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“For me choosing to stay as I was meant putting my life at risk.”

Billy-Joe Newington was 16 when he first told a doctor he was transgender. He’d been born a girl, called Connie, and had lived that life throughout his upbringing in Penarth. It was another two years before he felt able to confide in his friends.

“People would speak to me as if I wanted plastic surgery to make myself beautiful,” he said.

“They’d say, ‘You’re beautiful the way you are.’ They weren’t getting it.”

There are no official estimates of the number of transgender people living in Wales, or in the UK for that matter. That’s mainly because of the difficulty in measuring it accurately. Data can only be reliable when it relates for something people are willing to talk about. For Wales’ transgender communities, the persistent spectre of harassment, bullying and violence has meant that many have often felt inhibited from speaking about their true gender identities. But things seem to slowly be changing.

Last year, the Welsh Government published its first Transgender Action Plan - a document aimed at considering the extent how accepting public life in Wales was of transgender issues.

“Many trans people are now coming out at a younger age,” it noted. “This increases the likelihood that schools and youth organisations will encounter trans young people or a young person who has a family member who is transgender. According to GIRES (the Gender Identity Research and Education Society), a school of 1,000 pupils should expect around 10 to be gender variant to some degree.”

Gender dysphoria describes the incongruence between a gender assigned at birth, and the identity experienced by an individual. There is evidence that that disparity can originate before birth, and that it can start to be expressed in children as young as two. Many teachers will have experiences of children in their care displaying signs of this mismatch. This isn’t a new phenomenon. But it’s only recently that it’s something that society has started to feel able to begin discussing.

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Billy-Joe was in his 20s before he finally started receiving treatment that would help him become a man. Even then, his first access to medication was through a supply bought online.

“A year after my first appointment I got prescribed testosterone,” said the 29-year-old, who now works as a DJ in Cardiff.

“I was 24. I’d started taking it illegally a year before because I was desperate.”

Gender dysphoria can be an isolating and disorientating experience even in an environment that is tolerant and sympathetic. In an atmosphere of hostility, it can be exponentially worse.

Carol Nixon is 72 and lives in Penuwch, a village between Tregaron and Aberaeron in one of the more remote parts of Ceredigion. As a child, she was aware she was different to those around her. But it wasn’t until much later in her life that she started the process of transitioning.

“One knows what one is,” she said.

“I went to nursery school and I would line up with the girls and be told I was in the wrong line. That was slightly disorienting.”

(Image: supplied pic)

At Carol’s mixed primary school all her friends were girls. But things changed as she moved through the educational system.

“I was sent to secondary school and it was all boys,” she said.

“I was still not fully aware of what was going on.

“I felt a bit alienated and very lonely, because I wanted girls to talk to.

“It was a feeling that grew in me and I began to imagine myself as a girl.

“I very often started dressing as a girl, but not in public, not with the knowledge of family or friends.

“I was ashamed. I thought this was a terrible sin, an awful crime but I couldn’t not do it.

“I used to go about in public but in not well-frequented areas.”

Billy-Joe’s school experiences carried similar hallmarks, despite taking place around 50 years later.

Faced with the daunting prospect of opening up to everyone in his life about his true feelings, Billy-Joe flirted with a different option. For a period, he attempted to make peace with the gender assignment he’d been born with.

“It seemed like it might be an easier life,” he said.

“It lasted for six months, it made me so unhappy. It was harder than being me even though being me came with a thousand questions.

“When I was in my early years at high school I would watch how other guys would walk and how they would pick up their drinks and I taught myself to be male.

“So when I tried to be female I had to learn how to be a female.”

While plotting a course to gender realignment was not straightforward for Billy-Joe, he had long felt clear in his mind about the fact he was male. But things aren’t as clear-cut for everyone.

Jamie Morse started presenting as a woman this year.

“I started cross-dressing with a wig and stuffed bra,” she said.

“When I was feeling crappy about my exams at that time, being able to go home and try something I had known I had wanted to do was huge. That was March last year.

“I’m very lucky that I had a friend group that were OK with this.

“Over the summer when I was back home I could not particularly dress how I wanted so when I came back for my third year I felt like I was living in my own skin again.

“I had felt like my life was on hold. It was not just that I appeared different from how I normally am.

“It was having people look at me and not seeing what I see.”

The 20-year-old, who comes from St Davids but is at university in Cardiff, chose to retain the name Jamie because of its gender neutrality. But little else about her experience was so straightforward.

