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It's true. Tŵt Cymru is Exiting the EU. In celebration of the five year anniversary of Brexit, toot.wales is moving from France to the UK!

Never again will your Youtube preview card be in French. With our freedom from the oppressive EU wonks your toots are no longer required to be free from malformation or abnormal curvature. Finally, we can plough wasted millions into what's most important, the National Toot Service!

In all seriousness, we are growing and we want to be sure our service is meeting the needs of the community. This change also includes the long-overdue relocation of the non-profit management from the States to the UK. So, what are we doing?

New Web Hosting Provider

When toot.wales started we signed up with @mastohost@mastodon.social who have been an absolute dream and we cannot thank Hugo enough for the support he's given to us and to the many other Mastodon services he hosts. Masto Host is one of the most knowledgeable and ethical hosts available, and we highly recommend them.

However, as an older and somewhat large service, we are approaching the maximum size limit for the shared hosting service, and so we've decided to move to a dedicated host. We wanted to “bring toot home” so we are working with the fantastic team at @beasts@social.mythic-beasts.com to migrate our service to a UK datacenter where Mythic Beasts will take over the managed hosting portion of our service. They come highly recommended, and already host other local Mastodon servers.

Important to note that Mythic Beasts:

• Is Green Web Foundation verified
• Are Fediverse denizens with their own Mastodon server
• Has a dragon in their logo – who better to host y Ddraig?

Moving to a dedicated host increases our costs slightly, but gives us a lot of room to grow.

Down Time

We anticipate some outage while we move, we are tentatively planning for January 22nd, but please follow https://toot.wales/@teamtoot to stay up to date with our plans and any changes.

Use this down time to take stock of your life and the decisions you've made over the years. Document your findings, and post them when we come back online using the hashtag #DarkTimeToots – or just go outside and do something less boring instead.

New Non-Profit Approach

@jaz@toot.wales is based in New York, so to get things moving he set up a charitable organisation in NY which has been both our governance and our fundraising platform. This was never the long-term plan and due to the transatlantic money transfers we've seen a considerable portion of the donations going to bank fees.

We spent some time trying to become a UK-registered charity, but alas we could not convince the powers-that-be of our charitable mission – so we are moving to Open Collective.

We are finalising some dotted i's and crossed t's, but hopefully we'll be able to accept your donations on our new Open Collective profile very soon.

We will reach out to everyone who has recurring donations to ask very very vey nicely if you could please please pretty please continue donating but move it to Open Collective.

We will slowly wind down the 501c3 charity incorporated in New York over the course of the year, with the intent to be fully closed by end of year.

Sustainability

We are pre-paid for a year with Mythic Beasts. This means other than a few bills for domain names and such, you won't see an awful lot going on in our budget for a while, but our monthly costs are nearing £400 and growing, and that's with all moderator labour donated by our stalwart volunteer team. We strongly believe social networking is better in a non-profit, non-extractive environment but we rely on generous individuals to support this mission.

These changes also come at a time of considerable shift in the social media landscape, as the shareholder-driven corporations that hand out “free” social networking platforms in return for a deluge of advertising, addictive algorithms and non-stop invasions of your privacy are increasingly becoming more toxic and less interested in showing you the people and content you asked to follow.

One of the best ways you can support us, and independent social media in general, is to tell your friends. You don't have to quit the platform you're using to test the water on our side of the fence. We are open, safe, friendly, and growing. If you enjoy #BetterSocial then help us effect change by sharing the love with the people closest to you.

They don't have to join toot.wales – there are a number of great local services:

• https://mastodon.scot/
• https://mastodon.ie/
• https://ailbhean.co-shaoghal.net/
• https://mastodonapp.uk/
• and many more, check this map

And don't forget, there's also options like Pixelfed for sharing photos instead of Instagram, Feddit to switch from Reddit, or BookWyrm to enjoy a GoodReads-like social experience. And if your friends moved to Bluesky, ask them to follow @ap.brid.gy – which will allow their account to be found and followed by you on the Fediverse!

Diolch, Thank You!

When we started toot.wales the goal was to provide a privacy-first, safe social option for bilingual conversations. Roughly ten percent of all toots are yn Gymraeg, a stat that brings us great joy. More importantly, we see our feeds full of beautiful landscapes, standing stones, crochet, #Defaidodon sheep, #DysguCymraeg Welsh learners, local news, politics and weather, sports and more. If you haven't checked it recently, take a look at your personalised recommendations – you might be surprised!

All of us at Tîm Tŵt are thankful for your continued use of the service and your commitment to independent, decentralised social. We believe in it, and we hope you do too.

Diolch yn fawr iawn i bawb, edrych ymlaen!

