counselling

Trans* Jersey

An open letter to our trans partner

I am the wife of a trans woman who transitioned during our marriage. I am writing this to support partners as there are significant areas in common for us all but each of our paths on this journey may be very different. I also write to the trans person and just hope you both talk to each other. We want to keep our marriages intact.

There is no clear cut care pathway for partners here so do not be afraid to seek help and counselling. This journey can’t be done alone. Local GPs and counsellors are not specialists, so the more we speak up the more awareness will be raised. This is not a life choice for either of us; something that took me years to understand. I still ask myself: ‘why me’?

I had advanced notice before we got engaged that my husband was cross dressing since childhood. She agonised over telling me but we still got married and have now been together for over 30 years and married for 27. The prognosis for staying together is much higher if surprises and shocks are limited. We decided never to have children and life is a lot less complicated. However, it was still a shock when my partner decided to transition and, before I could understand the implications, she was self-medicating secretly. I went through hell. Women are good listeners and can be sympathetic, but I don’t like dishonesty, hiding or deception. We can detect little signs, and you may think your partner is having an affair if female clothing is found in the house which does not belong to you.

Helen and Betty 1For the trans partner: please remember that this is like a bereavement but with no body and no funeral. If you are going to throw clothes from your previous gender away warn your partner and, perhaps, allow us to keep some sentimental items – even if just for a while, so we can grieve in our own time. Acknowledge this grieving process is just like any other, it HURTS!

Keep open channels of communication at all times and also agree to stop talking if it is getting too much. My counsellor suggested we have a password to use if this is happening, and we then agree to talk later at an agreed time. So far that works for us.

The trans person may be tempted to rush into transitioning (coming out, HRT, ‘real life experience’ and possibly surgery) because it is a lifelong desire to change gender. For the partner, it is a constant ‘in your face’ tornado of selfish wants that completely ignores and threatens the relationship. The effects of HRT on the mind and the body are visibly shocking and can be upsetting for the partner who knew another person intimately. Thankfully, there are now several good books out there and web sites. Bear in mind that by ‘outing’ yourself as being trans, you do the same to your partner and they may be concerned about what others think. The partner of a trans person may worry about peoples’ perceptions: are we a lesbian couple, sisters, sisters-in-law…?

Our particular relationship has been strong enough to overcome this. My partner first attempted a kind of dual life of living as a woman outside work many years ago, but this time around its permanent and that was a big adjustment for me. In transition we now tend to avoid the same haunts we frequented because waiting staff would recognize me and wonder if I have a new relationship as we sit at the same table ordering the same favourite meals. Even in places we have never been to, the ‘couple’ in us still comes out as we say ‘we’ the whole time when talking. I have to be very blunt here and say a part of our success is that my partner is completely convincing and I doubt if I would remain if she was not. Do not ‘carry the monkey’: other peoples’ reactions are their problem not yours. Who to tell and when is up to you. We have now told all our best friends and family, but my partner’s family proved to be the most negative.

For me this is not a linear process either. I have not gone smoothly from timid enquiry, anger, depression, thinking and reading to acceptance. Some days are better than others. Several times I revisit each emotion forwards and then backwards. This is where counselling helps. You are not alone. Also, bear in mind this is no-one’s fault so try not to blame when you are at your most angry to accuse. If you think that is easier said than done, I totally agree as I am guilty of doing that often – even now. I was quite shocked in one professional counselling session in the UK to be told I had in fact married a woman all along! To be told it was all to do with conception, what happens in the womb and the brain was earth shattering. Read, read and read. I have found it quite fascinating, painful and absorbing.

Having gone through more than a woman should for love, my partner wants a Gender Recognition Certificate. In 2014 with same sex marriage legal, the process is still unclear for married people where a partner transitions and, yet, retains the same legal rights. The irony that we already live as same sex couples after surgery is lost on them.

To end on a lighter note; there have been many fun moments, e.g. I now get to buy more clothes than before as she understands the need, but co-ordinating what to wear out can be a laugh. In the end love is more important than gender.

