If you have a partner who is, or feels they may be, transsexual, you may be a little worried about what you can do to help them. Sometimes, the secretiveness that your partner may have practised for years will make her very reluctant to seek help, either from fear of ridicule, or because the kind of help on offer involves a permanent solution from which there may not be any return, either for herself or in terms of your relationship.
Some people who have spent years struggling with their feelings can find the thought of taking that definitive step towards treatment very frightening. As well as being an exciting prospect, treatment for transsexuals can often spell the end of everything they have been and known all their lives, and for that reason many try to hold off, especially older transsexuals in a relationship, particularly when they have children.
Sometimes male-to-female transsexuals try to continue to live as male in order to keep things the same, in a belief that by denying what they know inside themselves to be true, they are acting for the greater good. In these circumstances it can be quite difficult to persuade such a person that their 'best efforts' at conformity are not working and that they need to seek help. But should this situation be your reality, you will recognise that your partner is masking their discomfort and unhappiness.
So what can you do ?
The answer has to be to go through the proper channels. Some transsexuals try to stay outside the system and may self-prescribe hormones - this is dangerous and ill-advised for reasons I will come to later.
Initial counselling might be a good idea, especially for those who seem unsure of themselves. I know that counselling can also be of great benefit to some transvestites and this has been covered in the transvestism section very thoroughly with no need of repetition - link here
Firstly, you should get your transsexual partner to make an appointment with their GP. Some GPs are better than others at dealing with gender-dysphoric people; however there are guidelines as to what a Trans person has the right to expect in terms of treatment (both prescribed and actual ) details of which can be found here....
Usually, after a chat with the GP, there will be a referral to community psychiatric services. This in itself can be a problem for some transsexual people, who do not consider themselves to have a mental health problem, and may be quite strongly opposed to this course of action. However, while gender dysphoria is not itself a mental illness and should not be regarded as such, it may be associated with psychiatric conditions such as depression, and psychiatric assessment for the purpose of diagnosis is always required. Others may happily go through these stages without being bothered in any way.
Occasionally, a gender-dysphoric person may perceive themselves to be transsexual when they actually are not. They may, for example, be transvestites who have noticed and misunderstood similarities between themselves and transsexual people.The community mental health teams are quite adept in picking up those who have wrongly self-identified.
The next step forward will be referral to a GIC (a Gender Identity Clinic). These clinics nearly all have waiting lists and limited funds, so ensuring help is made available to those who need it most is achieved by going through local services first (except in Scotland*).
The wait to be seen by a GIC varies greatly depending on where you live. The busiest centre in the UK by far is Charing Cross Hospital in London. A wait to be seen here will be much longer than going to the 'Sandyford Initiative' in Scotland, to which patients can self-refer. (* Scotland remains unique within the UK in giving patients the option to self-refer and dispensing with the initial approach through local services).
Once you are in the system, what can your partner expect from attending a GIC ?
Whichever centre you go to, the procedure will be the same, as set down by the accepted standards of care (the Harry Benjamin guidelines). Your partner will be assessed independently by two psychiatrists who must both agree on a diagnosis of Gender Dysphoria, before matters are allowed to progress further.
Until quite recently, the usual procedure was that after a diagnosis was made, hormones were given and while taking these, the male-to-female transsexual person was required to undergo two years of 'real-life experience', living and working entirely and exclusively as a woman, before surgery would be considered.
Nowadays the NHS clinics require a year's real life trial before starting hormone therapy and discussion of surgical options. This is mainly because of legal action that was taken against certain doctors/clinics in the private sector, which has caused NHS GIC's to reassess their position. There is no actual legal requirement for a clinic to wait to prescribe hormone therapy. It is very much a 'swings and roundabouts' situation and somewhat harder for the transsexual to live full time without drug therapy.
What appears to have happened is that more people are going private or self-prescribing as the drugs necessary are more widely available than ever before. If your partner decides she cannot wait, it is always better to take hormones under medical supervision, where close monitoring will show up any problems. Your GP will usually be happy to assist by taking blood and regular monitoring.
Once your partner is in the system you may find she has some periods of self-doubt, which is quite natural and to be expected. In fact it would be a strange person who didn't worry about issues of such magnitude! No matter whether you are supporting a partner, or a former partner, it is important to realise that no matter how sure she is about the rightness of her course of action, such doubts may, and often do, occur. Try to be aware of how she may be feeling and just how overwhelming the whole process can sometimes seem.
It is just as important to recognise that whilst you may have an idea, of how she feels, be well read, or have spoken to other transsexual women, you can never completely know or understand exactly what a transsexual woman goes through. Every transsexual person's journey is unique and a journey on which ultimately, whether in a relationship or not, they have to travel alone to some extent.