Experiences of trans and gender diverse young people

I think it is, it is a problem that there isn’t, I don’t know any sort of information that’s relevant is very much going to cause a sort of dysphoric response, it’s aimed at, you know, the gender that you don’t feel you are and that applies both for trans guys and trans girls of course. And yeah I think maybe getting, I don’t know whether anywhere does it I mean the LGBT youth groups are kind of, they’re good with discussing it, good with discussion, discussing issues around like sexuality and stuff like that but they don’t get into like the more sort of kind of vulgar details of, you know, even the basics I think myself and like other trans people will be the one that would not know that I think a lot of people would assume oh you just know that. you know, like some of the basics like protection and stuff like that or like condom use and stuff like that and like I think it is these things that are, you know, because they’re so gendered, understandably to an extent really I think that’s alienating a lot of trans people so they end up just not having that basic knowledge and, in a way, I think that can later down the line alienate them from their sort of sexuality and having sexual experiences with others too.

Finding services like cliniQ have been like transformative I remember once I went to a sexual health clinic in [city] and I was like yo like can I get screened and then they gave me a form and because I said that I have sex with like the same gender they wouldn’t like let me be screened because, well they wouldn’t give me a take, take home pack to be screened because I’m at higher risk and so I have to go home, rather than having any screening they were like go home and then like you have to come back another time and I was like this makes no sense, first of all, and like when it’s like a, what’s it, afab on afab like there’s no, there’s no high risk it’s actually a lower risk and so I was just like what on earth is going on here. And so after that I tried to not go to like that service again and yeah found somewhere yeah found cliniQ and that’s the only place that I go to now and it’s been super helpful and they’ve like yeah they’ve, they’ve been very affirming in everything they’ve done that’s where I got my cervical screening done as well and all that kind of stuff, so yeah it’s been great.

One thing I do notice is you know, when I have done a STI screenings we have a kind of locally there’s that unity that do STI screenings and they ask, you know, are you male or female and would you describe yourself as Trans and they go further saying, you know, do you have a, do you have a penis or do you not have a penis I think was the question, so I kind of filled that out so you know which was fine as a question or set of questions. And you know, they sent the healthcare kit and it was non-gendered you know, it was a swab and stuff and just said, you know, with instructions using, you know, clinical language but not saying any reference to male or female. But I do notice at University or other places they’ll say like male chlamydia test kits, female chlamydia test kits for example which is just really like, you know, like they could just change that, you know, and say like, you know test kits for vagina or vaginal test kits or test kits, I don’t know exactly there’s, I’m sure there is language, they haven’t exactly got it but I feel small changes like that like not just make you saying male for female and I noticed as well they usually, the female ones are in the pink packaging and the male ones are in the blue packaging and it’s like, I do get that they want to try and code it so you can easily tell but I feel like there are other ways to do that that could be explored and, yeah that basically I feel like it should be, you know, my limited experience that yeah it should be a lot more less, sorry a lot less gendered because often they are and I’m lucky to have access to a service locally that isn’t gendered and is very good at that but I know that a lot of places aren’t that good and yeah.

I went to the like sexual health clinic and like obviously they gave me like the female form, because they read me as a female, on the day and it asked for things that aren’t relevant, you know, like, like, oh when was your last period? Have you been pregnant? And things like that where, things that I couldn’t answer because they just weren’t applicable and there was no questions about you know the fact that I had a penis, you know, like, it was an awkward thing.

But like I was fortunate in the, like and I think luckily like I went to, I went to talk to them, and they were like, “Oh we’re so sorry, we don’t have like a form that, so, I’ll give you both, both of them, so tick whatever applies,” and then, and they were really apologetic and like really like you know, they, they felt bad. They, they genuinely did, they didn’t want you know anyone to feel like, especially because you’re going to a sexual health clinic, it’s already an awkward situation for cis people I imagine and so like on top of that being trans as well, so yeah, like that was the essential, and like so yeah I had like the blood test or whatever and like pee in a cup I think it was, I can’t remember exactly. Yeah and then like that was it essentially, and they’d send me the results and like, “You’re all clear.”

