When puberty blockers are not available, puberty carries on and its changes become permanent, so many people grieve a voice, a height or a jawline they never chose. That grief is real and reasonable. It comes from the wait, not from anything the person did.
I'll call her Ines. She is a composite, drawn from many stories people have told me over the years, so nobody real can be found in her, but every part of what follows has happened to someone. I'm telling it because so many people ask me what the wait actually felt like, and because the answer is easier to hear from a life than from a list.
Ines was eleven when she told her mother. They were in the car, parked outside a supermarket, and her mother had just turned the engine off. Ines said it to the windscreen because that was easier than saying it to a face. She said she was a girl and had always known, and that she'd been waiting for the right moment, and that this was probably not it. Her mother laughed, a startled kind of laugh, and then cried, and then said, "Well, we've got shopping to do," and they sat there another ten minutes before either of them moved.
Her mother believed her from that first minute, and I think that is worth saying, because the story that follows could be mistaken for one about an unsupportive family, and it isn't. Her mother went home and read everything she could find. She learned that puberty blockers are medication that pauses puberty, that they have been used for decades for children whose puberty starts too early, and that for a trans child they give time before the changes that cannot be undone. She learned that this was exactly what her daughter needed. Then she found out how difficult it was to get.
The family doctor was kind and said she'd refer them. The public clinic wrote back with a waiting list that was measured in years, and a second letter, months later, confirmed it. Where families once might have found a private doctor willing to prescribe, that door is closing. In the UK, where many families look first, the sale and supply of puberty blockers on private prescription to trans young people has been banned, and other countries have followed. NHS prescriptions there are almost impossible to obtain, because the services and the expertise are not there. The cost of all that does not fall on the people who made the rules. It falls on a child, in months, and every month is a month of a puberty she did not want.
Ines did the things a child can do. She grew her hair. She wore the jumpers that hid her shoulders. She worked out that if she kept her arms folded in photographs she looked narrower. She also stopped talking much at school, because she could hear her own voice starting to wobble and dip, and she didn't want anyone else to hear it either.
The moment she still thinks about came when she was fourteen. Her grandmother rang the landline, as she always did on Sundays, and Ines picked up and said hello. There was a short silence, and then her grandmother said, kindly, warmly, "Oh, sorry, love, I thought I'd got your father." Ines said, "No, it's me," and passed the phone to her mum, walked to the bathroom, and ran the tap so nobody would hear her.
Her grandmother had meant nothing by it. That was the worst of it, there was nobody to be angry with. It was simply the sound of a body doing what bodies do, with nothing to stop it, and the person on the other end of the line hearing the wrong thing.
When Ines told me this years later, she wasn't crying. She said it quite lightly, the way you talk about something you've turned over so many times that it has worn smooth. What she wanted me to understand was that the regret is not about being trans. She has never wished she was anything else. The regret is about the wait: the voice that came in without her say, the shoulders, the six feet of height that means she has now apologised to more doorframes than people. She laughs when she says that. Then she stops laughing and says that she'd have given a lot to be five foot seven and have a voice that nobody mistook.
I hear versions of this constantly. People tell me they feel guilty for grieving, as though it means they're ungrateful for the life they have now, or as though it makes their parents' love somehow less. It doesn't. You can be glad of who you've become and still be sad about what you went through to get there, and both are true at once. The grief isn't a flaw in the way you've coped. It's a sensible response to being made to wait for something you needed while the clock kept running.
Her mother carried her own version. For a long time she asked herself whether she should have pushed harder, rung more people, found some other way. Ines told her, in the end, quite firmly, that she hadn't been the one who made her wait. That sentence took them both a long time to be able to say and to believe.
So what helped? Not one thing, and not quickly. Ines started hormones as soon as she could get them, and it changed how she felt in her skin more than she'd dared hope. Her skin softened, her body gradually changed shape, and something in her face relaxed that she hadn't known was tense. Hormones can't undo a deeper voice or a broader frame, but they do a great deal, and she remembers the first time she caught her reflection in a shop window and kept walking because it just looked like her.
The voice she worked on slowly, with recordings on her phone and a lot of embarrassment. Her younger sister turned out to be a merciless and loving coach. She would shout "Too low!" from the next room, and Ines would try again. Ines says now that the voice she has is one she built herself, which is a different thing from the voice she was given, and she's fonder of it for that.
If you're an adult at the stage of wanting to explore hormones, GenderGP, which I founded, can help with access to affirming care, including prescribing and monitoring. And if you're young and reading this: what you're feeling is real, and puberty does not wait. A parent or trusted adult on your side makes everything easier, though plenty of young people don't have one, and that doesn't put care out of reach. A doctor can look at where you actually are, which is something I can't do from a page.
If you missed the chance for blockers, you haven't missed your life. You have missed something real, and you're allowed to be sad about it, and angry too, at the system and not at yourself. Ines's mother still rings her grandmother on Sundays now, but it's Ines who picks up the phone. Her grandmother says, "Hello, my darling," and she gets it right every time.
If there is a story that you would like to share or hear about, just let Sammy know.
Dr Helen Webberley
Comments