Chapter 28

My preliminary interview

Of course Suzanne was right; I now had more than enough clothes to wear and in all probability I would need the insurance money to help finance my transition and begin my new life as a woman. I therefore decided that once I’d banked the cheque and it had cleared I would transfer all the funds from Tom’s to Clare’s account. I would then close Tom’s account as one more, largely symbolic step on the road. Yet at the same time I did feel that I deserved a small treat and was eager to experience the pleasures of going out and choosing something for myself to wear, rather than relying on the judgment and choices of my friends. I still had some money in Tom’s current account and would receive Clare’s first salary cheque the following week. I remembered a red and white floral dress that I’d seen in Marks and Spencer the previous Saturday morning but had refrained from trying on. The interaction of the two colours created a pleasing and very feminine appearance of pink. I therefore decided to call in at the Marble Arch branch on my way home from work and have another look at it.

The dress proved to be a light-weight chiffon type of material, and with short sleeves it was probably more suitable for summer wear than January, but it was fully lined and I knew it would go well with a pink Bolero jacket given to me by Suzanne. I took it to the changing room and tried it on. It certainly felt good to wear and as far as I could judge it suited me. It went through my mind that perhaps I ought to ask Debbie to come and check it out for me before I bought it, or at least ring home and ask Suzanne’s opinion, but then I decided to go ahead. If I was going to live successfully as a young woman I would need to feel confident about how I looked and what I wore and wouldn’t always be able to rely on my friends. Perhaps I might make some mistakes along the way, but didn’t every girl do so? I went ahead and bought it, and also a pink coral necklace and pair of earrings which I felt would go well with it.

In the event Suzanne was very flattering when I showed her the dress and accessories later that evening, and agreed that it would go well with the Bolero.

‘I never meant to suggest that you shouldn’t buy any new clothes for yourself, Clare, just that you should start to think about the long term future.’

‘I know, and of course you’re right, but having now discovered the pleasures of having nice clothes to wear, it is something of a temptation,’ I said admiring myself in the bedroom mirror. ‘I think I may even wear this outfit when I go for my first appointment at the clinic. Unfortunately this first appointment is made in the name of Tom Evans, but I’m determined not to make any compromise in my appearance or conduct as a result. What do you think?’

Suzanne smiled.

‘I think you will look fine, Clare. Were you successful in getting some time off next Wednesday?’

‘Yes Karen was happy for me to exchange my days off next week, although I didn’t spell out to her exactly what the appointment was for. She assumed it was so that I could accompany you to see your doctor.’

‘Well in some respects that is not too far from the truth. My doctor, a health visitor and a social worker from the hospital will be coming here next Wednesday morning to discuss my future and it would be helpful to me if you could also be present.’

‘Yes, of course, as long as I can be away soon after lunchtime.’

Our weekend seemed a little flat after the excitement of getting myself ready for a date, followed by my trip to Sunderland and the ultimate disappointment of the previous weekend, but I kept myself busy cleaning the flat and on various other chores. I also continued to be in regular brief contact with Dad, who seemed to be doing alright, and with Vera who was a lot chattier. There was still no word from Andy and I was coming to the conclusion that that friendship was probably now over, before it had really got established. I guess I was expecting a lot for him to accept me as a woman, whilst I was still physically (and indeed legally) a man, no matter what I felt like inside. But at least I had something to look forward to — my forthcoming appointment. Wednesday was going to be an important day for both Suzanne and myself for different reasons.

I helped Suzanne to get up early the following Wednesday and we were both dressed and had eaten some breakfast by the time her visitors arrived at 10.00am.

‘Now remember, Clare, we have to convince them that I will be able to manage at home, with your help. I do not wish to end my days in a hospital.’

‘Yes, of course, I understand.’

‘No matter what happens to me here, it is my wish to remain in my flat.’

‘Suzanne, even if I have to give up my part-time job, I will continue to look after you at home. That is my promise.’

Suzanne very much took the lead in the subsequent discussion between the medical professionals and us. I was introduced as her cousin Clare, who had taken on the role of her part-time, live-in care giver and that, if needs be, I would be prepared to take on the role full-time. I confirmed that this was so. Suzanne spelled out in no uncertain terms that she would be willing co-operate with any treatment undertaken in her own home, but refused absolutely to go into hospital. The doctor argued that she might be shortening her own life as a result, but when challenged he admitted that this could only be by a matter of weeks, if at all, and that the prognosis was grim whatever she did. It took some argument on her part to convince them, but eventually they agreed to her wishes. We decided that she would receive regular visits from the health visitor who would liaise with me and also with the hospital, but that she would continue to be treated at home.

