‘Patient is a Verb’ is a show in the early stage of development about trans people’s lived experiences of NHS gender identity services. Using 18 interviews with trans individuals across the UK, the piece weaves scripted monologues into a video game concept, that gives the creative team opportunity to play with graphics, movement and character to create a unique point of view.

The 45 minute work in progress performance begins strong, with the first 15 minutes or so feeling surprisingly tight for such an early stage piece. Opening in media res, we are introduced to two video game characters (Alex Sheppard, J Frank) who limber up before struggling to defeat the cartoonish villain, Dysphoria (Lisa Maeda). With minimal props, basic projection and no set, it is a testament to the acting talent of all three cast members that they quickly manage to establish this gamer setting. Brick (Sheppard) plays the game as a Knight – a nod to the masculine ideals that we will see the character struggle with as a trans man – whilst Darren (Frank) plays as a Shapeshifter – a clear parallel to their non-binary identity, an identity which they have been forced to suppress in order to access medical treatment. The battle is absurd and hilarious but as Darren stands ‘frozen’ to the side and the Dysphoria monster closes in on Brick, Brick’s panic and fear takes on a much more powerful resonance. From the outset, we are reminded that this is not actually a game; this is people’s real lives and real struggles.

Initially, I was worried that the video game concept could lead to a problematic narrative of linear transition; the idea that all trans people must follow a rigid path to attain a specific type of medicalised transition. In actuality, the show does a great job of showing that it is the medical system which is forcing people into set narratives and rigid boxes. The struggle of communicating with medical professionals is directly addressed in a series of vignettes, as Darren goes from doctor to doctor trying to give the ‘correct answers’ to be allowed to ‘level up’ to a referral to GIDS (the Gender Identity Development Service). The first doctor is openly clueless, cheerfully proclaiming that they are “learning as we go”. The next refuses to listen, patronisingly prescribing exercise and using previous mental health issues as a means to deliberately obstruct. Darren is presented as informed and well-prepared, with a pile of completed paperwork and knowledge of the step-by-step referral process: but it’s still not enough. It is an impossible system, not designed to be easily navigated – and there is no cheat code.

The show focuses on some interesting and nuanced trans issues that are not commonly given visibility on stage. For example, the lack of acknowledgement of non-binary identities within the NHS is a core theme of the piece, perhaps due to the devising process being led by a creative team that are majority non-binary. Darren must present themselves as a trans man in clinical settings in order to better fit the narrow criteria and limited understanding of their doctors. They must dress ‘extra masc’ for appointments because the risk of showing any femininity as someone AFAB (assigned female at birth) could jeopardise their access to gender affirming treatment. Additionally, the portrayal of Brick gives an illuminating insight into the pressures of masculinity on trans men. He puts on a ‘bro who lifts’ persona in group settings, which his friends tease him about, but in private we see that his obsessive exercise is compelled by his body dysmorphia and his urge to ‘bulk up’ for a more masculine physique. A trait that is often associated with toxic masculinity in cisgender men becomes a tender glimpse into the vulnerability of navigating the world as a trans man.

Towards the second half of the work-in-progress, some of the more underdeveloped elements surface. The transition from character-based scenes into the performers reciting scripted monologues is tonally awkward and the new format feels out of place within the overall piece. Given the promise of the earlier scenes, I think it likely that lack of time and resource is the reason behind this anomaly and I am keen to see how this material is shaped with more development. In terms of the performers, Maeda is a particular stand out. Their physicality cements the success of the movement-based work, and they navigate between multiple characters with apparent ease. Frank shines in their willingness to show vulnerability but could do with more nuance in sadder moments, whilst Sheppard has a natural off-the-cuff comic sensibility but comes across as less confident in scripted scenes. With further development, I hope there is room for some additional cast members, especially with a view to the inclusion of some AMAB (assigned male at birth) performers.

My final small gripe with what is otherwise an incredibly promising work in progress is its title. In the scripted monologue section, one quote states: “Be patient. Be a good patient.” I love the wordplay of this quote, which presumably forms the foundation of the show’s title. I am, however, not convinced by the repackaging into ‘Patient is a Verb’. The patient/patience parallel has promise and on the surface its intentions are apparent. And yet, pedantic though it may be, neither patient nor patience are verbs. In my opinion, the snappier ‘Patients’ or the more direct ‘To Be (a) Patient’ would both be better, less confusing ways to convey the same underlying idea. That said, to come out of a work in progress show with choice of title as the most notable critique is a real testament to the content of the show itself and to the talent of its creative team, who have already achieved so much with so little.

‘Patient is a Verb’ will next be showing on 15 – 17 September at Blue Elephant Theatre, Camberwell.