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The UK NHS Postcode Lottery

I am Stephanie Butterfield, and I am transitioning on the UK PCT-led NHS system. Whilst i feel fortunate to have had my trachea shave/vocal cord surgery and facial hair removal already, with my GRS also guaranteed when the time comes, I do however feel very frustrated at the UK postcode lottery, not just for me, but for others too.

The PCT’s (Primary Care Trusts), often treat transsexual procedures as unnecessary, or simply cosmetic, not thinking beyond their small mindedness and thinking about the TS patients’ quality of life.

The postcode lottery works like this – one PCT will fund a girl’s breast augmentation and facial hair removal, whereas another PCT will not. How, you may ask?  If it is the NHS (National Health Service), we should get even and equal access to funded treatments and operations available on the NHS.

However, each PCT has the right to decide funding at a local level; it’s this which allows the postcode lottery to thrive, leaving many transgirls and transguys frustrated at the unfairness of it all.

Another irritating feature of the NHS transition route is the waiting one has to do, from GP (general practitioner) to GIC (gender identity center), from 1st opinion to 2nd opinion, from 2nd opinion to the operation itself.

I am currently at the waiting for my 2nd opinion stage, an 8 and a half month wait as I write, and my latest frustration is being blocked from seeing an endocrinologist.



“A Boy’s Life” in The Atlantic

The November 2008 issue of The Atlantic magazine contains an article called “A Boy’s Life.”  It’s a comprehensive exploration of the topic of transgender children:  where it comes from, the struggles that parents and children experience as they strive to find ways to deal with it, and the difficult choices they must make in that process.

I’m not sure how I feel about this article.  Much of it is troubling, since I wish the whole topic of the origins of being transgender and how best to treat it to be neat and simple, but it just isn’t.  In the end, I believe that children should be allowed to make their own decisions to the extent that’s feasible.  (Obviously, that’s a huge loophole, but, for the moment, I have neither the time nor the inclination to try to define my position any further.)  If a child typed as a boy at birth wants to live as a girl, she should be allowed to do that with her parents’ support.  At the same time, her parents need to make clear that either choice is OK.  If she later decides that she wants to live as a boy, that too should be allowed.  Will it be more difficult then?  Yes, of course.  Every choice we make has consequences and, as much as we might like to, we cannot insulate our children from the consequences of their choices any more than we can avoid the consequences of our own.  But I believe that the challenges of returning to life as a boy, after living as a girl for weeks or months or years, will be less traumatic than growing up never having had the chance to have that experience and to make a more informed decision about her future.

Eventually, she will be faced with decisions that will have permanent, physical consequences — whether to begin cross-sex hormones, whether to have SRS.  That is where the use of hormone blockers has the greatest benefit, since they delay the onset of changes that will make living in her affirmed gender infinitely harder until she has the maturity and the information she needs to make that momentous decision, while retaining the option of allowing her puberty to proceed as it would without intervention.  In the end, however, it must be her decision, not her parents’, not her doctor’s.  None of can know what is truly best for another person, even our children.  All we can do is ask Spirit to guide our choices and the choices of our children and then trust that She will respond to our calls.

(Crossposted from my personal blog.)

My Wife, Bob

My Wife, Bob

I often wonder sometimes how I would have reacted if the shoe was on the other foot – that being, that, if one night, my wife would have come to bed, got under the sheets and surprised me wearing Men’s Briefs and genitalia to compliment them. Could I be ok with that, if it were me?

Lets take it a step further and add in Male hormones, a boy hair cut, facial hair and she would now like YOU to address her, as “him” – a “man” named Bob.

I have talked with hundreds of M2F cross dressers and transsexuals, and one of the things that I find that most (but not all) have overwhelmingly in common, is that they identify as heterosexual, or Trans-Lesbian. I wonder how any of these people (or anyone, for that matter) would feel if their wife came home and said, “I think I am man”.