“I could hide it from some people,” she said.

“I waited until early November to tell my parents. That was an experience in itself. That was the hardest.

“I said there is something important in my life, something I wanted to tell you,” she said.

“I was going to call you to tell you I’m transgender.

“It went quiet down the phone. A few seconds later she burst into tears.”

“That destroyed me. It sunk me into a month-long depression that I’m coming out of with counselling.

“I love my parents more than anything. I’d been getting excited about telling them.

“I don’t think they will ever feel the same way about me again.”

(Image: Rob Browne)

Jamie’s described how her close friends were less shocked than his family.

“They were like, ‘We kind of had a feeling,’ she said.

“I thought it would bother me that I had been prejudged, but it was a rare situation where being prejudged was positive.

“I was definitely surprised by that. One of the big things about transition is body dysmorphia where you have an intense disassociation from your body, where you can’t even look in the mirror.”

The more people you speak to in the transgender community, the more you realise the crucial connection between body image, identity, and self-worth.

For Billy-Joe, it was the growth of his facial hair that proved a pivotal moment. It initially emerged slowly because of the relatively low doses of testosterone he’d bought for himself online.

“When I had a prescription it started happening quickly,” he said.

“I felt more amazing every day. I took photos all the time.

“I was seriously excited, like any other young man getting facial hair coming through."

In the early days he borrowed a friend’s eyeshadow to darken the blond wisps that were emerging.

“Whatever Instagram filter made it pop out more, that’s what I was using,” he said.

“My brother has never been able to grow a full beard.

“He’s not very happy about mine.”

Sally Douglas lives in Lampeter. We’ve changed her name for this article at her request out of respect for her privacy.

She describes her gender identity as “an evolution” that started in her mid-20s. She’s now 52.

It’s an eye-opening account of the incremental and, at times, painful process that takes place long before any surgical procedures. Sally believes she could be in her 60s before she finally goes under the knife.

“It entailed lot of blood tests to find out what my testosterone levels were,” she said.

“I started on a low dose of oestrogen, I took two milligrams a day and that was increased. I now take eight milligrams a day.”

Androgen blockers were used to block the body’s production of testosterone.

“My testosterone levels are down to about eight units of whatever testosterone is measured in,” Sally said.

“For me to have any surgery they will want them down to about three or four.

“Periods were the most unexpected thing because I had been taking HRT for a year.

“I expected breast growth. Did I expect to have a time where I wanted to kill people every month? Not at all.

“In fact I’m in the middle of one at the moment.”

While significantly younger, Billy-Joe is a lot further down the road towards his biological transformation into becoming a man.

He had a double mastectomy around a year after initially starting to take testosterone, followed by a stage one phalloplasty, involving the creaton of a penis from his stomach. Stage two involved using skin grafts from his arm to make the urethra. Stage three saw the bladder connected. The process has left him with a scar stretching across his abdomen from his hip bone.

The final stage in January will finally give him fully functioning sexual organs.

“I’m not nervous about the operation at all,” he said.

“I’m a bit apprehensive because of my experience with the gender clinics.

“They have said the date won’t change but because of my experience I tend not to relax about that.”

For Jamie, the reality of surgery is some way off. He’s considering starting hormone therapy next year, but he still has some thinking to do about his future.

“Down the line that could lead to genital surgery and facial feminisation surgery.

“The surgery is a big thing. It is going to take a long time to get used to it.

“You have a choice about doing it. I’ve only just started figuring out how I feel about it.

“It’s not that I don’t want to, but it’s a surgery like any other.

“It’s not something I want to rush into, even though I am transgender. I don’t know if I want to make that huge body decision.”

The medical journey towards transitioning is an arduous and daunting one, full of hormone treatments, mood-altering medication and invasive surgery. It is process full of pain and discomfort.

But for many experiencing it, the greatest trauma comes from the battle for acceptance.

For Billy-Joe, surgery was the moment of greatest acceptance from those around him.

“My mum got quite upset after my surgery, I think because she did not realise I was so unhappy,” he said.

“I think she saw it from my perspective.”

Billy-Joe also wanted to cry.

“But they were happy tears,” he said.

“I was overwhelmed because I had been wearing a binder for six years.

“Though I remember looking down and thinking, ‘Is it supposed to be this flat?’”

Carol says she “more or less” describes herself as a trans woman, and recounts a life of relationships overshadowed by the issue of her gender.

“Being trans is a sensation in your own head,” she said.

