Wednesday, 30 April 2008

Goodbye Stephen and the charlatans you represent…


There is also a clear need to move away from the view, as contained in Diagnostic and Statistical Manual (DSM) IV and International Classification of Diseases 10, that transgender and transsexual identities are the result of pathological mental illness.

In order to reduce the stigma that currently exists another space within diagnostic structures needs to be found, for example within endocrinology or in surgery.

This might seem impossible, when the main Diagnostic Consultative Committees of the American Psychiatric Association (APA, 1994) and the World Health Organisation (WHO, 1994) are still firmly embedded in the idea that to be trans is to suffer from mental disorder, even though they both acknowledge there is no known cure, but that transgender medicine and surgery can alleviate a patient’s distress and anxiety, and often enable them to regain a place in society.

Though trans people have expressed their concerns repeatedly, and are currently lobbying the APA for a revision of the categorisation in the DSM V, there has yet to be seen a body of psychiatrists coming out on their side.


Transgender EuroStudy:
Legal Survey and Focus on the
Transgender Experience of Health Care

Full text at:

http://www.ilga-europe.org/europe/publications/non_periodical

So you see – the momentum builds!

Of course as Stephen Whittle the President of the World Professional Association for Transgender Health (WPATH, formerly known as the Harry Benjamin International Gender Dysphoria Association, was involved in the study analysis you can’t expect Press For Change to come out and say “no more” but the rest of us will. LOL

My motion to the UK Trades Union Conference will probably push things along nicely but I’m confident the days of the charlatan gender psychiatrists in the National Health Service are numbered. I got my confirmation to attend the TUC yesterday.

Talking of numbered days, I had my appeal hearing yesterday and for legal reasons I can’t say much but I will say I enjoyed it. My employer’s response was exactly as I anticipated but they hadn’t expected a detailed chronology from me proving the link between the start and end of the discrimination.

I delivered my letter to my GP today with comprehensive answers to my Primary Care Trust form applying for funding for surgery on the basis I am significantly different to the rest of the population that they offer gender dysphoria services to. Try I’m legally female & I have Ankylosing Spondylitis LOL

Then I realised hang on what happened to Choice & Patient Centric Care? So I’ll see my MP on Friday and ask her to write to head of PCT saying patients should have a choice Charing Cross Gender Identity Clinic or London Gender Clinic and surgery in Charing Cross or Sussex Nuffield as per the choices offered in other PCT. That would get them out of being sued for an illegal policy in terms of breaching the Gender Recognition Act and the Mental Capacity Act. It also guarantees I get surgery LOL

Finally I got a “fitness training” top and a yellow T shirt from Peacocks so I’m slowly replenishing my day to day wardrobe as a huge amount of my clothes are only fit for dusters now.

I mustn’t underestimate the opposition or get over confident but I will prevail…

Monday, 28 April 2008

Bit of a day and more to come…

I got a letter from Tax Credits awarding me the princely sum of £2.94 per week. As usual it was wrong! There is a fundamental flaw in the tax credits system in that they issue letters containing figures that are at least a year out of date.

You are expected immediately on receipt of the notification to correct the figures by telephoning them. It’s a sort of debt machine whereby you will always owe them.

I’m still in dispute with an alleged overpayment deferred by collection, as I don’t earn enough to enable them to recover it. I complained to recovery saying you’ve just paid me £10.34 increasing the debt. They said not my job and got awards to ring me who when I gave them the correct figure confirmed I wasn’t entitled as I’m so well paid. They did say keep the £10.34 we paid you in error as too low to collect!

Anyway I’ll translate that for you I’m in the poverty trap that Gordon Brown says doesn’t exist because of tax credits – wrong I pay more tax and get no credits. You aren’t getting my vote anymore mate!

Next I get notified that another council house swap is available this time a two bed flat in North London. It’s close to White Hart Lane rail station so 23 mins to Liverpool Street – nice eh? Well once I figured that out as Transport Direct wanted to send me on buses mind you in less than 2 years I do get a bus pass LOL I’m going to see the East London flat in May so maybe I can see this one as well as it’s a big 2 bed that sounds very similar to mine. So come on who wants to share? (Very close to Tottenham Hotspur Ground!)LOL

Then I get Anooshah the researcher from my Union on about my proposed motion for the TUC so we had a long chat about why removing the mental illness classification is the core issue for transgender & transsexual people. She’s a convert. I sent her by email some sites for research in addition to mine of course LOL

Then I wrote to Mosaic who are commissioned to do a documentary by Welcome Trust. Hopefully this will do the job as I’d like to be part of it.

