Normal is just a setting on the drier … or is it?

Nine days ago I attended my most recent GP appointment. Visiting my GP is a fairly regular occurrence for me these days. Transitioning has meant that between general checkups and pop-up medical issues, obtaining referrals to my milieu of medical specialists and subsequent GP followups, I have been seeing him on average a little more than once per month for the past three years. The purpose of my most recent visit was to renew my mental health care plan for 2019 … my fourth such plan since My Epiphany in 2016.  For those that haven’t yet taken advantage of a mental health care plan, I highly recommend them. They allow you to access a series of partially subsidised sessions with a mental health care professional. Being transgender, and then making the call to transition (not that there is actually any choice once you know you are transgender) is enough to destroy most people’s financial health, so every little bit of money you can claw back counts.

Having a mental health care plan in place is, for me, simultaneously about being able to access my psychologist at a cheaper rate, but at a baser level it is also about simply having the plan in place … having a plan helps guide you through the big stuff. In 2016 I visited my psychologist 6 times, firstly to make sure I wasn’t having some sort of breakdown or delusion. Once that was settled in the negative, my next aim was to try and understand why my brain had waited until what should have been the best parts of my life were over before it showed me the real me. I now clearly understand it’s logic and reasoning, but that’s a story for another day. Oh … and also to get a referral to an endocrinologist so I could start my long overdue hormonal transition. In 2017 and 2018 I only went to my psychologist 2 or 3 times both years. My brain had stopped whirling quite so vigorously by then, so I felt there wasn’t quite the pressing need. With the date set for my gender affirmation surgery rushing towards me (at the time of writing it is only 7 months away), I am expecting to use more of my allocated subsidised sessions this year … both before and after the procedure.

The first step in arranging my mental health care plan each time is to complete a DASS (Depression, Anxiety and Stress Scales). The DASS comes in a 42 question version for clinical situations, though my GP prefers the 21 question version … I assume because it only takes 3 minutes to complete, as opposed to 5 to 10 minutes for the longer version … a neater temporal fit for a GP appointment I suppose. The 21 questions seek to tease out any incidence over the previous week of hopelessness, lack of interest, propensity to anger, situational anxiety and the like. The participant answers either Never, Sometimes, Often or Almost Always for each question. This was my fourth attempt at a DASS21, so I well knew the drill. In the past I had usually stopped and pondered on at least a handful of questions … second guessing whether my annoyance was justified in a particular situation, for example. This time I breezed through nearly every question. I loitered ever so briefly on only one question. I was more sure of each answer, and more comfortable answering each question, than ever before. I was aware that my total completion time was much shorter too, but it was only when I had finished the last question and glanced back at my answers did I notice that I had circled ‘Never’ 18 times and ‘Sometimes’ only 3 times. This was a significant improvement on every other time, so I proudly slapped my pen down on the desk, swung the form around and slid it back towards my GP. I may also have ever so slightly puffed out my bosom.

He picked up my sheet of paper and with a satisfied, but slightly surprised, look on his face exclaimed “Well that’s a bit different to before!” I triumphantly beamed “Well I feel a bit different to before!” He tallied up my scores and almost off handedly said “Well … that all seems normal.” My first reaction was serene satisfaction, and was just about to move on when an overwhelming need for perspective kicked in. I realised that I needed to clarify what he, and The School of Psychology at the University of New South Wales, meant by normal. I needed to place this event in context, however painful my intervention may turn out to be. For it had suddenly occurred to me that the way I felt now … by far the best I have ever felt … is how I should have been feeling my whole life, but was disallowed by being forced to assimilate into a dangerously fictitious binary gender system. The enormity of the context struck me hard. The realisation that I have far more years of depression behind me than I will ever have years of joy and happiness in front of me is always painful. In these moments though, I try to remember my guiding rule that the way we live our life should be to never forget the journey that we undertook to get to the present, but to use that journey as a substrate on which to build our future, happier life.

5 or 10 seconds passed before I was finally able to ask “Are you telling me that this is how people normally feel?” In hindsight this must seem an absurd question for anyone that hasn’t either suffered from severe depression themselves, or otherwise aren’t intimate with it’s ravages. The usual guidance surrounding depression is to monitor extended periods of sadness and to seek help if the sadness persists. But no-one ever seems to have the magic solution for the people that have suffered from depression their entire adult life. I suspect a compulsory periodical DASS would help identify the cohort of people that suffer from long term depression but aren’t aware of it for whatever reason, but that is only my unqualified opinion. He said “Yes … I mean you won’t feel like this all the time … that won’t happen … but essentially … yes.” I protectively folded my arms a fraction of a second before my head collapsed heavily onto them, a reaction which thankfully prevented my head from hitting the desk hard. I stayed put, sobbing, with my head resting on my folded arms on the desk until I remembered that I wasn’t his only patient, and I probably should grieve elsewhere at another time for the past that I never had the opportunity to have. I could easily have stayed there and cried and cried and cried. But I had a new life to live.

I walked from my GP’s room a few minutes later, now chuckling at the emotional enormity of the past 15 minutes, clutching my mental health care plan in a white unmarked envelope. The two receptionists smiled at me, as they always do, and one of them asked of me “What’s so funny?” I proudly told them that my GP had finally declared me normal. They joined me in my chuckling. It is so very important to surround yourself with lovely, caring people.