At Tŵt Cymru, our mission is to provide a safe, welcoming, and inclusive space for Wales and the Welsh at home and abroad, along with the wider community of Welsh learners and people with ties to Cymru. Central to this mission is fostering a culture of civil discourse, where users can connect and express themselves without fear of harassment, hate, or harm. This is a commitment we take seriously, to ensure the safety and well-being of our community.

Recently, Meta Platforms announced significant changes to its policies and governance, explicitly allowing forms of speech that were previously deemed unacceptable due to their incivility or potential for harm. While we respect each platform’s right to define its own policies, these changes stand in direct opposition to Tŵt Cymru’s values. Specifically, the decision to tolerate previously prohibited speech creates an environment that risks amplifying harm, undermining trust, and marginalising already underserved communities.

Since Threads signalled their desire to federate, we have treated them like any other domain with which we connect. The recent changes in policy, governance, and stated approach by Meta’s leadership (in effect, the threads.net server admin) means this domain now represents a space which explicitly allows harm.

After thorough review, we have decided to defederate from the Meta Fediverse service threads.net on January 19th, 2025. This means users on Tŵt Cymru will no longer see or interact with threads.net content or accounts. If you prefer for your account to be hosted by a service that may remain connected to threads.net we recommend reviewing the larger servers at https://fedidb.org/network and enquiring as to their connectivity with threads.net, and migrating your account before the date above. If you need help migrating, please email help@toot.wales

Defederation will sever any existing connections; we are aware of 146 accounts that follow one or more threads.net accounts, and two threads.net accounts that follow one or more toot.wales account. Our server is aware of 3,838 accounts on threads.net, these will no longer be visible or searchable. The most-followed accounts are POTUS (soon to be managed by new staff), Meta employees, and Barack Obama.

Severing human connections is tough choice to make – and we do not make this decision lightly – but our decision is driven by our unwavering commitment to:

• Protecting Community Well-being: We prioritise the safety and inclusion of all users, especially those from marginalised groups who are disproportionately impacted by harmful speech.
• Preserving Civil Discourse: Allowing hateful speech and conduct erodes the quality of discussions and undermines efforts to build constructive and respectful dialogue.
• Aligning with Our Mission: Our federation policy explicitly requires partnerships with servers that share our core principles of community safety, mutual respect, and equitable engagement.

We believe that platforms have a responsibility to foster environments where users feel safe and valued. As threads.net moves in a direction incompatible with these principles, we are taking this step to ensure our space remains true to its mission. As part of this decision, we are amending our Federation Policy to include a new guideline as follows:

A third-party server whose publicly stated policies or principles significantly conflict with the mission and values of Tŵt Cymru may be subject to limitation or suspension.

Thank you for your understanding and ongoing support as we continue to prioritise the safety and well-being of our community.

A note from Jaz, founder of Tŵt Cymru

I want an open web, and I want safety. These two things stand in diametric opposition to each other, and managing any community is hard, really hard. By creating a space, I have a duty of care to the people in that space.

I am incredibly proud and grateful to have the help of a diverse, thoughtful, highly engaged moderation team. They have debated this issue, teased out all sides of several arguments, and it is the team as a whole that has come to this decision. This level of commitment and love gives the Fediverse its strength. In the most recent Fediverse moderator survey, the data shows one moderator for every 1,200 active accounts. No other social media service has this level of community care.

I firmly believe in localised governance; distributed and decentralised communities, and stand by the notion that anyone is free to associate, or to not associate, with whomever they please. I do not believe there is or should be a “global town square”, and the Fediverse reflects this with its 30,0000 communities, none of which connect to 100% of the network. This is a good thing.

When I look at the map I made of community- and language-focussed servers, I am delighted to see communities all around the world taking control of their governance and preserving their cultural norms.

As we continue to see a shift to the right in national governments and politics, I hope we and others can continue to offer an online alternative that is not dominated by a single country's ideals or politics. There are millions of lovely people using threads.net today, I am saddened to close the door to them. I hope they find joy in their connections on threads.net or wherever they may go next.

If you are reading this and you enjoy the social networking afforded to you by the Fediverse, tell your friends. Be the change you want to see in the world.

We have been testing the Mastodon feature “authorized fetch” for some time, and can now confirm we are going to move forward with this setting enabled.

When a server we are connected to is suspended, it continues to have access to all public posts and profiles, as this information is accessed anonymously unless authorized fetch is enabled.

Authorized fetch requires all Fediverse servers to identify themselves for each request, thereby allowing us to recognize and refuse access to suspended servers.

This does not completely protect any individual content that is posted using the “Public” setting, as this content is also freely available from any web browser. However, it removes the opportunity for suspended servers servers to fetch and interact with your content.

We additionally block access using other tools and resources, as part of our wider toolkit to reduce access for inauthentic actors.

This setting may impact some third-party Mastodon clients, please let us know at help@toot.wales if you encounter any issues.