We all could see that the interview had been quite draining for Suzanne, so we let her have a nap whilst I showed the visitors out of the flat.

‘You do realise how serious is your cousin’s condition, Miss Simpson. There is really nothing more that we can do and I am afraid that it can only be a matter of weeks now before the end.’

‘Yes, I’ve noticed how much she has declined over the last few weeks that I have been staying here. ‘What will happen at the end, doctor?’

‘It is impossible to say with certainty. Heart failure is the most likely outcome; she may even die in her sleep. You should be prepared for any eventuality.’

‘I see.’

‘When the time comes you should telephone the health visitor directly rather than the usual emergency number to call an ambulance; she will have my contact number.’

‘Thank you, doctor. I will do my best for her.

In some respects it felt wrong to be thinking about myself and my future after this rather sombre conversation, but I knew that Suzanne would want me to go ahead and keep my appointment. I also knew that it would be important for me to look my best. Our visitors were gone by 11.00am which gave me plenty of me time to get myself ready for my own appointment in the afternoon and then get us both some lunch.

When she woke at lunchtime, Suzanne resisted any attempt at discussing her condition any more, but rather turned the conversation on to me and my future.

‘You look very nice in that outfit, Clare, I can see you are developing an eye for what suits you,’ said Suzanne once she woke up from her sleep

‘Thank you. I didn’t want to go over the top with ‘girlyness’, but at the same time I don’t want to leave anybody in any doubt of my adopted gender.’

‘I don’t think there ever could be any danger of that now.’

‘So you appear to have got what you wanted this morning,’ I said changing the subject.

‘Yes I did, and thank you for your help in that matter. If you stay with me to the end, I promise to make it up to you.’

‘Suzanne, you have already done more than enough for me as it is. Apart from anything else you have shown me who I really am and how I want to spend the rest of my life.’

‘In that case I hope you get what you want this afternoon.’

My GP had referred me for a preliminary assessment of my gender identity ‘issues’ by a psychologist at the West London Mental Health Trust in Southall. This was some way outside the area in which I was then living but my doctor advised me that they had more experience in this field and worked closely with the Charing Cross Hospital Gender Identity Clinic which was now in Hammersmith. This unit had been in operation since the 1960s and was believed to be the largest such clinic in Europe and would be the best place to oversee my transition. However, they only accepted referrals from Mental Health professionals, and so this would be an important preliminary step.

I arrived at the Southall clinic in good time and went up to the reception.

‘My name is Thomas Evans, I have an appointment with Doctor Underwood,’ I said feeling my cheeks colouring as I did so.

There was a slight double-take on the part of the receptionist, and a typist working at a computer in the back office raised her eyes from her work for a second, but I’m sure they’d both come across this situation before.

‘Oh yes,’ she said consulting a list of appointments. As this is your first time here will you take a seat and complete this form please,’

She handed me a clip-board and pen and I followed her instructions. I filled in the form accurately with my given names, address, date and place of birth, National Health number etc. but I left question about my sex until the end. Eventually, instead of ticking either the M or the F box as requested, I crossed them both through and wrote ‘not sure’, then took the form back to the receptionist. She smiled and quickly read it through.

‘How would you like us to address you?’ she asked.

‘I’ve been using the name Clare Simpson at work, although I haven’t yet legally changed my name.’

‘Is that Miss or Ms?’ she asked.

‘Ms please,’ I replied, already feeling quite relieved.

She wrote on the top of my form ‘Prefers to be known as Ms. Clare Simpson.’

Thank you.’

She smiled and said, ‘Doctor Underwood is running a little late this afternoon, but she shouldn’t be more than ten minutes or so.’

I took off my outdoor coat and hung it on a coat hook provided, and took a seat in their waiting room. I took out a powder compact and checked my makeup in the mirror. It seemed ok, but I dabbed a little powder on the nose just to be on the safe side to give myself something to do. I then idly flicked through some copies of Elle and Cosmo whilst I waited to be called, trying to stop myself from feeling too nervous. In fact it was more like twenty minutes before I was invited to go through to the consulting room.

‘Please come in and take a seat Ms. ….. Simpson,’ said a middle aged woman, who was reading my form. May I call you Clare?’

‘Yes please, I should prefer that.’

‘I have a letter from your GP who suggests that you would be a suitable candidate to attend our Gender Identity Clinic. My job is to make an initial assessment of your overall mental health and to determine whether changing your gender is right for you. Although in your case you appear to have taken several steps down that road of your own volition.’

‘Yes, I started dressing as a woman last year, and I’ve been living full-time as Clare since the beginning of last December, and have no intention of ever going back to living as a male.’

I wanted to make my determination clear at the earliest opportunity.