“It’s a question of who you identify as.

“I don’t identify as a man, but I can’t claim all the rights of a woman.

“I started to transition when I was in my 50s. I retired as early as I possibly could because I wanted the freedom.

“It was a slow process. I began to realise that people were not being critical, that I did appear as a woman, and was given a lot of support and backing.”

A strong Christian, she left her first chapel feeling that support for her was by no means unanimous among the congregation. She found a more reassuring atmosphere among a new church in Aberystwyth.

“Before I came to Wales to live I thought people would be even more offended than anywhere else,” she said.

“But more or less the reverse has been the case. It’s possible that because I’m in a rural area people just take people as they find them.

“The only areas I would feel uncomfortable would be on estates where there are a lot of yobbos.

“I would feel vulnerable there and I don’t see any point in making myself a victim.”

(Image: supplied pic)

Carol was still living as a man when she got married. The relationship lasted for 28 years, but was scarred by the difficult issue of her gender identity. Carol’s ex-wife died last year.

“It was so hard on her,” she said.

“I was not a person chasing girls for pretty obvious reasons.

“But when this person took an interest I thought she was the one I had to marry. And so I did.

“From a sexual point of view it was a total disaster.

“We never really had sex. She thought it was her fault until she learned about my nature.

“The last thing she said to me was to use my name Carol,” Carol said.

“She said, ‘I love you Carol’ and then she died.

“That was so moving. It was the first time she had used that name with me.

“I always felt terrible about the pain I had put her through and I didn’t transition until after she had moved away.”

Like Carol, Jamie’s relationship also crumbled under the strain as she started to speak out about her new identity. Her girlfriend, also transgender has always had a more clear view of her future.

“She knew since she was about four,” Jamie said.

“I’ve always been effeminate and quite aware that I did not want to be strongly masculine.

“There are times I wonder how I’m going to cope and make this a happy life.

“But Cardiff feels like a place where I can go out in a wig and feel safe and happy.

“There are places at home where I couldn’t walk out in a wig and skirt.”

(Image: Rob Browne)

There have been a few unpleasant experiences in the capital’s pubs. One bar wouldn’t let Jamie in because of her clothes, while in another Jamie and her then-girlfriend were filmed kissing by fellow drinkers.

Sometime bars “don’t feel like great places to be”.

“I’m not going to stop being me,” Jamie said.

She can’t envisage going back to St Davids to live.

“I don’t think I could be gay or bisexual, let alone trans, there.

“If a person there is gay, that’s what they are known as forever.”

It’s hard to imagine the increased coverage of trans issues on mainstream channels failing to achieve a greater understanding among the general public about this sensitive and complex issue. But understanding achieves little unless it comes alongside tolerance, as Sally explains.

“I was speaking to someone in a shop and they called me ‘Sir’. I said, ‘These are boobs. Try looking at the person instead of listening to the voice.’

“People get one chance to make a mistake and I am unmerciful after that. Because if I am not they will never learn and they will debase other people’s rights.

“You can never walk in someone else’s shoes.

“All you can do is accept them and accept that, for them, what they feel is very real.

“I can’t understand why anyone would want to play golf. But I acknowledge their right to.”

One of the primary reasons why transgender people have traditionally not spoken openly about their lives has been the harassment, bullying, violence and intimidation that has characterised the way they have been treated by many.

Attitudes may be changing, but there remains a significant issue surrounding cyber-bullying in particular. Research suggests 91% of trans boys and 66% of trans girls experience harassment or bullying at school.

In Billy-Joe’s experience, perceptions have become more accepting during his own lifetime, although it’s online that problems still persist.

“There will always be people saying it’s wrong,” he said.

“People write on my You Tube that it’s Satanic, and that it is because I did not have a religious upbringing.

“Someone said ‘This is disgusting, you’ll be committing suicide before long.’

“But no one ever says anything to my face because a coward is a coward.”

When he broke the news to his parents they “never disowned me or anything.”

“I did not tell my mum I was transitioning until I was nearly 19 and she was like, ‘OK, what does this mean?’” said Billy-Joe, who lives in Cardiff.

“She was like, ‘Are you sure this is what you want to do? Because this is a big deal.’

And it’s that process that remains the most challenging part of the journey.

In Sally’s words, it’s this: “There is nothing easy about being trans. It’s hard work and you have to be very tough.”

Or as Billy-Joe puts it: “The most difficult thing has been the mental struggle. It’s a hell of a rollercoaster.”