For more information about authorized fetch, see:

• https://docs.joinmastodon.org/admin/config/#authorized_fetch
• https://fedi.tips/authorized-fetch/
• https://hub.sunny.garden/2023/06/28/what-does-authorized_fetch-actually-do/

We will be shutting down our blog and image sharing services on February 28, 2025

pix.toot.wales (Pixelfed) blogs.toot.wales (WriteFreely)

These services are rarely used, but require significant systems administration and content management.

We will notify each active user individually. For help retrieving an export, or moving servers, email us at help@toot.wales

Find a Pixelfed server: https://pixelfed.org/servers

Find a WriteFreely server: https://writefreely.org/instances

Byddwn yn cau ein gwasanaethau rhannu blog a delweddau ar Chwefror 28, 2025

pix.toot.wales (Pixelfed) blogs.toot.wales (WriteFreely)

Anaml y defnyddir y gwasanaethau hyn, ond mae angen gweinyddu systemau a rheoli cynnwys sylweddol arnynt.

Byddwn yn hysbysu pob defnyddiwr gweithredol yn unigol. I gael help i adalw allforyn, neu symud gweinyddion, e-bostiwch ni ar help@toot.wales

Dewch o hyd i serfwr Pixelfed: https://pixelfed.org/servers

Dewch o hyd i serfwr WriteFreely: https://writefreely.org/instances

Promoting your blog feed is easy on toot.wales!

Verify Your Site

On your blog site, add a link to your profile using the following specific HTML

<a rel="me" href="https://toot.wales/@myusername">Follow me on toot.wales</a>

You can put anything you like in the link text, “Follow me on Mastodon”, “Find me on Tŵt Cymru”, “Dilynwch fi ar Tŵt”, or use one of our icons from https://blogs.toot.wales/toot/dolen-i-link-to-twt

If you're using Wordpress, you'll need to add a Custom HTML block, or add the link as normal then go into Code editor mode to add the rel=“me” part.

You can get the code for your personal link at https://toot.wales/settings/verification

Then go to your profile and add a link to your blog. If you've already done this, open your profile and save it with no changes, this will trigger the verification and you'll get a snazzy green checkmark to show you've verified your link.

Federate Your Blog

Turning on federation means your blog will show up directly in your reader's feeds in the app of their choice. They can follow your blog posts and choose to be notified when a new post is available.

For blogs hosted on WordPress.com there is a video tutorial here: https://wordpress.com/support/enter-the-fediverse/

For WordPress blogs not on Wordpress.com you'll need the ActivityPub plugin, available at https://wordpress.org/plugins/activitypub/

Once you've federated, your blog now has its own profile that people can find and follow directly!

For example, this blog's profile is at https://toot.wales/@toot@blogs.toot.wales – you can search for @toot@blogs.toot.wales

Here's an example of what a wordpress.com blog looks like in the Fediverse:

Add Your Blog

We keep a directory of community bloggers and we'd love to add yours! Message us at @teamtoot@toot.wales with a link, title, and brief description of your blog.

Get Help

We'd love to help you promote your blog, if you need help just email us at help@toot.wales

It’s been two weeks since I had the procedure and I feel good.

The procedure was scheduled for Friday and I got the call Thursday telling us to be at the hospital at 7:30 am. The procedure was to be done in the ambulatory surgery area of the hospital. My wife was coming with me for support and to drive me back home. The hospital is about a 45 minute drive, so we left at 6:30 and arrived in good time.

The check-in procedure was very smooth and I was taken back in short order. I was seen by several people, the nurse coordinator, the OR nurse, a P.A., the anesthesiology residents and the anesthesiology attending. Finally the surgeon appeared and we discussed the procedure and made sure I still wanted to go through it.

The anesthesiology resident started my IV and gave me some sedative and I got wheeled to the OR. I remember moving myself from the stretcher onto the table and that’s about it.

I don’t have a strong memory of the early time in recovery. My recovery nurse was wonderful. As my head cleared I was visited by many of the same people I saw before the procedure. I was told it went perfectly.

We waited until my head cleared. It took a while for my blood pressure to chill out. My nurse kept asking me if I needed any pain meds and I kept saying no. Finally I started to feel some discomfort and agreed to some meds. She gave me some oxycodone. This was the first time I ever had it and it seemed to work.

Finally I was given the ok to go home. On our way I we picked up some oxycodone that had been prescribed. We got home about 12 hours after we left. I settled down for some tv and to relax. I wasn’t in pain but the area was quite swollen. I should have been icing the area, but I didn’t. By bed time I decided to take some Tylenol. I never touched the oxy.

Saturday and Sunday I just lazed around the house. The swelling decreased every day. It was sensitive and my skin was a painful. I also felt the feeling I expected. That feeling you get after you get kicked in the groin, not the initial pain, but the later nausea and discomfort. I felt that constantly. It slowly waned over 4 or 5 days.

