An anonymous trans man on his experience with, and need for St Peter’s Andrology Unit.
As a trans man, the news about St Peter’s Andrology Unit losing its NHS contract did not surprise me. Nor did it stir up a single drop of emotion. The state of trans healthcare in this country is nothing new.
I have been on testosterone for almost a decade, and am blessed with perfectly healed top surgery that’s sprouted just enough fuzz to cover the scars. My transness doesn’t affect me much. I exist in what appears on the outside to be a traditional cisgender heterosexual (cis-het) relationship.
I am privileged to live a very quiet life compared to many of my trans and non binary siblings. With the exception of a recent brush with a builder yelling “I’m a real boy!” in a Pinocchio voice from the heights of his scaffolding; most of the time my dealings with transphobia is fleeting remarks made by acquaintances. People who don’t know my trans status. All I can do is let my cheeks burn red with angst as I am unable to call them out without putting myself in danger. Being a ‘stealth’ trans man means a lifetime of letting things slide and really picking your battles.
How does that relate to surgery?
I have previously visited St Peter’s for a consultation with a surgeon. If you’re not familiar with FTM bottom surgery, here’a quick overview. I have the option to have part or all of my reproductive system removed. Some men will have a full hysterectomy, others may decided to keep their ovaries. Others may pass over this part of the process entirely.
The second decision I have to make is if I want a metoidioplasty or a phalloplasty. The first is sort of a case of the surgeon re-sculpting the area and any clitoral growth (an effect of taking testosterone). They turn it into something like a micro penis. The second of these procedures involves skin grafts from the leg/arm depending on the patient’s weight, and then the surgeon using said graft in conjunction with one of a number of implants which enable the resulting penis to get erect. If you want to use your penis for penetrative sex, they say you need to have a phalloplasty.
When I visited St Peters, the consultant only really wanted to talk to me about phalloplasty. That meant I came away from the hospital not really knowing all the facts about my treatment options.
I made the decision to put my treatment on hold so I could figure this out for myself.
After some research on the internet, connecting with the transmasc community online, and a few personal revelations. I know what surgery is actually right for me personally. I’ve mentally freed myself of the pressure enforced by the world to undergo extensive surgery just to make me look more like a cis gender man. Having a big swinging dick isn’t central to masculinity. That idea is as harmful to cis people as it is to trans people. By all accounts I consider myself more masculine than a number of my cis male friends. So I went and I got my GP to put in the referral back to Gender Identity Clinic (GIC). By virtue of having stepped out the queue to talk to St Peter’s as I’d not been given enough information and had to go away and find out for myself, I found myself back at the beginning of the waiting list to access treatment. The additional two years means that before I access this surgery I will have been in the medical transition process for 13 years since I first went to my GP in 2009.