The air-conditioned hospital room was as still as the grave. Somewhere beyond the window, the sun climbed above the hottest city on Earth. But lying here, I couldn’t stop my teeth chattering. I gave my companion Jenny a sideways glance. Her smile had given way to puckered lines that seemed to have frozen on her cheeks.

Then came the knock.

‘Your surgeon is scrubbed.’

The doors swung open and two porters pushed a steel slab of a trolley alongside my bed.

‘Lie flat and keep your arms tucked in. We will put you to sleep. Wake up again in nine hours.’

Richard Hoskins before embarking on his gender reassignment journey (left). Living as a woman named Rachel (right)

‘Wait,’ I felt the muscles tighten in my jaw. ‘Give us a few moments. Please…’

The porter looked anxiously at the nurse. She nodded and the doors soon closed behind them.

I clasped Jenny’s hand until I felt her bones crunch. ‘I’m scared. Am I crazy?’

She took a deep breath then let it out, infinitely slowly. ‘You told me you’d kill yourself if you didn’t go through with this.’

Then another knock, this time louder, more insistent. Matron stood at the threshold, hands on hips: ‘Dr Sutin is waiting for you in the operating theatre, Miss Rachel.’

It was late in 2016 and I’d flown out to Bangkok for the first in a series of operations to change sex from male to female.

Richard after the nine-hour facial surgery he had in Thailand in 2016. He said: 'My face was scarlet and had swollen to the size of a basketball. Midnight-blue lips were draped across my mouth'

It had taken months of desperation, hormone treatment, counselling and living in ‘role’ as a woman. Now I was about to embark upon physical surgery – the decisive, irreversible step.

At the time it was what I wanted most profoundly, and as I was wheeled towards the operating theatre, this seemed like the bravest moment of my life. Yet I was deeply mistaken.

I was not suffering from gender confusion at all. I had no need to transition. My reasons for wanting a new identity, I would eventually learn, were complex and nothing to do with being male or female.

But I’d undergone an extensive series of extremely serious operations before I finally called a halt, pulling back from the brink in the nick of time.

Today I am still a man and the relief is huge. Yet I have been left with a battered body and a series of disturbing questions about how I could have reached such a state of mind, and about the transitioning industry that helped rush me headlong to the operating theatre.

In fact, I have come to believe that for many of the growing numbers of men, women and, most alarmingly, children wishing to change sex, gender reassignment is nothing more than escapism.

It certainly was in my case. The least we can do is start to tell the truth.

Richard as he is today where he said his reasons for wanting a new identity were complex

For many years, I had been living an apparently contented life. I’m a successful author and criminologist known for my expertise in faith-based crimes, including ritual murders. I’ve done a great deal of work advising the police and some might know me from my 2012 bestseller The Boy In The River about the case of Adam, a victim of modern day witchcraft found floating in the Thames.

But October 2009 brought a cataclysm which blew my world apart. My 19-year-old son David climbed 65ft up an electricity pylon in Weston-super-Mare and reached for a 33,000-volt cable. Witnesses reported a blue thunderbolt and hearing a buzzing noise.

It should have killed him outright. But it didn’t. From his hospital bed a few days later he whispered: ‘It hurt me so much, Daddy.’

David seemed to have everything: good looks and a razor-sharp mind. Everyone adored him. But he was also troubled, especially at night when he would be struck by uncontrollable terrors. Crossing the threshold into adulthood, he was lost to the mental health system and in desperation he’d decided to try to end his own life.

Each time I stepped into David’s hospital room, his chest would swell. ‘Cuddle me,’ he pleaded. ‘Cuddle me.’ And so I did. I cuddled my little boy every day for 42 days. We held each other until our tears drenched his dressings, and then we held each other some more. The sight and smell of my son’s scorched flesh, then of rancid infection, are now part of me for ever.

I said goodbye to him the day before he died on December 4, 2009. I left the decision to switch off his life to his mother, Sue. I simply could not do it.

With hindsight, it’s not surprising that I chose to leave Richard behind and instead become Rachel. Largely raised by women, I’d had a lifelong admiration for the fairer sex. I loved womenswear and to this day my closest friends acknowledge in me a sensitive side.

But by 2009 I was in my second marriage and dressing up in women’s clothes was not a subject of conversation I wanted to have any time soon with my wife, especially as she mistakenly considered me an Indiana Jones type: an academic lecturer and adventurer.

This marriage ended following David’s death and I found myself increasingly alone with my own thoughts. In the months and years that followed, I turned to my feminine side.

