Was I Burned Out?

I’m back at work now after a five day break over the Christmas holiday and I’ve managed to arrive before 9 am two days running! This might not sound like much but over the past few months I’d been regularly starting between 10 and 10:30.

I was finding it difficult to get moving in the mornings. The alarm would go off at 7:30 am and I’d need every minute of the two hours before I had to leave to stumble through my routines and get ready for work. Saturdays were usually spent in PJs, slippers and robe, often not being able to summon the energy to wash or dress.

The start of the holidays was like that. Whole days spent watching shows and movies on Netflix. But then, after two “lazy” days, something changed. After about nine hours sleep I woke up at 8 feeling refreshed. I might still not have done much, but what else are holidays for? The change was that I felt alert, like a fog had cleared from my head, like weights pulling down on my limbs had sloughed away in the night.

I guess I really needed the time off. Time to rest and rebuild my energy. Time to gather a stockpile of spoons. I’d had no idea how exhausted I had become, but looking back I can see how I was trudging zombie-like through the days, going through the motions without much conscious thought.

You see, this is one of the down sides of autism. Many of us really have no idea when we’ve pushed ourselves too far, too hard, and our bodies are at the point of collapse. The warning signs don’t get picked up in time, if at all. And then it takes time — days — to recover.

How did I get to that point? How could I just ignore the signs? Well, the answer is that I just didn’t notice. I suppose one of the effects of tiredness is that it reduces awareness of the state of the body. In my case this doesn’t have to drop far before it’s hovering around zero.

The way to prevent this would probably involve planning ahead and putting breaks in place before I get to the point of needing them. But when am I likely to need them? I don’t know. If anybody has any suggestions I’d love to hear them.

One Step Closer

One week ago today I was in London attending my first appointment at the Charing Cross Gender Identity Clinic with one of their resident psychiatrists.

Although I was excited by the prospect of getting one step closer to accessing medical treatments for my Gender Dysphoria, I’d not been looking forward to traveling up there by train. I find using public transportation particularly stressful even when I’ve planned the journey meticulously: being confined in a small space with a group of strangers for a length of time causes me anxiety.

I worked until 11 am and then drove home via a store to pick up something quick and simple for my lunch during a brief stop at home before freshening up my makeup and heading out again to Farnborough, leaving myself plenty of time to park, walk to the station and buy my ticket. So far so good! The train arrived 15 minutes after I had taken a seat on the platform to wait, and I boarded along with several other people.

The carriage was about half-filled and I managed to find a seat next to a window. I much prefer to spend the journey staring out the window rather than risk making inadvertent eye contact with some person as I glance around inside the carriage.

It was about 45 minutes later that the train arrived at London Waterloo where I had to head to the Tube station to continue my journey. I don’t enjoy using the Tube, but it’s preferable to either the expense of a taxi or the uncertainty of trying to navigate bus routes. The only thing I do enjoy about the Tube is thoughts of Neil Gaiman’s Neverwhere that are evoked by the names of the stations as I pass through them or see them on the maps: Knightsbridge, Earl’s Court, Blackfriars.

One change at Piccadilly Circus and I arrived at Barons Court, the closest Tube station to the clinic. A short walk (0.7 miles according to Google maps) brought me to the clinic and I pressed the door buzzer to be let in. Through the door, up the stairs, through another door and there I was at the reception desk.

I handed my appointment letter to the receptionist and confirmed my details (name, home address, doctor) before being asked to take a seat in the waiting area. I had a little trouble picking up what the receptionist said because she wasn’t facing me as she spoke, instead looking down at the paperwork on her desk, and had to ask her to repeat herself a couple of times. I rely on lip reading to a degree when somebody is speaking so that I can better make out the words.

I sat down. I had arrived half an hour before my appointed time, which allowed me to sit and relax after the journey. I let my mind wander, daydreaming, and it seemed that very little time had passed when I heard my name called by the psychiatrist I was due to see. I followed her to her room and she began my assessment.

