It was a dull grey day at the end of January when I eventually got to fly to the appointment with the endocrinologist in Tenerife. Having a 10 o’clock appointment meant the only flight that was available to me in order to get there on time was the first flight of the morning at 8am. In order to make sure I made the flight I arrived at the airport an hour before, it’s a rare occasion that you are forced to wait for the security checkpoints to open. When they did it was straight through and on to the plane.
Taking off and climbing above the clouds in the early morning light was an experience, it helped immensely to reduce some of the nerves that I had been feeling about this trip, that had only been made worse by a weeks delay. The downside of the flight from La Palma to Tenerife is how brief it is, before you know it we were preparing to land in Tenerife.
Walking from the plane right past the baggage collection belts and winding my way through the throngs of tourists, I headed downstairs to locate the bus to the interchange, because in a great piece of logic, the tram system in Tenerife does not extend to the airport. This means taking a 5 min bus ride before I could change to the tram which delivers me right outside the hospital.
The next challenge was to figure out which of the many buildings that make up the university hospital was the one I needed to be in. When I had located the building, getting to the right place was easy as I knew which floor as that was on the appointment letter. The first thing when I arrived was being sent down to the nurse to be weighed and measured.
Then it was in with the doctor, most of the chat was going over my medical history, good job I had brought my initial report from Dr Reid and the surgical report from Dr Seghers, without these I might have had some issues proving that I had a trans diagnosis in the past. Some of his questions did seem intrusive especially regarding my sex life, however given the nature of the interview, it was understandable.
Then followed something that I hadn’t totally been prepared for, a physical examination, nothing particularly intimate. However I was on edge, when he said my blood pressure was a little high, and maybe it was due to being in hospital, I thought, “I’m sitting here in my knickers being poked and prodded and you don’t expect my blood pressure to be high”.
Once that was over and I was dressed, it was time to get the paperwork. First he wanted a full blood test to check my baseline hormone levels, a bone density scan to see what damage being off hormones has done to my skeleton. He also put me in for a mammogram due to the fact that my mother had breast cancer. He also gave me a copy of the contract I would have to sign to start hormone treatment, I have to sign this to say that I give consent due to the fact that technically the medicines are not licensed for what we are using them for.
With all this done I shall return on the 12th March and hopefully 12 years after arriving in Spain I will be back on HRT
This week I came close to a crash and burn, by Friday I was not in a good place and in fact my mind was going to places where it hadn’t been in a long time.
I realised that things were getting bad when on Friday morning while washing my face in the kitchen sink (still don’t have an indoor bathroom) I had serious thoughts of just reaching over to the knife block and pulling out a knife from it and cutting my arm. The thought passed in a flash but just the fact that my mind went there was scary, I’m still here and I’m coping better today but I need to process how I got to this point.
Over the last few months work has been pretty stressful, there are a number of factors, but somehow it has ended up with several projects all coming to a head in the next couple of weeks with compressed timescales, and some significant technical hurdles to overcome. This has meant a lot of chopping and changing and juggling with other day to day issues that we have to deal with.
Then Friday morning the bombshell hit, this was a front pager article in the Daily Telegraph, now I’m used to the regular Sunday morning hate piece from the Times but for some reason this was personal. As many of you may know I worked at the Telegraph for a number of years and while I was there I was very open about that fact that I was a trans woman. To see this transphobic article on the front page felt like a betrayal, now I know it has been 11 years since I left for Spain, but it will always have a soft spot in my heart due to the acceptance and respect I felt there.
I realised that I am once again teetering on the edge of a complete burnout, so I will take a rest this weekend and try and stave off the worst, until I can find a longer term solution.
It is normal for this time of year to make resolutions for the new year, I have made resolutions various times over the years and I’ve never really been that successful in keeping them. So this year I decided that I would take a slightly different track, I am to set some general goals and then some smaller actions that I can do to meet those goals. I’m not going to as far as full SMART methodology, but I would like to have thing more focused than just a simple goal that is vague and more than likely won’t be achieved.
This is almost a perennial on my list, every year I have but this down on the list and every year I have finished the year not a lot different from the start.
I’m however a little more determined this year than I have been of late. So how can I achieve this, here are some simple steps I want to make this year.
