Station 55
Lisa Walters (previously known as Andy Walters)
Age: 28 years old female
Patient
Patient's Story (Role player’s brief)
Patient’s Story
You are Lisa Walters, a 28-year-old transgender woman. You have been feeling low in mood and anxious for the past 2–3 months, particularly after recently undergoing gender reassignment surgery abroad. You would like a sick note, as you have already been off work for over a week.
You recently travelled to Turkey to undergo gender reassignment surgery, as you were unable to wait for the two-year social gender role transition required under the NHS pathway. You have now returned to the UK having had breast augmentation, vaginoplasty (creation of a neo-vagina), and orchidectomy (removal of testicles). You are currently on oestrogen and progesterone hormone replacement therapy, which was prescribed by the gender clinic, and they monitor you with regular blood tests.
Since returning to work, you’ve been feeling increasingly distressed. You have the impression that some colleagues may be talking about you behind your back, and you don’t feel accepted in the workplace. One colleague recently addressed you by your former name, “Andy,” despite your request to be called “Lisa.” You are also unsure about which toilet you should use at work, as you are now socially female
You feel very low in mood, anxious, and overwhelmed. You have no thoughts of suicide or self-harm. Although you love your job, you do not feel emotionally or mentally ready to return due to the current workplace environment. You would like a Fit Note (sick note), as you do not believe you can cope with work under these circumstances.
Social History: You do not smoke, drink alcohol, or use recreational drugs. You live alone but are well supported by your family.
Ideas: You believe your low mood and anxiety are linked to the difficult experience of returning to work. You feel that the social transition has been emotionally challenging, especially as you try to settle into your identity as a transgender woman.
Concerns: You are worried that colleagues may be talking about you behind your back and treating you differently, which makes you feel isolated and not accepted in the workplace. You are also unsure about which toilet you should use at work, whether male or female
Expectations: You would like a sick note to take time off work
If offered antidepressants: You do not want antidepressants or other medication; your preference is for talking therapy or counselling.
Say NO to any other questions asked outside of the details already provided in the scenario.