The incision was glued closed, so there are no stiches. I was told to just go easy on the area. Don’t scrub it in the shower. It has been quite secure and not painful at all. It feels like there is some harder tissue right under the scar which I assume is more glue or scar tissue. It too is getting smaller with time.

That was the way it was, just getting better each day. Now, 2 weeks later, I had a follow up appointment with the Urologist. The swelling is almost all gone. There is no pain. The incision is healing well. No infection. I’m cleared for most activity, except riding a bicycle.

The whole process was easy and not painful. I really hope the swelling continues to go down and the all the stuff down there continues to shrink. All in all it was a generally easy experience.

As I mentioned, I took a while to draft a letter supporting my position. I said:

Dr. Xx, thank you for the thoughtful reply. I do appreciate your caution in taking on such a permanent procedure.

I feel that I may not have presented myself in the best light at our recent appointment. As you know, I began this journey in April, 2021, over two years ago. At that time I began on the anti-androgen Spironolactone. I underwent the lengthy process of getting Cardiologist clearance and I was finally able to begin estrogen therapy in October, 2021. I have seen Dr. Yy on a regular basis since then

I have put together a great team of doctors to help me through this phase of my life, Dr. Yy, Endocrinology, Dr. Zz, Internal Medicine, Dr. Ww, Cardiology, you as Surgeon, Dr. Hh, Dermatology to help me recover my hair, Dr. Pp, Psychiatry, and Dr. Tt, Psychology. They have all been incredibly compassionate and supportive.

I have been consistent and devoted to my transition. At my last appointment with Dr. Yy in April, I brought up my interest in the next step of the medical transition, an orchiectomy. We discussed my motivations, including the medical benefits and the mental health benefits, especially the easing of dysphoria. She expressed her support, and I contacted your office for an appointment.

You have expressed your personal guidelines that patients should have 12 months of a “real life test”. I previously sent you some pages from the WPATH Standards of Care showing that they did not recommend a real life test for orchiectomies, just a year of hormone therapy. That was in fact from Version 7 of the SoC. Version 8 has reduced the recommendation to 6 months of hormones, and seems to have removed the real life test completely and several articles cited put doubt on the value of the real life test.

I note that SoC 5.6 recommends 6 months of hormone therapy before a gonadectomy.

In any event I would like to explain my transition and motivations. Your main concern seems to be the possibility of regret following a permanent procedure, and that a real life test will demonstrate the patient’s commitment and seriousness. I can understand the concern that younger patients may not be fully aware of the reality of their transition, and other patients may be struggling with a mental illness manifesting itself as gender dysphoria.

I am well aware of the permanence of the procedure. Concerns about fertility are not an issue. I’ve had my children and have no interest or need for more. Sexual desire as a male hasn’t been an issue for years. I acknowledge that there may be a need in the future for Testosterone supplementation and I expect to maintain my relationship with Dr. Yy. In fact I discussed this issue with Dr. Yy this week and she told me that very few of her Trans patients need Testosterone supplements.

I can begin by pointing out that I am 58 years old. I am not a 19 year old diving into this with abandon. I have known that I was a woman since the age of 9. That feeling has never wavered. I suppressed and denied it for decades, as many Trans people do, but there has never been a time I didn’t feel this way. SoC 5.3a recommends marked and sustained gender incongruence and I believe I fit this criterion with flying colors. I have also been in therapy for over a decade. My therapist is fully supportive of the diagnosis and supports the procedure.

SoC 5.4 also addresses the issue of surgery without social transition, noting that in some cases it may not be a feasible option and that this should not be a bar to treatment.

“Everyone’s transition is different” is a common statement in the community and I feel mine is unique. The first issue is that I am 6 foot 2 inches tall and in my life have weighed over 400 pounds. This presents a big impediment to a successful social transition, but I think I can overcome that eventually. The biggest impediment to my transition at the current time is familial and financial.

Unlike that 19 year old, I have a wife and 2 grown children. You’ve met my wife and she is supportive, but has strong feelings about the effect of my transition on the children. I don’t agree with her concerns, but I respect her wishes. In addition, I am essentially a small family business owner in a partnership with my father. My livelihood relies on personal relationships with my clients; I have no question that many clients would leave should I transition. Such a loss would affect not only myself and my family, but also the other people associated with the business including my father and our employees. I feel a heavy responsibility to my family and the possibility of harming them and their lives is a scary prospect. I am working on expanding and re-focusing the business to be more LGBT+ focused. Until then, I have some serious and practical impediments to full transition.

Two other examples of my moving my transition forward are that for the last two years, I have attended a bi-monthly support group, in my female presentation. They know me only as Jennifer. As part of that group I met with [Senior State Attorney General Officer], to discuss gender inclusivity in state legislation. The second example is that I was a panelist in an LGBT Patient Perspective Panel with Doctors from [Hospital], mostly attendings and residents from the Emergency Medicine Department. I helped provide a Trans patient’s perspective on a visit to the ER and how they could improve their interactions with Trans patients.

