bricks that built bodies

live from the Tavistock, 2014-18

TW: medical trauma, suicide and eating disorder mention

eliott (2017)

I used to think about dismantling the Tavistock clinic. I sat many times on the Buxton → Manchester Piccadilly → Leeds train connections for three hours at 8am, always with this Future Sound of London album on repeat, thinking about what would happen if I got a hammer and chisel and chipped apart the bricks of the clinic. Would it make them notice me, or would they continue to ignore? How much could I dismantle before someone stopped me? By the time I arrived at their front door, I had raised it to the ground and stood smiling at the receptionist amidst the invisible rubble.

I was hungover for my first appointment in 2016. Hungover but all too aware that this appointment was happening much earlier than other people’s because I had been hospitalised for a serious attempt on my life. We can give you a first appointment that is only seven months away, not eighteen months. Isn’t that great?

The atmosphere in the waiting room was thick. None of the children spoke to one another, but one parent spoke at length to my (also uncomfortable) mother to ask “what kind of kid did she have?” ‘Dress for the job you want’ was the dress code. Jay Prosser’s Second Skins notes how adept transsexuals have to become at autobiography in order to survive - “narrative is a second skin: the story the transsexual must weave around the body in order that this body may be ‘read’” [p101]. The story weaved around our bodies was held together with nervous energy. Every boy in men’s jackets, jeans and button downs, blue, black and grey; every girl in makeup, skirts and dresses, bright and pink. It was possible to fail this performance of gender and we knew that. Did I look the part of the tragic transgender child? I stared at the posters on the wall for youth groups or meet ups. One of them was a ‘support group to discuss healthcare accessibility’ with DELAYED UNTIL NOVEMBER written in red biro over the description.

My body was dissected in the consultation room. I was asked about my childhood - who were my friends? What toys did I play with? What clothes did I wear? I was asked if and how I masturbated, if I liked my breasts, if I wanted to become pregnant at any stage, and how distressed I got about menstruation. The question of genitals was brought up. I spoke of my hatred of my sexual organs and a desire to remove and replace them. The doctor expected me to be in pain, to be in constant dissonance with every aspect of my body - but also to be typically well, to be functional, to understand my responsibilities. I was consistently told that the Tavistock could delay or refuse my treatment for gender dysphoria if mental illness or neurodivergency was noted to be affecting me, ‘impairing my judgment’ or otherwise altering my ability to consent. I responded in this dance by trying to be the archetypal tragic transgender child: my body makes me scream if I look in the mirror, but I could smile again if I could see myself as male. Narrative second skins that made me shudder with embarrassment but always elicited a nod of recognition from the clinician. But that wasn’t enough.

Eliott has been living in full male role since 2015. The process of identifying himself as transgender is something Eliott reports as frustrating and a source of significant distress. He has not reported any underlying mental health problems. [T+P GIC, 2017]

In my final appointments with Tavistock, they admitted that they had done nothing for me. After being told in that consultation room that I would not receive any help for at least three years - until I was nineteen - I knew I would not survive only relying on them. The doctor watched me fail to hold back tears and could not offer any words of support. I instead accessed Dr Helen Webberley’s short-lived hormone clinic aged sixteen-seventeen before it was shut down by the GMC, forcing me to return to the Tavistock to ask (beg) them to both continue my treatment and/or refer me to an adult clinic. I had chipped apart the bricks before hastily pasting them back in place after realising that nothing existed outside of its walls.

In the physical exam the paediatrician performed before my transfer to an adult clinic, he pressed into my stomach and held my breast as he said I had a “fantastic figure” and he was “jealous” of my frame. I shut my eyes as I thought about how I had just lost 18kg in two months because of an eating disorder I was too panicked to get help for; living in ignorance, the paediatrician instead said approvingly: “it will be a shame if you decide to get surgery.”

Eliott’s past medical history is unremarkable. He has previously been under the CAMHS team for support with various complex difficulties. All these issues have now been resolved. [T+P GIC, 2018]

The narrative of Eliott has been resolved.

Transitioning as a child in England between 2014-2018 was monotonous, not in a light-hearted, ‘oh well, never mind!’ fashion but in one that relentlessly held children in a vice of perpetual nothingness and strangled belief in life beyond it. Monotony is built into its mechanisms. Being unable to fully live because healthcare is not only denied, but dangled above you just out of reach with the promise of a better future if only you wait just a few more months. The cold but tired repetition of the receptionist over the phone that yes, your appointment was cancelled and all care could be suspended because of political forces outside your control. The endless wait to be updated on where you are on the waiting list for an appointment to discuss how the clinic is unable to assist you.

Moments such as the inappropriate physical exam were fleeting; the main memory - or lack of memory, maybe a feeling or affect - was one of cloying paranoia over mundane, inane endeavours. I wrote about aspects of paranoia recently without explicitly labelling it, but it is more eloquently expanded by Eve Sedgwick:

The unidirectionally future-oriented vigilance of paranoia generates, paradoxically, a complex relation to temporality that burrows both backward and forward: because there must be no bad surprises, and because learning of the possibility of a bad surprise would itself constitute a bad surprise, paranoia requires that bad news be always already known. (Paranoid Reading, p130)

Bad news must already be known. From needing to know every transphobic government policy to every silly tweet from Linehan, the need to live as if the worst is already happening constructed a worldview based on refracting every paranoid fantasy onto my body and its place in the world. Whenever setbacks occurred, such as being told by cursory email in 2017 that Dr Webberley was being shut down and my access to HRT was being revoked, this reinforced my belief in a conspiracy to see myself and other trans children suffer as much as possible before they kill themselves: that “each unanticipated disaster demonstrates that you can never be paranoid enough.” (P.R, p142)

As an adult I worry I write about this too much. That it is getting old now, people aren’t interested, and it’s time to put it behind me. But I don’t think I can. I’ve only just begun to understand how deeply this has affected every part of my life; primarily, how a paranoia of transition prevention has dictated my choices.

I originally started writing this when it was announced that the Tavistock was shutting down. I’ve tried to write about this so many times, writing and editing and re-editing until deleting everything and starting again. I tried to muster up some anger or dismay that this clinic was being shut down - and I could find some. The Tavistock was the only option presented to transgender children and without it, there is nothing to fill the void - I’m not holding out for this government to create something better. But every time I start getting upset about the closure, I’m transported back to the white hospital room with the paediatrician holding my breast - it will be a shame if you get surgery - and I cannot maintain anger. Trans children don’t just deserve healthcare, they deserve dignity and for people to listen to them. And dignity was something missing within the Tavistock walls.