Six weeks before sex reassignment surgery (SRS), I am obliged to stop taking my hormones. I suddenly feel very differently about my forthcoming operation. I'd previously seen transition as a marathon: surgery was like breaking the tape, but the race was won far earlier. Now I reconsider: perhaps this is more like a difficult cup final after some hard previous rounds.
The surgery completely dominates my planning and thinking. My temporary job ended in March, and the knowledge that I'd be incapacitated for at least two months from mid-July made it difficult to find another. Ineligible for Employment and Support Allowance until after surgery, I sign on, the whole scenario feeling farcical as both my case worker and I know that I am unlikely to get a job, but still have to fulfil the jobseekers' criteria to get my weekly allowance, haemorrhaging money all the while.
It consumes my conversations as it inches closer. I am constantly asked how I feel: everyone expects a mixture of excited and nervous, and they are right. Above all, I'll be glad when it is over. I take a little holiday in late June, staying with friends in Scotland, and travel back on the first day of July. Then, for the next fortnight, my concerns over the practical, physical and psychological effects of SRS intensify by the day.
My psychotherapist, whom I've been seeing all year, tells me that I've barely touched on the surgery, so I devote my final pre-surgical appointment to it. After an hour of airing my anxieties, I feel calm and able to continue.
Final preparationsFive days before checking into hospital, I sign off. Returning from the Jobcentre, a man with a taste for "shemales" (his word) follows me home, making me feel far less secure in my house – my sanctuary in a life that has felt in constant chaos. I break down in tears, crying for 30 years of feeling like an outsider, 20 years of knowing this to be related to my gender, 10 years of exploring it, three years of transition and two years of writing about it, with all their stresses and traumas simultaneously hurtling to the fore.
For four days, everything makes me weep. At first it's painful, then cathartic, and finally just annoying – having not cried when I expected to for years, the sight of every ornament, every poster in my house sets me off, and I don't know when it'll stop. Eventually, I realise I need to get out: I visit old friends in Brighton, who indulge me as I discourse about the run-up to surgery and my feelings about it.
I return a day before admission: having to address the practicalities pulls me together, as I ensure I have everything I'll want or need during the seven-day stay. I've never been seriously ill or injured, so I've sought advice on what to take: I buy slippers and a crossword book. Once I've got everything on my list, and packed, I feel completely relaxed. I go to bed content, close my eyes, and then see a car crash outside my bedroom window. It's so vivid, it takes several moments to realise that the flaming wreckage is no more than the invention of my hyperactive subconscious, but once I do, I get a solid night's sleep – my last for some time.
Obsessed with being brave and independent, I'd travelled alone to my previous surgical appointments. This time, on advice, I've arranged for my friend Tania to take me to hospital. She arrives around midday: we eat in my favourite cafe and then get the tube to Hammersmith, well before I have to report to Charing Cross hospital reception at 4pm. We say little, putting our arms round each other, but once I've checked in, she gives me some earplugs and a cuddly tiger ("You'll need a soft toy, trust me"). Then she goes, telling me to surrender myself to the nurses, and I find my bed in F bay on the Marjorie Warren ward.
In the wardThere are six beds, with most but not all occupants also undergoing SRS. Reassuringly, there are two people who had surgery a day before, who can hold conversations and move unaided. We chat before the nurses take my weight and blood pressure, measuring me for stockings to fight deep vein thrombosis as I'll be spending so long in bed. I order dinner and then sleep, struggling more with the sweltering temperature than anything else.
At 5.30am, I'm woken for an enema: they have to thoroughly clear my bowels before the procedure. It's not pretty but I take it, shower and return to bed. At 7am, James Bellringer,the surgeon, enters with two consent forms – one for the hospital, the other for me. He asks if I will allow "the tissue removed" to be used for medical science. In the hazy half-light, I agree (to the disappointment, I imagine, of friends who've asked if they can have it). "I'll see you soon," he says. The anaesthetist comes soon after and asks several questions before I lie back down.
At 8.20am, I'm escorted upstairs. I take the lift to the 15th floor in my slippers, white hospital gown and navy stockings. The chattering voices in my head silence themselves, with just the closing bars of a favourite song, Laurie Anderson's O Superman, soaring through my mind, and I am ready.
Yuri, who assists the anaesthetist, lays me on a trolley and takes my blood pressure and temperature. The anaesthetist enters, attaching a cannula to my right wrist. She asks if I have any questions. "This'll definitely work, right?" Yes, she says, irked. "It's just that I studied 19th-century medicine," I say. "It didn't fill me with confidence."
"It'll be fine", she says, raising a needle. "You may feel a shooting sensation in your arm …"
I wake in the recovery room, dehydrated, my lips bone-dry. I demand water, but it's nil by mouth until I return to the ward. I'm slow to come round, though, and they won't move me until I'm fully awake, however much I ask. After what seems an age – I've no idea how long – they wheel my bed into the lift, and then back to F bay.
The women there are glad to see me back: I tell them that it went well, before finding a wave of "good luck" messages on my phone. I go on Twitter to say that I'm conscious again; throughout my stay, social media keeps me sane, providing contact with friends, family and well-wishers at any time, saving dozens of energy-sapping conversations.
Click here to read about the first night, the morning after and more.