But there’s, I know like, I think it was weird because like technically I would have been a candidate for PrEP, like I would have been possible, like because I know in Wales I think it has started in England now as well, but Wales they have a scheme for PrEP essentially, you’re put on PrEP if you’re like bisexual, like if you’re considered like sleeping with bisexual men or something like that, I can’t remember exactly, the exact thing. But like and it applied for trans women too, and stuff like that. And there was, so technically I would have been, but like it didn’t come up because at the time I was like sleeping with a cis woman, so it wasn’t an issue. And I’ve not, I was monogamous and not seeing other people.

So, yeah but like that was something they offered and considered, so they’ve been really good I’d say here at least. They’ve been like, you know they’ve been as far as the experience no like, I didn’t feel like I was being, like they were there to you know make sure I didn’t have any STI’s and they did it, to be honest. The only complaint was really the forms and they were really apologetic about it, so I can’t really even then, it was just kind of like they weren’t, like they, they were just being their happy friendly selves, they weren’t like, “Oh, you’re a trans person,” or anything like that. So, it was pretty good.

The only thing I have really thought about is sort of whole smear test thing and, and you know sort of when you, when you’re, when it’s overdue you get sort of bombarded at the desk, at reception whenever you’re trying to make an appointment for anything, and you know it’s not necessarily very private, and there are people around, and you know, there’s not much consideration for the fact that what they’re trying to get you to book, quite vocally, might not match up with how other people are perceiving you, and, and what potential difficulties that might cause you in those settings. Let alone once you’re actually, go ahead to actually go in, go in to get the test done, and you know again the gender language that’s around that, and you know the awareness of who’s doing it.

It’s an uncomfortable thing. Most trans people that I know have an ambivalent at best relationship, like binary trans people at the least have an ambivalent at best relationship with their genitals. So, you know, going to the sexual health clinic is not fun, ever for anyone. Whatever can be done to normalise and explain the decisions that’s been made and why things are structured the way they are structured. And again like, I don't know, part of me sometimes feels like, oh no are we asking too much, but like, is it too much to be asking that non-gendered language be used? Use they use like, you know, and again, I know people sort of well TERFs (Trans Exclusionary Radical Feminist)* in particular get up in arms about people with vaginas but just like, you know, biological female. Like, you know, that’s something. Though not necessarily a woman. You know, I don't know. Like, again, do I have the answers for this? No. I know what I’d like. But like do I think that would necessarily be acceptable to a cis majority population, no. Do I think ultimately, you know, it’s always a balance between what we’re going to be able to demand for ourselves and what we’re not going to be accepted for asking for, sometimes. Maybe it’s a bit pessimistic.

*See here for an introduction Pearce, R., Erikainen, S. and Vincent, B., (2020). TERF wars: An introduction. The Sociological Review, 68(4), pp.677-698.

With my sexual health clinic, I’ve actually been really impressed by their sort of attention to like trying to be more inclusive for trans people. I think it makes sense that like professionals themselves will still need to be like trained into like using the right kind of language and stuff like that, but you know I think that kind of, trans inclusive language sort of goes hand in hand with consent, right. And it’s about like asking for people’s pronouns, if they want to give them, and you know what name would you prefer, you know, what, what name do you go by? You know and within like a sexual health context you know, they’re not making assumptions about the type of sex that you’re having, or the identity of both you and any sexual partners, you know. And so like training around the language in that still I think, in my experience has a bit of a way to go, but like just being able to like fill out a form and be like honest about like you know, and feel comfortable in being honest about like this is my identity, and this is sort of this stuff that you need to know kind of thing, for an appointment.