I hope you will allow me to contribute to removing the misconceptions and stigma as regards transsexual people.

I am a member of T&G Unite LBGT forum and an active campaigner for the removal of the mental illness classification that is the root cause of the discrimination against both transgender & transsexual people.

It was abolished in the seventies for gay & lesbian people but we were left behind and a new mental illness created.

I have experienced a particularly difficult transition with my legal rights being constantly flouted by my employer.

I have experienced the wall of prejudice created by the Department of Health & my Primary Care Trust that I have fought with my MP Janet Dean until she gave up recognising that only legal action can ultimately force through change.

I have rewritten my Union Guide to Transgender people in the workplace.

Regrettably I have come into conflict with the Press For Change lobby group that have vested financial interests in maintaining the mental illness categorisation so I trust I will be allowed to provide balance to their views.

I have chronicled my experiences and battles in two blogs Diary of a Biscuit Making Transsexual & Fiona Fox's tales.

After that I finished off the letter to my prospective gender affirmation supplier and a letter to my GP with my input to her application for funding:

Here they are:

Gender Affirmation Surgery with Mr XXX

Having learned that I am expected to undergo a consultation with a psychiatrist prior to the above surgery I am concerned about this requirement.

I have met all the medical and legal requirements to obtain a gender recognition certificate and now have a female birth certificate. This demonstrates that I am totally committed to living the rest of my life as a female and I see this gender affirmation surgery as vital to my well being.

I do not accept there is any need or value for me in the requirement for this additional psychiatric assessment.

I anticipate that the requirement for this additional psychiatric assessment will change when you review your protocol to comply with the Mental Capacity Act 2005 combined with the Gender Recognition Act 2004.

I am however under stress and pressure with respect to my surgical status as for example employees at the factory where I work, aware of my pre-operative status, have threatened me with physical violence.

I am therefore prepared to submit to your requirement for a one off meeting with the psychiatrist, Dr ZZZ, so that there is no delay in undertaking the surgery that will reconcile my body with my legal status, whilst conforming to the protocols you have set up for providing this surgery.

I will advise my GP to include Dr ZZZ £180 fee in the application for Individual Funding to my Primary Care Trust

Notes to complete the Application Form for Individual Funding Process at South Staffordshire NHS\Primary Care Trust

Page 1 of form

I give consent to clinical information to be shared with Individual Treatment Panel and will provide supporting information & accept the outcome in writing.

Condition / Diagnosis details

Summary of current condition for treatment.


Maggie Fiona Fox has met the strict legal & medical criteria of the Gender Recognition Act 2004 and has a female birth certificate. She is considered capable of making her own decisions as defined by the Mental Capacity Act of 2005.

She has been under the care of Dr Richard Curtis a HM Government approved Gender Specialist for the past two years. She transitioned from male to female on 18 November 2005.

Diagnosis:
Transsexual as defined in ICD 10 and free of mental disorder

How will this condition alter over next 28 days.

This condition will not alter over the next 28 days.

Summary of previous related / relevant conditions:

Miss AAA of Queens Hospital Burton upon Trent diagnosed Maggie Fox as suffering from Ankylosing Spondylitis when the condition spread to her eyes as Iritis. She had suffered 20 years of extreme pain from this condition that had eluded the diagnostic skills of numerous consultants. She was subsequently referred to Dr BBB Consultant Rheumatologist and on her insistence was prescribed Phenylbutazone that enabled her to undertake a rigorous fitness regime resulting in her back setting in a relatively small stoop compared to others with such a severe state of advanced AS. She was discharged from Hospital care when Phenylbutazone was discontinued for human use. She has no spinal rotation, severely limited neck rotation and fused ribs such that her chest cannot expand. Her lung capacity is therefore significantly reduced though it is sufficient for general anaesthetic. She will be on anti-inflammatory medication for the rest of her life. Her current prescription is Meloxicam @ 2 X 7.5mg daily.

General Health status:

Maggie Fox is suffering from the combined stress of worrying about the time delay and funding for surgery and the effects of the discrimination at her work place where she has been threatened with violence for not yet having had surgical intervention. Her treatment by reactionary elements of the small market town she lives in is directly related to her not being perceived as female whilst in a pre-operative state.

