Dundee, the Independent Republic of Scotland
Day 1,660
I haven’t been to Dundee for over a decade, not since a friend’s hen do. The memory of Jägerbombs, flammable white nylon and penis straws makes me want to cry with nostalgia; a time when everything was simple and easy.
But, first, a trip to somewhere I didn’t anticipate visiting. Dundee’s largest sexual health clinic. Apparently my predecessors at Health Protection Scotland have been “hands off” leaders, which I think is a polite way of saying “lazy.” I don’t see how anyone can understand health policy in practice, and know what needs to change, without seeing it on the ground. My peers seem to think that’s radical. I think it’s just common sense, so here I am walking through the gray, dreary streets of Dundee.
I wait in the waiting room for Tanya Gilmore to pick me up and try to subtly eye up the four other people here. Two women and two men, all of whom are studiously looking at phones, magazines or their laps.
“Amanda?”
Tanya calls my name and ushers me into her office, a warm, welcoming room with fun graphic posters on the walls saying things like, “Check your boobs!” and “Be proud of your choice.”
“Thank you so much for agreeing to see me,” I say, but I don’t get any further into my speech before Tanya waves me away.
“I’m glad you want to see the work we do here. No need for a thank-you. Now, what can I do for you?”
It feels alarmingly like I’m one of her patients. I almost feel nervous despite the fact that, with the total lack of sex in my life for years, there is literally zero chance of me having an STI. “I want to know about your support groups. Your local area has lower uptakes of antidepressants and a lower suicide rate in the LGBTQ community. I want to know why, and replicate it.”
Tanya sits back in her chair and exhales. “It’s not that simple, you know.”
“Why not?”
“Well, for a start, you can’t replicate me and I’m the reason for this.”
“So help me understand.”
Tanya sighs and I sit, resolute. I need her help. The suicide rate of gay men has risen by 450 percent since November 2025. We don’t have enough data for the suicide rate of trans men and women but, anecdotally, it’s gone way, way up. There is a public health crisis in the LGBTQ community and Tanya is doing something right.
“Let’s go back to basics,” Tanya says. “Gender is a social construct. If I had a pound for every time I said that over the last fifteen years I’d have one of those Alaskan survival bunkers all the billionaires disappeared off to. But the Plague distinguished on the basis of sex and there was no fucking with it. None at all. It was the first time I had experienced a huge divide in the trans community. There wasn’t anger or discord, just stunned desolation. Trans women on this side—you’re all probably going to die. Trans men on that side—you’re all going to be fine. You have to understand, that’s not how our community normally works. Trans women were rendered helpless in the face of their XY chromosomes, and gay men became a super-minority. It was a nightmare.”
She stops and glares at me as if I’m forcing her to do something awful, dredging up terrible memories. “It was already really hard being trans in 2025, and being gay often wasn’t a picnic. But the Plague made everything so much worse. The process of supporting trans individuals, campaigning for expanded rights and making the world a better place for trans people became irrelevant to a lot of people.”
I have to interrupt and ask, as I’m dying to know. “Are you immune?”
“No. I still can’t believe that I’m alive, to be honest. It feels like for the first time in my life my body has actually helped me out. ‘I might have given you male sex at birth but I’ll do you a favor with the Plague. No death for you this time.’ I contracted it in December 2025 and survived. In the first few days after I survived I was glowing. I felt . . . lifted. Chosen. To be so close to death and have life handed back to you is an amazing thing.”
“And now you’re doing something extraordinary with your life.”
Tanya cackles. “Fuck off. I’ve been a nurse on and off for twenty years. I’m doing my job, which I’m required to do by the draft, I’m not Mother Teresa. Anyway. There’s less trolling now but trans women still get some awful comments. Saying that I should have died as the last thing the world needs is a man dressed up as a woman—it needs real men, and I should have stayed as one. Well, I’m a woman and I can’t help that a murderous Plague swept the planet leaving devastation in its wake. What the world does need is people. The point is that I understand. I’m not reading from some stupid leaflet with a useless mnemonic. I get it. How many support groups for gay men in Scotland exist now? Three. How many support groups are there for trans men and women in Scotland? I know the answer to that—it’s one. You’re looking at the person running it.”
