My Gender Transition Journey Roadmap

When I realized that I was transgender and that I needed to transition, seeing the long journey ahead was overwhelming. I couldn’t imagine reaching the end of that road, and yet here I am. I am at the top of that trans mountain, my medical transition is done.  Now I look back on my gender transition journey with wonder and fondness. Though tough and often painful, it has been the most epic adventure of my life. As I am often asked about waiting times in the transition process, I thought it might be helpful to map out my entire gender transition, journey, from start to finish.

No Gender Transition Journey is The Same

Before we begin, it is important to note that there is more than one way to transition. There is no one pathway or one surgery that defines a transgender person’s journey. Some trans people don’t feel the need to take any medical intervention. Others might just choose hormones and not surgery, or a mix of these. All transgender narratives are different. The way we each discover ourselves as transgender is as varied as the path we take.

My Personal Journey of Gender Transition

My gender transition journey has been social, medical, and surgical. It began with social changes, then cross-sex hormones in the form of testosterone, and finally surgery. I have had top surgery, which although referred to as a double mastectomy, is more accurately described as chest reconstruction. I have also had phalloplasty which is one of the lower surgery methods available to trans men.

It’s important to also note that this is my personal timeline. The waiting times to access NHS gender services have changed and are currently a lot longer. It’s impossible to say how long or short someone’s journey may be. There are many factors to take into account along the way. However, I hope that sharing my timeline may give you an idea of what to expect throughout the journey.

With that said, the following is my personal roadmap. I have highlighted key points along the way with my YouTube videos. You can have a chuckle, at how bad I once was at making videos. (I promise I have got better!) 

Mapping Out My Entire Gender Transition Journey

2011 November

Realizing I Was Transgender and Coming Out

With a sober head and a determination to make changes in my life, I was at last able to face the truth of my gender issues.

In hindsight, I can pinpoint events from as young as ten years old, where I knew my assigned gender wasn’t correct. However, as a child of the eighties, there was little information about transgender people.I simply did not have the words to explain how I felt. Had I had access to transgender information, I have no doubt that I would have recognized myself earlier. I had no idea that the pain I was experiencing, was gender dysphoria.

The knowledge that I was transgender was bittersweet at the time. Although I was relieved to understand what had been wrong all my life, I was also scared that I’d lose family and friends if I came out. In the end, the pain of denying the truth of who I was far greater than my fear of losing people. This realization gave me the push to come out and to my surprise people were, on the whole, very accepting.

2012 February

Request for Referral to a Gender Identity Clinic to Start my Gender Transition Journey

My next step after coming out was to be referred to a Gender Identity Clinic (GIC). At the time, I needed my GP to refer me first to a local psychiatrist to be assessed as having gender identity disorder (GID). Only after receiving this diagnosis, could I then be referred on to a gender identity clinic.  

Thankfully this has since changed and being transgender is no longer classed as a disorder. In 2013 the GID diagnosis was scrapped in favor of the term gender dysphoria. The need to see a psychiatrist was removed and self-referral to a clinic came into place.

My Social Gender Transition Journey Begins

2012 March

Changed My Name by Deed poll

At the time I transitioned, a great deal of emphasis was placed on the Real Life Experience (RLE). This is where you live in your ‘assumed gender’ full time, thus showing your readiness to transition.

I was also excited to have something official that confirmed who I was and marked my new start in life as a man.

2012 May

Appointment with Mental Health Team to Provide GID Diagnosis

Having researched, I knew I could request a specific clinic. I wished to attend The Laurels in Exeter because at the time it had the shortest waiting lists. The psychiatrist said he would do his best to refer me to the laurels.

However, when I received my referral letter, it listed Charing Cross GID, not the Laurels. A friend encouraged me to chase it up and see if I could get permission to swap. To my joy, my wish to attend the Laurels was approved.

If I had stayed with Charring Cross, I would likely have waited at least another six months for an appointment. At the time I transitioned, waiting lists were escalating and The Laurels were one of the few that would see you within a year of being referred. Now, of course, it’s far worse across all clinics and it isn’t uncommon to wait two to three years for a first appointment. Trans services are in dire need of an overhaul. Huge waiting times greatly impact our mental health and it is vital to learn tools to help you manage the wait.

2012 December

First Appointment at The Laurels Gender Identity Clinic

My first appointment was with a therapist, who would work with me throughout my transition.

2013 March

Appointment with The Clinic Doctor and Approval for Testosterone

Often, you needed two appointments with the clinic doctor, before they would give approval for cross-sex hormones. However, the Doctor felt that because I was older, and because I presented so clearly with gender dysphoria, he was happy to give his approval for me to start hormones straight away.

The Beginning of My Medical Gender Transition Journey

2013 April

First Testosterone Injection

I have issues with a fluctuating mood and some of the shorter-acting testosterones can cause a bit of a peak and trough in levels, thus affecting your mood. Nebido would be administered every twelve weeks initially. Then I would have my blood levels taken and if needed, the frequency of the dose changed.

2013 July

Granted Funding for Top Surgery and Referred to Mr. Andrew Yelland

I was very keen to get the ball rolling with my top surgery. My chest dysphoria was extreme and binding was becoming more and more painful. I had done my research on who might be the best surgeon for me.

At my second appointment with the Laurels clinic doctor, he said he was very happy to put me forward for top surgery. A couple of weeks after my appointment I received the notice of funding allocation and an official referral to the surgeon of my choice, Mr. Andrew Yelland.

