Sensing my fear, the doctor at the gender clinic dished out some helpful advice: imagine yourself as a movie character … In the first in a series of columns, Fred McConnell talks about life in transition

If you’re trans, you can pursue medical transition via an NHS gender clinic. It’s a multi-stage process: you might want one or more interventions or just to chat to someone. At my first appointment, instead of a prescription for testosterone (T), the doctor gave me some surprising advice. Sensing I wasn’t quite ready and that my problem was fear rather than self-doubt, she suggested I visualise myself as a strong masculine figure; a movie star or superhero. I was stunned: it was the survival tactic I’d been using, albeit with a persistent sense of shame, since childhood.

“James Bond,” I said, without hesitation.

I’ve always had a relationship with flawed heroes such as Die Hard’s John McClane, Mad Max and Indiana Jones. I would escape into their characters, mainlining their masculinity, replaying scenes in my mind’s eye, and walking with a copy-cat swagger.

Back in the consultation room, the doctor told me that mental resilience was key to transition. Before I could be prescribed T, I would have to socially transition, with a test-run at life as a male. This is referred to as Real Life Experience (RLE). It is also known as a fate worse than the closet. Mercifully, doctors take a relaxed approach to it these days.

My mum and I left with a printout that bore an appointment date six months hence. In the nearest cafe, we flopped on to a sofa, more afraid than excited. Then, like a pair of Vesper Lynds from the Casino Royale shower scene, we held each other and cried. Bond sat patiently, awaiting his cue.

I had to tell everyone in my life that I was male. This included the entire staff of the private members’ club I’d just started working at.

Sure, I am male, but I’m also trans. So, with my genetics and without testosterone, I neither looked nor sounded like myself. What good is social transition when it’s my word against society’s gender norms and taboos? “At the end’a the day, you are wotever’s in yer pants.” (Growing up in Kent, I’ve had conversations like this with real people.) I began to dread going out. As long as I kept my mouth shut people might just believe I was a 16-year-old boy. At times like this, I forced myself to think: what would 007 do?