You also seemed concerned that I would not be satisfied by the results cosmetically. That is not the primary objective, but it is a welcome effect. The removal of the testes will reduce the size of the area and will help the appearance, but the main objective is to get rid of them to ease my discomfort. They feel wrong, they do not belong there. Having them gone will improve my mental health.

I have been focused on moving my transition forward and am frustrated by the slowness of things. I believe an orchiectomy is a positive step I can take that would not be obvious to the outside world. It would allow me to move forward and take another step without harming my family.

So, I didn’t hear anything from him until the appointment. My anxiety was through the roof for days leading up to today. My wife couldn’t come to the appointment due to work commitments, so I went alone.

We started out with pleasantries and he said he hoped I understood that his message was supportive and I said I hoped I hadn’t sounded obnoxious in my letter.

He then opened by saying he was on board with the procedure and he thinks it will be a positive thing for me. My relief was palpable. We then talked for a good half an hour about the procedure, the scheduling and so on. He is currently scheduling surgery 4 weeks out, but I still need to get a short letter from my therapist, that she has already agreed to provide and a note from the cardiologist. He has to get approval from the insurance company, which he says is routine. I hope so.

I have now spoken to his office and we have a surgery date. I am incredibly excited.

I have mixed feelings about this experience. I understand his concern about doing permanent procedures that a patient might regret in the future. On the other hand, I object to his outdated standards that lag behind the current standards of care.

The Standards of Care are evolving positively. The old Harry Benjamin Standards of Care were first published in 1975 and amended several times, up until 2001. It had a very paternalistic attitude and was proscriptive. It had strict requirements to qualify as “transsexual” which was amended to “transgender” in later versions. These included crossdressing and real life experience. So, a patient had to really take potentially dangerous steps before getting treatment.

Those standards were supplanted by the WPATH Standards of Care and as I described above, they are much more patient focused. They now believe the patient and don’t make the patient jump through hoops to prove themselves.

My urologist still isn’t so enlightened. He says he is half way between the WPATH SoC 7 and 8. I think he is still being paternalistic, but he is improving. He doesn’t like the concept of “informed consent” where the patient asks for something, signs a waiver, and gets what they want.

I hope my experience has helped soften his position a little.

Having doctors in my family, I know very well how arrogant and paternalistic some doctors can be. They know best what is good for a patient. To some extent that is true, but they need to understand that the patient is the one in charge of their own lives. I don’t know my urologist’s age, but I am at least 15 years older than him. I know what I want and what I need in my transition. He doesn’t.

A doctor is trained to diagnose physical problems and provide treatment. Outside of psychiatrists, they are not trained in mental health. In my case a urologist is implementing a course of treatment requested by the patient. He hasn’t been involved in the diagnosis of the condition and doesn’t have a history with the patient. When a patient who has been working with a team of doctors and has been following a plan with those doctors, a new doctor should not step in with a new requirement and block the patient’s progress.

At the most, I would expect a doctor in this situation would want a letter from the Endocrinologist and Therapist. They should not be introducing new obstacles or setting up their own criteria for the procedure.

While his attitude is paternalistic, I can understand some of his caution. He is being asked to remove healthy tissue. There is no disease or injury to the testicles that would otherwise justify their removal. That idea goes against many doctors’ ethical mindset. He also has concerns about liability. There is not just the usual risk of malpractice, but also regret from that patient who then may try to turn around and blame the doctor. Again, letters from other doctors and waivers should cover that concern.

To conclude, I have my surgery date and I am looking forward to being free of the offending body parts. I hope it all goes well and I will report back after.

I finally broke through some gatekeeping.

As I approach my 2d anniversary of hrt, I felt that the next step I would like to take on my journey would be an orchiectomy. I’ve wanted them gone for as long as I can remember. They never felt right. I haven’t socially transitioned yet for a myriad of reasons, but this is something I can do to further my transition without coming out to the world.

I talked with my therapist and she supported the idea. At my next appointment with my endo, I talked to her and she also supported the idea. I spoke to my wife, I had mentioned the idea probably a year ago, and told her I was now ready. She has some reservations, mainly the usual risks of surgery. She is supportive, but still doesn’t fully understand the reality of being trans. She said she wants me to be happy and agreed to go with me to see the urologist.

I am a patient with the Gender Clinic at a large University Hospital near me. They are great, but there is just one urologist in the clinic. I had seen him when I began my journey for the possibility of Lupron treatments. So I made an appointment with him. I had to wait 6 weeks.

My wife and I went to the appointment. The result of the appointment was that he wasn’t sure about doing the procedure. I hadn’t socially transitioned and he usually looked for a full year of living in your correct gender. He referenced the WPATH Standards of Care and their recommendations for this surgery.

