Three tales of transition reveal the fear, regret – and happiness

Being trans seemed like the answer to everything and when Harriet said she wanted to be known as Ollie, it took her school just a day to accommodate the change.

Transition regrets after surgery can have lead to anger and trauma.

HARRIET

When Harriet said she wanted to be known as Ollie, it took her school just a day to accommodate the change. Fifteen-year-old Ollie, a trans boy, was a pupil at an all-girls’ school. Immediately after coming out, Ollie experienced a “honeymoon period”. Being trans seemed like the answer to everything: “Why I’d felt so strange, why I’d felt like I couldn’t relate to most people. There’s a whole list of things I felt I could now explain – sexuality crises, discomfort with being in a single-sex school, not knowing how to interact with my family, hating large social situations.”

A year later, in 2017, Ollie was first seen by the Gender Identity Development Service. Ollie knew what he wanted from GIDS: testosterone and then “top surgery” – a term used in the trans community to describe a double mastectomy and the construction of a more masculine-looking chest.

After a five-session assessment spread over seven months, Ollie got a referral to an adult gender identity clinic. He was offered an appointment after 15 months. Ollie was approved for testosterone at his first appointment and a year later he had a double mastectomy. Not long after having his breasts removed, Ollie started having doubts. The complications from the double mastectomy were “traumatic”, but Ollie’s health was also deteriorating more generally. He was frequently getting painful urinary infections because of vaginal atrophy, caused by the testosterone.

But it was more than this: Ollie knew he wasn’t a man. What’s more, he knew he was a woman attracted to other women. He stopped taking testosterone in November 2020 and identified once more as female. Ollie is now Harriet again. She regrets her transition.

“I suppose there is anger. I’m not a very angry person. But there are obvious things that should have been picked up.” It’s clear, she thinks now, that her trans identity was “a coping strategy”. “I can at least take comfort in the fact I’m no longer fighting an uphill battle against my own biology.”

People can be happy with just dressing in a way seen as typical of their preferred gender.

JACOB

Jacob has never really seen himself as a girl: “Even when I was, like, a toddler, I would go by names from male characters I saw on TV.”

In 2014, when Jacob was 11, he had his first appointment at GIDS. His mother asked the team if there was any kind of therapy that could help ease his distress. She and Jacob say they were told there wasn’t. But, Jacob says, the clinicians explained: “There’s this thing called hormone blockers. They’ll stop your puberty for as long as you need it to be stopped. And then as soon as you get old enough, you can go on testosterone.”

Jacob was pleased. “A cure is how they sold it to me.” Less invasive options, such as Jacob continuing to dress in the gender he preferred, weren’t discussed.

His GIDS assessment report stated: “Hormone blockers can provide young people with the opportunity to explore and experiment with their identities without the anxiety and challenges associated with ongoing pubertal development. It is considered to be a fully reversible treatment.”

Life for Jacob was immensely difficult. The blockers slowed down his puberty but they didn’t stop it. “I still got showings,” he says, referring to spots of blood. “I still got breast-tissue development.” His physical health suffered too. He gained “tons of weight”. Then there was the problem with his bones. They kept breaking. Jacob was advised to take vitamin D. His blood work showed that he was “incredibly deficient”.

After more than four years on the blockers, Jacob felt worse than he ever had before the medication. In 2019 he took his last injection. The improvement to his health was immediate.

In 2023 Jacob is 19 and still trans. He uses a male name and pronouns, and dresses in a way that he says is typically male. But he’s not on any medication. He hasn’t chosen to take testosterone. “I’m content with just being me. I’m happy dressing as a boy, I’m happy saying that I’m a ‘he’. And if people don’t believe it … it doesn’t really bother me.

“One of the biggest regrets in my life is that I went on blockers. I (did it) because I was petrified of the possibility of puberty.”

He says GIDS should have prepared him better for that and “not just given me this drug”. “I was a child and I still don’t know how it’s affected me properly or the full damage that it could have done to my body. And that is scary.”

For others, surgery has proven to be the best path.

PHOEBE

Phoebe told her parents when she was three years old that she was “saving all my Christmas money for an operation to become a lady”.

She was 15 when she was first seen by GIDS. Bullying would often be discussed at the appointments. “I suffered horrific abuse,” she explains. “I was teased and taunted for being gay.”

Phoebe’s desire to live as a woman wasn’t about whom she was attracted to; it was about who she was. “I was physically sick at times over what I saw in the mirror.”

At 16, she went on puberty blockers. Her clinicians at GIDS never pushed her towards transition. She said undergoing surgery just before she turned 20 was the best thing she’s ever done.

Almost a decade later, Phoebe hasn’t once regretted the surgery. But there is one thing she would change if she could. “Before I started hormone blockers I was asked about children. I was, like, ‘Oh my God, yeah, I’d love to be a mum.’ ” NHS fertility services refused to help her to freeze her sperm. The letter she received described the wish to preserve fertility as “at odds” with her pursuit of “gender reassignment”. It’s something Phoebe’s cried about subsequently in therapy.

Since her transition she has had relationships with men but admits that she has found it difficult. While there are men who will date trans women “with open arms”, she says, she’s not necessarily sure she’s found those men yet. Transitioning has been right for her, but she also thinks it’s right that the process takes time.

Case studies are extracted from Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children by Hannah Barnes. Some names have been changed