Page 2 of form:

Details of previous treatments / interventions

Treatment / Intervention Outcome


Progynova 3 X 2mg daily Body has visibly feminised

Cyproterone Acetate 50 mg daily Testosterone level is in female range

Finasteride 2.5mg daily Sufficient hair re-growth for hair weave

Summary of proposed treatment / intervention requiring funding

Summary of proposed treatment:


Consultation, assessment, bilateral orchiectomy, urethral reduction, cliteroplasty, labiaplasty, penile vaginoplasty surgery by Mr XXX at the Sussex Nuffield Hospital and then specialist post operative nursing under the care of Ms CCC.

What are the alternatives and why are they less effective (if none say so).

Alternative State why less effective/not preferred choice


Charing Cross Hospital The critical personalised individual nursing after care is not available for this patient who considers the standards in this hospital to be an unacceptable risk. The hospital’s assessment criteria for surgery fail to recognise her legal status.

Cost of Initial Treatment:

Pre-surgical genital hair removal by electrolysis from the penis and possibly the scrotum at a maximum estimated cost of £1,350 dependent on total area needed to be hair free specified by the surgeon.

Estimate is based on 18 hours of pain free electrolysis at £75 per hour at the London Gender Clinic though a suitable pain free local provider would be acceptable to the patient.

£10,500 fixed price for services provided by Sussex Nuffield Hospital subject to assessment.

Cost of subsequent treatments Frequency

Nil providing there are no surgical complications and genital hair is removed with a 3-month free of charge surgical revision correction period.

Duration / number of likely treatments Frequency

Nine two hour sessions of pain free electrolysis two weekly

Surgery at Sussex Nuffield Hospital Once

Total Cost of proposed treatment / intervention:

£11,850

Page 3 of form

Details of any variation in existing commissioned pathway required to administer treatment (e.g. 3 more outpatient appointments, one less day case procedure)

Not applicable as the new gender dysphoria commission pathway is not appropriate for this patient whose female birth certificate is proof absolute of her having achieved the implicit result of successfully living in a female role.

State any other information relating to this treatment the PCT should be aware of (e.g. previous experience)

Mr XXX the surgeon has never cut a bowel. No patient has ever required a colostomy. The majority of his patients are over 50 years of age and he has performed the surgery before on a patient with Ankylosing Spondylitis. His surgery is considered minimum risk. Only one patient of the hundreds treated has ever-required return to theatre.

The key recovery period of bed rest of 5 days after 12 hours of not being able to sit up requires additional care and pain relief for patients with severe Ankylosing Spondylitis.

Ms CCC is one of only two nurse practitioners recognised by the SMC & BNF in the specialist post operative care of gender affirmation patients and will provide a care pathway based on research but defined by individual patient needs. She heads a dedicated specialist team that have experience of surgical after care of a patient with Ankylosing Spondylitis.

The package price of £10,500 from the Sussex Nuffield can be broken down as approximately £125 consultation, £160 assessment £5,050 Mr XXX’s fee, £4,800 hospital costs, £650 anaesthetist fee. The 3-month postoperative endocrine check post surgery is not charged.

Sussex Nuffield Hospital has not had a case of MRSA or C-difficile

Mr XXX in common with other surgeons that perform the “penile inversion” method of gender surgery recommends that patients have genital electrolysis to eliminate the danger of infection from hair growing inside the body. Surgical correction of damage caused by ingrown hair typically costs £2,000.

Statement of exceptionality

(a) State why the patient is significantly different to the general population of patients with the condition in question to warrant being individually recommended for this treatment:

And /or:

(b) Why this treatment is likely to be of significantly more benefit to this patient than the average patient with this condition:


N.B. If a patient’s clinical condition matches the accepted indications for a treatment that is not funded, their circumstances are not, by definition, exceptional. The fact that the treatment is likely to be efficacious for a patient is not, in itself, a basis for exceptionality.

Under (a)

Maggie Fox has had severe Ankylosing Spondylitis that has left her with permanent calcification of spinal and chest ligaments and reduced lung capacity.

Whilst the reduced lung capacity does not prohibit general anaesthesia as indicated by her varicose vein surgery in 1999 at Queens Hospital Burton upon Trent the time in surgery and enforced bed rest will require additional post operative nursing care in a specialist unit.

Maggie Fox is legally female such that she matches the accepted indications for funding for surgery. Her gender specialist, Dr R Curtis, has considered her a suitable case for surgery since 2006

Page 4 of form

Clinical Effectiveness and outcomes


If no peer-reviewed publications exist please quantity the outcome you expect from this treatment any likely side effects or implications for this patient (with time scales)

The internationally accepted treatment sequence for transsexual people is assessment to eliminate any possibility of mental illness, provision of hormones under the care of a gender specialist and then surgery.