Also, my wife was not enthusiastic. She was supportive, but she worries about the risks. So we ended the appointment, agreeing to meet again in a month. He was going to talk to my therapist and psychiatrist. I walked out to my car and broke down and had a good cry.

Over the next few days I thought about the appointment and realized I had been totally unprepared to argue my case. I had thought that it was just a matter of expressing an interest in the procedure and being an established gender clinic patient. I didn’t expect the gatekeeping.

I decided to send the doctor a note through the clinic’s patient portal. Immediately after the appointment, I sent the following:

Dr. Xxxxxx, thank you for meeting us today. I appreciate your time and your concern and cautious approach. I just wanted to add to our discussion concerning the WPATH Standards of Care. They do not call for a year of living fully transitioned for orchiectomies. They do recommend that for vaginoplasty, but not orchiectomy.

I’ve attached the relevant pages if you are interested.

I will see you in August.

He replied:

Thank you for continuing a thoughtful discussion with me. I appreciate your point, but will also point you to the following paragraphs (see copied below, my emphasis), which has led me think carefully about your situation. While “technically” not part of orchiectomy criteria, it has become part of my general criteria, which I think you would agree is reasonable given the permanency of the procedure. I try to appreciate the patient perspective always when making medical decisions and I understand this is something you have been working on for many years. I appreciate your courage with your transition as it is often more complicated than what you want alone. Let's continue the discussion. Best regards, Xxxxx

The criterion noted above for some types of genital surgeries—i.e., that patients engage in 12 continuous months of living in a gender role that is congruent with their gender identity—is based on expert clinical consensus that this experience provides ample opportunity for patients to experience and socially adjust in their desired gender role, before undergoing irreversible surgery. As noted in section VII, the social aspects of changing one’s gender role are usually challenging—often more so than the physical aspects.

Changing gender role can have profound personal and social consequences, and the decision to do so should include an awareness of what the familial, interpersonal, educational, vocational, economic, and legal challenges are likely to be, so that people can function successfully in their gender role. Support from a qualified mental health professional and from peers can be invaluable in ensuring a successful gender role adaptation

The duration of 12 months allows for a range of different life experiences and events that may occur throughout the year (e.g., family events, holidays, vacations, season-specific work or school experiences). During this time, patients should present consistently, on a day-to-day basis and across all settings of life, in their desired gender role. This includes coming out to partners, family, friends, and community members (e.g., at school, work, other settings).

Health professionals should clearly document a patient’s experience in the gender role in the medical chart, including the start date of living full time for those who are preparing for genital surgery. In some situations, if needed, health professionals may request verification that this criterion has been fulfilled: They may communicate with individuals who have related to the patient in an identity-congruent gender role, or request documentation of a legal name and/or gender marker change, if applicable.

I was unsure about how to interpret this reply, was this a positive position or not? I was not encouraged and wanted to say more, so I took a few days to draft a reply. It is too long to add here, so I will post it as another blog.

To be Continued…….

An online friend on Mastodon posted the following:

Some cis people mourn who a person was when they transition.

What they don't seem to grasp is that we mourn too.

In much the same way you might mourn if you woke up to learn that you were in a coma for two or three decades.

You're awake and alive, and existing now, but what of the life that would have been?

@sasha_strange@tech.lgbt

This is so important to understand. This topic usually comes up in the context of a parent mourning the loss of a son or daughter who is transitioning. The parent may feel that their son has died and have trouble recognizing their new daughter. This is a completely natural and understandable reaction. How the parent deals with it is the big issue. Does the parent deny the daughter? Does the parent welcome the daughter with joy and open arms? Does the parent have compassion for their child and help them through the transition, love and support them and think of their child’s well-being before their own. Do they have the maturity and self-confidence to realize that their child is not doing this to hurt the parent or embarrass the parent. Does the parent have the ability to deal with their own feelings while also helping their child?

As a parent my instinct is to protect my child against every danger in the world. My kids are grown and have moved out on their own, yet this instinct remains and I have to restrain myself from trying to fix everything and let them do it and learn how to be confident and self-reliant adults in the world. But I am always there for them.

A parent who thinks that their own feelings about their child are more important than the child’s own feelings about itself are narcissists. I can hear the phrases, “Why are you doing this to me?”, “What will the neighbors think?”, “What do I tell Aunt Karen?”, “Why are you being so selfish?”, ”You killed my son.”, “My son is dead”. None of these things do anything other than hurt the child.

I feel a better way to frame it is to realize my child has been suffering for so long. If they had any other long term medical issue, I would not be angry at them. I would not try to talk or threaten them out of being sick. I would seek professional help and do everything I could to help my child.

