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James (he/they)

In the end I started testosterone before I started University. Without the combined support of PALS, my psychiatrist and the GP I doubt this would have been the case.

My name is James (he/they), I am 24 and identify as trans male/non-binary. I am on the Autistic Spectrum and suffer from Neurological Functional Symptoms and have experienced mental health issues for most of my life. I am currently in my final year of studying for a Master’s degree and also volunteer as a youth leader for a mental health charity.

A white person wearing lots of bracelets using a laptop

Content warning: ableism, transphobia

I had been with the GIC for a while, and it was finally time for the appointment to get my prescription for testosterone, so I could start medically transitioning. I’d suffered from mental health problems for the majority of my life and, like many others, not being able to start hormone replacement therapy had had an added impact on my mental well-being.

What ended up happening in the appointment was confusing. After discussing the side effects of starting hormones and the physician agreeing to start me on them, I was then told that I should freeze my eggs. I explained that I wasn’t comfortable freezing my eggs, that I had never wanted biological children due to personal and genetic health conditions, amongst other reasons. The physician insisted that it would ‘be a waste of good genes’ and that he would refer me to a local fertility clinic, that he would be ‘very disappointed’ if I did not go through with it. He also put a note in the letter back to my GP that he wished for me to have my eggs frozen before starting hormones.

Unfortunately, that didn’t end up being the only problem trying to start hormones. My mental health continued to decline and after a couple of months I had still not heard from the GIC. I ended up calling the GIC and was repeatedly told that the letter-writing process could take up to or over six months, despite the letter having been dictated during my appointment. After talking to both my psychiatrist and my GP, I eventually called PALS (Patient Advice and Liaison Service).

PALS ended up being lifesaving in the end. After speaking – and crying – to them, about the wait time for the letter to be written up and the personal urgency of starting hormones (having been told by the physician that I should be able to start before University, but this becoming increasingly unlikely), as well as the opinions of the psychiatrist and GP, they got in contact with the GIC to enquire why the wait for a letter was so long.

After a combination of having a letter sent to the GIC by my psychiatrist and PALS putting pressure on the GIC, they eventually expedited sending the letter to my GP. Once the GP received the letter, I was able to talk to them about not wanting to freeze my eggs, especially if it was going to prolong my start to hormones – not to mention the months it would take to come off of my medication for my mental health as well as the months on oestrogen that would surely take a toll. Luckily, my GP agreed. She felt it was sexist and old fashioned that it was expected that I freeze my eggs and decided to ignore the ‘request’ that hormones not be started till I have my eggs frozen.

In the end I started testosterone before I started University. Without the combined support of PALS, my psychiatrist and the GP I doubt this would have been the case.