Surgery for Maggie Fox is the final stage of this process having successfully completed the others with no apparent problems or side effects from hormone and anti-androgen therapy.

The surgery will eliminate the need for anti-androgens and the level of replacement hormone therapy should be less.

The surgery will eliminate the major cause of stress in this patient’s life and all postoperative studies indicate high levels of satisfaction with the surgical outcome and enhanced ability to blend in with society’s norms.

She is a former HM Government Computer Security Consultant and union activist for transsexual rights and will most likely be able to extend her work in this area post operatively. She currently works in a biscuit factory.

Whilst a large number of studies have been made all of which indicate a positive patient outcome with minimal side effects or implications none are sufficiently statistically robust to warrant inclusion in this submission.

There are equally no statistically robust studies to the contrary.

End

I believe the rest of the form is merely “tick box” so I leave that to you.

I look forward to seeing the completed form in time to meet the strict PCT deadline of submission of 10 days before 03/06/2008.

I recommend that you send all of the letters from my Gender Specialist plus the PCT commissioning information I have obtained for you from The London Gender Clinic.

That had better do the job or it’s off to the courts which of course reminded me to book my taxi for tomorrow as it’s appeal day with my employer.

As they say – Let battle commence …

Sunday, 27 April 2008

Well I’ve had a spot of retail therapy and a new hairstyle!

I’ve bought two tops from Primark and a cool Mac from Marks & Spencer. Yes that’s right me in Primark! I went there first as it’s always been my last call before heading for the station so I reversed the shop sequence ending up last at Marks & Spencer and I’m glad I did!

The tops I bought are dead cool. I tried both on in size 8 but they were “grinning” too much so I moved up to 10 - perfect. Primark cut to minimum size to save fabric whereas M&S go mostly to maximum so I’m always an 8 there on tops. The one top is a sort of USA style blouse in dark blue covered with white stars. I’m not taking up line dancing by the way even though I’ve got a suitable flared denim skirt LOL

The other one is a black plunge V top with a cream sewn in vest top to keep you decent. It shows off my tiny cleavage and makes me feel trendy & sexy without being “mutton dressed as lamb”. I’ll wear it next week at my appeal hearing!

Now the Mac was the one I spotted on the M&S web site and it’s so non M&S! Of course I had to try on all the others but this one stood out by a mile. It’s incredibly tight cut & shaped and really flatters my evolving figure. You can’t really wear it if you are over a size 14, as it’s not cut for the fuller figure. They had it in sizes 18 & 22 and it looked ridiculous. I bought a 12 that fitted me exactly it’s shaped such that you’d never wear a jacket underneath just vary top thickness by season. In case you not guessed I love it!

Now my new Mac will be perfect for my train journeys in England’s wet climate talking of which I had to laugh as when I got to Manchester I was warned of the danger of slippery surfaces in the train station due to the inclement weather. Now come on guys this is Manchester one of the wettest cities on the planet where us girls permanently keep collapsible umbrellas in our handbags. Get real it rains and in 3.5-inch heels we don’t rush around like men LOL

Anyway it wasn’t raining when I left Piccadilly station and I successfully dodged the showers all day so my little duck handled umbrella never appeared.

At Joana’s hairdressers Sarah confirmed that the scans showed she was having a girl. She knew and the divining was right – no surprise there. Anyway she’s blooming and everything is going well. Her daughter is due September 1st but she reckons she’ll be late arriving on her mum’s birthday. Yeah I said she’ll cause you lots of pain then pop out and say Happy Birthday Mum and scream the place down LOL

Had lots of chats with the girls at the salon and got told a few things that are too personal to repeat here. The consensus was I’d done the right thing in turning down the St Georges council flat as the south of Manchester is the “Wild West” though I was at pains to point out that I was only staying put to get PCT funding for surgery at some risk to my own safety from the Uttoxeter bigots from the factory. I looked at private rented rates for central Manchester and there are some brilliant places on the market if you have the income and I would have by now if it weren’t for my employer’s discrimination. Still I’m confident that will get settled in my favour.