If you’re Transgendered, try to imagine for one second that your not. Now imagine your beautiful wife that you fell in love with – and all her femininity that balances your masculinity, is now being offset by her’s. Think about your first company picnic, where you bring your wife and all your co-workers and even your boss is first exposed to your “spouse”, Bob. Could you deal with having to be forced to appear as a homosexual Gay man?
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A Lesson in Trans Etiquette

OK all you little boys out there. Here is your chance to better yourself. I am going to make this quick and simple and attempt not to offend anyone too badly.  Based on a true and very recent event.

If a woman walks into the room, be it a business or otherwise and you read her as TG/TS. Be polite and treat her as any other genetic woman. If you want to start a conversion with her, the first words out of you mouth had better not be “do you hang out at [a known ‘and nasty Tranny’ Bar]”. The woman is likely to take a great deal of offense at that as I DID. However being the polite and caring woman that I am, I chose not to get all pissed about it.

So why would I be offended by that question? . . . I am going to tell you.

It is about the same as someone walking up to a suspected gay man and asking him if he is a FAGGOT. Just because I am a TS is not an automatic ticket for me to hang out in “certain places”. I am NOT a “Tranny” and I DONT hang out at “Tranny” bars. I cannot say anything nice about the place I was asked about, so I won’t

I know I am a big woman and I know I get read. But do not rub it in my face by asking me or any other TS person that question or one like it if you do not know them or anything about them. And heaven help you if it is your conversation starter. I guarantee it to be a short conversation and I WON’T buy anything in your store.

Just because I or any other person is a transsexual (M2F or F2M) does not give you the right to call us out, especially in public. Treat me like women please and treat us with respect. And we will return that in kind.

The Few Who Shine

What’s with some people?

There are the kinds of people who can only handle a limited amount of pressure in their lives and then crumble and fall under the heavy weight. They are the ones who, even when the little black cloud that once hovered and rained over their every deed, refused to turn their face to the clear blue sky and become encouraged by the sun’s warmth.

These are the people who, in an auto accident, completely freeze and though may remain uninjured, are worthless in coming to their feet to help out others who are in worse shape. They end up becoming an added burden to the problem instead of rising up to shine over others. If they are witness to the accident, they may pull over but only stare in awe and amazement while others risk their lives to pull the injured to safety.

Why do some people’s fatalism make them indifferent in pursuing a path toward happiness?

Then there are others who, no matter what life throws their way and regardless of their economic status, their positive spirit rarely fades. Though they have their share of adversity, nothing except death eventually befalls their enduring spirit.

Their spirits illuminate the darkness that surrounds them.

Take for example, a recent visit I had to my state’s Department of Economic Security. I had an appointment with the state acting on behalf of a less fortunate relative who needs the state’s help in receiving healthcare and monetary assistance. The building is typical for a large government facility, its massive brown rectangular shape outside opening to reveal dozens of cubicles on the inside for its employees. Upon entering, I had to take a number and wait my turn among the many downtrodden and disadvantaged people.

The playfulness on the children’s faces was a sharp contrast to the sullen droopy faces on the adults who nervously awaited their turn. Oh to be a child without worry again!

After several minutes of waiting, I was finally called by an employee to follow her back to her tiny square with desk and chair inside the bright fluorescent monolithic room. As I sat down, Maria greeted me with a warm round smile. I explained to her that I was not the person on the application but was present and acting on her behalf because she could not be present for the meeting.

While answering question after question, I began to take notice of Maria’s cubicle. Its 7′ x 7′ space was full of bins and folders full of applications requesting state aid, but it was surprisingly clean and tidy, and there were awards posted in frames all along the inside walls. Yet the awards were given to her by her employer for “Most Organized Employee” and “In Recognition to Your Years of Service to the State.” Also on the walls were hand written certificates drawn by her three daughters in crayon like “Best Mommy in the World” and “Mom is #1.” One would think she had not accomplished anything substantial, but I began to see differently.

Throughout the meeting, I would ask her questions about her working with a state agency for eleven years and about her children. All the while she maintained a posture of grace and had an amazing bright smile despite her having to deal with the less fortunate on a daily basis.

“Doesn’t it get to you? I mean, working for the government like this, and having to deal with so much despair and people demanding assistance?” I asked her politely.