For the first time in a long time I feel put on the spot, like I’m not doing enough, like I’ve already made a mistake. I suspect this is how people who work for me usually feel when I’m talking to them. I can’t say that I enjoy the role reversal.
“I want to change that. That’s why I’m here.”
“Then you’re going to have to work hard to recruit men and women who are empathetic, have the right life experience, have the time after whatever Working Draft jobs they’re doing. The LGBTQ community is in crisis. The gay men who have seen their social circles, lovers, lives decimated. They need help.”
I can feel myself becoming defensive even though I know, logically, it’s not a helpful response. “We’ve all been working in what felt like a war zone for so long. I couldn’t worry about people’s mental health when I was fighting to get enough gauze and antibiotics and antiseptic to keep operating rooms open and people alive.”
Tanya snorts. “Guess what, mental health also keeps people alive.”
I was going to ask if I could sit in on one of the sessions Tanya is running this evening, but I have a feeling I’m going to be given short shrift. I understand it. I’ve been a disappointment, and yet I don’t regret the choices I’ve made. I think back to the horror show Gartnavel was, not long after the outbreak. The male doctors were all dead or waiting to die. There were two doctors in the hospital then who are still alive now who, I think, knew that they were immune—a radiologist and a general surgeon. Fuck, they were busy. All the doctors were. There was a shift in the numbers of doctors in a way you didn’t have with nurses. Only 11.5 percent of nurses were male; 87.8 percent of surgeons were male. It was, with the best will and staff effort in the world, a shit show.
And then there was the “emergency wing” of the hospital, which was this godforsaken bit of the building that used to be the maternity wing. There was obviously a lot less need for that so we converted it. You weren’t allowed to enter the wing unless you were visiting a patient or working there, in a useless attempt to stop the spread of the virus. But really, what was the point? Everyone carried it. We all knew that.
I stand up to leave, and just as I’m getting to the door, Tanya calls my name. “You doctors are all the same. You think you’ve got your priorities all in order, the way at the beginning of the Plague you’d do all your treatment protocols. Well, no doctor can say that you were responsible for any of the men who survived. There was no particular magic to it. It was plain old good fortune. You find me a doctor who wants to admit to that and I’ll turn into a raccoon. You’re not so keen on ‘luck,’ weirdly. It must be down to your exceptional caring skills. Of course, any time you ask a doctor something as simple as the name of a patient they go, ‘John? Jack? Joseph? Jean?’ You forget, nurses keep people more than just breathing, we keep them alive. I know what my priorities are and keeping people’s minds working is just as important as gauze and antibiotics. I’m doing something to keep people alive. What are you doing?”
I pause. What am I doing? Plenty to keep the Scottish population physically healthy. On this issue? Nothing. My cheeks begin to heat but I quickly tell myself to get on with it. Shame and regret don’t help anyone. I pride myself on being a doer. Am I seriously going to hear everything Tanya has just told me, go back to my office and act as though I wasn’t listening, or wail that I feel bad? No.
“Come and work for me.”
“What?” Tanya is stunned, which gives me a tiny amount of satisfaction after the scathing dressing-down she’s just given me.
“I want to hire you. Come and work for me in Glasgow. I’ll give you a budget, responsibility and a job. As you’ve so bluntly pointed out, I see patients, you see people. So help me. There’s a lot to do and not enough people to do it so I’m going to hire you and trust you to work on this issue and get it right.” I shrug. “I spend a lot of time pointing out what other people are doing wrong, and I’ve fired people who made mistakes, but those are empty gestures. They don’t do anything. So come work for me. Help me.”
Tanya is gaping at me, gulping a bit like a fish and I can’t figure out why she’s so surprised.
“You know, I got this job because I was angry and determined and persistent and wouldn’t shut up. It’s not so shocking I’d hire you for the same reason, is it?”
“You’re fucking weird, you know that,” Tanya says, but her face breaks into a smile and I know she’s going to say yes. “When do I start?”