After a consultation with her gender reassignment surgeon, the reality of impending surgery dawns on Juliet Jacques. Is she doing the right thing?

I'm finally moving towards the second major stage of the gender reassignment pathway – surgery.

I asked myself: "Is this still what you want to do?" I'd never regretted coming out as transsexual or starting hormone therapy, but both were reversible (at least to a point). This, less so. Some people live full-time in their desired gender without pursuing surgery, but I felt as certain as ever that it was the right course for me.

The clinicians at the Gender Identity Clinic agreed, so I awaited a consultation date. In the meantime, I focused on other things – where to live, where to work and what to write about.

On the appointed day I arrived at the clinic to meet surgeon James Bellringer and Manjit, the clinical nurse specialist.

Dr Bellringer's first query threw me: "Who do you live with?" I've been privileged enough to live alone for almost my entire transition, finding it helpful to have my own space as I came to terms with my changing body, so I've not covered housing in this blog. Associations cannot refuse accommodation 'to a transsexual person', but it can still be precarious for trans people if anyone around them takes exception.

Housing became an issue when I decided to move from Brighton to London. Knowing one-person flats anywhere near central London were beyond my means, I'd asked around and looked online for shares, fretting about the possibility of moving in with strangers. Several trans friends had struggled with abusive flatmates, and securing a place that I knew would be comfortable proved surprisingly difficult.

I told Dr Bellringer that, luckily, I'd found a housemate who I'd met before through mutual friends, and that we get on perfectly. "Is she close enough to look after you for a few weeks following surgery?" I explained that I'd raised this before moving in, and that she had kindly agreed to support me if necessary.

That covered, he asked how much I drink and smoke, if I have heart problems or diabetes, or have had any other operations. I was clear, so he raced through a detailed explanation of what they'll actually do to my body, covering potential outcomes and risks, with the ruthless efficiency of someone who does this several times a week.

Suddenly, I felt cold. I'd not read much beyond outlines of the available procedures. Certainly, I'd not been directly confronted with their physical realities in the way that Dr Bellringer put them to me. (If you want or need to know more about these – although I'm sure you're not reading this for voyeuristic reasons – he provides more information on what he offers here.)

"Any questions?"

Slightly stunned, I regrouped. As I'm temping, with no annual leave or sick pay, I expressed my fears about surgery's after-effects making it impossible to work for weeks or even months – something I'd not anticipated when I entered the pathway nearly three years ago. Rightly, Dr Bellringer said that the clinic cannot help this. "You'll be on benefits. It won't be much."

I asked when surgery is likely to take place. I won't get confirmation just yet, but it should be in about six months' time. Having grown so frustrated about the waiting times, and spent the last year anxious about when and how surgery (and convalescence) might interfere with my other life plans, this seemed dauntingly soon.

I had no more questions. As I left, they gave me documentation on the operation and how to prepare for my pre-admission appointment and my eight-day hospital stay. I headed out with plenty to consider about how I will handle the practical and physical ramifications, but with my conviction about my path unshaken.