“My gender is anything except girl,” they said, not without pride, as if punctuating the end of a lengthy interaction about prescriptions, healthcare-related forgery, and mixed feelings about Newham. There was a general murmur of encouragement from the group, before the needle specialist, wearing excellent dungarees, appeared with a selection of brightly coloured works to give to the sweet person on my right with enviable floppy hair. 

“Right, who’s for tea?” I more declared than asked. Many were. “I’ll make the tea but I probably haven’t got much more chat left in me,” I added, scouting for the stack of paper cups. Meanwhile, someone was sat at the back of the shop, next to the graphic novels, wincing over a fingerprick blood test for a sexual health screening. Another pair near the window by general fiction gave a burst of giggles. Taking advantage of the brief pause in conversation, I called, “tea?” across the ‘Staff Picks’ trolley. “Lemon and ginger for me,” came back one response, followed by “no thanks, I’m on the Haribo.” 

Outside, it’s dark and raining and there’s a generalized inclination to stay put in the warmth of the shop for as long as possible. Warm drinks and conversation flow, equipment and solidarity are offered and accepted, and for those two hours we are all part of a glimpse of an approach to trans healthcare that I think all of us, at one point, thought was impossible. Realisation of the impossible – is this what liberation feels like?

—- 

The needle exchange came as the latest in a long string of intuitive, joyous collaborations with The Love Tank. We’d first started working together around 2017, when I was doing a lot of community work in sexual health – something The Love Tank team had been trailblazing since their 2015 ‘PrEPster’ days. In 2022, my nightlife-worker pal Yannis and I started Safe Only, a non-profit collective driving cultural shifts towards peer centred harm-reduction in nightlife spaces. The two organizations have enjoyed a lively siblinghood ever since.

I don’t remember exactly when Safe Only and The Love Tank decided we were starting a needle exchange, some time in early 2024? The idea originally came from the manager of the bookshop, following a chat they’d had with a customer. I’d been a regular since it opened; we registered Safe Only as a company from its window booth, started our community dance class out of its basement, and delivered training to its staff. The Love Tank had been hosting all kinds of events amongst its shelves, anything from open mic nights to secret sneaky Mpox vaccines in the stockroom [speak to the person in the red scarf at the back of the shop, and say ‘I’m here for the brunch’]. 

My steady involvement in drug user peer-networks had connected me with brilliant individuals working in abolitionist harm reduction, and of course I had the beautiful Safe Only welfare team to draw on, so staffing the needle exchange with the right people from the get-go was as simple as sending a few text messages. So between everyone, we had a solid, pre-existing base for building something experimental, rooted, and resourced. Looking back on the immediate community cohesion is a testament to the laying of solid foundations, before the cornerstone. 

—-

A month passes, and the darkest February since 1979 gives way to a sleeping-lion March. We’re back in the bookshop. Budding daffodils and crocuses cheer the scrub at the side of local A-roads as camaraderie blossoms amongst the boxes of citric acid and naloxone. Alix is back, so is Julie, and they’re joined by newcomers Flic and Kai. Heaving my bike onto the curb, I wave at the familiar faces through the glass door, and cautiously roll it through the café tables to the back of the shop, before taking in the scene – the exchange is in full swing. 

I’m offered a cup of tea by testosterone go-to (and ubiquitous snack king) Theo, who brings me up to speed on the comings and goings so far, before returning to Teen Fiction, and catching up with Alix, who wears a background smile as they catch up about things I can’t make out from the sofa by the window. I smile too, and look through the steam of my lemon and ginger onto the rush hour hubbub outside, silenced by the pane glass shopfront. Exchange… I consider, and wince off a minor scald from my not-yet-drinkable tea. I think about what’s being exchanged here. 

A knock on the glass door snaps me back into the moment. I don’t recognize the face, but I’m reassured by a collage of badges and patches on their oversized denim jacket, and lift the latch – “Can I just drop these off? And maybe pick up some more?” they ask, nodding towards the familiar purple plastic tube tucked into their tote. After introducing them to the snack table (politely declined), I lead them towards Tate, deep in the concentration of a needle stock audit. On my way back to the sofa I hear the two of them chuckling together, and smile myself. 

Tea less molten, I take a deep slurp, and let it swill under my tongue. I mull on the rich network of exchanges taking place within and around me – I care, I am cared for; I provide, I am provided for; we share, we receive; they are uncertain, they feel held – the reciprocal exchange of one state of being for another, a lateral structure which totally debunks the clinical ‘professional/service user’ model of formalized healthcare, which we’re taught is the only viable model. The realization of the impossible. 

Denim jacket trots past me with a cheeky thumbs up, and out into the twilight. Easy, I think, watching them dissolve into the distance… and then I’m struck by how unlikely that feels, how against the pervasive narrative when it comes to trans healthcare. But it should feel easy, of course it should. Self-actualizing healthcare should breathe freely into existence, and the cosy scene around me is proof that in the hands of its own community, there’s no need for waiting lists, gate keeping, alienating diagnoses, pathologizing assessments…. the mechanisms that keep so many trans people locked outside of their own potential. In the hands of its own community, the care we need is a pleasure, and abundant. 

—- 

We divvy up the leftover snacks and go our separate ways along the high street. The needle exchange is packed away for now, but that interim is just a chance for the roots to strengthen and nourish next month’s fruit – and if you wade through the bracken there’s a thriving orchard of loving, radical mutual aid growing by the minute, with enough juicy, ripe fruit for everyone. Socials, solidarity cafes, polycules flirting amongst test tubes, community workshops… Liberatory trans healthcare is alive and flourishing, as it always has been, and always will be. I push off on my bike and pedal home. The evening air is chilled, but it will be a long time before the warmth of the evening leaves me. 

Dani Singer is a co-founder of Safe Only CIC