“It’s really hard to be on that list and have that time waiting,” says Sylvian Cunningham.

Last year, the 17-year-old reached an important landmark in his life. He realised that he was the wrong gender.

Born a girl, he has spent his teenage years battling complex emotions as he came to terms with who he really is.

Now he is at the start of a long journey to make the physical transition to being male.

“At the moment I am pre-transition,” he says, wrapping his hands around a glass of water as he describes his feelings in a cafe in Shrewsbury.

“I do want to do testosterone and I do want to do the surgeries.”

Sylvian Cunningham

But there is a long wait ahead for Sylvian. He will have to have a referral as an adult and faces a minimum two-year wait to get therapy appointments and tests before any surgery can take place.

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“I’m pre all of that,” he says. “It’s a long, long time. People say that it at least makes me sure of who I am, but also it’s kind of sad.”

He faces these challenges at a time when the issue of being trans is prevalent in the news, but that didn’t make it easy for him to come to terms with himself.

As a young child Sylvian felt equally at home playing with Barbie dolls and wearing dresses as he did climbing trees and playing football.

But when he went to high school his feelings about his own identity became more complicated.

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Sylvian Cunningham

“Initially I thought I was gay, a lesbian,” he says.

“Then I started to get so much discomfort with my body itself. I experimented with being non-binary first – so being genderless, using ‘they’ and ‘them’ as pronouns. But after a while that didn’t fit either and it was hard to stick with it. Then it developed further.”

Sylvian wanted to try wearing male clothes and travelled to Telford to buy a shirt.

“It was just a green top, but it was from a male section,” he says.

“In the back of my mind I thought everyone was watching me and seeing me buy it and knew what I was doing. I never wore that top.

“Then for my 15th birthday I was given money and I bought a binder, which basically compresses your chest to make it look a lot flatter.

“I needed to present myself as masculine, I needed to have this feeling of looking like I have a flat chest in order to be perceived right.”

Sylvian Cunningham

Sylvian was confused, and couldn’t put his feelings into words. Gender dysphoria – the distress a person experiences as a result of the sex and gender they were assigned at birth – was not something he understood.

He now studies music at Liverpool Institute of Performing Arts three days a week, while living at home in Shrewsbury, and worried that taking testosterone would affect his passion for music.

“I was seeing my chest and saying this isn’t right,” he adds. “I started to research. I was slightly aware of the word transgender which I had heard on the playground. I questioned my self-worth. I hit rock bottom and thought ‘I can’t do this anymore’.

“There was nothing in the media that was ‘this musician is trans’, in fact there was just lots of videos online saying ‘you’ll ruin your voice with testosterone’. I thought I was just going to sit in a hole and ignore it. I was just searching online to try and find why I felt the way I did. There was just nothing positive at all.”

He is androgynous in appearance and points to icons like David Bowie and Prince giving him the confidence to be a trans musician.

Although he also admits that because of his androgynous looks, that may also help him avoid some of the abuse that those who transition from female to male receive.

Sylvian Cunningham

“Male to female transitions are the ones that get the big hit and the most abuse,” he says. “There is so much stigma about men.

“I had an experience with a more extreme religious person protesting in Shrewsbury. They called gay people ‘perverts’.

“I went up to them and asked if we could talk about it being a trans or queer person. I wasn’t going to apologise for who I am. He told me I was a beautiful woman and that’s all I’ll ever be. Things like that don’t impact me, but I was bothered he wasn’t willing to listen and learn though.

“A lot of the time people get confused about my appearance. Because I work in a place dealing with customers all the time, people are like ‘I can’t tell whether you’re a boy or a girl, so I don’t know what to call you’.

“Normally people call me a girl, 'she' and 'her' as a safe bet first of all. There will be an odd occasion when someone calls me he and it makes me so happy.

“You become really sensitive to language. Something as small as ‘mate or ‘love’ and you can tell if someone has seen you as male or female. I’m still only getting into the habit of correcting people. I have spent a long time not correcting people and just taking it, which is not good.”

Sylvian Cunningham

For two years at school Sylvian did not use a public toilet at all.

“Toilets are a big issue for me. I get so frightened about going into a male toilet sometimes,” he says.

“There is a fear in the back of my mind that I will walk into a toilet and that someone is going to beat you, stab you and you have no way out of it. And even when I go into a female public toilet people do look at me weirdly as to say ‘what’s a guy doing in here?’.

“I haven’t gone swimming in years because of the situation with changing rooms. I used to be so dedicated to it. I did try after I came out, but it was just so hard. That has been one of the biggest losses for me because I loved swimming so much.”

Sylvian accepts that while he is accepted by friends and family, that life is likely to remain complicated and at times difficult.

“This is something that will impact me for the rest of my life,” he says. “Taking hormones as an example, that doesn’t stop. The surgeries themselves are something I haven’t worried about because I want them so desperately. I’ll take whatever comes with it.

“You can’t be trans and be happy. You have happiness, but if you are trans then typically you will struggle with mental health issues.”