So Joana cut my hair a bit shorter and with a more emphasised fringe. I’m well pleased as the induced stress from discrimination at work I’ve been under has aged me a lot and I no longer look younger than my true age. It’s therefore important to have a trendy style balance that’s not supposed to be exclusively for 20 somethings’ whilst avoiding the extra ageing curly perms/blue rinse approach. She did a brilliant job so I’m well pleased. It’s getting closer to a bob but it isn’t if you know what I mean. I think it’s cool and I left feeling more confident in myself exactly what the day was all about!

So there you have it. All the pathetic inadequate people have tried their best to destroy me and very nearly succeeded but they failed. Now it’s time to make them pay the price. I’ve forgiven them, I’ve paid to God what is God’s but I’m not letting them off the pay unto Caesar that which is Caesar’s bit…

Thursday, 24 April 2008

There’s always a defence but it isn’t a good one...

It’s been an interesting week since I last wrote in this blog. “J” my gay friend rang me “We need to talk about some human rights issues – can you be in White Hart tomorrow at 11am?

Well yes I got there at 11:20am, as he’s always late. No “J” so I ring him and he’s forgotten! LOL Anyway he can get there in 10mins and I have a nice glass of chardonnay so who cares. “J” arrives and in his inimitable style brings me up to date with his global exploits. I reciprocate with my issues of Transsexual & Transgender human rights. I’m not sure the White Hart is used to such discussions. When I’ve been there before it’s been should England play 4-4-2 or 3-1-5-1 or a diamond or…

Then I spent 3 days going through every evidence document, manual diary entries and blog entries cross referencing them to produce the most comprehensive chronological presentation ready for my Grievance Appeal hearing. It is devastating stuff now I can so easily demonstrate my version of events is true so I banged a copy off to the legal team as it’s a lot better than the one they did which I based it on.

I spoke at length to my Gender Consultant’s secretary and then to Mr Phil Thomas’s (my preferred surgeon) secretary. I got some excellent information for the special application for funding that my PCT will hear on 2 June. My GP has got until the middle of May to submit the application so I’m chilled as I’ve pretty much got everything I need.

Dr “LR” briefed me on the correct letter to send so that I don’t compromise my legal rights by agreeing to a one off meeting with a psychiatrist they insist on giving a second opinion. Done wrong it would weaken my potential legal case if it comes to a show down in the courts with my PCT but I won’t fall into that trap.

“L” has been magnificent by encouraging me but giving me time & space when I needed it. I’ve been waking up in the early hours scribbling down notes or double checking I have evidence so it’s been exhausting but it’s worth the effort.

Call on mobile, “Where are you?” “In the hall” I said, “well your doorbell isn’t working” LOL It was Chris! So I rehearsed my presentation with her over coffee until we fell about laughing at her statement “they really think they can defend that when you have the meeting minutes”? My reply was “Well yes there’s always a defence but it isn’t a good one!” LOL

We then got on to more interesting stuff before Chris went off to have her hair done and I went and paid my rent, got some food in and a present of Port & Stilton for her Dad’s birthday on Saturday. I’m addicted to mussels in white wine sauce at the moment it’s my Saturday night treat. Well OK that and some wine and chocolate too.

On the way to Lidl a lady driving a car pulled over and asked me to point her in the right direction. She’d come off at the wrong Uttoxeter exit off A50 yes we have two and I know we’re a one-tranny town too! Anyway point is we chatted with lots of eye contact and she didn’t “make me” Hey that’s better than last year’s dodging half full coke cans being thrown at me!

Chris’s hair looked great after her hairdresser had finished so we joked about Paul noticing, as men don’t. I always did when Chris & I were together but then I was a bit different LOL She said she told him yesterday “I’m having my hair done tomorrow” and this morning “Don’t forget I’m having my hair done today”. So he’s got no excuse when she gets home and does the hair flick LOL

Anyway I’m off to Manchester tomorrow to get my hair done & mooch about the shops to see if there are any bargains. I intend to go into next week’s meeting feeling totally chilled.

“J” rang tonight to ask me to see Janet Dean my MP regarding incitement to hatred against transgender people I think I’m an expert on that issue now so I’ll enjoy making a labour MP squirm. Hey ho the life of an activist is never dull or quiet. On the other hand perhaps I should get a certain fat Irish bigot to explain that issue to her but I expect she has already. After all with that law protecting transgender people I can think of a dozen people to arrest in this town. Now let me see shall I name them – Oh no I already have in my grievances! LOL

Friday, 18 April 2008

The trouble is you are so busy fighting the battles you can’t see you’ve won the war…

That was from Chris over lunch & coffee at mine after I’d showed her the letter & form from my PCT for Individual Funding for my surgery.

