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Diagnosed and sent on my way

Instead of my lack of energy being seen as evidence of mental illness, it was, to them, evidence that I wasn’t serious about being trans. Surely if I was trans, I would try harder to look like a man, even if I was incredibly ill?

by Grayson

I did not originally go to CAMHS (Child and Adolescent Mental Health Services) because I thought I was mentally ill. I was referred to CAMHS because I told my GP that I wanted to begin transitioning, and he told me I needed to undergo a psychiatric evaluation before that could happen.

I did eventually get my referral to Tavistock Clinic (even if CAMHS did lose it several times first), but I also got a diagnosis of depression and anxiety; which was the start of four very long years of abortive CBT attempts, and a revolving door of care workers. Then, soon after my 18th birthday, just before moving to adult services, I was given a diagnosis of borderline personality disorder, and sent on my way.

Personally, I do not see this diagnosis as useful or accurate to my experiences – it has done far more to hurt me than help me. The doctor who gave me the diagnosis has done so without justifying its use, and even when explaining it to me, the actual number of my official symptoms seems to wander depending on the psychiatrist’s mood.

One thing has always stayed the same: Unstable sense of self. This symptom is when a BPD sufferer’s personality and identity can be heavily influenced; they can take on traits of the people they’re around, and this constant reflection of other people’s traits can be confusing when trying to understand your own identity. When I ask why this symptom had been attributed to me, my transgender identity was always cited as the reason – despite the fact I have been applying for medical transition since I was 14, and have never wavered in that. 

But to them, they just did not believe that I really ‘wanted to be a man’. I showed up to appointments in leggings and sweatshirts – I was severely ill at the time, and barely able to dress myself. Instead of my lack of energy being seen as evidence of mental illness, it was, to them, evidence that I wasn’t serious about being trans. Surely if I was trans, I would try harder to look like a man, even if I was incredibly ill?

One of the most challenging parts of trying to receive treatment under this doctor was when he discharged me, suddenly, without reason. I was told by his secretary that they had spoken with my gender clinic, and it had been confirmed that they would be the ones treating me for my severe and complex mental health problems, instead of the mental health service. In talking to the clinic myself, they said they log all phone calls from psychiatrists, and mine had never even called to inquire – let alone actually speak to the doctors there. Only in catching them in that lie did they re-register me to their services, with no explanation. Throughout my entire experience with this man, until I transferred to different services at university, I felt like he was obsessed with my trans identity – trying to pin as many of my problems on that, so he didn’t have to treat me.

My experience is one of many trans people who are trying to navigate treatment from deeply undereducated doctors – TransActual reports that 13% of trans people have had a negative experience with a GP, almost twice that of cis people. The treatment I received under this doctor was ignorant at best, and transphobic and neglectful at its worst. In the UK, marginalised people are often forced to accept sub-standard mental health treatment within an already crumbling system. We are expected to trust doctors with our recovery who don’t understand our identity and identity specific trauma; and the NHS is not doing enough to ensure that trans people and other minorities are being treated with equal care.

This article was funded by The LGBT+ Futures: Equity Fund in partnership with the The National Lottery Community Fund.