It was a basic room. A short desk placed firmly against the corner near the door with a functional computer terminal and a cold metal framed desk chair that looked like it had been designed with nothing but a pencil and a right angle. At the other end two comfortable low slung soft furnished chairs and a small round table between them, sometimes with a box of tissues that told a lot more about the room, clinging to the fringes of the Mental Health Unit, than the odd leaflet hanging from the pin board. The vertical blinds were half way, enough to catch a flash of someone walking outside, a patient or member of staff in a less than fetching but caring green nursing overall. You know the type. So baggy to cover even the most attractive person beyond recognition.
It was the first time I’d met the psychologist. I was supposed to meet him some time before but as with many of the administrative problems in a hospital he’d been double-booked. I had been sat in the waiting room when the psychiatrist, bustling his way to his next paitent, had spotted me and asked why I was still waiting. He collared the psychologist, who was also on his way to his next patient, they had a quick conversation in lowered tones. I could still just about hear them but it was quiet enough that the other patients in the waiting room couldn’t hear. They were far too disinterested in listening. Some where obviously couples with marital issues and some were those who just had some kind of deep depression. It was easier to tell that you might think. There is a look on a face of someone who is in a very dark place that is just unmistakable; even the television on the reception desk showing an episode of Loose Women couldn’t avert their attention from their core darkness. In fact I remember more recently having a quick session with the psychiatrist who incidentally overseas my care. We stepped into the room, the door hadn’t quite closed behind us he said loudly, “God, look at the miserable faces out there!” You could have picked my jaw up off the floor; he’s quite a character at times. For those who don’t know the difference between the psychiatrist and psychologist, a friend of mine once described it simply as this, Psychiatrist is medical and can prescribe, a psychologist does not prescribe. Sure, it’s a lot more than that but for this, we shall go no further.
“He’s been booked in for you today at one.”, said the Psychiatrist under his breath.
“I have a patient now, they’ve double booked. I’ll be free at four, but I can’t do any earlier.”
“He’s come a long way, I don’t think it would be fair to wait all afternoon.” The fact was I hadn’t come a long way but scheduling these types of appointments into a working life can make it feel that way.
The Psychiatrist apologised for the confusion but it wasn’t a big deal for me. While I was anxious to get started I certainly didn’t want to moan about it. I’d waited most of my life for this, an extra week wouldn’t matter. We arranged another date by post.
“Hi, my name is José Basurto, you can call me José, not doctor or Jos-ee.”, he said gently, ensuring that everything would be casual and making it clear that a lot of people mispronounce his name. This isn’t his real name of course but for the purposes of the blog, it shall be.
José suggested that may be the best idea was for me to spend a number of sessions with a female psychologist and the remainder with a male psychologist, unless of course I had a preference for one or the other. While I wanted to do both I did have some minor fears of being in session with a female psychologist, not for any reason other than being worried that she may be offended by someone who could be a bit of a fake. It’s one of my troubles that I keep coming back to which is the cyclic thought that sometimes I’m just a bit of a fake, a facade of being a woman, a performance put on for those I’d like to convince. It’s one thing to look convincing, another to be accepted. Over time I would come to realise that the so called facade was in fact a reflection of my true self, the genuine inner ego, that is ego in the original meaning. May be we’ll come to this at a later date.
For now though the transition from visiting the Occupational Therapist to a psychologist, who isn’t a gender specialist (also more on this later), was actually a seamless progression. This was because my therapist had to some extent gone as far as she could, in fact she had gone way beyond her remit. When I saw the Occupational Therapist for the first time I actually came away realising I’d not told her about the gender issue. I’d talked about the depression I had, which was why I was referred to her from the GP, and I was a little disappointed in myself for not saying anything by the end of my first session. The occasion to bring it up hadn’t actually surfaced and I didn’t want to just come out with it cutting her off mid-sentence or suddenly change the subject so I waited until the week after. The second session was when the occasion was exactly the time to mention it.
There was some kind of open question, “So what other issues do you think there could be?”
“There is something…”, I said, my heart now instantly racing, I took a breath not actually looking directly at her. Then there was a good ten seconds of silence which felt like ten minutes, nerves kicking in hard.
Then even more silence, it was almost ridiculous, but she waited without any sign of impatience.
“I’m transgendered.”, I said nervously but clear. I couldn’t even say I wanted to be a woman, it didn’t seem right. I knew I wanted to be female but I think my fear is that being a women is a right of passage and comes with growth and not just a decision. I wasn’t quite there yet.
“Oh right.”, she said with genuine intrigue, adjusting herself in her chair as if an interesting discovery had been made. It was at that precise moment that from then on I would be at total ease with talking about my gender dysphoria with anyone in the medical profession. It was now just a thing that I had. No more a problem to discuss than eczema or the last time I had tonsillitis. In fact the next time I went to one of my GPs, about something completely non-gender related, I had quite a sweet thoughtful moment. I spoke to the Doctor about whatever the problem was and it was one of those on the bed examination times. He’d obviously been reading my record, as they do before a consultation, and the top entry would have most likely have been my next referral to the Psychiastry unit, or may be the GPs in the practice all had a chat about up and coming patient issues at their monthly meeting of some kind.
“Would you prefer a female doctor for your examination?”, he said very kindly and sensitively.
“No, it’s fine.”, I replied.
This was the first time, ever I think, that anyone has ever gone out of their way to make me feel comfortable with who I am and to actually give some forethought for my feelings. Of course I have no problem in either gender of GP, they’re a professional and gender doesn’t come into it for me. Providing they can do what they need to that’s all that matters but that small act of kindness had a lot of meaning for me.
Back with the psychologist things were therefore at a progression. The Occupational Therapist had, whilst stating she had no specialism in gender dysphoria, would try and help as much as she could, which she did without going beyond her knowledge. In fact she had even done a little research before some of our sessions. José was now the person to take those reigns along with a female psychologist, we’ll call her Catherine, under his instruction for a number of months. José and I had a few sessions. He explained how he thought Catherine and I were a good match. I, as a case, would form part of her up and coming work and I would benefit from having sessions from another psychologist. José has an excellent way of making me feel at ease and to talk openly but before my real work with him I was about to start a journey with Catherine for several months. Catherine would be taking me to psychological places that sometimes would make me laugh, sometimes make me afraid or even lead to some corridors of confusion that seemed to lead to a door beyond which was just empty space where I would fall silent and avoid eye contact. So began the humanistic and integrative exploratory psychotherapy. My sessions with Catherine would be the hardest self discovery yet.
Until next time. x