Much of this attitude comes from ignorance. Ignorance just means not knowing something and is understandable, as long as they seek to learn the truth. A parent that refuses to learn, or refuses to accept the truth of gender dysphoria is directly harming their child.

But, few people understand that the trans person also mourns. They mourn the loss of what could have been. If you are lucky enough to have realized your reality at an early age and were encouraged and supported in your gender exploration and presentation, you don’t have as much to miss.

Those of us who were unable to face their gender issues until adulthood, in my case, my 50s, have missed plenty. I grew up a boy. I did boy things, I wore boy clothes, played with boy toys, played boy sports, and was a Boy Scout. At the time I didn’t know any different. I didn’t mind these things, and some of them I enjoyed, but I was never happy, never satisfied, never content. I was not able to form deep meaningful relationships with friends. I knew there was something wrong with me and I was afraid of opening myself up to anyone. At the time I told myself I was boring and overweight, and no one would be interested in spending time with me.

I realize now that I didn’t know who I was. I wasn’t me, the all American boy. I was a confused kid. I spent my life feeling that; Insecure, unsure of myself and my place in the world. When finally, in my 50s, the truth broke through. I finally realized who and what I was. I was a woman, I should have grown up as a girl, and suddenly it all made sense. All those puzzle pieces fell into place. I now knew why I was so out of it as a kid and through the rest of my life.

Here’s where we get to the mourning. I began to realize all the experiences I missed growing up. I didn’t get to do the girl stuff. I didn’t make friends with other girls, have the sleep overs, learn the behaviors and mannerisms of being a girl. I didn’t get to learn all that fun girl stuff, like fashion and makeup along with the not so fun stuff, like heartbreak and periods and so on. Of course, I am not reducing girlhood to these few things, I am trying to give some examples.

I realized that I will never get those experiences. I will never know what it is like to be a young girl, a teenage girl, a young adult woman and an adult woman. I now hopefully get the chance to experience being a mature woman. I particularly think about my high school and college years. That is the time for lots of confusion and problems, but also joy and freedom. I had a ’79 Jeep CJ-7 that I loved and always had the image of driving with the top down and my long hair blowing in the wind, looking good, feeling good. Doing that as a boy was great, but not the same in any way.

One TV show that appealed to me back then was the Mary Tyler Moore Show. That is who I wanted to be. That was the life I wanted; a young, single, confident, capable, and intelligent woman. Needless to say, I missed out on that fantasy. My daughter is living that now and I am envious of her and I support her as much as possible.

The feeling of missing out on a childhood, lost experiences never to be found, is real and painful. It really is mourning a lost life. Parents, friends and others should be aware of this and be supportive.

The joy a trans person experiences when they accept themselves is profound. They may appear almost giddy and full of life. But underneath, next to the fear of coming out and the reactions of the outside world, is also the disappointment of realizing all they missed out on in their life. While they are celebrating the birth of their new self, they are mourning the lost childhood they never got to know.

Every human who has ever lived, that had a secret, had to decide whether to share that secret with the outside. This conundrum is not exclusive to LGBT+ people, but that is what I want to discuss. My personal experience is with the T part of that initialism. Coming out is a deeply personal decision and one that everyone must make for themselves. Add in the issue of transitioning and it becomes even more difficult. First a disclaimer, I would never make light of the struggle of the L, G, and B. Perhaps I am being naïve in this blog post. I have not had any of the experiences of a gay person coming out and living their authentic life. I do not know their struggle and I cannot know their actual journey and compare it to mine. There are many similarities, but I want to draw attention to one big difference. They can choose who they come out to, and they can generally walk in the world without drawing attention. They come out once to each person they choose to tell.

A Trans person has the same issues with regard to who to tell, but deciding to transition will mean coming out every time they step out the door. A gay person can come out to their family and still go into work the next day without worrying that everyone else will know. A trans person will come in to work looking very different from the day before, and they will be noticed. You can’t choose to tell just your family and close friends if you plan to transition.

So, that is what I am struggling with now. I’m sliding out of my mid-50s. I’ve spent my entire life playing the part of a man in society. It is all I know. I’ve been pretty convincing. I’ve nurtured relationships, and built a business in that guise. Coming out to family is doable, but transitioning and living as my authentic self has some serious potential pitfalls. I have no experience being a woman. I’ve known that I wasn’t right my whole life, but I didn’t get the opportunity to socialize and interact with the world as a girl. How am I supposed to do this?

The first is the fear of looking absurd. Some AMABs can appear very convincing when presenting as a woman. Not so much for me. First, I am 6’ 2”. While not impossible, that is way out of the norm. Second, I weigh too much, way too much. Even if I lost the weight, I am not a slight person. I will stand out. To put the cherry on top, I wear a size 15 men’s shoe. That is a hard enough size to find for men, women’s shoes in that size are rarer than hen’s teeth. Surprisingly women’s stores seem to do well for “extended sizes” and I can find stuff to wear.