And she’s right!

We were discussing the offer of a flat I’d received from Manchester Housing and the effect it would have on my life.

OK there’s the obvious gain of walking away from the ignorance and prejudice of my employer, this town and the local PCT but at what cost to me?

At least here I know who & where my enemies are but most importantly I know their weaknesses.

Sure I gain a break from the intense psychological pressure they put me under but they do that to get me to give up, drive me away and achieve their victory.

I have the law, truth and justice on my side and now it is for me to choose the place of final victory.

So I’m not going to run I’ll finish the war here on my chosen ground.

I’ve put my belief in God & Love and the ultimate victory of Truth so my personal resurrection will be here…

Sunday, 13 April 2008

I’m sorry I don’t speak Celtic…. There’s tasty!

Wonderful Welsh humour line in Dr Who’s latest episode that is one of the best entertainment programmes ever produced. I’ve been a fan since William Hartnell first appeared. He was a lot more edgy than David Tennant’s incarnation. Adding Catherine Tate as the companion is a masterstroke. I was a huge fan of her beforehand as I think she is a comic actress of the highest order.

Dr Who is pure escapism entertainment at it’s best and it’s nice to just get away from the serious stuff for a bit.

Unfortunately there is more serious stuff around at the moment than I’ve ever known as capitalist greed produces some of its worst global excesses.

I am ashamed of England at the moment lead as we are by a Scottish accountant who knows the cost of everything but the value of nothing.

We have a global food crisis on our hands brought about by the conversion of food crops to bio fuel crops in the name of saving us from global warming. More like let’s reduce the power of the oil producing states by producing fuel from plants. OK we then haven’t got enough food to go around but who cares we’ve saved the planet. Nice eh?

Meanwhile lets make sure we have lots of nice guns and other military equipment to play with and that’ll make the world a safer and nicer place whilst we rip off the developed world by yet more inventive get rich quick money scams. The current financial market crisis gets more financial support than any human being in need of food to survive.

My Mum used to say the problem is men rule the world as women would not make such a mess and she was right.

Underneath the horrors of global capitalist exploitation lives a more fundamental evil the domination of women. We see this every day now in the poor souls forced to dress in “religious” approved clothing to satisfy the control instincts of men. The burka and all it symbolises is an affront to freedom and liberty for women everywhere.

I saw this picture on the BBC web site and found it most distressing. It symbolises all that is wrong in this world. The woman scrabbles in the dirt, in her approved clothing to salvage some food for her family whilst the soldier smirks in male superiority.

It mustn’t stay like this women must change the world…



The greatness of a nation consists not so much in the number of its people or the extent of its territory as in the extent and justice of its compassion.

Wednesday, 9 April 2008

South Staffordshire PCT policy

I've had a copy of My PCT policy on "gender dysphoria services" and if I was in any doubt about the institutional transphobia of the NHS then the document confirms it!

If I had the patience I'd rip it apart in detail as it demonstrates that the charlatan psychiatrists that control NHS policy don't actually remotely understand the condition.

Anyway that ridicule is for another day & blog entry LOL

This is my response to it in so that the legal battle is now defined!

FROM: Maggie Fiona Fox

09 April 2007

To: Mr XXX Director of Commissioning South Staffordshire PCT Anglesey House Towers Business Park Rugely Staffordshire WF15 1UL

Dear Mr XXX,

I am now in receipt of a copy of the Commissioning Policy & Referral Guidelines for Gender Dysphoria Services that has been sent to me via my GP Dr YYY.

For clarity:

I do not accept that these guidelines are applicable to me as I am legally female.

This is proof absolute that I have archived the result implicit in your guidelines of successfully living in a female role.

I therefore expect my request for funding to be considered by the Individual Treatment Panel.

I look forward to your response,

Yours sincerely,

Maggie Fiona Fox

Copy to Dr YYY & Dr R Curtis

Tuesday, 8 April 2008

A to Z of friendship...