Now I’m not one for fad diets, I’ve tried them in the past and they don’t work well for me, something that I have tried and found works OK for me is to have 2 days a week when I have a restricted calorie intake. I want to continue this and also be a little more careful of the portion sizes, as I’m normally cooking for two it’s difficult as a lot of recipes are for 4 servings and just simply halving the recipe doesn’t always work out with workable quantities. So what I have been doing is when I make something for example a shepherds pie then I will make 2, one to eat then and freeze the other part for later.
I have already started to get more exercise than I did a couple of years ago, because with going into the office most days, this enables me to park at the other end of town and walk 20 minutes to the office and back again at night. I want to add a little bit to this with some gentle core exercises once or twice a week, and hopefully introduce doing some sit ups once a week.
Language and Voice
The key things that has come out of my more recent activism and other activities is two fold, the first is that my Spanish is atrocious. I’m OK on a day to day basis but under pressure I tend to mumble and struggle to grasp for words, So I need to be a little bit more confident with the language and extend my vocabulary, I should really get back to using DuoLingo each day so that the Spanish comes easier to recall.
The next thing is my voice, when I transitioned I didn’t have any formal voice training and while again I’m OK on a day to day basis but recently I had a conference call where I had a substantial echo and it was very disconcerting, and again with doing more public speaking I’d like the experience to be a little less dysphoric. I’m going to be using “The voice book for Trans and Non-Binary people” to try and train my voice a bit better.
Thats most of the stuff that I would like to change personally on a day to day basis, there are some other things that I would like to achieve this year, but more specific things.
Having written the book last year the big thing is to get it edited into something that I feel ready to publish, I have only let one person read it so far. I deliberately left it to one side after I finished the draft so that I could come back to it again with fresh eyes in January. I’m also still hunting around for a publisher, I got one rejection so far and that was on commercial grounds as they already have a number of similar titles, but they did give me a list of other places to try. I’m still awaiting to hear from one, and a number of options are still open at this point.
I’m still looking at what else I can do, I’ve definitely been bitten by the writing bug and I don’t think the current book will be my last, in the meantime while I search for inspiration I hope to keep writing things for this blog and who knows maybe some other things for elsewhere.
During the festive break it customary to look back over the past year and put down a few words. Well one thing I can say about 2018 is that it has been quite a ride this year.
When the year started I had no idea quite the way it was going to pan out, it started innocently enough with just work to think about.
Shortly after returning from a trip to the UK I decided that I was finally ready to do something that I had thought about for quite a while, and I announced on April 1st of all dates that I had decided to write a memoir of my life and experiences, I set myself the goal of completing it for the following year and after a bit of research, decided that I would aim for a figure of around 100 thousand words.
I had only just started to write some basic word bits and pieces while staying at a hotel to celebrate Helens birthday I decided to just check up on family on Facebook, I wasn’t friends with my sister on Facebook but I knew how to find her profile through the search. From there I could jump off to other family members to see what was going on, when I did this I got a shock, there was a picture of Sarah in a wedding dress, I knew this photo was a couple of years old as it was what she wore when she renewed her vows a couple of years previously. This piqued my interest so I clicked on the comments, as I read them my heart sank, it was all “we are sorry for your loss” and other platitudes like that, the sort of thing you would write if someone had died. So I reached out to make contact, my fears were confirmed, my sister had collapsed a day or so previously and had died.
A few days later I was back on the plane to the UK, not knowing when I was coming back or what would happen there in the UK, by this time I was back into contact with several members of my family that I hadn’t spoken to in 20 years.
Over the next few days I had several tense and nervous reunions with long lost family members and catching up on the past 20 years, it was a period of very mixed emotions. I also a had a very brief encounter with my step mother, who now suffers from dementia and most of the time wasn’t even aware of who I was, then just for one brief moment there was like a flash of clarity and she said “Oh so your a woman now”, the patronising tone of voice and the inflections were there and instantly I was transported back to being a teenager. Then like a fleeting summer shower it was gone and she was back to asking where I lived again for the tenth time.