(Photograph is not of the post author but of Helen Boyd and her partner, Betty Crow. Helen is the author of She’s Not the Man I Married.)

Trans* Jersey

Change management tools

These are Trans* Jersey’s top tips for managing the change that your transition will create for those closest to you. They are drawn from business theories of managing change in the workplace but we think that they work for us, too. If you want to keep your personal relationships intact during your transition, you will need to expend some effort to do so. It isn’t enough to shrug and say that it’s up to your friends and family to just accept what you are telling them. It’s not fair to them to dump the news on their doorstep with no support to help them understand it. It’s a two-way process; it’s up to both you and them.

Because gender dysphoria and transitioning is so poorly understood at present, you will need to be a bit of an educator as well as a manager of change within your “team”. Teaching may not be a skill that you currently possess but you can take a couple of short cuts.

1) Any teacher will tell you that lesson planning is a large part of the job. For us that simply means planning what we are going to say, when we are going to say it and to which audience we are going to say it. If you aren’t good at this, before any important conversation, write down what you want to say and don’t be embarrassed to use your notes.

2) Use the educational resources developed by others. Do your research to make it easy for you and those closest to you. Point your friends and family to websites, books, blogs, etc that do the educator’s job for you and don’t forget to follow up with them to allow them to ask you questions about what they’ve read.

changemgmtOur tips (taken from a number of business publications including the Acas advisory booklet on how to manage change):

