Navigating healthcare: Top tips from trans people, for trans people

Being trans means you move through much of the world in a way cis people will never understand.

From dealing with necessary yet traditionally gendered procedures, such as cervical smears and prostate checks, to gender-affirming procedures, that goes double when it comes to healthcare.

As Joanne Lockwood, the founder and CEO of SEE Change Happen and a diversity and inclusion specialist, tells Metro.co.uk: ‘Trans healthcare is, in most cases, a complex and daunting process and sometimes finding the right provider or getting the care you need can be a challenge.’

We thought Pride would be a particularly good time to get some advice by trans people for trans people on how to navigate the complexities of healthcare.

Your body isn’t wrong – society’s perception of what your body means is the thing that’s wrong

Ruben, a 27-year-old trans man, knows first-hand that waiting lists for gender clinics can be very, very long.

‘With private trans healthcare at an exorbitant cost,’ he adds, ‘I know that getting that referral and waiting for appointments, or hormones, or surgery is frustrating, to say the least.

‘I know there are moments where the dysphoria is so bad that you want to claw your way out of the skin that you’re in, just to be free of it.

‘I know there are days when you present as your gender, and you’re so confident that this time they’ll have to get your pronouns right, and instead strangers hand you the wrong ones, and you have to smile and act like it’s fine when it feels like a gut punch.

‘I’ve been there. Some days, I’m still there.

‘I don’t know how, but somewhere along in my own waiting, I found a poem by Ollie Schminkey that helped me reframe the way I think about my body. One line called out to me: “I am not trapped in my body. I am trapped in other people’s perceptions of my body”.

‘It was something that flipped a switch in me. I’d never heard it phrased that way before, but I realised that my body is a man’s body because I, the person inhabiting it, am a man.’

While Ruben appreciates that this line of thought isn’t magically going to help people the same way HRT or surgery can, he feels ‘it’s important correct the narrative that has been given to us, because it can allow us to find comfort in the bodies that we inhabit’.

He adds: ‘Changing our thinking can help in a small way, and I just want trans youth to know very emphatically that your body is your gender, regardless of the way things are configured.

‘I am a man, so my body is a man’s body, and my vagina is a man’s vagina. The same applies to trans women and non-binary folks.’

Find a healthcare provider who is knowledgeable about trans care – not all providers are

Joanne, who is a trans woman, says finding the right healthcare provider is key.

She says: ‘There are online directories of these providers, such as trans friendly GP directory from actionfortranshealth.org.uk. If there’s not one in your area, ask around in any queer networks you are a part of – the chances are someone you know is aware of a good provider near you or a good place to start.

‘Existing healthcare has its limitations. Doctors may not be as knowledgeable as you think they should be, but you have the power to do your own research via Google or online forums and understand your own body and medications.

‘Search “trans journey” on YouTube and learn about the kind of transition you want. However, do be careful about the advice you receive – you may get conflicting information.’

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Going private for gender-affirming surgeries is an option – charities can help with funding

Rowan is in the midst of saving to pay for a gender-affirming radical breast reduction procedure.

‘I personally haven’t sought a referral to the Gender Identity Clinic (GIC) through the NHS for a few reasons,’ they explain. ‘I’m non-binary and what I am seeking as a gender-affirming surgery (a radical breast reduction, rather than full top-surgery) is not available via the NHS.

‘I have chosen to save and go private both so I don’t have to join a years-long waiting list (the GIC is currently seeing people who were referred in 2017 for their first appointments) and to be able to access the surgery that is right for me.

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‘Unfortunately, the high waiting times mean many trans individuals are going private leaving people having to raise thousands for gender-affirming surgeries. Personally, I have been doing lots of overtime and picking up freelance work to raise funds for my surgery.

‘I am currently around halfway to my £9,000 goal, but many are not in a position where they can raise the funds themselves and rely on fundraising to access surgery – for those going down this route I would recommend looking to charities such as Action for Trans* Health and Trans Aid Cymru who offer small cash grants to support trans folks most in need of it.’

Most people are kind and understanding

Becs Sawyer, 63, says opening up to loved ones will often ultimately be worth it, despite any fears you may have.

‘I wish I had known that the vast majority of people are very kind and understanding,’ she tells us.

‘When you are open and honest, the fear of ridicule and rejection is often unfounded.

‘I often get asked for my advice from trans women as they start their journey of transition. The most important advice I share really has nothing to do with them but, rather with their loved ones.

‘We’ve known since we were knee-high to a grasshopper that we are in – as the classic line goes – the wrong body, but when we share our trans status with people we know and love this is news to them and they will be playing catch up with us for quite a long time.

‘They need time and patience as they come to terms with and adjust to what to them will be a whole new person.’

Help us raise £10k for Kyiv Pride and a UK LGBT+ charity

To celebrate 50 years of Pride, Metro.co.uk has teamed up with Kyiv Pride to raise money for their important work in Ukraine.

