if people can understand and get over their biases and assumptions about how gender stereotypes work I think it allows – not just trans people – but cis people as well to put aside their fears or their generalisations and express themselves in a more truthful manner. If a trans person does not conform to the gender they are transitioning to and has a few aspects that are traditionally to do with their birth gender it is viewed that they don’t know what they are doing or that they are not “trans enough.” Trans women especially are actually held to really unrealistic expectations of femininity that you would never really hold anyone else to. I prefer to wear jeans, tshirt and a jacket usually and that in no way means I am less trans or less of a woman. Everybody has a self-expression, and it is really a very bad and inaccurate way of judging somebody’s gender identity. The best way is just to ask them. When I started going up to the gender clinic in Glasgow I just went dressed as I normally would, which was jeans and ripped T-shirt. I don’t feel like I was being taken seriously. In the second appointment I was wearing more stereotypically manly clothes and I feel like I was being taken much better. There are large amount of people that need to access these services that actually do not identify as male or female. They identify as either a mix of both, or in between or outside of that or any combination of the spectrum of gender, as opposed to being in the binary. And a lot of the time they are forced to pretend to be something they are not or told they should be something they are not. And that what they are is not valid enough. A lot of them do feel dysphoria the same as other people but their gender presentation is just not to the strict standards that doctors have historically required from people. So as a result they have been denied treatment that they need just as much as everybody else. I think a lot of people still have this generalisation in their head that there is male and female and that there is nothing else. Where as in reality we have figured out that gender is more of a spectrum. That there is male and female, and there is a lot in between encompassing non-binary and various other identities. The medical profession is a bit behind on this, and I think they need to get a bit more aware of issues regarding trans and non-binary people. There is of difference between how people express themselves and how people identify themselves And figure out ways to best serve the patients needs rather than trying to fit people in various boxes. I was at a GIC appointment, and the doctor had asked me if I was interested in being referred for bottom surgery. I said it wasn’t really something I was interested in at that point, and she said: ‘Oh, well that’s fine, because gender is a spectrum anyway.’ ‘And if you’re non-binary you probably don’t want bottom surgery’. And I thought that was quite a strange assumption to make that just because I said I didn’t want bottom surgery that I would be non-binary because I’d always said that I was a binary trans man. It was great that she recognised that gender was a spectrum and not everyone attending the clinic would be a binary trans person. But to assume that a binary trans person wouldn’t want bottom surgery or someone not wanting bottom surgery would be non binary I thought was a bit of a jump to make. Another thing that people have very much experienced is that when they are in a room with a health care professional it feels like a power struggle because the trans person’s autonomy has been taken away in that situation and the control of their entire life is in the hands of someone who will never truly understand. People need to pretend they are something that they aren’t, they need to perform to different standards of gender, different expectations of masculinity and femininity that cisgender people would not be held to in that kind of situation. There’s also been a lot of experience of having to jump through hoops. It almost feels like you are having to do an exam or a test to prove that you are trans enough. And to have to live up to societies expectations as opposed to being true to yourself which should be the whole point of this process. It would be so refreshing not to be asked over and over again: ‘Why are you taking testosterone?’ ‘Are you sure that skin condition is not because the hormone blocker?’ Gender related medication does not have anything to do with my cold, or my broken leg or with anything to do but taking testosterone or taking hormone blockers. I had a GP appointment once that was completely not trans related at all. And the GP was one I hadn’t seen before and she was very interested in me being trans even though that wasn’t what I had been in for at all. Most of the appointment was her asking me questions like: ‘Are you sure you haven’t started taking hormones yet?’ And I was like: ‘Yes…’ And then trying to make the subject back onto what I was there for. And then she would be asking questions again like: ‘So you haven’t taken anything? You haven’t had any surgery?’ And saying: ‘Wait do you want to be a man? Do you sleep with men or women?’ I was just about to leave and she said: ‘Oh, one more thing…’ ‘Do you still get periods?’ And I was just like: ‘Yeaaah…’ And just ran out as fast as I could because it was so awkward. I just wanted to answer and leave. I just thought it was kind of unprofessional. I have been told before that I’m not ready to go on hormones because of my mental health and they thought that my depression was actually the reason I was developing these gender issues. But in fact, it’s completely the other way around. Because if someone has crippling gender dysphoria and they feel this way everytime they look in the mirror and everytime they walk out of the house, of course that is going to give anxiety and possible depression and other things. Irrespective of whether a deed poll has happened, a trans person deserves to have their chosen names and chosen pronouns respected. When I personally went to my GP and told them about my name change They refused to update any documents without a deed poll, and even then they took a very long time to do so because they didn’t see it as something that was that important. But it is incredibly disrespectful to ignore this kind of thing. One thing I found quite awkward is that if I have had to book an appointment for something that is typically something that a cis woman might have like a smear test [cervical screening] or something. And I go to the desk and ask to book in for that and the receptionist might ask me: ‘Why would you want one of those, you don’t need that’. ‘You’re a man, men don’t need those’. And then I have to go into detail and explain: ‘No, it’s because I’m trans, I do need those, some men do need those’. And having to educate receptionists, but also at the same time out myself to whoever can overhear because we are usually in quite a public place and there is not much privacy and people stand quite close behind you, the chairs are kind of everywhere and when you got to go and walk and sit down and just be around all these people who’ve just heard you have this quite personal conversation is really uncomfortable. When I came out as trans I had already done a lot of prior research into how hormones and and transition health care works. But when I spoke to my doctor about it he was unaware of certain issues. Recently I had problems with changing my details on the NHS and he was unaware of how that worked and seemed to just think I’m stuck with my name on my NHS details. But I went and did some digging and found that there are ways to do it and I had to inform my GP and my practice how to do those things. And they did them, but they were completely unaware of how these processes work. A lot of the time trans people are constantly having to do their own research and find ways to get the health care that they need and inform their GPs when in reality I feel more GPs and more doctors need to be aware of these issues forefront and able to inform their patients. Every time I go to the nurse to get my hormone blockers I need to tell her why she is giving me the hormone blockers, and that they are not testosterone even how it works within my body and what that hormone blocker does. She’s a medical professional. She should know how all of this works. It’s not her fault, it is that medical professionals don’t get access to this kind of information and don’t get a specific course or a set of guidelines of what this medication does. Pretty much ever since I started hormones I’ve basically had to speak to my GP and let her know exactly how I am supposed to go through with my care, even from sending off my referral to actually being seen by a gender clinic, I had to explain what needed to be in the referral who it was supposed to go to… I was only 15 at the time and I was having to do research on how I should be taking care of my own health when I hoped to go to a professional and they would explain that to me. After I started hormones I was checking in with my doctor, making sure they had received my prescriptions and checking up when I was having letters come through from the gender clinic to them I was basically acting like a middle-man the entire time. I was just hoping that surgeons and the gender clinic and my GP would all speak to each other for me rather than me having to intervene and being the middle-man between all these services. It was a bit confusing and not what I was hoping for out of the health care service, to be honest. It’s incredibly important that GPs, especially in rural areas where they are less like to meet a trans person in their every day life have enough training on at least the basics of transition such as the hormones and also the psychological issues that may go alongside being trans. I was denied blockers on the NHS originally by my local, rural funding board because it was deemed unorthodox use if it and it was a frivolous way to spend NHS money. And it is very important that we educate people that this is not the case, and that we absolutely are deserving of it, just as much as anyone else that is suffering with a hormone imbalance. Not enough doctors, GPs, nurses are being educated in basic trans health care and I think it would benefit a lot of people if there was more basic training for GPs on this is how the hormone process works, this is how you might use a binder… And just all these basic little things that can help them along and just alleviate a lot of pressure on gender identity clinics. A reason why it’s also very important for GPs to have at least the basic knowledge is that when a young trans person that has just realised they are trans comes to their doctor asking for assistance, even if the doctor is not knowledgeable the specific matter they shouldat least be able to point them in the right direction to access resources online or clinics or other services that can help them deal with those specific needs.