To The Edge of the Nether (And Back Again)

So at long last, after 18 months of waiting, I had a GIC appointment. How was it? Meh.

Let’s re-cap: I live on the South Coast, but I used to live in Yorkshire. When I signed up for the GIC, I signed up for the one in Sheffield, as it was the nearest one with the shortest wait time. I can’t transfer to another one. So I have a hell of a journey getting to it.

My solution was to come stay up in Yorkshire for a bit and have a sort of mini-holiday. This meant I was able to make something more of the trip. I made this decision with some hesitation, as I was less than enthused about visiting my hometown, a place with a lot of bad memories and baggage. So I tried to balance it out by arranging some fun activities around the week. One was getting to meet up with the lovely Ruth, who I know some of you will also know from here on WordPress, while also meeting up with Evie, a friend from Twitter.

It was nice to see two friends, as well as spending time with my partner’s mother, but the headline event was the long-awaited GIC appointment…


Appointment #1

I found it very amusing that I was traveling to Nether Edge, the location of Sheffield’s Porterbrook Clinic. Nether Edge sounded to me like something out of a high fantasy novel. I was traveling to the edge of the nether, to finally access the legendary and mysterious gender clinic, a fitting quest for my journey North (…yes there is a nether regions joke in here too somewhere, but I’ll leave that one to you).

I traveled down to Sheffield from my partner’s mother’s flat, which I’d arrived at the day before. This meant grabbing a taxi, then a train ride, and finally another taxi. So not quite a straightforward journey, but certainly easier and more practical than going from home, 250+ miles away.

I arrived about an hour early, meaning I had plenty of time to sit in the waiting room. I felt pretty confident and relaxed about the prospect of the appointment, so in a very Mia-esque decision I decided to spend the time playing with selfie apps and tweeting.

Despite having a 90 minute time slot for the appointment, I’d had my appointment and gotten back to the train station to head home in that same 90 minute window, which I guess tells you a lot. As a first appointment, there was little to talk about. I was seen by a friendly doctor who noted that I’m fairly “straightforward” as cases go, which I took to mean that I’ve already removed a lot of the barriers they want to see gone before I progress. Namely: I’ve changed my name, I work full time, I’m on (monitored*) HRT, I’m out to everyone, I have no issues with alcohol or drugs etc. there really was very little I can talk to them about. In terms of what they can help me with in the short term, there’s nothing I could think of. For now, I’m all about getting through this assessment period, so I can eventually reach: a surgery referral, funding for what remains of laser, and NHS HRT.

All in all, the appointment was little more than an introduction and a rundown of where I’m at in terms of my transition. There was also some of the usual questions, such as when did my dysphoria start, how did I feel as a teenager etc. It was as mundane as you’d expect from a first appointment, but quite the anti-climax after well over a year of waiting for it.

The doctor mentioned I should be able to stick future appointments together, doing two on one day, to save me traveling all the way up from the South Coast. It was simply just something I should tell the receptionist. When I then went and told the receptionist this after my appointment, they laughed in my face and said that wasn’t possible. So whether they were being a difficult ass, or the doctor was misinformed, I’ll leave that up to your imagination. But the idea of travelling back up at least another 3-4 times before even getting onto their care pathway, once just for a 15 minute appointment too, is an exhausting idea.

Honestly, I find it outright silly that the system is so inflexible. I have a letter from a private doctor who’s been seeing people for years, who specifically states that in his opinion I have gender dysphoria based on his assessment of me. The GIC doctor was happy to see the letter and considered it useful, yet all the evidence in the world doesn’t change the fact I have to follow the same rigid path as someone arriving for the first time, with very different circumstances to me, unsure of what they want. It bugs me most because I’m using someone’s potential appointment slot, for an appointment that’s arguably unnecessary for me, I don’t need advice, I don’t need guidance or emotional support, I just need to get onto the care pathway. Yet by marching me down the same path, as if I haven’t been transitioning on my own for over half a year, it slows me down and uses resources on me unnecessarily. I would rather they tailor care to patients, allowing me to skip one or two appointments, and give those slots to those who need them more than I do. But that’s not an option, it’s their way or nothing.