Starting my Surgical Gender Transition Journey

2013 November

Top Surgery with Mr Yelland at The Nuffield in Brighton

The time between referral and appointment dragged by. I appreciate that this four-month wait was short in comparison to the current wait for surgery. However, four months was considered to be a long wait at that time. I decided that Andrew Yelland was worth a longer waiting time because his results were amazing. I had made sure to do lots of research in preparing for top surgery.

2014 March

Gender Transition Journey Put on Hold Whilst I worked Through Lower Surgery Decisions

After healing from top surgery, I had a follow-up appointment in March 2014 with The Laurels clinic doctor. This appointment was to discuss the next steps. I had initially thought that I only wanted top surgery and perhaps a hysterectomy.

2014 August

Decided on Phalloplasty and First Signature for Referral

After lots of soul searching, I decided that I needed to pursue lower surgery. My research showed that the best surgery for me would be radial forearm free flap phalloplasty.

I returned to see my clinic doctor. In order to be referred for lower surgery at the time I transitioned, I needed two official signatures. My clinic doctor was incredibly happy to refer me and give his signature. The second signature had to be with an independent psychiatrist.

2014 November

Second Signature for Referral

I was worried about seeing a new psychiatrist because I have a complex mental health history. My concern was that my mental health challenges might hold me back in my transition. The Laurels had made it very clear that mental health issues did not prevent someone from transitioning. It was understood that a lot of trans people, due to the distress of gender dysphoria, might present with coexisting mental health issues. However, I worried that an independent psychiatrist might not see it that way.

I need not have worried. The psychiatrist said that I was a perfect candidate for surgery, in being in great health physically and in managing my mental health conditions. He was happy to provide my second signature for surgery. Now I could be referred to St Peter’s Andrology where the lower surgery team was based.

2015 January

Assessment For Phalloplasty

I received an appointment for an assessment at St Peter’s Andrology Centre. If all went well, I would be placed on the list for my first stage of phalloplasty.

This appointment went over my medical history and assessed my current health. As I wanted radial forearm phalloplasty, it was important my skin was good and the blood supply strong. I had a few concerns because I had a history of self-harm. However, none of my scars were deep and my skin was in good condition and suitable for a skin graft. I was put on the list for first stage phalloplasty.

2015 August

First Stage Phalloplasty: Creation of The Phallus

I had been told it would be a three-month wait for my first stage, so I had hoped for a date in April. However, April came and went with no sign of a date.

I had exams in June, and I was concerned about healing in time for those. I was fortunate to be able to be flexible with my studies as I am an Open University Student. However, the exam dates could not be moved. I, therefore, made the difficult decision to delay surgery until after my exams, so that I would have a free chunk of time to recover. I used the extra waiting time to gather my hospital kit bag.

2016 April

Second Stage Phalloplasty: Urethral Hook-up, Hysterectomy, Vaginectomy, and Glansplasty

Stage two went ahead with no issues, the urethral hook-up was successful, and soon, I was a forty-four-year-old man, learning to use the toilet all over again.

2017 January

Third Stage Phalloplasty: Insertion of The Erectile Device – Failed

My surgery seemed to be going well. Suddenly, here I was at the third and final stage, where I would have the erectile device fitted.  I had been lucky so far to have no complications but here was where my luck ran out. On attempting to fit the erectile device an issue was found in my newly created urethra and the procedure had to be abandoned. What made this worse, was that I experienced poor care by the hospital and by the surgeon. Additionally, immediately post op, I began to have issues with my bladder.

2017 March

Urinary Issues Result in Being Unhooked. A Setback in My Gender Transition Journey

For the weeks following my failed stage three, I was in pain and peeing constantly. Eventually, I was readmitted to the hospital. I was to have a cystoscopy, a camera inserted int the bladder to see what the issue was.

2017 October

Rehook up Success

I was terrified that my I might permanently lose the ability to stand to pee. However, in the October of 2017 at The Hospital of St John and St Elizabeth in London, I awoke to find it had been successful. This was of great relief.

2018 August

Second Attempt at The Erectile Device: Success!

Returning to St John’s and Elizabeth, I was nervous and dare not hope for the best in case the surgery failed again. I had been having a few issues with frequent urination and with post-void dripping. I had worried this might mean there was another urethral stricture, especially as I was also feeling rather unwell.

However, a check-up with my doctor had discovered I had hypothyroidism, an underactive thyroid. It seemed that urination issues could also be caused by having an underactive thyroid. This gave me a glimmer of hope.

My Gender Transition Journey Is Complete!

It feels incredibly surreal to have reached the end of my medical transition. In many ways, it feels like only yesterday when I realized, I was transgender and thought the mountain ahead of me looked too steep to climb. Now here I am at the top of that mountain.

Other than needing my pump device replaced at some point, I am now free from the surgical chains which have steered my life for so many years. No more jumping through hoops to prove who I am, no more waiting at the mercy of long waiting times, no more pain and frustration. My body is no longer a medical site, it is mine.

At The End of My Gender Transition Journey, a New Adventure Begins

In many ways, the journey is just beginning. It is only now, in being fully embodied as the man I have always been, that I am free to find my way in the world. My mission now is to pay it forward. It was the kindness, wisdom, and encouragement of others ahead of me, which have helped me to get to where I am today. It is for this reason, that I am writing my memoirs, of my transition and of my surgical journey.

---

I really hope that this blog has been of help, if so, please do let me know in the comments below. Also, if you have any questions, I am very happy to help if I can. You can also check out my list of recommended gender transition essentials.

---