It was nothing to do with sex – I’ve never been attracted to men, just to be clear – but it was something that I wanted quite powerfully all the same. What might it be like to put on make-up? To wear those clothes outside? To step into the ladies’ loos? I drove down to the local Tesco superstore and filled up a trolley with everything from ladies’ briefs to frilly tops, skin-tight jeans to mascara. It felt both scary and thrilling.

I trawled YouTube for make-up tutorials, and after a couple of months became quite proficient.

I learned how to apply subtle tones, how to hide lines and disguise the stubble that increasingly bothered me. But I soon realised that if I really wanted to change my gender then I had to go a whole lot deeper than just dressing up in women’s clothes and applying Touche Eclat. In autumn 2014, I surfed the dark web – the bit of the internet where you go to find stuff not thrown up by conventional search engines. I was in search of feminising hormones – a dangerous step to take, yet one that proved disturbingly easy.

I found what I wanted when I stumbled upon a site registered with the South Sea island of Vanuatu. I filled in all the details and steadied my hand enough to hit the pay button. A month passed. Then, early one afternoon, when I had resigned myself to having thrown away £400 on a scam, my postman Malcolm pressed the doorbell. If he was surprised to find me in female clothes, he masked it well.

A few minutes later the meds tumbled out of the padded bag. They all seemed bona fide and a few even carried expiry dates.

How could I tell that they hadn’t been cobbled together from God-knows-what ingredients on a Guangzhou backstreet? The truth is I couldn’t.

The effects were certainly profound, and almost immediately my breasts began to grow.

Within weeks I was regretting it, however. Feeling desperately ill, I staggered to my doctor’s surgery and confessed.

And it was from that point onwards that I found myself enmeshed in the National Health Service gender identity machine.

I was informed that, conventionally, someone wishing to change sex should wait two years before being prescribed life-changing hormones – an entirely sensible rule.

Normally I would be required to ‘live in role’ first. As I soon discovered, however, the system bends over backwards for anyone who wants to transition. I was not so much fast-tracked as catapulted through the system.

Within six weeks I had been interviewed by all the required consultants, a process normally lasting more than two years. I’m sure I was fairly convincing, but then anyone can give convincing answers with the help of Google.

Then, in February 2015, I was sent to Nottingham for the final consultation that would place me on the NHS process to full gender reassignment surgery and recognition as Rachel by the state.

Feeling inspired, I clutched my handbag and walked confidently into the ladies’ loos for the first time at London’s St Pancras station. What was it like inside there? Could I apply my make-up surrounded by other women? Would I be rumbled?

In truth, none of the ladies in there gave me a second look, and all the time I lived as a woman that remained the case.

I came to think of the ladies’ as my safest space on Earth. In there, no one could hurt me. If I’d stopped and listened to that voice I might have realised it was a vital clue to something else going on.

Over the next 18 months, I continued to take the NHS-prescribed medications. These were testosterone blockers and oestrogen. The state also paid for me to undergo 80 hours of extremely painful electrolysis on my face. My stubble was systematically plucked out.

But it wasn’t sufficient. To be convincing I needed to go under the surgeon’s scalpel.

I knew the NHS would never provide facial surgery so, with the blessing of Health Service professionals, I went in search of private treatment. I found that the world leaders in the field are Thai doctors and, having scrabbled around for every ounce of funding possible, I flew out to Bangkok.

My close friend Jenny, who had followed my path into transition with a mixture of compassion and increasing anxiety, insisted on flying out soon after so that she could nurse me.

The surgery took nine hours and was a process of quite astonishing brutality. At the last minute, I’d decided to include forehead reconstruction around my orbital rims, to make them more almond shaped. So Dr Sutin ground down my eye sockets, particularly around the outer and upper rims, after peeling my face away from my skull.

He performed neck and cheek liposuction, a full neck and facelift and separate eye-lifts. He reduced my facial skin in size before stitching it back on to my skull.

My new, lower hairline now extended from the top of my head around and behind my ears.

When the swelling disappeared, my face would be smaller than before, my forehead a couple of inches shorter and flatter, and my ears apparently smaller. The aftermath of the operation was a blur of semi-conscious nausea and pain.

I was dimly aware of a nurse trying to wake me by shouting my name, Rachel, and scratching my palm.

I threw up every time I awoke. And my temples felt as if someone had put them in a vice, then tightened it another 50 turns.

As my £15,000 covered only a one-night stay, I was discharged and had to stagger into a taxi still carrying my drip and the drainage catheters. Back in our hotel room, Jenny propped up my pillows and I peered at the apparition staring back at me from a mirror at the end of the bed.

