Megan Leyman

Hello all to a post with a different format than I’m used to! 

Last month I had a video appointment with a doctor at Gender Services about my transition and that so far and thought I share the assessment Consultant Neuropsychiatrist typed up to share to my actual doctor (whom I very rarely see due to how medical practices are nowadays, not their fault), I will censor only a few of the tests results that are mentioned because I rather keep some things a secret BUT EVERYTHING ELSE WILL BE KEPT IN SO JUST AN FYI after sharing the assessment, I will then add my thoughts afterward. 

“I met Megan today on MS Teams, the sound and visual quality was good at both ends. She is in reasonably good spirits, working full-time in a local bakery at night, living at home with mum, stepdad and brother reporting good support from family and no issues. No adult safeguarding or self-harm concerns. 

She is struggling to lose weight though has dropped a little and her current BMI is _____based on  _____ weight, height ___. Her blood results show a very low _____________ despite attempting to use gel 3 mgs daily (she does forget), particularly the evening dose, she is in effect hypogonadal as a result of the very effective suppression of testosterone by the Leuprorelin acetate and over time this will both thwart her desire to feminise her appearance and potentially build in problems with bone mineral density. She is a non-smoker who rarely drinks alcohol and doesn’t use drugs. Her diet is dependent to a large degree on starches and sugary food, she works surrounded by pastries and tends to snack on crisps and chocolate, she is aware what a healthy diet should look like and even has an ‘Eat Well plate. 

I have advised her to go to the online Eat Well guide and particularly switch away from high carbohydrate intake. She goes to the gym, though erratically and will attempt to improve her attendance, particularly as it is directly opposite where she works. 

She has no concerns on review of systems and none of her other blood results suggest a metabolic syndrome evolving, though her last _________. She has access to a BP monitor at home and will forward us her latest blood pressure 

She is undertaking speech and language work with our GIC speech and language therapist and is very pleased with the progress she has made, though her resting voice today was in the male range. Her appearance is feminised but she feels that is largely due to her weight and as a result of her appearance she generally passes until she begins to speak, particularly when she is customer facing and wants this to improve. 

She is online a fair bit and is doing a You Tube blog about her experience and is in contact with others who have undergone surgery, she is seeking full feminising genitoplasty including vaginoplasty and I have explained the referral criteria for that would require a BMI of 30 which gives her a target weight of 16st 9lb. I think we should begin the process of surgical counselling, it would help support and encourage her towards further weight loss and as the waiting time is uncertain for feminising surgery but typically will be over a year, once she has completed our counselling further delay is inevitable and as she ages the surgical recovery time increases 

I have reviewed her blood results which show a very disappointing trend on both gels and patches when she has had access to either, she has rarely reached even the bottom of the female follicular range and the only time she was in the female range was when taking 2 mgs oral oestradiol in 2022. Whilst gels and patches are preferable, she is simply not going to get the absorption for whatever reason and both gel and patch supply have continued to be disrupted due to high demand and supply lag 

She is applying for a female indicator passport and wishes to travel to Japan next year. She has a stable female binary identity and has no doubts or regrets about treatment so far.” 

So yeah, the appointment did cover a lot, since this appointment I have nearly lost 1 out of the 2 stone needed for the surgery, I am taking it seriously as the surgery is the last of my 3 main goals in transitioning. 

1. Come out as Megan/ Took a while but came out in November 2019 

2. Change my passport/ I had to give this a long think as I wanted to confirm that I wanted to do it, it is now done, I confess I don’t like my new picture, but I will change it again in the future 

3. Have surgery  

 If you want to know what the whole surgery entails, this link will go into it (properly best not to read it while eating!). 

I’m still waiting to switch to hormones in pill forms as the gel one that I’ve been using for quite some time isn’t doing me any justice, then this post goes live I should have some again (I originally thought they weren’t having any affect compared to the gel but is the complete opposite). 

Out of the appointments I get from Gender Services (which I get every like 6 months?), this one is one that has stuck out to me as I learnt a lot and I was able to tell them what I wanted to do next as I previously said I will save surgery for the future but it’s been 4 years and I have decided now is the same to take the steps. 

Alongside the weight lost is some counselling I need to take eg to learn about the process and if I really want to go through it as it’s such a huge thing. 

I know full well the change isn’t going to make me into a full woman, I will have mostly a male body still with things that look female but as I mentioned in previous posts, I am ok just looking like one at least to get some form of understanding what a woman goes through as that has been a curiosity since school for me. 

I have shared the curiosity of what I had in the Change is Scary posts, so I won’t re-share it and I won’t take those words back as that curiosity has since helped me become a lot happier with myself. I think if I was able to speak to my 13/14/15 year old self I think he would be proud of my achievement so far. 

With that I end this post, thanks for reading, please leave any questions down below. 

Megan