Four Weeks

If all goes according to plan, in four and a half weeks’ time I’ll have a vagina.

Fuck.

A year ago this felt unattainable, a pipe dream, a vague concept, and now it’s really finally happening.

Assuming everything runs to schedule, I’ll be healed and back on my feet by Christmas.

It’s very surreal, knowing that my life is about to be, consensually, really quite difficult and scary and risky for a little while, but also knowing that the end state is going to bring me a lot of joy and peace. As someone who grew up with strong cPTSD and fear surrounding medical procedures and healthcare workers, getting to this point has taken a lot of work and self discovery. Ever since my first flu vaccine I’ve had a lifelong fear of needles and a distrust of doctors.

Therapy has helped a lot, not only with changing my thinking away from seeing healthcare workers as adversarial, to also helping me deal with anxious situations. My therapy journey isn’t really something I’ve made a huge deal about publicly because honestly, I kinda wish it was something everyone was able to access. I felt like I was a “normal” person who just wanted to understand themselves better, and that’s exactly what I got out of it: understanding my body, mood and emotions, and being able to work to my own brain’s strengths. Everyone is unique and I feel like they would benefit greatly from this.

But being able to calm that fight-or-flight feeling of anxiety when it comes up, and being able to breathe and talk things through with people, has saved my ass in so many situations recently, not just in healthcare settings. It’s helped me at parties, trying new experiences, even with making big life decisions.

There’s also been some amount of exposure therapy too in the last year. When I first started taking hormones, I had to have my first ever blood test, and I was absolutely terrified. I spent the hour before I had to leave my flat pacing around and nearly talking myself out of going; and throughout the entire journey me and my partner at the time were actively fighting this strong urge I had to just turn around and run away and not think about it any more. Now—after one and a bit years, six blood tests, three blocker injections into the ass check, a set of lobe piercings, and eight(??) injections into my arm—I feel a lot more composed and comfortable around doctors, nurses and other healthcare workers.

There’s so much that I’m really ecstatic about, and it feels like that there’s many things I’ll be able to do that have been a struggle up until now. Swimmings and doing sports will feel so much easier and comfortable for me. Being able to have more freedom in the clothes I wear without feeling self conscious. And being able to look at myself in the mirror and being happier with my body are things are going to give me tremendous joy, amongst other things. I’m incredibly excited about being able to modify my body in a way that makes me more comfortable and at peace.

This excitement is paired with a very real, very tangible fear about the whole process. This will be my first ever hospital stay, my first ever surgery, my first ever time receiving general anaesthetic. The experience is all new to me, and that in itself is scary. The prospect of ten weeks of aftercare before I’m walking around reasonably comfortable, at a minimum, is a very daunting prospect. And all of the waiting and anticipation and worries of things either going wrong or the surgery getting postponed for any reason is giving me a lot to stress about.

I’m really fortunate to have the support and love of so many around me. So many offers of support and assistance in the weeks after the surgery, people talking through and sharing their own experiences, and so many well wishers. Knowing that there’s a lot of really wonderful people behind me has given me so much comfort in these past couple of months, as the days tick down to V-Day. And, boy, are the days going by quickly. I started writing this post at six weeks. It is now four and a half. Blink and we’ll be at surgery day.

And honestly I feel a lot of anger at the system. I’m incredibly fortunate to be able to work for a company that covers surgery and that I was able to go the private route, see psychiatrists almost exactly a year after starting hormones, and booking in with a surgeon with a roughly ten week wait for private patients, for a rough “value” of £26,000.

I think that a lot of non trans people following my story do not realise how diabolical the situation is for the majority of trans people in the UK. I’ll describe the process.

NHS patients first need to tackle the horrendously long GIC waiting list (they are seeing patients from 2018. If this was my only option, I could potentially be waiting five or six years for my first diagnostic appointment). I’d then need to wait another eighteen months just to get started on hormones, then another year to be assessed for surgery. Finally, after referral to the Gender Dysphoria National Referral Support Service (GDNRSS), which can many months, it can take six to nine months for the referral to reach the surgeon and hospital and a surgery to be scheduled. No one has the luxury of this time to wait. No one should have to wait this long. It is cruel, demeaning and kills people, to say it bluntly. And the fact that the system has become this “pay to win” model, where if you happen to have a spare twenty-six grand or work with a supportive employer you can jump the queue, is fucking diabolical.

When you hear me and other trans people talk about “GIC reform”, this is what we mean. Removing the humiliating, bullying psychiatrists that ask invasive and irrelevant questions with the goal of catching people out. Changing the system to an informed consent model so that GPs can initiate and monitoring hormone therapy, without having to wait for a GIC or buying medicine from the Internet (there’s also a safety element here too, many of my peers cannot afford to pay for private blood tests). Training more surgeons who are able to perform these life saving surgeries (there are no phalloplasty surgeons in the UK, by the way. Let that sink in). There’s so much that can and should be done, but is just not happening. Money is being thrown at the GIC model, which is not translating to higher patient throughput or happiness. We need reform.

I realise this took a tangent, but the key takeaway is that I’m finally getting a vagina, which comes with its own bittersweet feelings. There’s so much for me to celebrate about my own journey, but it’s marred by just how bitter the current landscape is for trans people in the UK. I’ll be keeping updates on my social media, links for which can be found below. Onwards and upwards, 12th October.

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🐦 Twitter: @maisieccino

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