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The Cost of Transition

Writing by Justine White. Illustration by Justine White.

Content Warning: suicide, gender dysphoria

Distraught, I sit against my radiator having mulled over the same thought for a whole 40 minutes which is now lost to me. Another 40 minutes I could have had oestrogen pulsing through my veins. Another 40 minutes my body could have ceased its production of damaging testosterone. The thought in my head? The cost of achieving it.

My mind started fixating on the cost in warmer months when the feeling of isolation was still a novelty, but it’s now cold outside and every day has become a monotonous chore. The radiator remains a frigid and bitter metallic, the only thing radiating through my body a seemingly incurable dysphoria. But it is curable, I know it is. I just can’t afford it.

Forty minutes ago my GP phoned me, the fourth I’ve spoken to this year. I thought I was four weeks away from starting (on hormones); she breaks to me it won’t be until next year. But it won’t be with her, it’ll be with a Doctor X, with a cost of £250. Just for a diagnosis. 

It seems ironic that a few pills each week or an injection every three weeks could be my cure. I could grow into a new body and have the puberty I wanted, even if that meant being hormonal; a cost I would happily endure. But instead I wait, the possibility of being prescribed a drug which costs pennies to manufacture being withheld because the NHS doesn’t want to take my word for it that I am in fact a woman.

How can I be cured? How can I begin to recover? Any leftover societal trauma will replay in my ‘female’ brain, just like I will have to take a jab every month just to appear as if I even have a female brain. A nose so angular a maths student could use the Pythagorean theorem on, an Adam’s apple so large I could actually have an apple stuck down my throat, and a jawline so sharp I could cut myself with it - they always remind me of how I appear as an impersonator to society, a fake, a phoney. I begin to believe, to fear, that society won’t ever see me as a woman. The cost is not just financial.

And if, and only if, I pass —my whole worth seems to depend on it—and become who I’ve only ever dreamed of, does the cost include a potential end to my family? Questions pour in from relatives seeing Justine, ‘I wonder why you have chosen to do this? Will it bring you happiness? A little advice from those older and wiser may be in order!’ I can’t seem to make up my mind whether all this will be worth it. 

Phoebe Bridgers’ ‘I Know the End’ plays, the final song on her 40-minute album, a wakeup call of sorts. The song speaks of the current apocalypse, but all I can think about is my own. Bridgers’ repeats over and over in these final minutes, ‘the end is here’, and I believe her. I’ve lost hope.

Yet I don’t want this to be my end. I’ve thought about it - 9 in 10 of us have - but deep down I know my end isn’t here, or even with a Doctor X. After her will come another doctor, another £250, and after some blood tests I might actually be getting somewhere, closer to the end of my despair.

Our end doesn’t have to be with sodium hypochlorite running down our throats or the end of a knife stained like beetroot, us sleeping in a ditch or being put in the wrong jail cell, an unwanted hand between our (fetishised) thighs or worse yet a bullet straight between our (panicked) eyes. It shouldn’t end with us being starved to death in a cage with the key to our escape lying just out of reach, medical professionals only allowing us to escape if we prove something so blatantly obvious; that we are trapped, starving. If only the cost of us transitioning wasn’t so high. Then again, I have no choice but to pay.

Who should I make the cheque out to again?

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