Despite war raging around them, Kyiv Pride continue to help LGBTQ+ people, offering those in need shelter, food and psychological support.

We will be splitting the cash with a grassroots charity closer to home.

You can donate here

It’s OK to guard your mental health and not follow everything going on in the media

Sometimes, disengaging from the discourse is one of the best things someone can do to protect their mental health.

Ruben says: ‘There’s a lot of negativity going around about trans people. You do not have to follow it all. You are not expected to follow it all.

‘I say this because when I first started transitioning, I felt like I had to keep up with everything. I was struggling with exams, with depression, with anxiety, and on top of that, I was breaking my own heart reading all of the news going around. I remember that I cried for days about Leelah Alcorn in 2014.

‘At that time, being trans felt like I was an open wound, and instead of allowing myself to heal, I instead kept putting salt on it; kept picking the scab; kept opening it wider.

‘Don’t do that to yourselves. I can’t tell you how much my mental health improved when I downloaded a Chrome add-on that removes trending hashtags on Twitter and stopped getting alerted when JK Rowling was spouting vitriol.’

Talk to other trans folks

Rowan says talking to fellow trans people ‘can be so helpful.’

They add: ‘I am in a number of Facebook groups for trans folks including one centred around top surgery and breast reduction advice and I have found hearing other people’s experiences and advice so useful. 

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‘I think in these conversations, amplifying trans voices is key, as often conversations around trans folks centre cis voices.

‘I am an illustrator on an upcoming trans-led publication from Marginal Publishing which will be released in 2022, called ‘How it is and How it Should be – Shaping a Future for Young People’ (although the title is subject to change).

‘Being part of a project about trans lives in the UK, created by trans young people has been so exciting, and I really hope it can be a useful tool for other trans folks as well as allies who want to be more informed.’

The journey never really stops

Becs, who works as a spiritual medium, tells us: ‘I have spent the last 25 years going through my own personal journey of transition. In truth, the journey never really stops, as we continue to develop into our genuine selves.

‘I knew from my very earliest memories I was unlike all the other boys, never fitting in no matter how I tried, going to sleep every night wishing I could wake up as the me I knew I was.

‘As anyone contemplates transition to allow themselves to blossom and grow into their authentic self, the minefield that is hormones, surgery and lifestyle changes is daunting.

‘I would urge anyone taking those first tentative steps to know that all things are possible but, changes can be slow and frustrating. There will be plenty of down days as well as the wonderful ones. Any life-changing surgeries are steps along the way to fulfilling your true potential – research every step carefully and meticulously.’

Be as resilient as you can be

Joanne says that, unfortunately, ‘this journey is never easy.’

She says: ‘We can be angry, we can feel upset and consequently shut down and ignore our pain, or we can seek solutions by taking charge of our own bodies and advocating for our own healthcare, whilst seeking as much support as possible.

‘It’s about moving past the frustration a “no” brings us, in order to track down the person who wants to support you and says “yes”. Knowing your rights really helps!

‘Remember that we live in an imperfect world. Our reality is that we are navigating a cis heteronormative world that is only just realising that we deserve, and have always deserved, a place within it.

‘Always ensure you refer to a medical professional. Make a plan and learn how to navigate the system and get as much support as you can from friends and family as you make your way.’

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Know that you are loveable.

‘This is the most important one, for me,’ says Ruben.

‘What I really want trans youngsters to know is that you are loveable and if you want it, you can find love – and not the table scraps we’ve been told we’d be lucky to get. It is not something that is unattainable for you, even though that is the narrative we have so often been told.

‘We are not monsters, or freaks, or people who will be lucky to find someone. In fact, it’s the complete opposite: someone will be lucky to find us.

‘We are special, infinite, and so, so deserving of love – be it from partners, friends, or family.’

Do you have a story to share?

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Metro.co.uk celebrates 50 years of Pride

This year marks 50 years of Pride, so it seems only fitting that Metro.co.uk goes above and beyond in our ongoing LGBTQ+ support, through a wealth of content that not only celebrates all things Pride, but also share stories, take time to reflect and raises awareness for the community this Pride Month.

MORE: Find all of Metro.co.uk’s Pride coverage right here

And we’ve got some great names on board to help us, too. From a list of famous guest editors taking over the site for a week that includes Rob Rinder, Nicola Adams, Peter Tatchell, Kimberly Hart-Simpson, John Whaite, Anna Richardson and Dr Ranj, we’ll also have the likes Sir Ian McKellen and Drag Race stars The Vivienne, Lawrence Chaney and Tia Kofi offering their insights. 

During Pride Month, which runs from 1 – 30 June, Metro.co.uk will also be supporting Kyiv Pride, a Ukrainian charity forced to work harder than ever to protect the rights of the LGBTQ+ community during times of conflict. To find out more about their work, and what you can do to support them, click here.

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