I didn't write this "L" sent it to me as it rather neatly sums up how we feel about each other:

A TRUE FRIEND:

(A)ccepts you as you are
(B)elieves in "you"
(C)alls you just to say "HI"
(D)oesn't give up on you
(E)nvisions the whole of you (even the unfinished parts)
(F)orgives your mistakes
(G)ives unconditionally
(H)elps you
(I)nvites you over
(J)ust "be" with you
(K)eeps you close at heart
(L)oves you for who you are
(M)akes a difference in your life
(N)ever Judges
(O)ffer support
(P)icks you up
(Q)uiets your fears
(R)aises your spirits
(S)ays nice things about you
(T)ells you the truth when you need to hear it
(U)nderstands you
(V)alues you
(W)alks beside you
(X)-plains thing you don't understand
(Y)ells when you won't listen

Sunday, 6 April 2008

"Our policy has been to create the context for change, then to apply changes within that context."

That quote is from The Head of Change and People at Terminal 5 but it could have come from anyone in Government or the Department of Health.

Completely meaningless and irrelevant it neatly sums up my Primary care Trust who after two years of painstaking research have yet to decide on the clinical pathway for transsexual people. In other words they are trying to hide an illegal blanket ban on surgery by procrastination.

I’ve now got a copy of the reply to my GP to my request for funding for surgery. Here is my reply for your entertainment…

FROM: Maggie Fiona Fox
08 April 2007

To: Mr XXX XXX Director of Commissioning South Staffordshire PCT Anglesey House Towers Business Park Rugely Staffordshire WF15 1UL

Dear Mr XXX,

I am now in receipt of a copy of the response to my GP, Dr ZZZ, by your assistant planning manager and I am most concerned by the response that seems to indicate that the request for funding by Dr ZZZ has not been understood.

The request was for funding to be referred for surgery to Mr Phil Thomas based on the advice of my gender specialist Dr Richard Curtis.

After nearly two years of consideration that you still have to decide on “gender dysphoria services” is of no relevance other than if of course it were a disguised blanket ban on surgery it would be illegal. (Appeals Court Ruling N-W Lancashire Health Authority vs. A, D and G.)

The request for funding to a specific surgeon is due the complications of my underlying medical condition of severe Ankylosing Spondylitis that means I am significantly different from the general population (for example 50% lung capacity and no spinal rotation) to warrant individual recommendation for treatment as I will require intensive post operative care and minimal time in surgery.

The significant benefits being that I will stand a better chance of surviving the operation, minimise the risk of requiring additional correctional procedures and optimise after care recovery (including pain control) from the surgery being carried out by the UK’s leading surgeon in this field together with the specialist nursing facility that is in place at the Sussex Nuffield Hospital.

I think the problem may be that the Individual Treatment Panel could be confused by the misinformation on my condition regrettably permeating the NHS.

Gender dysphoria or gender identity disorder or transsexualism is a recognised medical condition for which the treatment sequence is simply assessment to eliminate any possibility of mental illness, provision of hormones under the care of a gender specialist and then surgery.

I have been assessed by one of your own psychiatrists and I have a HM Government approved gender specialist Dr Richard Curtis so there is no question regarding diagnosis and treatment.

I am on hormone therapy and have now completed two and half years living in my true gender and been awarded a gender recognition certificate on the grounds that this is a permanent change.

I do not require any “services”. I just naturally require surgery to complete the physical change. Risk now to my mental health is related to the chance of denial of surgery. I am fully aware of the consequences and risks of surgery and under the Mental Capacity Act of 2005 there is no basis to assume I am not competent to realise the consequences and make this decision.

In view of this I would therefore ask that you personally present my case directly to the Individual Treatment Panel as I have already provided more than adequate evidential documentation via Dr ZZZ.

I look forward to your response,

Yours sincerely,



Maggie Fiona Fox

Copy to Dr ZZZ & Dr R Curtis

Summary of my clinical case:

I have a HM Government recognised Gender Specialist that has recommended me for surgery with a UK surgeon.

The recommendation is due to my underlying medical condition.

I already have a totally effective hormone and anti-androgen regime that has dramatically increased my “acceptability” to the general public.

I exceed all the internationally accepted criteria for readiness for surgery.

I have a Gender Recognition Certificate and a female birth certificate.

My gender specialist is an approved NHS contractor to other PCT.

The surgeon I want operates within the NHS.

Finally may I commend that the PCT operates a policy that “funding for surgery will be provided to anyone who obtains a gender recognition certificate” as to get one you have to prove you are committed to a permanent lifelong change and exceed the criteria for surgery. If you haven’t already had surgery you have to explain why not!

Saturday, 5 April 2008

So who do you think you’re fooling…

I went to Manchester yesterday. Joana was out for day but the rest of the team were busy doing a great job. They are a happy crew and it shows. The big news is Sarah is pregnant. I’m so pleased for her as she’ll be a great Mum. Sarah is a lovely intelligent girl who has been totally supportive of me. She is someone I admire greatly.

