'Even as a child I knew I was in the wrong body' - Cumbria trans nurse shares emotional journey

She battled with it all of her life, eventually taking the brave decision, in her forties, to make the transition and undergo surgery.

At the time she was working as a nurse in Cumbria and as far as she knows, became the county's first trans nurse.

It was an emotional journey, and not always easy.

But she has now come so far in being accepted as Rachael that she can't even bring herself to say what her name was before.

She's almost wiped it from her mind, like something that was never meant to be. To herself, she was always Rachael, and now to the rest of the world she can finally be that person too.

Ten years after her surgery, she is much happier and thanks to supportive colleagues, remains in the same job.

And her role now goes beyond nursing. Rachael has become an LGBT role model, helping to pave the way for others working in the NHS to make the transition, and raising trans awareness nationally.

She was recently invited to attend an NHS 70th anniversary celebration at Buckingham Palace - a huge achievement for someone who had lived a secret life, fearing she'd never be accepted.

Rachael is happy to talk about her own journey because she wants to make it easier for others facing a similar battle.

"I've always known. As far back as I can remember. Even as a child I knew I was in the wrong body," she said.

She still recalls the moment she told her boss her secret.

"I remember it as if it was yesterday. I told one of the sisters, who is now a matron. She was also an RCN (Royal College of Nursing) rep so I spoke to her in that capacity initially.

"I just said to her, 'I'm going to transition'. I thought it was a big deal but she just looked at me and said 'is that all?' It was weird. I'd thought I might lose my job or something.

"I thought there would be media cameras everywhere - because I remembered a doctor who was outed in the national press. I'd been really worried because of that."

Rachael then spoke to another sister, then gradually told her other colleagues. She said some staff found it easier than others, but the vast majority were incredibly supportive.

"It wasn't as bad as I thought it was going to be, but it was still tough. I didn't have the confidence.

"But my colleagues just accept me for who I am. Overall it's been been very positive really.

"I do regret not coming out when I was a student nurse. When I was on placement I used to take two suitcases - one with my 'normal' clothes and one with Rachael's clothes. It was awful. You were living in fear of getting caught, that rumours would start.

"I lived a clandestine life."

Now 56, Rachel didn't go into nursing straight from school.

She said she didn't have the qualifications, but decided to start night school in 1985.

Then she found out about a health and social care GNVQ that she could do at Carlisle College but money was an issue, so she moved back in with her mum to make things easier.

It was worth the effort and Rachael qualified with a distinction, from which she was encouraged to go and complete a degree in nursing.

She got a place at what was then St Martin's in Lancaster and graduated in 1999.

"My first job was in Manchester, at the Royal Infirmary, but I got homesick. I came back to Carlisle and have worked at the Cumberland Infirmary since 2000," recalled Rachael.

Initially she started off on medical wards, then moved into orthopedics and trauma in 2001 and has worked in that department ever since.

Feeling settled in Carlisle, she eventually decided it was time to stop living a lie and live openly as Rachael, receiving support from close friends.

It came at an emotional time, as her mum was in hospital with cancer, but said she backed her decision and was still her rock throughout.

"My mum was my best friend. I wouldn't say she was happy about it, but she supported me.

"Her biggest worry was that my family would disown me. She didn't want that to happen," she said.

Rachael had to fight to get the funding for her surgery, saying at the time it was a postcode lottery - something that has since changed, and Rachael is now among those working with NHS England to shape future policies for trans patients.

"I had to live the real life test for two years before I could be considered for surgery," she explained.

Rachael said she started the transition slowly, first introducing her colleagues to Rachael at a Christmas party, before taking the plunge. "It was around the time of the first floods. I stopped work in the January and came back in as Rachael," she said.

She eventually underwent surgery in 2007, exactly 10 years ago.

Sadly Rachael's mum died in 2005, not long after she started her transition. But she is ever grateful for the support her mum gave her - and said that despite her fears, the rest of the family have also now accepted her.

"I recently went to a family wedding. Some of the people there hadn't seen me for 30 years and I wondered how they would take it, but it was all fine," she said.

Rachael is now keen to use her own experiences to support others - and her openness has helped to gain her national recognition.

She said before she came out, there had never been a trans nurse at North Cumbria University Hospitals NHS Trust. "At the time there was no policies at the trust. They hadn't come across it before. They are now starting to develop detailed policies and I'm part of that," she explained.

"I'm happy to work in the trust to support anyone in a similar position. As part of the new policy I've said it would be nice to have someone to talk to, as a kind of mentor."

Rachael is also active within the Royal College of Nursing, becoming an equality and diversity champion and attending various events.

Last year told her story at a conference in London, in front of delegates from the Nursing and Midwifery Council, Care Quality Commission and NHS England.

She also attended a marginalisation event in Berlin in 2012. "I met people from all over Europe and made some strong friendships after sharing our stories of coming out," she said.

Most recently, in March this year, Rachael travelled to London for the NHS anniversary event at Buckingham Palace, where she met Prince Charles.

"It was quite surreal really. How many times do you go to London and joke about popping in to Buckingham Palace.

"He did speak to me. He saw on my bagde that I was from Cumbria so we talked about Carlisle and the floods.

"It was quite an honour for me to be there. I was the only Cumbrian that I know of who was there," she said.

Ten years on from her surgery, she said she now can't imagine life as anyone but Rachael. "I don't really think about it now. I'm just Rachael. The only thing I'm after is my gender identity certificate. I'm in the process of getting that. Having it would just cement that acceptance," she explained.

"I've got closer friends now. I've made a lot of close friends through the RCN.

"I remember, before I came out, hearing some negative vibes about trans nurses. It did put me off, but I did come out and have been very active in the RCN ever since. It's not been an issue."

Generally she said there is far more awareness about the trans community, and said fellow Cumbrian, TV star India Willoughby, has helped to put the issue in the public eye.

"I think people are becoming more aware. I do not think it's as hidden as it used to be," said Rachael.

"I remember last year I did get a verbal abuse. That does still really hurt. It puts you down. But it's not as common."

Rachael said remains passionate about the NHS, and hopes it has a strong future. She added that her dream job would be as a nurse supporting those going through transition.