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Trans Healthcare Attention Deficit Death Meditation

Being trans in 2023 means knowing deep in your bones that looking out to the world to confirm that you’re safe and that your needs will be met is simply not an option.

by Fred Turtle

Content warning: This article makes reference to death and suicide

I have called my local pharmacy seventeen times already today. No one has answered yet. I have a tally chart. I hate making phone calls; I’m counting to keep myself sane. Each time the line goes dead without an answer, I give myself another point. I’m winning. I’m getting a high score! That’s not the sound of a door slamming shut in my face repeatedly, it’s the sound of my resolute determination and perseverance. That’s not the sound of a failing system abandoning those it purports to care for, it’s the sound of my resilience being tested and strengthened. It’s okay if you’re not totally convinced. I’m not either.

I’m calling to ask if my Testosterone is ready to collect. It’s been three weeks since my Sustanon prescription was released by a GP who I’ve never met or spoken to. There’s a laminated sign in the pharmacy by the counter which says that prescriptions will be ready after 3pm, seven days after ordering. I’ve been calling the pharmacy sporadically either on my break or on the way to work, but as the days stretch on without my shot, today I am determined to speak to a human being and get some human answers. That, or get a new personal best on this game of Futile Phone Calls to the Uncaring Void™. I’m treating it like a death meditation.

Being trans in 2023 means knowing deep in your bones that looking out to the world to confirm that you’re safe and that your needs will be met is simply not an option. My post-it tally chart is a jedi mind trick that helps me to stay calm in the face of a very real despair. How many of us are in therapy dealing with feelings of helplessness, abandonment, grief, and anger through a veil of confusion and self-doubt, as if these feelings are not proportionate and reasonable reactions to an unconscionable system of violence and neglect? What’s more— and what’s worse— how many of us don’t even make it to therapy? 

I realised I had ADHD in 2019, shortly before I realised that I was trans. These dual processes of self-examination, extension, and expansion happened side by side (or spiral by spiral) and revealed parts of me that have been inextricably linked for my entire life. Learning about my neurodivergence helped me to accept myself and release some of the toxic shame that was paralysing me; beginning to live more authentically made it possible to build a healthy sense of identity and work on the self-esteem issues that had compounded from years of trauma and stress. Those of us who live right smack bang in the middle of the gorgeous, mutable Venn diagram that is transness and neurodivergence know that there is so much to be learned about each through the lens of the other, and how exhilarating and transformative the spiral journeys we take towards ourselves can be.

As we surrender our masks and disguises, our often-excruciating vulnerability is rewarded abundantly. There is loss, hurt, rejection, anxiety— but there is also liberation. Our relationships can become places of sacred riot and play, relentless compassion, and newfound optimism. Our creativity blooms, our energy shifts, and hope for the future appears on the horizon like the iceberg that sank the titanic. Because while our private, personal realities may be revived and imbued with the magic of connection, there’s the rest of the world to deal with. The nascent hope for the future that glows within us must be ceaselessly fuelled and protected as it is met by that door slamming, over and over. The phone cuts dead. The bodies pile up and we have no space or time allotted for us to mourn. The newspapers, the politicians, the talk shows, the bullshit, bullshit, bullshit. It gets to be too much, too often.

If we cannot feel our grief, our authenticity is threatened. They don’t want us to feel our grief. One of the most significant gifts my neurodivergence has given me is a strong and complex emotional empathy, particularly in response to the pain of injustice; while this pain can be debilitating, it has also been incredibly motivating. It helps me to help others. It helps me to step outside myself and connect with other trans people in new and creative ways. It helps me to take care of myself, because in the face of everything, how could prioritising my peace and wellbeing be anything other than righteous defiance, holy rebellion, a flow of constant direct action challenging the transphobia that threatens to eradicate us?

Trans community is amazing. We are constantly seeking new loopholes, new pockets of possibility and protection, ways of building the right kind of connections and securing the protocols which keep us alive— but it cannot be emphasised enough how tenuous and fragile the threads that we’re hanging on by feel sometimes. If the systems that we rely on are already breaking, breaking, broken, we can become like scavengers picking through a wreckage for scraps, for anything that will keep us going; we make decisions about our health and our lives without dignity, without support, without proper information and consent. I have no cheat-sheet, life-hack system that I can offer for those who are neurodivergent and struggling with accessing trans healthcare in the UK right now, because like…Hey! Me too. But if you’re without community right now, here’s your sign to bolster your support systems. 

During the pandemic I participated in 10 weeks of group art therapy offered by Spectra London, whose services are amongst some of the most accessible and affirming I have ever received: let me tell you, when everyone in the therapy group is trans including the therapist, something shifts. I witnessed and participated in the sort of radical, world-altering healing that up to that point I had only dreamed of, and I know that I move through my life more freely because of this experience. Help, community, support, connection: it IS out there for us. And the more we fight to access it, the more empowered we will become to make the changes necessary for trans joy— which means trans health— to become the rule, and not the exception.

The final score on this round of Futile Phone Calls to the Uncaring Void™ was 47. I admit that that probably says more about me than it does about the pharmacy, because who calls a number that many times when there’s clearly some sort of hostage situation going down which has the pharmacists wrist-bound and unable to answer the phone for hours. I never got through to anyone, and I still haven’t received my prescription. I’m okay, though. The void might not care, but the trans people I know and love—the trans people who I live, and fight for, do— and on days like today, remembering that is the most powerful medicine of all. 

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