During this period I got to take a little break for myself in Brighton and was able to meet up with one or two people that I had only know on twitter, or I hadn’t met in a long time, the night ended with me escorting a distinguished trans author bake to her hotel via the search for chips.
Sarah’s funeral was hard, on so many levels, and at the reception afterwards I felt a little uncomfortable, nobody was outwardly transphobic to my face but I know there were whispers and comments made while I was out of earshot.
I had no sooner got back to La Palma when I was off on a mother plane this time just across the water to Tenerife to go and see Status Quo in concert.
June and July were filled with Pride related events, such as painting one of the benches in the town square with the pride flag colours to match the trans flag bench we had painted previously. Then there was the big parade, and me speaking to the assembled crown of a few hundred from the balcony, one of the proudest moments of the year, this year I really upped my trans activism, and it felt good to be doing things again. I had wanted to be able to get to the Uk and go to the Trans Pride event in Brighton but logistics wasn’t easy, so I had to unfortunately miss it this year.
In October I sent Helen off to help her daughter Rachel out in New Zealand and a month or so later I two joined her there and spent a few weeks in New Zealand, including a train journey across the north island.
Even with all this global travel I continued to write the book which I finished the 1st draft at the beginning of December, I then put it to one side so that I could start editing in the New Year. But I didn’t get a chance to rest on my laurels as I was required to don my activists hat ( and one of my acquisitions this year was a very nice purple fedora hat, which incidentally has it’s own twitter account @goodtranshat ) and I will be representing trans people at a roundtable discussion tomorrow night, that is after I appeared on the radio yesterday to promote the event.
What will 2019 hold? well that could be the source of another whole blog post, I want to improve the way I work to make it less taxing on my mental health, and of course edit and publish the book.
When I first came to Spain back in 2007, I didn’t get a formal introduction to the Doctor as I think I was working at the time. So I didn’t get my current medication that I had from the UK transferred over, and I thought I would be OK. I’d been taking hormones since 1998 and I didn’t think that it was urgent to sort out right away, and I would sort it out later, well one thing lead to another and it never happened, even when I started to be treated for high blood pressure it I never brought it up.
A couple of years ago when I started to realise that I had slipped into a depressive state and started to take action to deal with it, I decided that as well as an antidepressant ( I initially started on st. John’s wort) I would try and take some thing that was as close to a hormone that I could get, I found something that was based on a soja extract. The combination of these two did help to stabilise my mood and make it a little bit easier to get things under control.
A few weeks ago just before I left for New Zealand I decided that I would approach the doctor and ask if she could put me back on hormones properly. At first she said that she would have to send me to the hospital so that they could do a ultrasound to check what was going on with my ovaries, I gave a chuckle at this point and explained that wouldn’t do any good, which got a blank look from the GP, So I took an intake of breath and explained that I was trans, etc, etc. She said she would give me hormones, but required a blood test first, This would have to wait until I returned as I was leaving in a few days and wouldn’t be back for about 3 weeks. So on my return I got the tests done and then went back to speak to the doctor, only this time I get a different doctor, and she said that she can’t do it and refers me to the endocrinologist at the central hospital on the island.
So I wait a few weeks to get a phone call from the hospital with an appointment, So at the required time I arrive at the hospital. When I finally get into the talk to the endocrinologist, she’s a little confused as to why I’m there, so I explain. It turns out that for some reason the original doctor totally screwed up the blood tests and referral it was down on the system as hyperthyroidism which is not right at all, and that there were no hormone levels on the blood test, only the thyroid hormone levels.
Then she drops that bombshell, that she can’t put me on hormones as a trans woman without approval from the specialist gender clinic in Tenerife so she sent them a referral. So once again 20 years later, I’m back on a waiting list for an appointment with a gender clinic.
This a typical thing across the globe with any form of trans healthcare, had I been a cis woman presented at an endocrinologist with these hormone levels, then I would have been on HRT right away, but because I’m trans I have to jump through the hoops like a performing seal once again. There is an expression of the trans broken leg where you go for treatment of a completely unrelated medical condition, but it’s gets complicated or made harder just you are trans.
So hopefully sometime in the new year I’ll get a phone call and then I can take a flight over to Tenerife and continue the next step in the journey. It will be interesting to experience the gender clinic process in a new country.