I was a little nervous at the start, but the opening question, “Why are you here today?” was easy enough to answer since it is something I have been thinking about since before I came out last year. The questions were quite comprehensive and covered my medical history, family, home and work situations, and my experience of gender non-conformity up to and including transitioning.

We established my priorities for treatment (facial hair removal, hormones, genital surgery, voice feminization) and I was pleasantly surprised when she said that they could apply for funding to cover electrolysis or laser hair removal. I guess it’s because it’s such a major issue for me: I had no hesitation in identifying it as number one on my list because it’s the thing I focus on every time I look in a mirror.

Hormone treatment came second because I need the changes they bring to body shape (breast development and redistribution of body fat) to reduce the gap between my self-image and my physical reality. Genital surgery was a definite yes, although it was only when she asked directly about the mechanics of sex between me and Anne that I actually realized how much of an obstacle the wrong genitalia has become.

Voice coaching was not something I had thought much about. I had largely resigned myself to getting called “sir” on the phone. It got added to the list after I talked about how I used to enjoy singing karaoke now and again, but haven’t felt able to do so since I transitioned because my voice has too low a pitch. I joked that I’d never be singing soprano whatever happened, to which she responded that I might be surprised how much a voice can change. I decided then that it was definitely worth a try.

That completed my first assessment. I was asked to make an appointment for my second assessment (with a different clinician) which will be in 6 months time, and sent for blood tests at the neighboring Charing Cross Hospital. Once they had drawn the blood samples it was all over, time to head home.

It all seemed to go very smoothly. There was no hint of judgement in relation to my expression of my gender identity, my age at transition, my sexual orientation, my depression, anxiety or poorly-developed social skills. I simply responded to the questioning and put across how I felt about the mismatch between my physical body and my gender identity. In other words, the reasons why I need medical treatment.

The journey home was difficult. It was the middle of rush hour (5:30 pm) with thousands of people crowding the trains and station concourse. It was only my determination and desire to get back home that stopped me from finding some cafe to sit and wait for everywhere to become less crowded. It was standing room only on the train out of Waterloo, passengers filling the aisles with barely six inches between me and the people around me. Luckily the majority of passengers left the train at the first stop, the commuter town of Surbiton, and I could sit for the rest of my journey.

It was with relief that I stepped from the train on arriving at Farnborough, and despite the light rain I enjoyed the walk to where I had parked my car. Getting into my car felt so good. I was finally back in my own space, able to relax and feel safe. The roads were not busy and it didn’t take long to drive home where I could put my feet up, relax with a glass of cider and spend the remainder of the evening with Anne: that was when I realized just how tired I was.

It took a couple of days before I completely got over the exhaustion from the traveling, but it was well worth it to progress past another milestone on my path to fully realizing my identity.

We Care A Lot

Being a carer is hard work at times. Don’t get me wrong: I’m not complaining. I do it through choice. But lately caring for Anne has become a whole lot harder. Her illnesses have gotten worse and she has become very depressed, frequently experiencing suicidal thoughts.

I can’t switch off from it. I’m receptive to her state of mind, and — believe me — when you’re prone to depression yourself it’s extremely stressful to feel the echoes of somebody else’s. It negatively affects my own emotional state and after a while, day after day, it builds up to the point at which I have to do my best to shut off. To lock myself away and wait for the overwhelming feelings to recede.

It is exhausting. I have found myself needing to take a break more and more often. And that is a cause of stress in itself because I feel guilty for failing to be there constantly. She relies on me, she needs my help, and I’m not always able to respond.

I’m aware that I’m not looking after myself as well as I would normally. I’m mostly subsisting on take-out food and candy. Things like washing are falling to a bare minimum. I’m becoming snappy far too often, my motivation is poor and I’m feeling low. Oh, and aspects of my gender dysphoria are increasingly intruding on my thoughts.

There is a feeling that I’m losing control, adrift and at the mercy of life’s currents. I know from past experience that this is a dangerous situation for me because it is a powerful trigger for self harm: cutting in my case. The thoughts and impulses are there, even as I write this. I sat for about an hour over the weekend holding a blade, just thinking about using it.