We had the usual pregnancy chat and everything is going well. She’s convinced she’s having a girl especially as her Aunt’s dowsing test confirmed it. She’ll have a better idea at the next scan. She’s picked girls names as well but not boys.

That set me thinking what happens when a woman believing she’s having a girl in fact has a boy. Does her belief transmit to the unborn child? You could argue that for a time both life forces are dependent on each other with the spirits coexisting. But how much are they joined? OK we can define the physical part but what about the brain? When babies are born they already know certain things or they wouldn’t survive. Would that belief have transmitted & lodged somewhere deep in the subconscious of the child?

I get told today that I think too much about issues like that but having had a high level scientific education I can’t stop myself reading and researching as much as I can.

During the week I had an MSN conversation that I’m now ashamed of. I chatted to someone who calls himself or herself a woman though they work as a man and do not intend to take hormones or have surgery. They saw two categories cross-dressers and women. They argued that the world outside of work saw them as a woman so they were one and I ridiculed that. I was as bad as the worst of the bigots by defining categories rather than being inclusive. I’m sorry, I apologise.

It’s made me reassess my core beliefs and perhaps that’s no bad thing.

As usual I travelled through Manchester suffering no abuse though I was perhaps more conscious than ever of reactions to how I project. I think I’ve been kidding myself I can pass as female as all I’ve learnt to do is blend in more in an environment where people have other things on their mind.

I think Manchester is easier as well because I’m not the only transsexual in the city. I spotted one in Piccadilly station – it wasn’t difficult over 6 ft tall and huge frame. Her clothes didn’t give her away but her body shape did.

There is a tiny, tiny minority who can fool most of the people most of the time but the vast majority of us don’t and can’t. The male skeletal shape, the lack of hips, the facial shape, the brows, the Adam’s apple, the voice, the hands the feet, I could go on & on. OK some of those can be fixed by surgery but not all but there will always be something that reveals your male past.

So when I said that post-operative transsexual is a non-existent state I was wrong. It is in fact the best state that a male to female transsexual can ever achieve. You can never become a woman.

I wasn’t immediately obvious but now I discover that HM Government doesn’t just make a list of who is transsexual but it records those who are pre-operative differently to those who are post-operative. My friends who have had gender reassignment surgery get a birth certificate with girl on it but those who have yet to have this operation get female.

Now you may think girl = female but no it doesn’t. HM Government shows on your birth certificate you are adopted by listing your adoptive parents and using a country of birth not a town and county. This means you get just England if you are adopted so everyone who knows the rules (like every HM Government Official who might want to see your birth certificate) can spot it on a short certificate instantly (short certificates exclude parents names & occupations). The same applies with the sex column where they will only allow girl if you’ve had the operation. After all every one in authority must know that or society will break down!

So I feel cheated and betrayed in terms of my new birth certificate. That’s not a new pair of emotions as regards our glorious Labour Government who were forced into the Gender Recognition act by the European Human Rights Courts but really didn’t want to do it. Advised by Press for Change we have a mess that perpetuates bigotry but what do they care? Press for Change want the trans cross dressing agenda of the divine right to wear a skirt in public and stuff you transsexuals after all you are all mentally ill.

So where do I go from here?

One thing I know is that being a transsexual person is not a mental illness it is too fundamental to be one though I freely acknowledge that you get to a point where it is transition or die. I chose to stay alive and transition and looking back now it wasn’t my best decision.

I’ve had the Health Service refuse to fund my treatment or provide me with any support physical or otherwise.

I’ve had my employer flout the law, discriminate against me and treat me with utter contempt.

My local Union branch has betrayed me.

I’ve had a complete mental breakdown that the medical professionals [sic] won’t even acknowledge.

I’ve been ridiculed by a bigoted community and socially excluded.

I’ve found it impossible to build a relationship because friends and family of the person I love would not allow it.

The stress has made my Ankylosing Spondylitis worse and has aged me more than the benefits of anti-androgens and estrogens can fight.

I’ll battle on for a bit, as I don’t want my employer or the health service or the local community to get away with their discrimination without a fight.

The problem is that my will to live has been totally destroyed. I live for some justice so that those who follow me may find it easier but I know that it is unsustainable. I don’t fear death but I don’t love life anymore.

I’ll be pleased when all this is over and I don’t have to try to fool anyone anymore…