Truthfully I don’t think I’d be as grumpy about this reality if reaching the clinic was easy for me. Instead, after agonising over it, I realised I really need 3 days off work to pull off each appointment. A day to travel up and stay nearby, a day to travel to and attend the appointment, then a day to travel back home. Even if I was rich and could take the train for every step, it would still be very risky, only just would I be able to do the whole thing in a day, starting the journey at about 5:30am and returning home late at night. With my budget I have to work with coaches, the only way I could find to do a short trip on the coach meant arriving home at 2am, 24 hours after setting off the following night. Attending the appointment on no sleep, after being awake at least 14 hours, seemed like a pretty ridiculous idea. At best I could probably do it in 2 days, but that would still mean getting back very late at night, if I had another afternoon appointment. Honestly, England’s crappy travel network is as much to blame as the distance itself.

Treat Yo’ Self

Outside of the appointment, things got pretty stressful up there. I hesitate to write about it here as a blog has a bit more permanence, but I did talk about it over on Twitter last week as it happened. I ended up closing my old blog simply because I had recorded too many personal specifics to leave it hanging freely, so I’m very reluctant to let this blog end up in the same situation. Thus for now, please just take my word for it that the week was punctuated by a pretty tiresome event in the middle. It’s not too difficult to use your imagination and work out who or what may have occurred by visiting my hometown.

Anyway, when I got back home I felt pretty low. I was soon to be returning to work, despite feeling that I could really do with a day or two to relax. More than anything I felt agitated and restless.

I’d been keeping myself entertained lately by playing old video games that I was sick to death of. I love video games, along with comics they’re my favourite way to relax. I joked with my partner that continuing to pour hours into wandering around Fallout 4 had ceased to be fun about 20 hours worth of gameplay ago, but I kept doing it every other night out of a sense of wanting to playing something that I could lose myself in. I’m a sucker for anything open world, any game where I can just walk around in a big open space I’ll gobble right up. But I’d long ago harvested Fallout of everything worthwhile it had to show me.

So then I decided, as it’s been a long time since I’ve treated myself to anything new, I’m going to pick up a new video game. After the crappy weekend I had, I was dying for something immersive, to let me forget about everything and kill some time. I wanted something with legs, that’d keep me busy and give me something to look forward to unwinding with after work. Since friends repeatedly were singing the praises of the new World of Warcraft expansion, I decided to re-subscribe.

So I’ve returned to a game that I have had a rather complicated relationship with in the past. WoW is a game that I began playing at launch, that rapidly became a large part of my life. I loved it, it got me through some very stressful times. But when I was at my lowest point a few years ago, feeling aimless and deeply unsatisfied, I substituted feelings of accomplishment and worth by focusing on goals in the game. I repeatedly distracted myself from how unhappy I was without actually doing anything to fix the cause, or at least work towards changing my outlook. Feelings of loneliness and (what I now recognise as) dysphoria, were drowned by running around as a virtual elf for the day. I finally quit a few years ago when I realised I had exhausted the game’s content and wasn’t even enjoying it anymore, I just preferred being in that world to the disappointing mess that was my life at the time.

Now that I’m over half a year into my transition, as well as being a bit older and having a full time job, I feel like I can have a healthier relationship with such a large and engaging video game. I can use its wealth of content to lose myself in after work, while I truck on with transition. It’s a small relaxing break, rather than an escape from myself.

I realise that “I bought a video game” sounds like a painfully mundane and dull thing to blog about, but… I’m actually really happy with it! I forgot how nice it is just to buy yourself a gift and for once not pour everything into necessities each month. It should keep me busy for the foreseeable future.

Truthfully I do feel a bit guilty, but it was a fairly inexpensive purchase and I feel like after a tough week, I’m justified doing something for myself for a change. Money is still very tight, but I’ve got enough to handle my monthly laser sessions and as long as I stick to the coaches for my GIC trips, I’ll be okay. I now only need to see my private doctor every 6 months too, which is helpful as that money can stay in the transition pot for laser and travel.

So I think that’ll do it for this blog post, I’ll be back when I have something else to report. Until then, you can find me running around Azeroth as an elf, again.


*A few people have asked me how the GIC reacted to me already being on HRT. They were fine with it, but they were very, very keen for evidence that my levels have been monitored by a professional, whose advice I’ve been following to the letter. They weren’t interested in recording the date I started HRT, they wanted the date that “monitored HRT” started. It’s worth mentioning that this is entirely in reference to surgery eligibility, it had nothing to do with approving me for HRT on the NHS, which won’t happen yet either.