  • Act quickly, the longer the uncertainty lasts the worse people will feel. The anticipatory phase of change can cause anxiety and stress. Communication needs to be built into the planning process for change right from the very start when you decide: the issues; objectives; audience; and message you want to communicate about your transition. Connecting with your team and laying the groundwork for open, honest discussions sets the stage for a connected and collaborative change. Ideally, this first phase needs to be done swiftly so that people hear the same message at the same time and do not hear about your transition through rumour. For more information about how to achieve this, see Trans* Jersey’s page on Transition Management.
  • Involve stakeholders at the earliest stage in planning change. Your friends and family cannot realistically be involved in the healthcare aspects of your transition but you can involve them in all the social aspects. Thoroughly outline the details of your transition and communicate the high‑level types of changes that will be happening to you. Don’t lose people to “denial”. Involve them early and often to avoid some of the darker valleys of Fisher’s Transition Curve. Accept any advice they offer and, if it fits in with your plan, include it. If it doesn’t fit in with your plan, explain why. Don’t be bullied into compromising or changing your plan – you are the manager of your transition and you have the final say in how it will work.
  • Tell the truth! It can be tempting to gloss over the more damaging impacts of change. Don’t compromise your truth to appease other people. It won’t work. You will be unhappy with a partial transition and they will never learn to fully accept your change. Change can be painful so don’t draw it out for those around you. Tell them you are transitioning and then do so!
  • Build on positive feedback – some stakeholders may be relieved or even happy that something’s been done at last. There will be people in your life who always knew that you were different and will be thrilled that you have finally found a way to express that difference and be happy. These people are your champions – use them. Ask them to chat to other friends or family members who may be struggling with your news.
  • Offer reassurance. Reassurance is really important. Your key messages may well be based on your immediate objectives for your transition. However, these can seem like a big step to someone who has not caught up to where you are in the process. Provide context for your transition that makes the changes taking place meaningful to individuals, such as talking about your childhood experiences of dysphoria with people who knew you then. Those people who love us are the ones who have invested the most in our lives. A lot of their fears and worries around our transition are going to be for our health and safety. Make sure that they know it is going to be okay, that you are getting the best advice you can and that you are taking sensible precautions to stay safe.
  • Consult with stakeholders as soon as possible. Early warning of changes to your plan or new things that are happening to you during your transition can help people adjust. Hormone therapy, for example, is not an exact science. Everyone reacts differently. If your hormones are affecting you emotionally, let your friends and family know as soon as possible.
  • Be clear and consistent about the message you are putting across. This refers to good “lesson planning” again. Plan important conversations well in advance. Don’t rush them. You may only get one opportunity to say what you need to say so it needs to be clear, concise and easily understood by the person receiving the news. Try to keep your important communications short and to the point. Don’t “kitchen sink”. People can only be expected to take in two or three key messages at a time.
  • Think about the way you communicate. The more face-to-face communication you have with stakeholders the better. You may not be able to answer all questions during one session so consider using emails or newsletters to respond to queries. Always use plain English. Avoid jargon, it will only dilute your message and confuse your audience. See Trans* Jersey’s page on communicating assertively.
  • Address personal concerns and give stakeholders the chance for questions – constructive criticism can be very positive! Questions are good. It means that your friends and family are engaging with your transition and want to know more. Try to be patient, open and honest with their inquiries. If there are questions that you do not feel comfortable answering, say so but make it clear that it is fine for them to ask any question they wish, you just reserve the right not to answer.
  • Recognise how individuals feel. Taking regular “mood checks” on how people are feeling at different stages of the change will help you plan your communications strategy. Become a good listener and use the Transition Curve to help understand where people might be struggling with your transition. You should be able to work out what messages are not getting through or how to tackle any resistance to change. Be patient and try to help these people move on in their acceptance of the change. Rather than lecturing friends and family about how they should be feeling about your transition, a  better tactic is to ask questions to get them to explore why they feel like that.
  • Plan for stakeholders who cannot accept the changes and want to leave. Despite your best efforts, you may lose a friend or family member in the course of your transition. If you do, accept the loss of that relationship and allow yourself time to mourn that loss. Don’t expend energy on someone who refuses to take your journey with you. Let them go. You never know, they may realise that their life is poorer without you and come back in the future.
  • Provide training where necessary for new duties or procedures. Again, this speaks to the need to educate those around us about our transition. This doesn’t only include the clinical facts about gender dysphoria, hormones and surgery, but also includes educating our friends and family about who we are and how we want to be treated by society now.
  • Keep communicating. Don’t communicate for the sake of it but don’t be afraid to repeat your messages. Remember everyone will be at different stages in coming to terms with the change happening around them. See Trans* Jersey’s page on communicating assertively.
  • Offer strong leadership and motivation. This is your transition and, if you don’t own it, nobody will. Be clear about what you want from it and stick to that goal. To keep your transition in a positive place, inform and educate your stakeholders about the benefits of your transition and the good things that are already coming from it. You want to build confidence. Being open and positive about it will attract support from many more people than just your friends and family for what you are doing. Being shy or, worse, embarrassed and ashamed of your transition will provoke the same reaction in others. Everyone likes to be associated with success so you need to put in the work to ensure that your transition is the success you want it to be. Inspire them by helping them to visualize the future and their new role in your life!
  • Provide counselling where appropriate. For those people struggling with your transition, suggest that they go and see their GP to get a recommendation for a few counselling sessions to help them process the change that is happening. Be prepared to have this suggestion rejected – some people still have a stigma about going to see a counsellor – but make the offer none the less. The counsellor doesn’t need to be a gender specialist. Coping with change is within the remit of most psychologists. Your friend or family member should be able to get this counselling covered by their medical insurance or through the Jersey health service.
  • Set up a working group to work on specific problem areas. Where you encounter resistance to your transition, recruit your champions to help you. Ask them for their advice on how to approach the person who is resistant, ask them if they will have a chat to the resistant person for you to find out what might be bothering them, or ask them to accompany you as a mediator for your conversation with the person who is resistant.
  • Involve stakeholders in reviewing ongoing changes. There are lots of mini-milestones in transitioning where you can involve other people. Friends and family may feel honoured and, therefore, more invested if they are asked to be included at a moment that has significance for you. For example, ask them for their input when you go shopping for new clothes, MtFs might ask female friends and relatives for make-up advice, FtMs might ask male friends and relatives for tips on how to “talk sports”, take a friend or family member with you when you change your name or get your new documents, etc.
  • Celebrate successes. About a year into your transition, you will know who your supporters are and the hard work of managing your friends and family’s reaction to your transition should be behind you so make sure that you do something to thank them, maybe have a “transition anniversary” party or send everyone a personalised card thanking them for their support. Your friends and family will appreciate the gesture and it will be a way of marking the end of your role as the change manager for your “team”.
Trans* Jersey

