I got a letter from the NHS yesterday. I’ve been waiting for it for a long time.

I’ve been waiting a long time because while it was dictated on the 9th of July, it wasn’t typed until the 2nd of August and didn’t get here until the 14th of September. It had been sent by mistake to my previous GP (NHS systems are not joined up, it turns out: just because my GP has the right details doesn’t mean other bits of the NHS do), and as my previous GP is an arse he didn’t let the sender know that I’m not his patient any more.

Trans people are used to waiting, though. The letter is from the Sandyford gender identity service, to which I self-referred in October 2016. It’s taken 23 months to get a written diagnosis.

This is it.

The codes are from the World Health Organisation, and they’re out of date: as of June 2018, being trans is no longer considered to be a mental disorder and has been removed from the International Classification of Diseases, as homosexuality was in the 1970s. It takes a while for the medical establishment to catch up, though, so at the moment trans stuff still comes under the umbrella of mental health.

So this is a bit of a double-edged sword, because on the one hand it’s confirmation that I’m not making this shit up – but on the other it gives me a pathology, a label of ‘disorder’ for something that the medical and psychiatric consensus agrees is not a disorder. There is nothing wrong with me, because being trans is just part of the infinite variety of human brains and bodies.

But that’s a rant for another day. What difference does having a diagnosis actually make?

The short answer is “not much”. It means the end of having to go to and pay for a private GP for my supervised hormone treatment, and it means all my healthcare is now in the hands of my (great!) local GP surgery. Although the savings I’ll make from not paying for prescriptions are dwarfed by the costs of electrolysis now my NHS funding has run out: I’m saving about £50 a month and paying out around £150 a week.

The bigger picture? It makes no difference whatsoever. Being a “real” trans woman, ie someone who’s gone through the various gatekeepers, doesn’t impress the trannier-than-thou brigade for whom the only “real” trans people are the ones who’ve had bottom surgery. And it doesn’t make me any more acceptable to the bigots who lie and say they have no issues with “real” trans people.

Mainly, though, it’s no big deal because it’s already in the rear view mirror. I know I’m trans. This is just the admin finally catching up.