And I use like the self-test kits, on a regular basis just for like check-ups and stuff, and I use Sexual Health UK I think it’s called or Sexual Health 24 or something like that, and their like forms essentially for like signing up and stuff I’ve found really, really good. I think there’s still some assumptions that they make, in terms of the types of sex that you might be having so it does need a bit of work, but in terms of being able to put down like assigned gender at birth, and what particular tests, like you know oral tests for example, I think I’ve found really like empowering, you know I think as I say still some work to go, I think it could be but I think it’s a really strong foundation for like moving forward, right. Like I think that the stuff that needs changing is stuff around like what images are you using with each test, right, to show like how do you do the test. Thinking about like how to make those images more trans inclusive and also like is there a way of presenting this information in a way that isn’t assuming what body parts you have based on you know what type of sex that essentially whoever put this stuff together is assuming that you must be having kind of thing. But yeah I think just opening up those options and understanding that like there is so many different ways for people to live and experience their health, you know I would love to see that brought across to like the rest of the healthcare of our services that I engage with, you know and thinking about like you know, having more inclusive forms to fill out, and asking as well, like, you know you want to update any of this stuff, and it doesn’t have to be like an assumption based thing, right, it’s more just like understanding that because people’s gender identity and gender journeys are likely to change at some point, right, there’s no harm done in just every year or whatever, just sending an update saying you know here are some options for you to pick, you know, do you need to update anything?

I did have to correct a GP recently who was a, so he kept, I had to, he yeah we were talking about a specific situation and then he, a specific treatment and he kept talking about had to correct his saying women and I was like oh excuse me I’m like can you say people with vaginas instead of like repeatedly saying women and I think he was a bit taken aback that someone would say that to him because he was obviously like in this position of power and, and being quite like mansplaining to me and I think I was just like you, you keep saying like women and this is kind of like it’s not like an appropriate to this situation, yeah. But he did correct himself but I think he was like quite taken aback actually.

I think just, them having that information and actually listening to trans people, which shouldn’t be a big hurdle but for some reason is. And like paying attention to what they’re saying, and learning how to use gender neutral language, just in general, and also I question the, I mean in general I question the necessity for having sex markers on things anyway.

Cos, I understand that in some cases it’s a way of making sure that you get the care that you need, or something, that’s directed for you. So things like cervical screenings, or huh, I can’t remember what it’s called, there’s a certain thing to do with your veins, that is only like is more of a risk for people assigned male at birth, and like when you get to like, I don’t know, like 60 or something they want to check that, but basically I was reading a whole thing about how you need to make sure that that information goes to the right people, like trans women don’t need to get appointments for cervical screenings, generally, but also I was talking to a lot of intersex people about how language needs to be much more specific, because when you’re, if you’re talking about say periods, you saying a person with a vagina is not necessarily including, or it doesn’t necessarily include all the people that you’re talking about, well not like some people have vaginas and don’t have periods. Some people don’t have, like some cis women don’t have periods, some intersex people have a vagina but no uterus or whatever. So, like having, I just, you need to be specific. And I think that GP’s could do well to like actually have that information and understand that.

I’ve known since I was very young, before I was trans, that I never wanted to carry my own children. I did not want; I did not want to carry my own children. So that’s always been there, but then as I’ve grown up, I realise I just, I, I don’t want kids. It’s just a general thing, I don’t think it’s really trans related but yeah so, I don’t want kids in the future.

I really want children and one of the good things that my GP did do which I much respect her for was refer me to the [city] Fertility Clinic and I went there and had a discussion with one of the practitioners about the possibility of having like getting my eggs stored and later on like either putting them in a partner or like looking to give birth myself and like the possibilities. And that kind of stuff which was a really good discussion and I, yeah I really wanna have children, I’d love to have my eggs stored and I don’t ever see myself having a hysterectomy as well even though, and I felt like, it’s more of a like ideological decision not to do that because I feel for so long Trans masculine people were told they have to have hysterectomy’s and I feel like it’s a like form of sterilisation when there’s actually no risk and I know Michael Toze wrote a really powerful paper looking at how Trans masculine people had been told to have hysterectomy’s when they actually found the risk was, was nothing. And so to me that’s like more of an ideological thing about who should have babies, who’s allowed to have children, who’s allowed to like reproduce and all that kind of stuff and like especially with the history of like black women being sterilised in parts of the world still and throughout history that’s not something that I want to do. And so yeah I would love to have a baby either through storing my eggs and then putting those eggs into a partner or into a surrogate and giving birth that way or carrying a baby myself is something that I like before I came out and like transitioned and whatnot I was like I’m not carrying no baby [laughter] I’m not doing none of that, but feeling more in control of my body like I own my body, my body is mine has given me space to think about carrying myself which is something that I’m quite open to now and I’m also open to like adoption and other forms of other routes to like having a family.