MtF timeline

For those who are still questioning their gender, take some time to read this site, to surf the Internet and watch video clips uploaded by transwomen, to read some of the excellent personal accounts of transitioning available as books from Amazon, and to feel comfortable with the idea that you are trans*. This is an important step and not one that should be hurried. It can take years to reach a point of ease with who you are.

However, it is worth reaching that point before you more forward with your transition, especially in Jersey. We all know how quickly news travels in small communities, more so than in a big city. You are unlikely to be able to keep your transition a secret in the island. You need to be prepared to ‘out’ yourself to all sorts of people in order to get their help and you can only do that if you are proud and confident about who you are.

Having reached a place where you know that you are transgender, your first point of contact is your doctor/GP in Jersey. Explain to them that you are unhappy with the gender assigned to you at birth and that you would like to start the process of transitioning. Ask your GP to write a letter of referral to a gender therapist (if going the privately funded route) or to a psychiatrist within the health services in Jersey (if going the publicly funded route).

There are no gender therapists in Jersey so you will have to go to the UK for counselling. Your GP can either refer you privately to a gender clinic of your choice or your Jersey psychiatrist can refer you through the NHS to the Charing Cross Gender Identity Clinic. The advantages of going private are that you control the timetable and can get things moving as quickly as you need to. The disadvantage is that you pay for private consultations (see the finance page). The NHS route is free but you are stuck with their timescale.

Remember that your therapist is not there to ‘judge’ you. They are there to help you make sure that transitioning is what you want to do. Therapy is a time for you to ask questions about transitioning, to be honest with yourself and answer the therapist’s questions as openly as you can, to think about alternatives to transitioning and to understand why they are not an option for you, and to double-check your feelings with an impartial and skilled observer.

Depending on how you and your therapist feel about your readiness to transition, the next step is either to change your name by deed poll to the name by which you want to be known going forward or to commence hormone therapy.

For more information about changing your name and all your documents, see the change of name page.

evolution-womanJersey has the necessary skills on the island to administer your hormone therapy, which will be a lifelong commitment to taking estrogen, progestogen and antiandrogen in some form. Your therapist will need to provide a letter to your GP or psychiatrist recommending that you commence hormone therapy, the appropriate delivery method of the hormones and the doses that you require. Your GP or psychiatrist can then refer you to the island’s endocrinologist. This can be done privately, for which you will pay, or you can be referred through the States system, which is free.

For more information about hormone therapy, see the hormones page.

This may be as far as you wish to go in your transition. You may consider the changes made by the hormone therapy sufficient to allow you to pass as a woman. However, you may elect to undergo one or more surgical procedures to further feminise your body. If so, you will need to leave the island again for your operation(s). Jersey has no surgeons who can perform this specialist surgery. You will need to decide whether you wish to pay for surgery privately or whether you are prepared to wait for surgery in the UK through the NHS.

If you elect to have surgery through the NHS, you need to ask your NHS therapist to place you on the NHS waiting list.

If you elect to have private surgery there are two advantages: you can choose your surgeon, so you can choose to see anyone in the world who takes private patients, and the timing of your surgery is your choice. You should research your surgeon carefully, taking time to read testimonials from transwomen who have had surgery with them. If you are unsure about your choice, ask your GP for their opinion.

Once you have selected your surgeon, contact them directly. You do not need to go back to your GP for a referral. However, the surgeon will undoubtedly want a letter from your therapist or GP referring you after you have made the initial contact.

For more information about surgery, see the surgery page.

