Paul Rowe says he no longer knows what gender he is. Fifteen years ago, he underwent genital surgery to become a woman. But after seven years of living in his female persona, Paula, he stopped wearing women's clothes and now considers himself trapped in gender limbo.
When we meet, Rowe, 54, is wearing baggy cut-off combat trousers, a denim shirt and a baggy T-shirt. He says he wears loose clothing to try to disguise his breasts, which developed after taking female hormones. His grey hair is long and straggly. As a result of electrolysis and surgery to reduce his lower jaw, his face is quite androgynous. However, his strong arms and broad hands look manly. His voice is soft but also masculine.
"Some days I'm Paul, other days I'm Paula," he says. "I'm trapped between male and female. Sometimes I don't know which toilets to go into. I get challenged if I go in the ladies but if I go in the gents they stare at my boobs. I just wish we had unisex toilets like on the continent."
Rowe, who grew up in Cornwall, dressed in women's clothes from early childhood. "I have five brothers, it was a very macho household," he recalls. "But while they were out playing rugby I was secretly dressing up in my mum's clothes."
He suffered from anxiety throughout his teens and found cross dressing a way of coping. "I was shy and lonely," he says. "I felt comfortable in women's clothes - it was a release for me."
Rowe says he only felt driven to physically change gender in 1988, following a series of personal traumas. Over the previous four years his mother had dies, he had gone through two divorces and lost his job as a geologist. He started drinking heavily and was admitted to a psychiatric hospital with severe depression. When Rowe returned home he discovered his second wife, Wendy, had walked out on him and he succumbed to despair.
"I came out of hospital to an empty house and thought I'd had enough of this. It's either suicide or something else," he recalls.
The "something else" ended up being a sex change. Rowe says he was encouraged to undergo gender reassignment by members of a transvestite support group: "You learn all these things you need to say and do to get a sex change from transsexual and transvestite groups."
But he contends he was not in his right mind when he made the decision to change gender. "I would have done anything to change my life," he says. " I was totally obsessed with changing my identity. I thought by changing sex I could put the heartaches I'd suffered as a man behind me."
In January 1988, Rowe had his first appointment with a psychiatrist at the gender identity clinic at Charing Cross hospital, the main NHS centre dealing with the treatment of gender identity disorders, including transsexualism. The psychiatrist warned him of the seriousness of his decision to change sex. But Rowe says he was too distraught to take it in.
"As your body changes you have new hopes for the future," he says. "It was almost a religious experience. What I was looking for was some sort of change but it was the wrong change."
International guidelines state that patients usually have lived full-time in their desired gender role for at least a year before genital surgery, to see how they cope with work, family, friends and relationships.
But Rowe says few people were aware of what he was doing because he had little contact with his family at that time. "I used to dress as a woman in the toilets of Victoria station before the appointments with my psychiatrist," he says. "I changed back immediately in the hospital toilets. You feel as though you should meet the expectations of the transsexual sorority and the doctors."
The transgender psychiatrist prescribed Rowe oestrogen and anti-androgens, to suppress his body's production of testosterone. Following surgery to reshape his jaw and reduce the size of his Adam's apple, he underwent genital surgery in July 1989. In total the operations cost him around £13,000. "I sold my house to pay for the operations," he says. "In the weeks before my sex change I was living in a camper van."
His hopes of a happier life after the surgery did not last. Two weeks later Rowe's father died of lung cancer, which left him depressed again. When he turned up at the funeral as a woman, he says some friends and family were outraged. He says: "My brothers were shocked by what I'd done. Some people said to my face I was responsible for killing my dad."
Rowe cut off all contact with his brothers and moved into a small flat in Penzance, 30 miles away from where he grew up. Things seemed to be looking up when he met a divorcee called Peter who moved in with him. Rowe insists that he was never attracted to men before changing sex. He says that they became lovers because he was desperate to live like a woman and Peter didn't care about his background. "I was accepted well as a woman," he says. "I was quite a gentle person."
The couple moved to Harrow in north-west London, after Rowe was accepted on a photography course. But a year later Peter died suddenly of a heart attack. Rowe was alone and depressed again. Over the next couple of years he came to doubt whether he had been right to change gender.
"I thought: 'what the hell have I done?' " he says. "I loved playing folk music on the guitar which was a fairly male thing. I was too ashamed to try to rejoin that crowd. And I'd always liked working on cars. I realised I hadn't really wanted to be a woman. I just wanted to be happy."
Happiness now seems out of reach to Rowe. Since he stopped wearing women's clothes and make-up he has been harassed by gangs of youths. "I've been spat at in the street and called names like paedophile, geezer and weirdo," he says. One episode of harassment culminated with a brick through his car windscreen. "The police were no help," he says. "I got the impression that they thought if you're a weirdo what do you expect."
Thinking he might fit into society better, Rowe nearly had a mastectomy in March. But he backed out in fear of suffering complications. "I didn't want to go through any more pain," he says. He knows that any surgery to try to 'reverse' his sex change operation and build him a new penis would not leave him with anything that looked realistic. He says: "I can never become a complete man again. There's no turning back."
Rowe says his story should be a warning to those who think that changing sex will automatically change their lives for the better. He now believes that he was a transvestite but became confused about his gender identity because of his depression. "I think that society should be more accepting of people who do not confirm to traditional dress codes," he says. "All I can hope for now really is making the best of a bad job."