“No, it doesn’t. Management sometimes gets to me,” she joked. “But I love living in this community. I love taking care of my daughters, and I love helping people. I even love my job and I take pride in my area here. My coworkers always laugh at me because I’m so tidy.”

Just then, the phone rang and she answered what seemed like very direct questions with a stern “yes” and “no.” Then she told the person on the other line who I was and gave them the case number. She promptly hung up and looked over at me with a sigh.

“Who was that?”

She sighed again. “It was someone from the state at their headquarters in a different city calling us at random to find out what we’re doing and making sure we’re staying busy.”

I was bothered by that. I thought she would be too. But she seemed to shrug off the inanity of a micromanaging agency and completed the paperwork cheerfully. As I got up to walk out, I thanked her for her kindness and encouraged her to never let anyone or anything take that away from her. I told her that I knew her simple smile and gentle spirit would be a tremendous source of comfort to those who sat in my chair. My words seemed to impact her with an affirmation she wasn’t used to hearing.

There was clearly something different about Maria that blew me away. Her teflon-coated optimistic spirit really made me think about my own personal difficulties, and I wondered what I could do to walk with the same light she had in her life.

Maria, and those with kindred spirits like hers, give me purpose in my circumstances.

I may struggle with transition. My circumstances may create chaos in my life. No one ever said being true to myself would be easy. No doubt there will be days where I’m tempted to give in to sit on the curb and watch the accidents surrounding my life injure and terrorize my family, my friends, and me. But I am alive, I’m still breathing, and I need to find that same illiminous spirit that has lurked in the shadows of my heart for too long.

It’s time to be like Maria.

It’s time to get off the curb.

It’s time to shine.

Happy posts?

So…does anyone like to read happy posts?  Sometimes I wonder if posts about things going well and the adventures that go with it are not as interesting or read as much as the posts about the struggles of transition.  In my case, transition has been pretty straight forward so far, almost like a non-event.  That makes me wonder if I have much to offer the trans community in my posts.  I’d actually rather talk about the fun we have with our hobbies than to talk about going to the bank as Amber and being treated like any other customer, what’s so interesting about that?  Nobody ever shows up with torches and pitchforks, it’s a non event, even going to Home Depot as Amber and dealing with a cashier that has known the old guy for 15 years was a non-event, no reaction at all, just normal customer service.  Nothing to see here folks, just life happening.  Does anybody really want to hear about stuff like that?

Transition at work, the dilemma

I know that most of the readers here have their own issues with transition at work, one of the more tricky parts of transition.  My particular situation is a bit complicated.  As most of you know, I came out to my boss around the middle of June, and he was supportive of my issues.  I told him at that time that I would eventually tell everyone else that works there, the other 5 employees.  And, as you know, I did tell them toward the end of July.   Now, everyone at work knows about me and I’ve been relaxing a lot more and not trying to hide the transition developments at work, they all seem to be OK with it so far, but they haven’t actually seen Amber fully yet.  After my appearance at the theater and the resulting fallout, I’ve been a bit more cautious about pushing my transition at work.  The problem is that our customers don’t know about me, and if the reaction from one of the workers at the theater is any indication, some of them would not want me to come to their place of business as Amber.  The other problem is that our business depends on the relationship with our accounts, they can go to another company like ours any time the want to, there’s plenty of competition for the business.   So, if I cost us an account because of my transition freaking out the owner of the business, the company I work for loses money.  Not good for my job.  The boss says that he’s supportive of me and my transition, but if it affects his business, the bottom line becomes more important than my transition, or my job, probably.  It doesn’t take a rocket scientist to figure that out.

If I transition at a natural pace, as my body changes, people see it and deal with it.   Of course, that takes just short of forever.   If I just start showing up at the accounts presenting as I would choose to do, I risk damaging the company’s income, and thus, my job.   I think about this a lot when I’m working at a place that I go to enough that they recognize me, how am I going to deal with things like going to the ladies room at the place, when they knew me from before the change?  That may be the biggest issue, even if my new appearance doesn’t freak them out.  I haven’t come up with a workable solution to all this yet, short of getting a different job where I can start as Amber, and that’s really impractical and unlikely at this point in time!  What’s a middle aged girl to do?