Finally, take ownership of your transition. If you are not getting the answers you require from your health professional, keep asking until you do. Research as much as you can and prepare the questions you want answered before every consultation. Your Jersey GP may never have taken a patient through a transition process so you may need to guide them on what they need to do next for you.

Trans* Jersey

FtM timeline

For those who are still questioning their gender, take some time to read this site, to surf the Internet and watch video clips uploaded by transmen, to read some of the excellent personal accounts of transitioning available as books from Amazon, and to feel comfortable with the idea that you are trans*. This is an important step and not one that should be hurried. It can take years to reach a point of ease with who you are.

However, it is worth reaching that point before you more forward with your transition, especially in Jersey. We all know how quickly news travels in small communities, more so than in a big city. You are unlikely to be able to keep your transition a secret in the island. You need to be prepared to ‘out’ yourself to all sorts of people in order to get their help and you can only do that if you are proud and confident about who you are.

Having reached a place where you know that you are transgender, your first point of contact is your doctor/GP in Jersey. Explain to them that you are unhappy with the gender assigned to you at birth and that you would like to start the process of transitioning. Ask your GP to write a letter of referral to a gender therapist (if going the privately funded route) or to a psychiatrist within the health services in Jersey (if going the publicly funded route).

There are no gender therapists in Jersey so you will have to go to the UK for counselling. Your GP can either refer you privately to a gender clinic of your choice or your Jersey psychiatrist can refer you through the NHS to the Charing Cross Gender Identity Clinic. The advantages of going private are that you control the timetable and can get things moving as quickly as you need to. The disadvantage is that you pay for private consultations (see the finance page). The NHS route is free but you are stuck with their timescale.

Remember that your therapist is not there to ‘judge’ you. They are there to help you make sure that transitioning is what you want to do. Therapy is a time for you to ask questions about transitioning, to be honest with yourself and answer the therapist’s questions as openly as you can, to think about alternatives to transitioning and to understand why they are not an option for you, and to double-check your feelings with an impartial and skilled observer.

Depending on how you and your therapist feel about your readiness to transition, the next step is either to change your name by deed poll to the name by which you want to be known going forward or to commence hormone therapy.

For more information about changing your name and all your documents, see the change of name page.

timelineJersey has the necessary skills on the island to administer your hormone therapy, which will be a lifelong commitment to taking testosterone. Your therapist will need to provide a letter to your GP or psychiatrist recommending that you commence hormone therapy, the appropriate delivery method of the testosterone and the dose that you require. Your GP or psychiatrist can then refer you to the island’s endocrinologist. This can be done privately, for which you will pay, or you can be referred through the States system, which is free.

For more information about hormone therapy, see the hormones page.

This may be as far as you wish to go in your transition. You may consider the changes made by the hormone therapy sufficient to allow you to pass as a man. However, you may elect to undergo one or more surgical procedures to further masculinise your body. If so, you will need to leave the island again for your operation(s). Jersey has no surgeons who can perform this specialist surgery. You will need to decide whether you wish to pay for surgery privately or whether you are prepared to wait for surgery in the UK through the NHS.

If you elect to have surgery through the NHS, you need to ask your NHS therapist to place you on the NHS waiting list.

If you elect to have private surgery there are two advantages: you can choose your surgeon, so you can choose to see anyone in the world who takes private patients, and the timing of your surgery is your choice. You should research your surgeon carefully, taking time to read testimonials from transmen who have had surgery with them. If you are unsure about your choice, ask your GP for their opinion.

Once you have selected your surgeon, contact them directly. You do not need to go back to your GP for a referral. However, the surgeon will undoubtedly want a letter from your therapist or GP referring you after you have made the initial contact.

For more information about surgery, see the surgery page.

Finally, take ownership of your transition. If you are not getting the answers you require from your health professional, keep asking until you do. Research as much as you can and prepare the questions you want answered before every consultation. Your Jersey GP may never have taken a patient through a transition process so you may need to guide them on what they need to do next for you.