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It was 2018, and we had only been in the UK for a few months when J said the words that changed everything.
I was in bed, had just woken up, and J was heading to the bathroom. “Hi, my love,” I say. “How are you?”
He turned slowly. He was completely pale. “I don’t want to live anymore,” he said absently, before turning away. I was devastated. He was my life partner – the person I loved most in the world – and moving to my home country had pushed him to that.
At that point, I couldn’t have got us out of the UK fast enough.
A year ago, living in Great Britain had been our dream. When we realized J was eligible for a visa, we danced in the kitchen of our Massachusetts home. That said, we knew it would be a great transition for both of us. I had always lived in the United States, and although I had lived in Britain for the first three decades of my life, I had been in Massachusetts for over 10 years. Now, as a double citizen, I never planned to leave. But every time J and I visited England together, I saw how the place brightened up, and when he shared his dream of living there, I found out I wanted it too.
There were so many reasons to make the trip. Among them was the British National Health Service, which is paid by taxes. We knew the NHS was in a lot of trouble with countless budget cuts, but it also offered health care that was effectively free and had a deeply committed staff. As freelancers, using the NHS would mean we would no longer have to spend more than a thousand dollars a month on health insurance.
Despite this, we have been particularly keen on finding out whether the NHS will give J access to his testosterone, which he couldn’t even think of living without. I called a British activist helpline about it, just to be sure. “I see no reason why J would be turned down,” we were told. “You just have to make an appointment with the doctor. “
We were relieved. It looked like the move would be sure.
Once in the UK we made an appointment with a well respected GP for trans patients. However, this doctor told us that when it came to J’s prescription, his hands were tied. Legally, if she were to prescribe gender-affirming hormones, she would have to get clearance from a gender dysphoria clinic. “Everything is fine,” she said. “We will fax them today. “
I recognized a red flag when he saw one. He had read everything about gender dysphoria clinics in the UK (then called gender identity clinics) so he knew there were only seven in England and Wales. Whether using the NHS or private insurance, specialists at these UK clinics were the only ones who could diagnose trans and non-binary people with gender dysphoria. Without this diagnosis, there is no legal access to gender-affirming hormones, surgery and more. However, the waiting lists for these clinics were huge. Back then, it took two horrible years for trans, non-binary people to get on the first date. (These days, the wait is three to five years. No wonder activists are pushing for change.) So when exactly would such a clinic have time to answer our GP’s fax?
We waited impatiently. We called our doctor’s office every day. More faxes were sent to the clinic, but there was no response. We contacted J’s American doctors, who were very supportive of us, but due to British laws and the fact that testosterone was a controlled substance, there was nothing they could do to help J.’s cause.
During this time, my husband saw his remaining testosterone stock decrease more and more every week. It was as if he disappeared with the precious liquid in that vial. I had known he was a boy when he was 5 years old, even though he had been told he was not. He had waited decades for the courage to come out and live in his real sex. Then because of the way the US works he had to jump through outrageous hoops just to prove he was who he claimed to be, so he could access trans health care and more. again. But it was all meant to be over now. He had seen the UK as his ‘new start’. Yet he was there, ignored. No one seemed to care.
During this time, I continued to frantically call the NHS helpline, but to no avail. Then one day I had a conversation with someone who was ready to argue. “So just to confirm,” I said, “the only reason my partner has to take a break from his meds is because he’s a transgender immigrant? “
For a moment there was silence.
Finally, I was asked to email someone and repeat what I said. I did it immediately. The gender dysphoria clinic faxed their clearance to J’s GP within 24 hours.
Yet the battle was far from over. J had been told that he could not receive more than a “bridging order” until he was “assessed” by a UK gender dysphoria clinic. In other words, just to prove that he was what he claimed to be, he would be forced to revert to the invasive “assessments” he had undergone in the United States.
“It’s like my whole transition is invalid here,” he said. “They act like I haven’t even started.” What questions were they going to ask J during this assessment? What were they going to make him talk about or do? The mere thought was overwhelming and triggering, like something from George Orwell “One thousand nine hundred and eighty four. “
As we were discussing whether to stay in England, I remembered what it had been like during J.’s first transition. I watched him walk into the public men’s bathroom with his hood down over his face and his face. head down, as we both hoped he would blend in with a man and escape all danger. I would wait outside with my phone in my hand, my heart pounding in my head, trying not to think about the very real threat of anti-trans violence.
That toilet had started to feel more secure once J started to mix as a male. But now, years later, the UK felt riskier than that toilet. How could I be sure that J would come out unscathed?
So we packed our things, gave all our furniture, got on the plane and didn’t look back. That’s not to say that leaving wasn’t difficult. Before transporting our suitcases to Heathrow Airport, I remember taking one last glance at the chilly sun that descended on the streets. All around us, we could hear the warm, familiar accents that sounded so much like mine. It hurt that we didn’t belong here.
Since J is trans and I am non-binary, we both knew America is oppressive as well. In the United States, if you need to make a medical transition, you are also subject to dehumanizing“Assessments” to prove your gender dysphoria – and that’s assuming your health care provider agrees to treat you.
Trans youth also experience oppression. For example, we often deny trans and non-binary youth hormone blockers, which studies suggest are really saving. All of these slights also slow or prevent trans and non-binary access to gender-affirming care, although studies suggest faster access could dramatically reduce widespread suicide and depression.
Here’s what I’d like to see: Instead of making trans and non-binary people wait for gender-affirming hormones, surgeries and hormone blockers at their own risk, we must focus on the dangers of delaying and blocking such support – and we must do so urgently. After all, according to the Trevor project, more than half of trans and non-binary youth have considered suicide in the past year. Yes, trans and non-binary people literally die because they cannot access gender care. So if our governments and healthcare professionals truly believe trans lives are important, it’s time to put those words into action.
Star Williams (they / them) is a freelance writer who lives in Massachusetts. In addition to publishing fiction and non-fiction in numerous magazines and journals, they have served as Editors at Narrative Magazine and Writing Professor / Manuscript Consultant at Grub Street. Star has won writing awards for her non-fiction, fiction, and screenwriting for Glimmer Train and Screencraft, among others. They love their weird stuffed animal, Duck, who has his own blog at www.chuckleduck.life. Star and Duck are also on Instagram at @ducking_ace.