My face was scarlet and had swollen to the size of a basketball. Midnight-blue lips were draped across my mouth.

But it was my eyes, or what was left of them, that really made me want to weep. Aqua-clear irises were now angry blotches. Lava lines flowed outwards from them, as if my whole head had become a volcanic eruption.

What the hell had I done? And it was at that moment that the doubts finally bubbled to the surface.

When a NHS referral letter to Brighton’s Nuffield Hospital landed on my doormat three months later, in March 2017, for me to undergo full vaginoplasty – the transformation of all my male parts into a female vagina – I was finally pushed into thinking for myself.

So instead of following the NHS cavalcade, I took myself on a private consultation to gender psychotherapist Michelle Bridgman and Professor Gordon Turnbull, of the Nightingale Clinic, London.

They diagnosed me as suffering from complex PTSD: multiple severe traumas.

I didn’t have gender dysphoria – or gender confusion – as I had thought. I was trying to escape real, visceral and gut-wrenching pain. I had chosen profoundly the wrong way to fix it and the NHS had been all too ready to help me on the way.

What shocks me with hindsight is that no one looked more deeply into my life story.

At no point did anyone in the gender clinics talk me through what had happened with my son David and about the 42 days I spent by his bedside watching him die from his burns.

Nor did they bother to find out about the earlier traumas I had suffered.

My childhood had been ripped apart by a teacher who got a ten-year sentence for sexual abuse. Working in the Congo as a young man, I’d had to bury my first children, twins, who became sick and died. Then there were the hundreds of gruesome police cases I had advised on.

There was no shortage of clues for anyone who had bothered to look – and if it was true in my case, how many others are similarly misdiagnosed?

How many adolescents desperately wishing to change sex are really trying to escape some other form of pain? How many of the children, often girls, who drag their distraught mothers along to the Tavistock gender reassignment clinic in London are really suffering from poor body image in the Instagram era?

The numbers are huge. Tavistock specialists saw 2,000 children in the past year alone and report a six-fold increase in those aged three to 18 being referred in the last five years. Yes, three-year-olds. Although there are a few emerging voices like mine, the cavalry charge towards gender transition is in full gallop.

From April 2017 until the end of last year, I underwent intensive trauma counselling. It wasn’t easy. But I’ve learned that it’s possible to overcome the past and to start living once again in the present.

In October I went to David’s grave for only the second time in ten years. On one of the last warm days of the autumn, I sat on a bench and ate my lunch as the birds sang around me. I had the most profound sense that David wasn’t there. That he wanted me to move on. To be released.

Coming back to my true self as Richard was one of the greatest things I ever did. From time to time I felt a tug to escape into Rachel, but that has now passed.

I do regret what I’ve done to my body. There are some changes that are irreversible. I have to take daily corrective male hormones. I will probably need breast reduction surgery. I carry physical scars. My sinuses have never been the same and I still have no feeling across large parts of my head.

But I am also lucky and grateful to still be alive.

What propels someone to slice their face off their skull and rearrange it? To alter the body they were born into so fundamentally?

People told me that I was a survivor. I guess they saw me as living proof that whatever the fates might bombard you with, you can still make it through. But no one really got the torment of even the most mundane, everyday things. Driving anywhere near a pylon. Switching on a kettle. Lighting a fire. Running through autumn leaves. Watching Holby City, for God’s sake. And it didn’t really matter if there were no triggers. The pain was always there.

For a decade, I ran and ran. I tried to escape my life, my very identity. I changed my gender to leave Richard and his life behind.

Inspired by youthful images of smiling women, I grabbed the chance for a different life.

I know I’m unusual and that few others have experienced the multiple traumas to have befallen me.

I accept, too, there are some people who feel they have no choice but to change gender and I have sympathy, although I suspect the true numbers are small. For the few who genuinely feel they have no choice, perhaps a third gender would be a way forward: neither male nor female.

For as I know all too well, it is nigh impossible for surgeons to replicate female body parts in full, nor can they alter the XY chromosomes with which most men are born.

There is, after all, an added issue here about respect for women born as women. Looking back, I sometimes think that I was insensitive, that in my rush to change identity I trampled through places which rightly afford women their own dignity and space. What really gave me the right to use ladies’ loos, for example?

Most of all, we need to recognise that gender transition can, in truth, be a misguided attempt to escape the person you were born to be – and demand a halt to this dangerous headlong charge.