  1. Chrissy_bea · September 28, 2016

    Sounds a bit like my trip to CHX a couple of months ago hon though at least there the two consultants I had seen privately both work there so all I was really doing was either handing over a ton of info for CHX to copy and put into their records and go over what I’d said to other people previously, so like you my appointment there was a non event really. xxxxxxxx


    • Mia Violet (@OhMiaGod) · September 28, 2016

      Yeah, oddly they weren’t very bothered about evidence, or not as much as I’d expected. Deed poll, the letter from my doctor and my hormone levels were all they wanted. I’d brought more but they said not to bother handing it over. I guess that could be seen as a good thing, that they didn’t doubt me.


  2. ruthmartina2014 · September 28, 2016

    It was great to finally meet you and your partner too, Mia 🙂
    From what you say, it sounds like my ‘screening’ appointment at Leeds covered more ground than your first appointment proper. I understand their circumspection around surgery, but would have thought that fast-tracking you onto NHS HRT would be a no-brainer, especially as I understand it’s handled locally by your GP – unless of course the fact that your GP is in a different CCG creates administrative issues in terms of which bit of the NHS pays.
    The impression I got from Leeds is that each pathway is tailored to the individual rather than ‘one size fits all’, so I’m also a bit surprised that Sheffield is forcing you down a particular route regardless of circumstances. And how ridiculous that you can’t transfer to a more local clinic! Can you imagine if that were the case for other conditions? “Sorry Mrs Smith, I know you’ve moved to Edinburgh since your knee operation, but we need you to come to Penzance for your regular check-ups”
    Anyway, let me know when you’re heading north again for Level 2…


    • Mia Violet (@OhMiaGod) · September 29, 2016

      Yeah, it’s frustrating for sure. The whole process did seem awfully old fashioned and rigid from what they were saying. I am left wondering if I’d have been better going to Leeds but oh well, I’m here now, time to ride it out.

      I didn’t mention it in the blog post, but I’m going to try again at looking at transferring once I’m on the “care pathway” and out of this assessment period. Though I suppose once I’m into that stage there’ll be much less appointments as there’s little to talk to me about.

      I’ll let you know when I’ll be back! I was told to expect the end of October but we’ve arrived at the end of September and no sign of a second appointment letter, so I’m starting to think it’ll be November or later. Apparently their projections are a bit off right now as 2 new members of staff are about to come in, but 1 older member just left.


  3. michellen1960 · September 29, 2016

    Wishing you good luck on your journey. Hopefully you will not come up against too many ‘Jobs worth types’


    • Mia Violet (@OhMiaGod) · September 29, 2016

      Thanks! It sounds like my two assessments will be with different members of staff so we’ll see… but I had a good first impression at least from the first doctor, hopefully the rest are as friendly.

      Liked by 1 person

  4. Emily Iris · September 29, 2016

    Ugh, that sounds frustrating. Although I’m not familiar with the realities of the NHS GIC system, maddening bureaucracy is all too relatable. It feels as though trans people always have more to deal with than others, wherever we live. So glad you’re taking care of yourself. Video games are a big part of my self care, too, as is buying myself little presents everyone in a while. Keep treating yo’ self. 😉


  5. bcass · September 29, 2016

    ” When I then went and told the receptionist this after my appointment, they laughed in my face and said that wasn’t possible. So whether they were being a difficult ass, or the doctor was misinformed, I’ll leave that up to your imagination.”

    Write to Katie Roe and tell her that the Dr said one thing, the receptionist another and ask for clarification. See

    for contact details (way down at the bottom). I had appointments doubled up when I was at CHX because I was 200 miles away. The other thing I did was to ask for afternoon appointments so that I could travel down by train and back on the same day.

    ” I was seen by a friendly doctor who noted that I’m fairly “straightforward” as cases go, which I took to mean that I’ve already removed a lot of the barriers they want to see gone”

    Yes, that is fairly much what it means. TBH, not much will change for you as you are already doing most of what they would do for you. It is really only a method of getting GRS paid for, so whilst it may be tedious just think of the £11K you will save in the future.


    • Mia Violet (@OhMiaGod) · September 30, 2016

      Thanks for the link, I’ll get on that 🙂

      Regarding the money, yeah, that’s exactly it. If I get some money to finish off laser that’s a bonus, making my HRT easier and on the NHS is another bonus, the real reason I’m here is because there’s no way I could possibly afford surgery on my own.


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