I’ve never ever been able to picture myself physically having children, myself. And that’s something that still stands. Having children though, I guess, that’s something that has always been important to me, so I’ve always had that distinction and I’ve always known, I think, growing up and now that I’ve never wanted to biologically carry a child, but I’ve always wanted to have children. And so I guess, you know freezing my eggs was a part of that, and kind of looking forwards to the future, and again, almost kind of, I almost kind of separated myself from that emotionally and said, “Right this is something I just need to do,” and there’s going to be parts of it, you know I had to inject myself twice a day for two weeks, there were parts of it that, that were really unpleasant. But it was kind of, it was, I was quite focussed on the fact that if I wanted to have biological children one day I would need to do that, so I did it.

And right now I, I don’t know if I will ever use those eggs for myself. I don’t know what I’ll do with them. It’s nice to know that I have them, and that’s why I’d recommend to any person, any trans person to, to just think about your fertility before you undergo a transition, just, just have a thought about it. And I’m glad I did.

But now, I mean in terms of having children I think trans, queer people generally you know it’s nice to know that I think the concept of a trans person, an LGBT person having a child is becoming more acceptable in our society slowly, and there are still barriers, but that gives me hope I think because I would love to have children one day, and the means to me almost is less important than actually being able to support a child, and to be able to be a parent.

So, and that’s something I think, I think LGBT young people I know I did as a young person, came to terms with that quite early on, that I would not be having children via a normal means, so it’s something that I’ve almost kind of made my peace with really. That being said if I do become a parent that, the reality of it is a lot different than thinking about that as an abstract thing, but yeah, no, having children is important, so, whatever that looks like I’ll look forward to it I think.

[GIDS] were constantly like, “You should see fertility, fertility, cos you’ve got to go to fertility before you go on blockers.” Like this should be done afterwards pretty much. So And they said that it won’t take very long to do, so we’re like “Oh okay, lets do,” cos this was like just before we were going to go get on blockers, like, “Okay lets go do fertility,” just, and if it works it works. And if it doesn’t work, then eh, cos I, I talked really fast then, I wasn’t too bothered about having my sperm taken, I don’t mind adopting, if I do want kids. I don’t even know if I want kids yet. But we went to see fertility, we had to see this fertility therapist, you know, another therapist to talk about it, and then after that we had more bloods done, the fertility , we had to wait a few months, or was it like just one, it was like a month.

We had to wait one or two months after the seeing the therapist person, and then we went and did the whole sperm donation thing, or whatever it’s called, like keeping it, I can’t remember what it’s called. Keeping the sperm, but there was no sperm present. So, then it failed basically. And it was just like an extra one or two months not on blockers, pretty much, cos we had to not go on blockers to it. So, it was just kind of like a pointless extension.

