If you're transgender in the UK, and would like to physically transition, you should very seriously consider self-medicating or seeking private care. Do not wait. That list is getting longer, and rules about what's available routinely change without accountability. By the time you get to the end of that list, the care you were promised may not even exist any more. If you want it, do it. Your life is valuable, and you deserve to start living it. Now.
I've been musing about some of the emotions coming up around it.
On the one hand, it's helpfully clarifying. If you're ready to take on an expense, and possibly a legal/medical risk too, it helps to cement and actualise that yes, this is something you want enough to just take it.
The current gender system - in which you must humbly petition an authority figure for approval and permission to live as transgender - encourages dependency. It encourages us to transfer some of our "responsibility" for transition onto a stranger. "I have to transition because I have a medical condition and this is the only cure" or "This doctor is an expert and he agrees this is what is best for me" is a dangerous perspective from which to make a decision of this magnitude. In contrast, "I want to do this so I'm going to fucking do it and nobody can stop me" is an ideal foundation for building strength, autonomy and courage. These are skills you'll need regardless, so having that as the core as your process feels healthy.
(when I see the words of ideologically anti-trans detrans activists, I brood on the failings of the gender system that allowed them to be harmed. For all that I disagree with their goals, I can't disagree about their experience: of a gender system that is impersonal, requires conformity, and does not care for the wellbeing of its patients. Of course, that movement is aiming to remove access to transition healthcare for everybody; rather than reforming or replacing current systems so that this harm is no longer caused. All the same, I feel that these people went into a system which encouraged them to offload responsibility for their own choices onto gender doctors, and who now seek someone to "blame" for that. Processes with no gatekeeping, no approval, no stranger who will judge and affirm you would, I feel, reduce the chance of unhappy detransitioners even lower than it is now; nobody would have any illusions that their choice to transition was anything other than their choice)
On the other hand, transition is a vulnerable time. Oh, how I would like someone in authority to reassure me and tell me it's ok, to tell me this is the right choice, nd help me through a warm, safe process - cossetted within a compassionate system where my hand is held and my feelings centered. I guess letting go of our "need" for that is valuable; but all the same. Anyone who's done proper drugs will let you know: the context in which you take a drug, the expectations you have for it, how safe you feel and your mood going in, can profoundly shift how you experience that drug. Even abstract cultural things, like the fact the English are more likely to get violent when drunk than folk from other countries. Transition healthcare isn't a drug, as such; but it's also not *not* a drug. It's a substance you're taking which will profoundly change things about your life experience (Our desire for HRT to "not be a Drug drug like actual Drugs" says more about the stigmatisation of drug users/our learned beliefs about drugs, than it does about drug-use or transition).
for that reason, I feel like embracing the punky radicalism of it as an act and aesthetic is actually pretty vital. I've written about this before, but my associations of the early internet were always deeply cyberpunk (even though i was like, 8 or 9, and have no idea where I was learning this idea from). My fantasies of the web were, and still are, of an underground place where cool crimes occur: not the kinds of crime that hurt people, of course, but counter-cultural, anti-establishment hacking. Hacking for what end? idk, I was eight. I didn't really know what you'd do when you'd hacked something, only that it would be subversive and take down the system, and that you would never be found, and it'd look like this:
I have to say, gendercrime feels so discordant to everything my life has been until now; deeply absurd and unecessary. This vision I have of a cybergoth-streetpunk-hacker was always someone who was not me, who has always been so uncool that I haven't even been offered drugs (something my secondary school anti-drugs program assured me would happen a lot. That or being peer-pressured into stealing hairbands from a shop). But it helps to have an emotional "cradle", a political and aesthetic fantasy by which my new life is held and made comprehensible. Maybe I'll get one of those funky gas masks next & pretend it's a corona thing when I wear it to the shops
Another factor is discovering how abruptly my politics have moved five notches towards anarchism. Anarchism is a big political school, but a key part of it is being opposed to the centralised state - and developing alternative skills or community to provide those same services for yourself. Due to my experiences with community in the past, relying on a social group instead of the state has always seemed flawed; it just recreates those same messed up power dynamics on a mini-scale. But the reality of being transgender is that you're routinely failed and harmed by systems set up to (theoretically) assist you; seeing an underbelly that the privileged struggle to believe exists. Policing, healthcare, housing, borders, welfare, work: or, probably, some combination. That loss of trust is trauma (assuming you ever had trust); a permanent hit to your sense of stability and what is certain, a permanent sense of being on the outside, of being insecure - of being valued.
There's a very good tweet which calls on Western leftists to very seriously start looking at 3rd World leftism as a model. The tweet puts it more eloquently than me, but it goes something like: in profoundly corrupt countries like in Latin America, leftists know they cannot win in a fair fight through the ballot box, and so they organise to win in different ways. In the west, however, many leftists and most liberals have a innate sense that we are "not like that" and ultimately, though flawed, our democracy is OK and worth our time. But - this isn't really true. Our electoral systems wildly favour wealth and establishment power, and are in many ways corrupt; there's a kind of relieved racism that goes into looking at an imagined 3rd world country as dodgy and undemocratic, while assuming that the caucasian gloss of our own system is just. Therefore, if we're serious about winning, we need to start organising like those 3rd world leftists - we need to really believe that our nations are dodgy and undemocratic too - to build the power to make change real, in ways which don't rely on winning an election. I think this is a useful analogy for transgender people. Our trancestors did not wait patiently on a list for seven years for permission; they just fucking did it. Often by lying, by stealing, by scrabbling for cash by unorthodox means, by hacking about with systems that weren't designed for them and - let's be clear - often being harmed or killed in the process. The presence of a Gender Clinic and a National Health Service and a cultural Transgender Tipping Point is a kind of mirage that lulls us into sleeping; into feeling like nowadays, we're better than all of that, and if you only sit and wait your turn some-one will help you. Here is the reality: there is functionally no trans medicine available through the NHS. This is also kinda true for many other conditions, and we're fortunate as transgender people that we can create our own healthcare with comparative ease.
To take control of your own healthcare is to accept that reality, and claim it as a banner with pride. To refuse to be victimised by it, to reject patiently waiting like an abusee in the hope that the State can change. It builds resilience, and turns you into a Have instead of a Havenot; a person who has refused to be a failure on one stage, walked off set and onto a new one in which you are the protagonist. It takes some time to internalise this new world; but slow practice builds power. To say: this cannot hurt me any more, because I have rejected all that it is.
And so, I leave with you the thought on which I started: nobody is coming for us, and it is time to be strong on our own account, and prepare the systems and alternatives for people like us to flourish - regardless of what we are "permitted". If you're in the UK, and hoping to transition medically, you should be looking into either private healthcare or self-medicating.
Be brave, little one.