Whilst waiting for professional assessment (should I ever be able to get any), I've been researching gender and dysphoria etc and have found that as well as the 'mainstream' model (which I think seems to view gender identity as either a socially conditioned behavioural performance or as a personal psychology arising from brain structure, and thus gender dysmorphia and variance as the outworking of an 'abnormal' brain structure worked out within culture - there is current debate over whether dysmorphia is a prerequisite for transgender identity, and whether non-binary identities are the same thing), there is also another (largely criticised) model - Blanchard's autogynophillia framework, which sees 'true' transwomen as basically gay men who transition to increase sexual activity options, and 'false' transwomen/late-onset dysmorphia sufferers as heterosexuals with a peculiar erotic paraphilia/fetish (an inverted and gender reversed autosexuality).
I'm not sure either of these models really seem to fit someone like me who seems to have changed in later life (and whose gender therefore doesn't seem connected to a hardwired brain structure), and whose gender identity is likely connected in some way to their sexuality but who doesn't get erotically aroused by cross dressing nor desires sex with themselves (or anyone else).
Are there alternative models of understanding gender that people know of?
In my own head I see gender/sex as the interplay between multiple factors: chromosomes; bodily function and appearance; brain structure; personal identity and psychology; behaviour within a social context.
I also see it paradigmatically, so that there is an idealised 'man', say, which would have these chromosomes, this hyper-masculine physiology, this male brain, this identity, and in such a such a culture these behaviours, and the closer to that type someone gets the more a 'man' they are, and the farther away the less likely that society (or sub-culture, or even individual) will be inclined to accept them as 'man' and they are more likely to have different terms used of them. Ultimately it's all a semantic game then, where there's very fuzzy and generationally changing borders between what gender terms are likely to be socially accepted/given to a person.
Hmmm, you say you have no idea, but that sounds pretty much like a good summary to me.
There are the basic genetic determinants and then there are how those genes express themselves or not. There are environmental factors both micro and macro which can shape the way someone develops from zygote to mature being. There can be triggers of all kinds which our bodies may or man not respond to, and can respond to in different ways. As you say, it's multiple factors and to some extent it becomes semantics.
I am sorry that you haven't found the kind of help you need from the NHS so far. My only advise is to keep hopeful and keep bashing on with them. I can see that you would like some answers that are satisfactory and haven't found them yet. I also have been in a place like that and then someone (on a helpline) said to me 'you seem to be really uncomfortable with uncertainty'. I had never thought of it like that before but yes, that was me. So a lot of the therapy I have been having since has orientated around accepting that 'uncertainty' is okay. I hated not knowing the answers to questions but have been learning to be comfortable with saying 'I don't know'.
Anyway, I have no idea if that helps at all but there it is. What I am saying is that you may or may not find answers but what you can do is find peace with yourself. Sometimes that's all we can hope for.
Yeah, I'll keep on with the NHS. I understand they're in a really bad spot right now which is probably making everything even more slow. But I honestly expect that after my mental health assessment they will have nothing left to offer me, or at least that's what I've been led to believe by them do far.
Regarding uncertainty I hear you . Most of my life has been a coming to terms with (amongst other things) the total lack of certainty anyone can have over anything. I tried being a pyrrhonian sceptic for a while, but that's hard too - I can't help forming beliefs and opinions even when I know I don't really have enough understanding to justify them. Human nature, I guess. Uncertainty is ok in the abstract, but it can be stressful when you have to make serious personal choices about actions and know that if you get it wrong there can be bad consequences for yourself and others. I guess we all just do the best we can with our limited understandings Some uncertainties are sensible to feel uncomfortable over, but it's how we manage that stress that I think may be the issue.
I doubt I'll ever get a full understanding of my personal psychology, but I'd like to get enough to at least have a modicum of confidence when making life changing decisions. And for that I need the input of experts and others.