Ok so in terms of fertility, so what they do is they ask you before they sign you off on the hormones if you, you know, “if you want children we need to sort out your fertility” etc. but obviously me being me obviously because of all the waiting and the rush I was kind of like, “no I don't really care at the moment, that's fine”. Now I completely regret that because although it's probably still possible to do, it's going to be, it's going to be a bit stressful. Because what they say is, in order to, in order to preserve your eggs you have to come off your hormones. So imagine how stressful that's going to be and obviously basically where I take a blocker, obviously there's not enough research around it to say this is definite. But the theory is, that it should pause the aging of your eggs. So hopefully when that time comes for me to, you know get that done which I need to do quite soon, hopefully we can get some good ones, some good ones that can be used later on for IVF situation. Because if not then that's it and I'll accept that because obviously it was my decision to you know not do it before when I was young and healthier and it's something that I’ll have to live with. But you know I can't sort of harp on that. In terms of, I mean at the moment I could potentially, technically I could potentially get pregnant and carry a baby but I don't think that's kind of, I don't think that's a bit of me at the moment where I am. I mean hats off to any trans guy that does that I think that's absolutely beautiful. I mean if I was with someone and it was the only option then of course I would 100% do it but there's no need for me to do it at the moment. And I mean that’s the one thing that they ask you not to do, because of course all of your body is just going through so much already. But yeah I would obviously recommend that anyone obviously thinking of doing a medical transition, no matter how you feel at the time, I think that you should make sure you look into your fertility options. Because later down the line, especially if you're young, when you're starting out, later down the line you never know how you're going to feel. Because even just recently literally just the other day I was talking to some girl from a dating app and she basically just asked about kids and stuff like that and you know I said to her, “it's a bit, it's not straightforward, it's not straightforward for myself”. And yeah I haven't really heard back from her since so. But I mean fair play because obviously she's around my age so 29, so of course she knows what she wants and obviously if she can't get that then there's no point in wasting each other's time. But it is sad, it is sad because I do feel like obviously I'm missing out on things. But at the same time, it is what it is, this is how it is. So you know I think it's one of those things where it's going to be a bit of a mission for me to get that sorted but I will eventually take the time to do it before of course I start having my bottom surgery stages done.

The other NHS pathway I took was in order to freezing of sperm and stuff before I started hormones. Me and my girlfriend are planning to get married and have children one day and all the rest. We wanted to kind of have that there as an option. It was semi-private. It was in [city] Women’s Hospital which is an NHS hospital, but was privately costed and so you had to fund it and pay for like the freezing for X amount of years and all of the rest and tests and stuff. It was in an NHS facility with NHS staff. They were all really supportive like how I had experience it like with the fully NHS pathway everyone was really nice and supportive and great and that was all amazing. But there was less of that kind of nonsense in a way. I just kind of went point a, point b, point c, now you’re done. Which was great because I had to do that before starting hormones. It was like a week or so I had hormones ready and I couldn’t take them because I was still doing this. Had there been those kind of barriers in the way like there were with the NHS service, it would have just extended my deadlines so much, which was a really nice experience to just not have that.

When I went to freeze sperm and stuff, obviously like there is a very sexual component to that. It was fine, like I never felt discriminated against because of my gender or anything. I had to go, I had to go through what was technically a male pathway, but I was constantly referred to as [name] and made to feel comfortable with all of that and made to like be reassured in that regard, like on the little like vials where they’re collect the sperm, they wrote, they wrote, prefers [name] on it, which is nice. I was like, ah, thank you guys. Everyone was very understanding and caring. I had to share male facilities because they don’t make like a collection room just for trans women. That would be unnecessary and a waste of money. I didn’t feel uncomfortable with that. I wasn’t like, I don’t want this. Take me to my private room, please. Gold leather only. But it was like, it was a bit like, I understand why I have to go the male route, but it’s like I wish there was an alternative. But that’s been my only real experience. And even then, they were very understanding and very empathetic. I was in a women’s hospital and it was nice. And like the process went very smoothly and they got it all done very efficiently and like, even now, with post check-ups and stuff, they’re still calling me like hi, [name], here’s what’s going on. They are never really implicitly tied my body in my physical sex with my gender or anything like that. That’s been rewarding and went probably better than I expected it would when I first started that process.

And my girlfriend is cis gender and so she can get pregnant and stuff. But in that regard I guess I’m fortunate, because we can have biological children of our own and that’s something we want. There is almost that kind of like stigma there, especially as a homosexual couple. It’s like I almost get, I get scared that I don’t want them to be bullied when we grow up or anything. Hopefully, we’re in a better world by like 10, 15 years’ time when they start going to primary school and stuff. However, it is still a bit nerve-wracking especially as a trans parent, I don’t want that to reflect upon them necessarily in any negative light.

I’m very excited about the prospect of becoming a parent someday. Not for a long while yet. And like the support systems to getting my sperm frozen has been really great. I’m really, really happy with that. And I feel confident that like, I got a call, I think it was two days ago that said like, it’s all clear. It’s all like frozen and good and you’ve got 14, so you can have 14 kids. And I was like, great. I’m gonna have like two. I can’t wait. They’re gonna be there for like up to 50 years, I think.