So, assuming I got the clothes right. The hair, makeup, whatever. I’m still a giant presence and will never be able to blend into the background the way I have wanted my whole life.

The next fear is rejection. My wife knows and is broadly supportive. She does not want me to tell our kids because she is afraid it will emotionally harm them. We have a 28 year old daughter living on her own in NYC and a 23 year old son pursuing a PhD in Albany. They are both well educated and very liberal. My son has a couple of friends who are non-binary, so he is well familiar with the concept. My daughter gets along well with his friends as well as having her own LGB friends. My wife is particularly worried about our son feeling betrayed and abandoned by his male role model. That he will feel he has been lied to his whole life. At first I didn’t think that would happen, but now doubts are creeping in and my wife’s worry is eating into my psyche.

Then there is my father. He is 93 years old now, still going strong, but won’t be around forever. He and I have built a business together over the past 28 years, so we see each other every weekday and get along well. One positive is that one of our clients confided in him that they have a grandchild who is trans. Then his, I guess you would say, girlfriend has disclosed that she too has a grandchild who is trans. So, he knows it is a thing and it does not repulse him. He is definitely confused by the phenomenon.

When he told me about these two kids, my reply was that they just needed love and support and they would do fine. I didn’t make a big deal about it, but inside I was screaming, We have a part time secretary/assistant who has worked with my dad for 40 years. I overheard the two of them talking over lunch and her saying that she was so glad they were past the stage where they have to worry about these things. I gave a little internal chuckle at that.

I have lots of thoughts about telling him and how it would play out. You see, when I was about 12 or 13, he walked in on me dressed in women’s clothes. I had snuck some of my mom’s stuff. He demanded to know what I was doing, and as a terrified kid, I said, I don’t know. He told me to take it off and then he came to my room and again asked and I again said I didn’t know. He said don’t do it again and don’t tell your mother. And that was it. Needless to say, it didn’t stop the feelings and the desire to dress. It continued on and I was just more careful.

But from that day on, I lived in fear of that coming back to bite me. Fear of him saying something. I knew it was wrong, weird, and perverted. I was terrified of messing up, making a mistake and him bringing the incident. I have likened it to the sword of Damocles, hanging over my head. It wasn’t until recently that I was able to work through the trauma associated with it. I can say that EMDR worked amazingly well for me.

So, what do I imagine would happen if I told him. I think he would believe me. I think I would break down. I worry that he would feel guilty about the incident, if he even remembers it. Since he is aware of the “condition”, I don’t think he would be hostile. I would like the chance to discuss it with him and explain what I was dealing with growing up, but I don’t want to blame him or make him feel guilty. I know he already regrets traveling for work so much and not being home all the time. I hold no ill will, my parents did the best they could and it was pretty good.

He is 93, still very healthy, but age is most certainly catching up. He is not the most steady on his feet and uses a walker sometimes. He has developed prostate cancer, but if you last until your 90s, a man will get prostate cancer. It won’t kill him. He’s also developed a basal cell carcinoma behind his ear. Also treatable. Pretty amazing since he spent a lot of time outside and never used sunscreen or wore a hat. So, a part of me wants to just wait it out and I won’t have to tell him. But, his mother lived to 103, and I am getting older every day.

Then there is my sister. She’s 2 ½ years younger than me. We had a younger sister who died at age 30 from epilepsy. Anyway, my sister had difficulties growing up. She’s been exposed to every lifestyle out there and would probably deal fine with it.

I don’t have much more in the family department. I have one sister in law, who I think would be fine. I have some cousins I haven’t seen in over 5 years. My mother in law and her sisters might be a problem.

The next huge issue would be work related. I am essentially a small business owner and my business requires a personal connection. There is no doubt some of the people we work with would not be receptive to a trans person. We would certainly lose business. I can’t inflict that on my father and I can’t afford that. So, that is another big hurdle. If I worked for some major company, they would likely have policies in place to protect employees and I could probably transition with minimal disruption. Not so when your business relies on personal connections. So, before I do anything I will have to cultivate some more business with LGBT+ friendly people.

I am fortunate enough to be physically large and strong enough and mature enough to not worry too much about bullying. I know that is a major obstacle to younger people coming out. I had a bit of verbal bullying about my weight as a kid, but I never really faced any physical bullying. Actually the only time a kid did try to bully me was in junior high school, I picked him up and held him against the school lockers and suggested he stop the behavior.

So, these are some of the obstacles to transitioning that trans people face. Were I just gay, I could still tell a small group of people and continue on my way. I wouldn’t have to tell the world. It wouldn’t be obvious just looking at me that I was gay. But, if I want to live as my real self, there is no hiding. Oh, there I go, the grass is always greener, right? I apologize if I am making light of anyone’s experience. However, that is the place my brain is right now.