Sunday, 3 May 2015

Decision making

Two important decisions were made this week, in amidst dealing with granulation and other matters.

The first one occurred on Thursday and was an on the spot decision that I was surprised to have made. I had a meeting at the Laurel's gender clinic as part of the patient participation group I am a member of. Facts and figures were trotted out and it was clear the clinic was struggling to deal with a massive influx of referrals. This has come about because of waiting times being published about all 7 clinics. This document,, shows that in January there was a 16 week wait time for the Laurels as opposed to nearly 18 months for Leeds. If you lived in the Leeds area, were desperate for diagnosis and treatment (as many people with gender dysphoria are) and had the means to travel to Exeter, then you would likely consider this option.

The reality is that people have flocked from all over the country to the Laurel's and the backlog of referrals is massive. The 16 weeks has now increased to 22-23 weeks* and we were given a plan on how the clinic were going to resolve the issue. However it was going to take time and at the moment, only new patients could be admitted once an existing patient was discharged. 

I considered this briefly and within the meeting suggested whether it was necessary for me to continue at the clinic for the year I was funded for. Were I to need anything they could provide, I would not even have thought about leaving, but the truth is that I have finished my transitioning and at this time, there is nothing more the clinic can provide for me. The clinic manager accepted this offer and asked me to write to her later to confirm my decision. I got home, talked it over with Mandy and then wrote an email confirming it.

As part of this I have also offered to volunteer within the clinic. They have a small volunteer base and part of the criteria for this is that you have to be discharged to do so. I felt it might be something I could be a part of as well as perhaps bringing more up to date experiences to the current base. 

Interestingly, when I emailed Lynda (my therapist) about this, she seemed a little upset in her reply. I told her clearly my decisions why and also that it was not the end and we were allowed to converse by email in the future. She wants to involve me in some research and I do not have to be a client to do this. I also mentioned about volunteering and that we would see each other more regularly, but even so, she seemed unhappy with my decision. 

It was always my decision to make, and I have made it. It feels right, I do not need any more help in this regards and I am effectively "bed blocking" so to speak. It is time to move on. I have replied again to Lynda suggesting perhaps another appointment so that she can formally discharge me herself, but sooner rather than later. I am not technically discharged yet, but it is imminent.

Following Thursday, Friday saw me making another important decision, a far more upsetting one. I returned to my voluntary work a fortnight ago and whilst I was ok with the first day, last week found another volunteer having a go at me. My solution at that time was to walk out.

I agreed to return after discussing it with the charity's director but as Friday loomed, I found myself very uneasy with the prospect of going back in. On my morning run, I churned it all through my mind and made the decision to resign. I returned from the run, dilated, showered, breakfasted and then wrote my resignation. I drove into Taunton and with tears in my eyes, I handed the letter to the person who is in charge of the office. 

We discussed things, he was reluctant for me to do this but accepted that he has to respect my decision. After more discussion with him and another volunteer, we decided to keep the option open for me to return after the summer.

This was not an easy decision for me. I reflected back on it and realise that I may not have been ready to return to this work. Whilst I am physically fit and recovered from my surgery, it is also apparent that emotionally I am most definitely not. When I left the building I had a long chat with another volunteer and I was crying as I was talking to her. This new phase of my life with the more powerful effects of the hormones is taking some adjustment and the work I was doing is not suitable at this time. It is harsh work, having to take in some distressing situations. On top of that is a cramped office that means everyone is on top of each other as well as a couple of other issues that I am not at liberty to divulge. It was simply too much for me at this time.

I returned home, and wrote to the director stating I had resigned. I also said that perhaps it was a hasty decision and that if it was agreeable, I would like to stick to the idea of returning in September. I also explained a little more in depth about my hormones and how they were affecting me this time around. At this time, I have had no reply but she is away on holiday.

So, after making these two massive decisions, how do I feel? 

The Laurels; I feel good. Staying another nine months was truly pointless. It was just going to be a waste of resources. It was good to chat to Lynda, but there was now nothing to be gained from it. My GP and myself are well on top of everything and any issues, we can soon contact the Laurel's for advice.

The voluntary work; This was a harder decision. I feel it was right for me and although I need something to do, I wonder just how rested I am after my surgery. I returned after 3 months as this was recommended. However, the three months recovery has not been restful. I resumed my non-lifting caring duties for Mandy quite soon as well as having the maintenance of my surgery to contend with. There is so much to do post-op and those three months are pretty intense. I am going to take it a little easier for the next few months. I forget sometimes how involved my caring duties are too and perhaps I should not rush back into work. Of course, I still have other small pieces of work I do and I intend to carry on with them and there is also the possibility of the Laurel's although that is going to be much less intense than the work I was doing.

* I was given permission to disclose this information as I saw fit.


  1. Dear Lucy, I reckon you are being very level-headed and making good decisions. You were right to return to your voluntary work after 3 months, as that was the advice you'd been given; and you were equally right to face the fact that you were not ready for it. You're still going through a massive life change, and the way you cope with life's ups and downs post-op is unique to you. We are all different, and there's no saying how long it may take to achieve some sort of equilibrium.

    As for The Laurels, I can understand why Lynda is a bit upset. She's a sensitive and caring person, and she put a lot of effort into making your transition possible. But you're ready to move on, and I hope she takes that as a compliment. And, as you say, it doesn't mean that you'll never see her again.

    I'm not surprised that The Laurels is getting a flood of referrals. On the contrary, I'm amazed that there haven't been droves of folk heading west from Leeds and Charing +. It does, however, explain why I haven't heard from Lynda. The last time we met, we agreed that she could invite me back after a year or so for a progress chat. They had no funding for this, but were keen to offer it at the time. Well, the year has come and gone, and now I understand why.

    1. Hi Angela,

      I agree that with my voluntary work, I needed to try it to see what was going to happen. Since making the decision to resign, I have felt much better in myself. Today, I was talking about it all again with a friend and encountered another facet to it all. The job involves serious fighting for peoples rights, and I winder whether the fight has gone out of me at the moment? I have spent so long fighting for everything, that perhaps I need a break from it all. Sad that it is to admit this, but I can't see me returning at all.

      The Laurels, I am still a little puzzled by her reaction as I have tried to set in place ways that she can keep in touch and for me to be a part of any research work. plus by volunteering, I could be in a position to see her every week. They are completely swamped with referrals and from all over the country. It will ease, another set of official figures will be published soon and then they will all be heading to Daventry. The NHS has agreed to get wait times to treatment(!) to under 18 weeks but I can't see this happening without a serious injection of cash.

      The yearly progress reviews, I was told they are now gone. The clinic can't cope with them any longer due to the issues mentioned. Once you are discharged that is it apart from simple advice for a GP. Otherwise it's a re-referral although such referrals will be fast tracked back in - meaning no assessment but still having to wait 22-23 weeks.

      Lucy x

    2. Hopefully with regards the Laurel's, the upset has been resolved. Lynda emailed me today with an offer of an appointment Friday. She can now do the final discharge herself and possibly see Mandy for the last time.