Yeah. I went to a fertility clinic before I went on hormones to freeze sperm. I went on these like Well Man tablets, type of thing for a month long and they tested my sperm and they were like yeah, it’s good but you need more volume. Go and take these pills and like so I take the pills and I don’t wank for like five days or something beforehand. I come back and I do the business and like have these ampules of sperm which are now frozen and then I went on hormones because as soon as you go on hormones it can start to impact your fertility can’t it. And now, I have no idea what my fertility status is. And I can confirm that there’s a different volume and a different consistency and so I think it is changed, yes.

I am a parent and my girlfriend is his mum, and that’s how it works. And it’s quite interesting to see how people just assume that he now has two Mums, because I think it’s easy for people to look at non-binary people and just go well, “I don’t understand that, I don’t have a metric to measure that against,” and to just kind of, “You look like this to me, so that’s what you’re going to be.”

So like he’s been going to the same nursery since he was about one and a half, and his whole the whole time he’s been there they’ve known that the name that I use as a parent is Zazzy, and they’ve never used that for me. So he has these, and it’s not like an intentional malicious thing, but they’re, they’ll be like, and hospitals do this as well, where they’ll say, “Oh Mum can you do this,” or, “Oh Dad, can you do this,” and I think, like I understand that you don’t time to learn everybody’s names, all the time but it does, every time you have to think do I come out to you? Do I have this conversation again? And it’s always quite a difficult thing to decide, especially in the moment. And also like, well sometimes when you have that conversation and it’s so exhausting to have, and they say, “Oh okay, I’ll take that on board,” and the next time they come in, they refer back to the, the other thing that they were saying, and it’s like okay, well that clearly didn’t stick. So it’s quite a difficult position to be in.

And also in a way my, I think like my girlfriend’s experience of going from one binary gender to another, in other people’s eyes has made it like easier for her, so she’s, everyone kind of sees her and goes, “Oh something’s different.” Whereas with me, I’m just essentially, I mean I don’t look anything like I did when I was younger but that doesn’t, it’s not because I’ve changed from a binary gender to a different binary gender, and I think that people struggle to understand that.

What would be helpful for pregnant non-binary people?

I think that like the smallest but first step would be to not have everything be about pregnant women and mothers, like pregnant people as you just said is an easy thing to say, it’s an easy way to change it, and I have another anecdote: I was at, when I was working at a youth group, they had a sexual health nurse come in, and we basically discussed like 90% of the group was trans, and we discussed with her beforehand the importance of using non-gendered language so being very specific. So if you’re talking about what she would have said was, ‘when a man and a woman have sex’, which I don’t know why she was talking about this in a very queer youth group, but you say, you know like penis in vagina sex, or whatever like you need to be very specific, and she was like, “Okay, okay. I’ll try my best; I’ll try my best.”

And she kept messing it up and so like halfway through this talk we stopped and we said to her, “Okay just a reminder, can you try to use neutral terms,” and she said, “Okay yeah, I’m really sorry, I thought I was,” and then like so I said, I explained to her, I was like, “So for example, I am a non-binary parent. I had a baby, but I’m not a mother and I’m not a woman.” So, like, and she was like, “Okay, okay.” And she says, she went, “When a pregnant woman,” and then she looked at me and then she said, “Oh I mean lady,” and I was like “What?” Those are the same word.

And so that, like, is, it’s something that obviously takes some time to learn but you should take that time. And I also think that representation is really important, I have never found another non-binary parent who looks like me, like most of the non-binary parents that I know are very androgynous, like and I don’t know them personally, I know of them, are very androgynous, have, since they had their child had top surgery or you know had top surgery previously to having, or being pregnant, and also the majority of them are American. I don’t know whether that’s just the overlap of the people that I follow, but and I like the trans pregnancy as a whole seems to be very focussed on trans men being pregnant, so the trans pregnancy project I’ve kind of followed a bit on Twitter, but it is very trans masc focussed. And that’s not who I am, but I am still a trans person who was pregnant.