Imagine waking up each day feeling not right, feeling socially and professionally isolated with overwhelming obsessional thoughts and feelings of guilt affecting your ability to function normally or practice effectively.
I have a condition known as gender dysphoria. Other terms include gender incongruence, transexualism and transgender.
I have undergone gender reassignment surgery and also feminizing facial surgery , I am now a ‘trans’ woman
Gender dysphoria affects 21 in 100,000 with up to 1500 new cases presenting each year for treatment and the rate of presentations rapidly increasing year on year. This rate compares with a similar number of cases of bacterial meningitis presenting each year in the UK. Males make up 80% but like many conditions the number of females presenting is increasing. At 30-40%, the suicide rate is 25 times the average for the whole population.
Treatment is often 100% successful and often life saving but can be difficult to access. Two out of three general practitioners have no experience dealing with these patients, they are often treated with little sympathy by the general public the media and society in general. They are often ridiculed and humiliated and may experience verbal and even physical abuse.
Recent studies show brain structure to be different in ‘trans’ women and ‘trans’ men, this indicates that there is probable a genetic component to gender dysphoria.
A visit to the GP’s waiting room can be a frightening experience because of the negative reaction of the general public.
I worked as a GP for 29 years , for the first 21 years as a man.
I initially self referred to a psychiatrist outside my area, I thought my situation was impossible and had feelings of guilt and suffered from highs and lows when I would have frequent suicidal thoughts. I started to have facial hair removal treatment and a series of facial cosmetic procedures, I had counselling and was referred to a gender identity clinic, I had speech therapy and eventually had GRS (gender reassignment surgery) with breast augmentation in Thailand after completing one year of real life experience as a female. I was able to continue to practise but only after the GMC insisted I be examined by two psychiatrists to confirm I was fit to practise.
My PCT instructed me to write and inform all 12,000 of the practice patients, I was stalked by the local press who eventually manufactured and published a story and syndicated it to six national newspapers and two Sunday newspapers, despite receiving no comments from me.
The reaction from family, friends, colleagues and patients was both negative and in cases very positive.
I lost some very close friends, I received one unpleasant letter from a patient, I received many letters of support from patients and the practice staff was very supportive.
To be transgendered is to be lumped together with lesbian, gay and bi-sexual organisations but this condition has nothing to do with sexual preference. It is a hard and long journey for most trans people with many difficulties to overcome even after treatment.
There is often controversy over gender identity during major sporting events; this year’s success with the Paralympics shows that we can enjoy and accept the talents of sportsmen and women with physical disabilities and gender dysphoria is portrayed in popular films and television series. I hope that with greater understanding will also come acceptance.
Dr Wensy Peters is a retired GP from Gosport