Preparing food and cooking
I am unable to prepare fresh food for myself. Sometimes I can manage a trip outside to get ready meals to last me a day or two but much more frequently I have to rely on takeaway delivery in order to eat, however sometimes I am unable to deal with the stress of ordering it and picking it up from the door so I do not eat that day. I cannot eat any food that requires kitchen utensils because I have no ability to do the washing up.

    Eating and drinking
My food intake is very dependant on my dissociation levels and memory issues. It is not uncommon for me to be so out of it that I do not recognise my hunger, or remember that I have not eaten, so I go days without eating (generally this happens 2-3 days a week). Since eating at all is so difficult I generally just have one small meal a day on the days that I eat. I frequently find myself very dehydrated because I have been too dissociated to notice thirst levels for days. If many days of not eating happen together I can be too malnourised to handle digestion so can only eat very small amounts that day with lots of retching and vomiting (about once every 2 weeks). My diet is poor because I can only eat food that does not require kitchen utensils (this includes knives and forks, so generally I only eat pizza).

    Managing treatments, taking medication, and monitering your health levels.
Due to dissociation or memory issues I have very limited understanding of whether I have taken my medication in time or at all, and may not be aware enough to think of it for weeks. My doctors is half an hour's walk away and that is frequently much too far for me to travel. My dissociation makes it difficult to fall asleep at regular times so it is very rare for me to be awake at a time early enough to be able to secure doctors appointments so health issues can go months before a day arises where it is possible.

    Washing and bathing.
I usually only manage to do clothing and bedding washing once every 6 months or so due to dissociation. I frequently go for a week without washing my body or hair.

    Managing toilet needs or incontienence
As a transgender person accessing public toilets is stressful and difficult, so I can only manage it rarely and with distress.

    Dressing and undressing
No issues, though the issues that I have washing clothing mean that the clothing that I have available at that time might be inappropriate for weather etc.

    Speaking to people, hearing and understanding what they say and being understood
I experienced an intense memory loss a few years ago and had to relearn how to form words and make sentences so can frequently slur my words significantly, especially when I have not eaten.
I experience phases of muteness when significantly dissociated (about 2-3 hours once a week).
When significantly dissociated I completely fail to internalise or understand the words that people say to me, making me completely vulnerable and incapable (2-3 hours, once a fortnight).

    Reading and understanding signs, symbols, and written words.
When in a very intense dissociative phase I will not be able to process the world around me at all, such as recognising roadsigns, road crossings, or roads.

    Mixing with other people
Social settings are very difficult for me. I suffer from anxiety that makes me very scared of people and unable to engage with them. Socialisation often acts as a trigger for dissociation, where I begin to become very confused and disorientated  and unsure of where I am etc., as well as shutting down completely and not responding to what is going on around me at all.
Two times in the last month my fear response to being around people has gotten so intense that my joints tense so hard from flinching that they lock up and leave me unable to speak or move or breathe.
Due to memory problems it is very difficult for me to remember if and when I have last seen people and what happened on those occaisions, or the existence of people at all. I frequently end up in situations where someone knows me and has spent time with me but I don't know who they are. This can make it tricky knowing what is appropriate to say in front of which people as I don't know what happened last time.
When in a dissociative state I can become very childlike and trusting. Believing everything that people tell me. This puts me in a vulnerable position around people as I do not have the ability to recognise social cues and judge whether someone is trustworthy or trying to exploit me.

    Making decisions about spending or managing money
Because of eating issues I spend a lot of money on takeaways. I lived in homeless accomodation for 4 years and spent two years before benefits living off £30 a month for food and basic needs, so I am used to not feeling that it is appropriate to pay for basic needs to the extent that many people would (for instance, I may not go to an appointment because I am unable to walk in my current state but I couldn't imagine paying all that money for a bus, despite having the money to do so and it being good for me).

    Planning and following a route to another place
Due to dissocative amnesia, about twice a month I have been finding myself in town or outside with no memories of where I am or how I got there or what reason I might have had to be outside. Sometimes this has been combined with me forgetting who I am and where I live, which is very dangerous and scary!

    Moving around
The distance that I can travel changes due to how much I have been eating. During emaciated periods it can be very difficult to travel, or even get out of bed. There is also a higher risk of getting confused and forgetting what I am doing on more distant journeys. Due to mood problems in the last 5 months I have developed intense chronic psychosomatic genital pain, which left me bedridden for a month from the pain and comes back for day of being bedridden about once every 10 days, and makes the prospect difficult even on mild days.

     Is there anything else you think we should know about your health condition or disability?
A lot of the things written here differ from last year's assessment quite considerably. This is because since last year I have started therapy with Ciara SURNAME and those sessions have helped a lot to identify exactly what my issues are. Before I was so overwhelmed and scared that I couldn't pick up on anything in particular but now we know how much dissociation and memory issues have been the cause of that.