I haven’t yet because I do consider it something of a last resort. I’m just concerned that the time when I yield to my impulses is getting closer by the day: the time when I will regain the illusion of control over my life, at least for a while. The temptation is strong but so far my fear of falling into the cycle of dependency has stayed my hand.

The Opposite of Hugs

I love hugs. That comforting feeling of envelopment engendering an ambiance of safety in the folds of a loving embrace. Sometimes my need is so great and the release so totally involving that I am reduced to tears.

It is said that a thing is known by its opposite, and that is true of hugs for me. Because there are times when I yearn, when I physically ache for those few moments of relief. To be held tightly and be able to let go of all my immediate fears and worries.

My need manifests as a feeling of absolute emptiness. My heart is a void that cries out to be filled with that demonstration of love, of physical closeness. Such a desolation of spirit. I am exposed, flayed, eviscerated. Left as an empty husk of a person.

My world is without light; all I see is shadows of what surrounds me. Until I am released by the touch of another, bringing a golden light into my darkness, restoring my pain-wracked body, showing me that there is hope. Giving me another day to live.

Trust and the Poetic Form

Trust is such an important concept. I couldn’t get by without the trust I have in my wife to handle certain aspects of my life. And trust extends to the readers I have here: I trust you to interpret what I write in the way I intended it.

That goes especially for my poetry (not that I have a particularly high opinion of my scribblings, as I’ve mentioned before). But still, I use poetry to capture images in my mind and can only hope that some echo of what I see id transferred to my readers. Some thoughts are easier to represent in a form other than prose. Poetry provides the means to stimulate a reader into an expectation of an interpretation beyond the literal.

This strikes me as ironic given my own literal inclination. The strange thing is that to me what I write in poetic form is literal. It’s a translation of what I see in my mind’s eye into words.

The potential problem is that it might be too dependent on my own experiences, my own response to particular words and phrases. But I persist because I trust that my readers will understand my meanings. After all, I believe that we have more in common than not.

Plus ça Change

Flicking through channels on the TV last night, looking for something to watch (anything as long as it’s not endless re-runs), we came across a show on TLC called Body Bizarre that featured a transgender couple. I have to admit I wasn’t expecting much: the show’s sensationalist title as good as tells you this is going to be a modern-day freak show.

Sadly I was proved right. The narration did use pronouns correctly and showed the two young people just living normal lives, but that was as good as it got. The show fell back on old stereotypes, using terms such as “born a boy”. Most cis (non-trans) people won’t pick up on this as problematic, but it is an inaccurate and misleading description because it implies that the person’s gender identity has changed: that they have chosen to be a different gender. I am female. I was born female, but the gender I was assigned at birth was male. I was not “born a boy”, I just looked like one.

The other serious problem with the reporting in this show was the focus on genital surgery. Somebody watching this who didn’t know any better would think this is the biggest part of transitioning and would not be aware that a large number of trans people opt not to have these procedures. In fact the process of transition was barely mentioned: you would think that it was like flipping a switch. Male one day and female the next. There was no suggestion of the difficulties faced by somebody who is transitioning, or of how long the process can take.

The picture of transgender life painted by this “documentary” was so incomplete and slanted that I feel it only qualifies as factual on a technicality: the few facts presented seemed to be accurate. It provided little information about gender dysphoria or its treatment: considering that the channel is called TLC — The Learning Channel — it was mostly free of any educational value. The superficial treatment of a condition that is associated with shockingly high levels of depression and suicide did nothing to further anybody’s understanding and does not benefit trans people.

There are documentaries that provide in-depth coverage of this subject, that portray their trans subjects accurately and with respect. That will educate their audience and give them some insight into our lives. That will foster the understanding that leads to acceptance. I know: I have seen some of them. This was not one.

