Horizon

How do you know your gender?

I knew I was not a boy or a man. I've never felt that way.

I've always just identified as female.

Do you see yourself as male, female or somewhere in between?

Growing up, I couldn't understand why people put the label on me,

that I was a girl, because to me, I was just a boy.

Try to put me in a dress, I'd start screaming. Yeah.

Millions of people around the world do not associate with the gender

they were assigned at birth.

There's parts of the body which shouldn't be there.

My head has never really felt connected to my body.

And they want to do something about it.

In this film, we find out what it's really like

to transition your gender,

and what happens biologically and psychologically

through the eyes of the people who are living it.

The first time when you go out as a woman is such an alien thing to do

but, at the same time, it felt really right.

I feel like I'm just now beginning my life at 25.

Yes! What's that say?

Testosterone! Testosterone!

Testosterone!

We discover how science is trying to uncover the true nature

of gender identity.

What can we figure out about physiology, brain morphology,

that helps us understand

the formation of gender identity in anyone,

is a relatively new field of study.

While, at the same time, advances in modern medicine

are helping people to transition to the gender they identify with.

Some people sort of mistakenly think there's only one surgery

you can have if you're transgender.

Oh, my God!

Here we are!

I'm here!

I was probably about seven or eight years old when I realised

that something wasn't quite right.

But it took me a long, long time to really kind of put my finger

on what that was.

It was only one I was about 21

that I realised that I was trans and that I wanted to transition,

or needed to transition.

According to the sound codes, that's the fault.

That's what was causing the fault on the train,

so that's what I've changed today.

I'm a 24-year-old transgender women,

which means that I was assigned male at birth but identify as a woman.

I work as a rolling stock engineer for London Midland.

I started socially transitioning about 18 months ago.

I think social transition is probably the hardest part of transitioning.

It certainly requires the most guts.

It's where you have to stand out from the crowd and say,

"This is me, this is who I am."

It's a massive, massive step.

I wanted to be perceived as a woman, so I started wearing female clothes,

I changed my name.

I was quite nervous at the time.

It's such an alien thing to do,

the first time when you go out as a woman,

but, at the same time, it felt really right.

One of the first jobs I remember working with you

was changing a toilet level sensor.

So it weren't... Nice start to your London Midland career!

It wasn't a very pleasant job!

I was a bit concerned about coming out in a masculine environment,

but the other side of the coin was that

transitioning was kind of the most important thing to do.

The first thing I recall from higher management was a brief.

One or two people were a little bit apprehensive and unsure about how...

On the workshop floor, I think everyone was a bit apprehensive,

not because we were going to say anything inappropriate,

but in case we accidentally said something.

You've seen the banter that we have, you know.

They didn't want to offend you.

I think everyone's been really good, how accepting they've been.

Do you class yourself, then, as transgender?

I class myself as transgender, yeah.

So, as I understand, then, you're in the process...

When you have changed your gender, that's what you want to do?

So I'm going through a process at the moment to change.

But when that's complete, then you will be female?

Yeah. And not transgender, but you will be female?

Pretty much, yeah.

It'll probably take another 18 months to two years or so

to complete the process, including surgery.

When did you decide on this?

Is it just a decision or is it just something that grew on you...?

I don't think it's a decision

so much as almost a compulsion of something that you have to do.

So what happens then?

Excuse my ignorance, but you just go down the doctor's?

Pretty much. So I had to go to the doctor and he referred me

to the gender clinic and, about 13 months later, I had an appointment.

A lot of people like to get hung up on the medical side of transition,

but socially transitioning is the thing that's really made the biggest

difference to my life,

because it allows me to live authentically and be who I am.

Bend, and stretch.

And bend, and good.

Last one. Rise and lower, up and down.

Straight legs forward, and stop.

Straight legs backwards, and stop.

Stop in first position.

My name's Samantha.

I'm a transgender female.

For me, social transitioning was secretive.

The first time I was about 12.

I just happened to be in a situation

where I could go through my sister's wardrobe.

Everyone had gone out.

Very quickly, I had some of my sister's clothes on.

I slowly collected a collection of her things,

that she didn't notice were missing, under my bed.

And it became when everyone had gone to bed, then that was my time.

At the same time now so you've got both straight legs.

Dance for me was a means of escape.

My dance teacher was great.

Even from a young age, she allowed me to present as female.

It was good until my mum one day was going through my drawers,

tidying up, and spotted a drawer full of my sister's clothes.

And it was brought out for everyone to see and, you know,

thrown out on the floor in the living room, and I was shamed.

And it was taken away and they said,

"If you ever do this again, we'll tell everyone."

Around 18, 19 years old, I decided I was going to socially transition.

But, unfortunately, my parents clocked on...

...and they were not happy.

So they then had a choice.

I could be who I wanted to be, but I had to get away,

or I could stay where I was, but I could never be who I wanted to be.

So it was a very hard decision.

I chose life over my family.

Social transition definitely is the key to the whole pathway

before you've had the hormones,

before you've had all the other stuff.

You need that confidence to be able to stand up and be counted.

If you don't, then who are you as a person?

I realised that just wearing the clothes wasn't enough for me.

I knew I'd need to have some work done on my body,

I knew I needed some interventions, and I needed help.

I'm going to the gender identity clinic in Sheffield

to see Dr Coakley.

There is a huge demand on the services,

which can lead to very long waiting lists.

So you are waiting, you know, sometimes 18, 19 months,

just to see the first person to say,

"Yes, you are suffering from gender dysphoria, but don't worry,"

"we've got a solution for that."

Can you tell me a little bit about what your experience

of socially transitioning was, and the lead-up to it?

It's been mixed.

I think the main improvement was, obviously,

not having to live two lives.

How was your mood leading up to that decision?

I was lost.

The thoughts just spiralled down to, you know, why do I exist?

Gender dysphoria,

it's where my brain gender does not match up with my biological sex,

and the mix-up of the two can cause major distress.

Did you have thoughts about harming yourself?

Yeah, I've had a few suicidal attempts.

I knew that, if I didn't have the help, you know, within a year,

it probably wouldn't have been an attempt,

it would've been successful.

I'd never be fully accepted as female because I had a penis,

and it's something when you go outside, a lot of people comment.

There goes, you know, a bloke in a dress.

And there's only so much abuse you can take

from yourself and other people

before, eventually, life just seems to get easier thinking about dying.

It's been reported that as many as 40% of transgender people

have attempted suicide.

So when was it that everything moved forward for you?

Probably the last six months, really,

coming to terms with a lot more of my little demons themselves.

I'd carried this letter in my pocket for about a week.

I was too scared to give it to them.

You think you are going to get alienated for it

and lose all your friends and your family,

you hear all these horror stories.

One night after dinner, I ran through the living room,

dropped the letter on my dad's lap and sprinted upstairs.

So how did you feel when I came out?

I found it difficult to start off with.

Because I did feel like I was grieving a bit for a daughter.

And I took blimming ages to get used to pronouns, didn't I?

I got "Jamie" quick, but you were still a she for a good long while

before I managed to get my head around it.

The hardest thing for me was actually going to tell my parents,

that basically that of their four grandchildren,

their only granddaughter was now a grandson.

Yeah, a grandson, yeah.

And they found it very difficult. Yeah.

Because it's not an easy path.

The potential for transphobia, for discrimination and the like

is not something we would want you to suffer from.

I think back to when you were 14,

and you were self harming,

which was really the start of the depression,

whether you really knew then.