To the world, I had the appearance of what society has defined to be a woman. Nevertheless, this was not the picture I had of myself, not when I was a kid, and even less so as a teenager. I always knew what I wanted to look like. A human being with more or less long hair, a beard, muscles. I remember when I first watched Tarzan, I had wanted his same features. I remember also wanting to be a pirate with a moustache, like that of Jack Sparrow. The perception of myself may have changed over time, but I know one thing: the perception of myself is valid and is no one else’s business. If I am now the complete opposite of Tarzan (I have very short hair, I like fashion, and would not stand being in a jungle), I still want this masculine figure which society has constructed. This masculine figure is part of my identity and isn’t debatable or changeable. Society is what creates the image of the stereotypical man and woman, not nature. Many women, for example, may have the possibility to grow a beard, nevertheless it is not accepted; it is not defined as a woman’s physical attribute, even though ‘nature’ gave her that possibility. This codification of what is acceptable and what isn’t, is making our paths, as trans persons, much more difficult and inaccessible.

I noticed these difficulties when I was refused hormone therapy under the reason that I hadn’t been referred by an accredited psychologist or psychiatrist. I couldn’t understand why to get access to a medication that is vital for me, I had to, for at least a year and with no assurance of even getting a referral, go over intimate and private details of my life with a person I didn’t know. I say vital medication because during puberty and after, I fell into a huge depression which I couldn’t get out of. I was feeling invisible, and sometimes too visible. I could feel the heaviness of my body every day. I was so uncomfortable with myself. I didn’t have many friends. I tried to escape reality through love and even religion; it was a way to forget - forget how much I hated the way I looked. For me, it is not about ‘changing sex’, it is about feeling more comfortable with one’s own body. In fact, many trans people are completely fine with their genitalia or other secondary sexual characteristics.

I was mad at this endocrinologist. I remember the way she looked at me when I told her what I went to her for. She thought I wanted to have a masculine figure in order to go out with girls, and gave me the speech of how it was ok to be a lesbian. It was totally absurd.

From this moment, I knew I had a long way to go.

This long path included going to a psychologist. A friend of mine recommended a center in Hamra which was LGBTQ inclusive and offered counselling sessions. I went there thinking that I would finally be understood, but it wasn’t the case. I was confronted with a psychologist trying to uncover the underlying reason as to why I am trans. She was distorting my words and absolutely wanted to find out why I am trans. I felt like I was standing in front of Dr Freud, and it didn’t take me long before slamming the door.

I was then advised by a teacher to see a psychoanalyst - which was even worse. She charged me a huge amount of money on our first meeting (which was supposedly just to get to know each other and see if I am willing to go through therapy with her), she had a supercilious tone and tried to get it through to me that if I don’t choose to do a therapy for at least a year, I will never have access to hormones (not only in Lebanon but anywhere else). It is important to note that the least costing therapy session is approximately $40, so imagine this price on a yearly basis: that’s $1920 per year, to be exact.

Not surprisingly, what she said was wrong. Many countries, including doctors providing comprehensive care in Lebanon, do not impose a year of therapy on transgender people to prescribe hormones and access to surgery. In fact, during this time (around the end of 2014) I was looking forward to travelling and getting my hormone treatment and surgery outside of Lebanon – where not only did I have a bad experience with the endocrinologist and the psychologists, but also with some surgeons. I cannot say those surgeons weren’t nice or were judgmental, but it was the same discourse again and again: I had to get referrals from psychologists. I must mention that these surgeons were plastic surgeons, they modify women’s and men’s bodies, making them more masculine or feminine, every day without asking them for any referral. This is what makes me angry. They made me feel like a child who doesn’t know what is good for him.  