Ghost Story

Perception is a strange phenomenon. Seeing is not really believing, and while the truth may be out there, there’s no guarantee it’s standing up and waving its metaphorical arms to be noticed. I don’t believe in ghosts, but…

I was about 8 or 9 at the time, lying in my bed that was up against one corner of my bedroom, the long left side against an outside wall. Beyond the foot of my bed in the same wall was the window, a large 6′ x 4′ single pane. Closed. I was waking up although it was still dark — I don’t recall what time of year it was.

All was still and quiet, no sounds from the rest of the single-story house. Not from my brother’s room next to mine, nor from my parents across the hallway. It was as if I was alone in the world.

But then I became aware that I was not alone. There was somebody else in the room with me. Standing next to my bed, looking over and down on me was a figure. Standing to my left, where the wall should have been. A young woman with dark hair, wearing a simple long white dress.

I guess I ought to have been scared by her impossible nature but she was a comforting presence, radiating calm and peace. She never moved or spoke, and I could not describe her face to you at all, but she had a beauty and elegance to rival any fairytale princess.

I hadn’t noticed her arrival, nor did I notice when she vanished never to be seen again. I’ve never forgotten her. I wonder sometimes who she was. Was she some figment of my imagination? Was she perhaps an angel watching over me? Or was I seeing my future self, the person I am inside?

I don’t know, will never know the “truth” of this experience. It was mine alone, and I must make of it what I will. But I still don’t believe in ghosts.

I Support @Sonnolenta

The story so far: this open letter on a friend’s blog calmly and rationally asked a number of the chefs from TV’s Iron Chef and Chopped to consider alternatives to Autism Speaks (AS) when supporting autism charities and autistic people. It sets out the well-publicized issues with AS’s repeated negative portrayals of autism and autistic people as tragic, broken and a burden on the rest of society. Portrayals that strongly suggest the lives of autistic children are defined by suffering; that carry the unspoken presumption that it would have been better if autistic people like me and many of my friends had never been born.

Please take the time to read Cristiana’s letter. It was written in response to her autistic son’s reaction to discovering that chef Michael Symon was to donate $50,000 to AS. She pleads from the heart as well as the head for autism organizations such as ASAN and AWN to receive the recognition they deserve. Let me be clear: she is not demanding that anybody cease their support for AS just on her say-so. Rather, she sets out the evidence to support her case, and asks that the reader makes an informed decision based on that.I’m posting this to signal boost because she could use all the support she can get in this. If you agree, please add your voice to hers and show that we are not just a few isolated individuals but an active community.

Thank you.

My Experience of Gender Transition

It’s over seven months now since I transitioned to living full-time as a woman and I think it’s a good time to review what has happened in that time and what I’ve learned.

My Work Transition

At work

Hard at work (soundtrack by Green Day)

The time has certainly flown. It doesn’t seem so long since I first turned up at work as Alex. Perhaps preparation was the key — I discussed it with HR beforehand — but it went without a hitch. I visited a local solicitor on a Friday evening to have my Statutory Declaration — my legal change of name — witnessed. I had printed several copies of my own document based on a template on the Citizens’ Advice Bureau web site. The solicitor checked the wording and I had four of them witnessed at £5 each. Quite a bargain! and I ended up with four original documents from which I made a number of photocopies. (Some organisations require an original when changing one’s name; most do not.)

The following Monday morning I arrived at work as a woman for the first time and sent a company-wide email in which I simply stated that I am a trans woman and I had changed my name. I included a brief description and links to information on the web as well as two of my own blog posts.

The reactions ranged from total indifference to active support, and sitting here months later I can say that I have not had a single negative experience at work. Understandably, since I had been in the job for seven years as a male, some people have slipped up occasionally with pronouns but they correct themselves and I just let it go as an honest mistake.

Changing my name on my employment records was straightforward with a copy of the declaration for my personnel file, and I had already contacted the Inland Revenue and my bank to inform them so that all my details would be in step. I was issued a pass in my new name with an updated photo, and my company login and email address were altered that same day.

