My Response to the Care Quality Commission

My Response to the Care Quality Commission

I received a letter back in December from the CQC regarding my “experience of receiving care and treatment at the Charing Cross Gender Identity Clinic”. This was my response.

Ref: INS1-2206743716


I’d like to tell you about my experience of Charing Cross Gender Identity Clinic. I was referred to them early in 2014. I heard nothing for months and phoned the clinic a couple of times to make sure that they had received my referral. I finally had my first assessment (with Dr. Lenihan) in December of that year – about a 9-10 months wait.

After seeing her, on my way out I made an appointment for my second assessment in May 2015 with Dr. Lorimer. At the time, given how long I had waited for my first appointment, I thought a mere five month wait wasn’t too bad!

However, a few weeks before the date I received a phone call from the clinic telling me that the doctor was unavailable due to a holiday and they would have to cancel my appointment. It’s difficult to express just how crushing a blow this was. I had expectations of finally getting approval for the treatment that would allow me to move forward with my life and for that to be taken away from me was devastating.It triggered months of severe depression, affecting my physical health, my work and the relationship with my wife. Things only started to improve after I finally received a letter giving me a new date to see Dr Lorimer, on January 15th (last Friday).

So, I turned up at the clinic (45 minuted early because of the vaguaries of public transport into London) only to be told that I didn’t have an appointment: hadn’t I gotten the message the week before telling me that it had been cancelled (again!).

Obviously I hadn’t got the message; there’s no way I’d endure the travel into London just for fun! I don’t think it’s acceptable to simply leave a voicemail with no guarantee that it will be picked up. For me communication by letter or email would be better (I have anxiety issues using the phone and don’t pick up calls where the number is withheld or unknown to me; I also do not answer calls during work hours).

Anyway, I’m currently here, over 13 months since my first assessment, fighting depression again with no end in sight for this limbo I find myself in. Given what I was told by the admin staff about Dr. Lorimer’s health problems I really can’t see at the moment that I’ll ever progress to the point where I can begin to receive treatment (HRT, surgery). All this waiting is beyond unreasonable.

I don’t think the woefully inadequate level of service provision for trans people is in any way acceptable. In what other sector of the health service would such waiting times be remotely acceptable, especially given the hugely detrimental effect it has on people’s well-being and quality of life?


Alex Forshaw (Ms.)

How To Come Out As Trans – Part 1

How To Come Out As Trans – Part 1

You’re trans. You intend to transition from your current assigned-at-birth presentation to live your life in a way that feels right. What next?

Where to start?

Most of us have family, maybe a partner, maybe children. The people who are closest to us, the ones who believe they know us. One way or another they’re going to find out at some point that we’re not the person they thought they knew.

The first step is the hardest. Telling the first person involves a whole lot of trust. You hope with all your heart that they will accept you but you fear deeply that they will reject you.

I started by dropping increasingly broad hints to friends I felt I could trust, gauging their reactions. If it had gone badly I think I’d have been reluctant to move forward and I’d have maybe given in to the stirrings of suicidal thoughts: I felt so strongly that I couldn’t go on pretending to be someone I’m not.

A couple of weeks later I told a close online friend how I felt, who I really was, and they were wonderfully supportive. At this point my depression was putting such a strain on my marriage that we were at breaking point: we were practically separated. I came out to my wife: at that point I figured things couldn’t get worse whatever her reaction.

I didn’t have a plan beyond that moment. I didn’t know if I’d lose everything, be on my own. That was no longer as important to me as living the rest of my life as a woman. Some people called me brave but I don’t accept that. I did what I had to do to survive the crisis in my life. If I’d been brave I’d have come out earlier instead of hiding it for decades because of my fear of rejection.

For may trans people in relationships coming out breaks that bond. It’s not easy to accept but it’s the truth that most marriages will not last long after one of the partners comes out as trans.

Being open and coming out might be “the right thing” but telling your partner that the person they are with, that they thought they knew so well, is not who they believed them to be will be a huge shock. People react differently but it’s not uncommon for there to be anger, grief, denial and other emotions that are very similar to losing a loved one.

The trouble is that not being honest about who you are can be equally destructive. If it is revealed by somebody else it undermines trust on top of their other reactions to finding out the truth. If you continue to hide it it will damage your mental health and the effects of that can also destroy a marriage, even lead to your death.

It’s such a hard call to make and I can’t tell anybody else what to do for the best. My personal feeling is that it is best to be honest and to tell your partner sooner rather than later. Yes, there is a significant risk that they will reject you and that can be devastating. But the alternatives are equally bleak.

If they find out from someone else then you are guilty of keeping a huge secret from them, destroying feelings of trust. If you continue to deny the truth of your gender identity you will probably harm yourself mentally.

Even if they accept you as trans that does not mean that your relationship is secure. Gender is a factor in sexual attraction for many people and a partner who is strictly hetero- or homosexual may find it difficult if not impossible to remain attracted to you.

If this all sounds very negative and hopeless then I’m sorry, but for the majority of trans people in relationships when they come out, the relationship does not survive. Some do: mine did, and indeed is stronger than before. But mine is the exception. The uncomfortable, brutal truth is that you cannot expect your relationship to continue after coming out. Even if it does then it will almost certainly be in a different form.

The Thief Of Time

The Thief Of Time

I’ve been putting off writing this post. No, seriously, I must have fired up the WordPress editor ten times now and each time I’ve found some distraction to take me away from writing.

Procrastination. Deferring tasks until the last minute and then rushing to complete them by the deadline.

It’s not that I sit there idle, wasting the minutes and hours while I could be working productively. I rarely have any difficulty finding activities to satisfy my need for interesting stimulation.

It’s rather that I need a certain level of stimulation to engage with a task. To feel motivated enough to start it. Dishes pile up in the kitchen sick because although it only takes about five minutes to wash them (I’ve timed it–doesn’t everyone?), and I don’t find the task onerous, I fail to summon enough interest in the activity until it’s nearly bed time and I feel a sense of urgency.

As a child homework presented the same obstacles, except for the few instances such as essay writing that I felt enthused about. To be honest, most homework is a mind-numbingly tedious repetition of what was already learned in that day’s lesson. I used to complete most assignments in the break time before class.

The same afflicts me at work to this day. I’ve been known to spend hours or days coding on personal (although still work-related) projects at the expense of what I’m due to deliver. That work gets put off until I feel that the time remaining fits my gut feeling of the effort required. Having said that, I have a good track record of delivering on time.

That last point is important. I’m fulfilling my obligations. In many ways I view my procrastination as a positive thing. The focus that is instilled in me by the pressure of the impending deadline concentrates my mind wonderfully.

Where otherwise I might tentatively poke around, mind not completely on what I’m doing and consequently making bad choices and failing to consider problems in sufficient depth, instead it’s like a finely-tuned engine running at its peak. It becomes easy to sink into the comfortable mental flow where it all just happens without the sensation of effort.

There’s a fine line between the energizing pull of a looming deadline, fueling the fires of creative endeavor, and a crippling anxiety triggered by fear of failing in my task. I’ve become adept–at least in the absence of external factors that strew tacks in my path–of maintaining my balance on that razor’s edge.

It’s exhilarating, such a sense of capability, of almost unbounded potential. It feels as if I can achieve anything I set my mind to. The sheer pleasure! It’s an addicting experience but one that appears to cause no harm.

They call procrastination the “thief of time” but I disagree. For me it’s a form of time management that maximizes my overall productivity, the key to unlocking my highest abilities. Far from stealing time from me it gives me the ability to use my time to its fullest potential.