‘I see, and have you experienced any problems living in a different gender?’

‘Not really, apart from having to break the news to my father, that is. In every other respect I have never felt as contented with my life as I do now.’

‘How did your father react to your news?’

‘He was surprised, but not angry. I think he is coming to terms with my decision.’

‘And your mother?’

‘She died just over a year ago.’

‘I’m sorry to hear that. Do you have any brothers or sisters?’

‘No, I was an only child.’

She looked again at my form.

‘I notice that you have written the word ‘not sure’ next to the box asking what sex you are. Why did you do that?’

‘Well, it isn’t that I’m unsure of my physical sex, although I’ve always been small for my age and have never really developed many overtly male physical characteristics. As far as I’m aware I am a fully-functioning male, or at least I was until I started taking the Aldactone, but I’ve never really felt like a male in my head.’

‘So what does a male feel like?’

I smiled.

‘That’s just the point, I don’t know, but I do know that I’m not one.’

She smiled at me in response.

‘However, as soon as I started dressing, acting, and then living as a woman it felt just ‘right‘ for me somehow. It is difficult to explain but I felt as if this is who I really was, or at least who I should have been.’

‘In that case why did you leave it until you were nearly twenty before taking any action to rectify your situation?’

‘My mother was seriously ill for nearly three years before she died and I felt that I couldn’t saddle her or my father with any additional problems about my own life. Prior to that, although I realised that other people didn’t feel the same way as I did, I assumed that one day I’d grow out of the feelings that things weren’t quite right in my life.’

‘So what makes you sure now that you won’t grow out of these feelings one day and want to revert to being male and perhaps starting a family?’

‘I’m absolutely certain,’ I replied looking her straight in the eyes. ‘I’ve never been so sure of anything in my life. I feel more comfortable with myself, and in the way I interact with others. I have more friends and find it easier to talk to people as a woman. I realise the sacrifices that I will inevitably make by taking female hormones and eventually having surgery, but am happy to make them. Now that I have seen how good life can be for me as a woman, I couldn’t bear to go back to living as a male again.’

Doctor Underwood spent another twenty minutes or so probing different aspects of my decision and asked for details of my background, childhood, education, job, domestic circumstances, sex life and my mental health generally, taking notes as she did so. She also spelled out the implications of my proposed course of action for my future, and that once I started there could be no going back. I did my best to convince her that I was well-balanced, happy and had given serious thought to my future. Eventually she brought the interview to an end.

‘Well Clare, you appear to have several things going for you in your quest to live your life as a woman. You present to me as a convincing and attractive young woman, who has lived and worked successfully in her chosen gender for some time. You seem to have a regular and stable life with a job and accommodation, which is important for those undergoing transition. What is more, you appear to have faced up to the task of informing your family. From looking at you I do not believe that you will require speech therapy, ENT surgery or extensive laser treatment to be able to pass successfully as a woman. I therefore endorse the opinion of your GP and am happy to recommend that you should become a patient of the Gender Identity Clinic.’

‘Thank you Doctor Underwood.’ I replied, suddenly realising how relieved I felt.

‘You will receive an appointment letter from them and they will discuss with you what they can do to help you. I do warn you that they will want to see you at least twice and investigate the reasons for your wishing to change gender in some depth before they will agree to prescribe any female hormones.’

‘Yes, Doctor, I do understand the situation.

‘Any other decisions about surgery will depend upon the opinion of the consultants as to your suitability, and will inevitably be subject to waiting lists.’

‘I realise that, but will I at least be able to continue taking the testosterone blockers in the meanwhile?’

‘Yes, you should be able to get a repeat prescription from your GP. I will write confirming my recommendation’

‘How long will it take before I am given an appointment?’

‘I’m not sure, it is a busy clinic, but as you live within easy travelling distance and can be quite flexible as to when you can attend, it may be possible for you to be placed on a list of patients who can fill in at short notice in the event of cancellations.’

‘Yes please, I should like that. Now that I have decided on my course of action, I want to get the ball rolling as soon as possible.’

‘I understand your wish, Clare, but we don’t want the ball rolling so fast that it cannot be stopped if need be.’

Oh yes we do,’ I thought to myself, but just smiled and said nothing.

I thanked her and left feeling really elated. I collected my coat. The receptionist smiled at me as I left and I smiled back. I guess she could see from my face that I’d got what I wanted. On the way out I stopped off at the ladies to give myself an opportunity to gather my thoughts and check on my makeup once again. I also rang both Suzanne and Debbie on my way home to tell them the good news. They both said how pleased they were for me. Debbie said that she would call round to the flat after work so I could give her a detailed account, as it might be difficult for me to discuss it in front of the others in the office.