In October 2014, I fled to London. I had previously done some research on physicians who would prescribe hormones, and found a doctor who has a center specialized in trans health. Transhealth, the name of this clinic, is where I decided to go. I had an initial appointment with Dr. Curtis (who owns the clinic) - he charged quite a lot, but it was worth it. He mentioned all the effects a transition might have on a person (positive and negative, medical and non-medical), and he gave me tons of sheet so I could read them and sign them before agreeing to go into the process. He also advised me to see a counselor for two sessions, just to make sure that the decision of transitioning is taken by myself with full awareness. Seeing a counselor made a lot more sense than seeing a psychologist or psychiatrist. In fact, counselors do not see you as ‘ill’ or potentially ill; their only role is to advise and make sure people know what to expect in the process of surgery and hormones. In London, only two sessions are required, and it was quite easy to get an affordable price.

The session with the counselor went well, she was very understanding and had a clear knowledge of what it means, socially and medically, to be trans. I did the two sessions in two weeks, I then had the approval of Dr. Curtis and started hormones on January 15th of 2015. It was such an exciting date - I remember waking up every day and looking for changes. Changes come slowly but they happen. I now have been on Testosterone for four years, with a deep voice, a much more socially defined masculine body (but that was mainly because of my fitness activities), and still waiting impatiently for a beard to grow.

I also did my top-surgery in London. It was also easy to access and I didn’t have to go through counselling sessions. I just got a referral from Dr. Curtis and one month later I was ready for surgery. I had my top-surgery privately with Dr. Miles Berry. He was very friendly and his team adorable. He respected the pronouns I prefer and so did the nurses. I stayed only one night at the hospital and didn’t have any discomfort with the team. I then had five follow-up appointments, and if I had any question I could email or phone them at any time. Having done this surgery was a relief, I was free to walk and run without being self-conscious. I can go topless at the beach, something I used to dream of. This surgery also gave me the privilege of passing, which means that when people see me, they perceive a man and do not question my identity. For certain trans individuals, passing is vital. It helps them become less vulnerable in the streets and in public spaces which are usually very harsh on transgender individuals.

It is important to mention though, that this is my medical experience; it will certainly differ a lot from a person to another. Some might have a great experience with Lebanese surgeons and a bad one from UK surgeons. More and more doctors in Lebanon are willing to learn and help. But overall, I guess, it is all about the general healthcare system. The nurses and surgeons in the UK are trained on trans issues and can face charges if they do not respect a person’s identity. The UK healthcare system also gives access to the treatment for free for UK citizens and persons holding a visa (even if it is a student one).  In Lebanon, surgeries might be expensive and are sometimes not done properly, and staff are generally untrained.

I am grateful for the support of my girlfriend, family and friends. I am very lucky to have met people who accept me without judgment, people who respect my identity. Even though I had to go through painful steps to express my discomfort and to be able to exist as myself, I had the wonderful surprise of being listened to and supported by amazing people. Sometimes, people can surpass our expectations in a very positive way.

Four years on testosterone, 3 years post-op, and I don’t have any single regret. I cannot say that life became perfect and that I am the happiest person on Earth. But what I can say is, that I am more confident and feel more comfortable with myself and with others. When I do feel down occasionally, it is because trans people still have a long way to go to feel perfectly safe and accepted in our societies. I was lucky to receive support from people around me, but this is definitely not the case for all trans people. Some are threatened to death, some are abused, some are left on the streets… 

I still feel threatened at times as I know that my body doesn’t exactly fit the expectation of what a man’s may look like. I am scared of having to go into a hospital or even toilets which is the most basic thing. I just hope one day, society will permit us to live without all those fears, and will recognize that being trans is not simple. We must sometimes fight against our own bodies; sometimes it takes a long and painful process of accepting one’s trans identity, sometimes we surpass our fears to go through rough surgeries. But what is even more important to note is that we are not that different. We all modify our bodies for multiple reasons (gym, diets, hair removal, fat removal, tattoos, piercings etc.), and this is our choice and OUR choice only. As human beings we have the possibility and privilege to create our own and unique self, so why all this shaming?

-- by Salim