What Happened Since

When I transitioned at work I was taking medication for depression that was caused by my gender dysphoria. I’ve written about that before, but I’ll just summarise: the SSRI pills (Citalopram) helped a lot initially with the low mood, loss of appetite and poor concentration, but I did suffer moderate side-effects including nausea and disturbed sleep. After I transitioned I increasingly felt that the negatives of the medication were outweighing the benefits, especially since transitioning improved the circumstances that were the main cause of my depression.

Now that I’ve been off the pills for several weeks I feel more myself. I’m better motivated, I’m sleeping well, my appetite is normal and I’m able to concentrate fully. I do still feel very low at times — the depression hasn’t been magically cured — but it’s manageable.

My relationship with my wife, Anne, continues to be strong even though her illness means we have not been out socially at all since New Year. Her support is another factor helping me cope with my depression.

What I’ve Learned

I went into my transition with an open mind and only the minimum of planning — not one of my strengths. All I have — all I need — to guide me is my self-image. I know who I am and the steps I take along the way are to bring me closer to that.

That’s not to say I didn’t learn all I could about transitioning, about the various options for medical treatment and about other trans people’s experiences through their writings. There are a number of things I’ve learned; some practical, some important and some trivial.

  • There are no “right” or “wrong” ways to transition, no particular order in which steps must be completed. Indeed, there are no compulsory steps at all. It’s important to find what works for you because your situation and individual needs will be particular to you.
  • It takes longer to get ready in the morning. Showering, dressing, applying make-up and styling my hair means that my morning routine is longer and more time-consuming than it used to be. Rather than get up earlier I now start work later. (I’ve never been a morning person!)
  • I am very self-conscious about my facial hair. I have not yet had any form of hair removal treatment so I rely on shaving my face and reducing the shadow using make-up. I am reluctant to go out the door, even into our back garden, without at least a shave and some foundation.
  • I hate shaving my face! I have sensitive skin and after shaving it is always reddened, dry and sore in places. I also, despite all my years of experience, still manage to cut myself with the razor more often than not.
  • Pretty much everybody I interact with at work and outside just treats me normally. Maybe I shouldn’t be surprised, but I kind of expected to be regarded as a bit of a freak. This was one of my most pleasant surprises.
  • I feel more vulnerable when I’m out on my own than when I was presenting as male.
  • The NHS services for the treatment of gender dysphoria are seriously under funded and under resourced. It took over 6 months to even get a response from the Charing Cross clinic after my referral, and it is likely to take many more months before I get my first appointment for assessment. All this is required before any treatment such as HRT will be considered.
  • There is more variation in the sizing of women’s clothing than men’s. One item labelled size 20 (UK) could be equivalent to another labelled 16. Being able to judge a garment’s size by eye is a useful skill to develop.
  • Driving in heels doesn’t affect my control of the vehicle but can cause a lot of wear on the backs of the shoes. I now wear flat shoes for driving and change when I get where I’m going.
  • Having my ears pierced didn’t hurt much at all. I guess the earlobes are not very sensitive.
  • It’s not worth spending a lot on clothes when starting your wardrobe for your new gender role. It takes time to learn what colours and styles suit you, and what feels most comfortable.
  • It is worth having a reasonable budget for shoes, and taking your time when choosing them. Don’t forget that any shoes for work will be on your feet all day, so don’t sacrifice comfort for looks.
  • Sports bras that have built-in padding work great with breast enhancers (aka “chicken fillets”). They’re comfortable, keep things in place well, and the pads smooth out any “lumps” as well as adding a little extra size.
  • A lot of women’s clothes use softer fabrics than men’s, which is a bonus for someone like me who has above normal tactile sensitivity.
  • Fancy outfits are fun and great for going out (or to work), but don’t forget to include something casual for popping down to the shops, lounging around watching movies, and doing chores. As much as I love a dress and heels, I find a T-shirt and leggings or pyjamas are most comfortable and practical in and around the home.
  • Invest in a practical bag. Very few dresses or skirts have pockets, so you’ll need something to carry your wallet/purse, keys, phone, etc. while making sure you can actually find these items. It’s not good if retrieving your keys means emptying your bag every time you arrive at your front door!