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Among the thousands of supportive emails I’ve had have been many medical people saying much the same. One of the worst was from a nurse who worked on a geriatric ward and said she’d just been given guidance on what to do with a patient with dementia who was suffering severe distress because they no longer understood what had happened to their surgically-altered body or why they were being talked about as the opposite sex. She said she’d never met or heard of any gay person with Alzheimer’s who’d forgotten that they were same-sex attracted and asked, rhetorically, why medical staff like her were pressured never to talk about the issue or ask questions. She also said her patient wasn’t the only older trans-identified person with Alzheimer’s she knew of who was deeply disturbed by changes in their body they no longer remembered wanting or consenting to.