Progress/advice

[Stephanie-L]

Well, I got my hormone letter today, and went to an appointment with my primary care doc for a physical. I asked if she would manage my hormones, labs, etc, but she doesn't feel comfortable with that. She did give me a name of an endocrinologist that she has sent other trans patients to. The problem is that when I google him the reviews from patients are at best mixed. Some seem to love him and claim he is the person who saved their life, while others say he is distant, doesn't listen and doesn't know what he is doing. There is also a divide regarding the quality of the office staff, some have had no problem, others can't get any help. The interesting thing is these are from the same time periods. I could understand if the good and bad were from different times, thus different staff, but they are often only days apart. Any advice that you all can give would be great. I am sure I can tell if he is a quack once I meet him and talk a bit, but I really don't want to waste money and time if I don't need to. Thanks..........Stephanie

[Katesback]

Ummm I would hope you realized that ALL the information for you to become an expert on HORMONES is right here on the internet. To add to it most is published by medical doctors that know what they are doing. I have a feeling you did not do your homework because if you had you would have taken the information (the stuff written by doctors) to your doctor and asked him/her to give you the exact perscriptions you need because you know what they are and the info backs it.

As far as the endo. First of all there is really no need for an endo because the info you gatherd from doing your homework can guide any doctor on the dosages and bloods tests. IF your dead set on this endo, I guess they way I look at it I have not met many doctors that had nice personalities. I really could care less about thier personality. If its an issue with you then I guess I dont know what to tell you. If your worried about the office staff then I have to ask you are you really serious about transitioning because sweety you better be ready for a TON of shit from people in all sorts of environments! DO you understand what I just wrote? I hope you do because the trans community is filled with a ton of people that really cant take the heat of transition and do half hearted attempts. The end result is just that. You will meet these people at support groups. If you are serious you will some day come to realize that these people are not helping you and you will move on. If your not really serious then the trans community will embrace you and you can take shelter under thier wings. Just beware that thier wings are filled with holes and you will still get wet.

Katie

[Stephanie-L]

Katie, it appears you have missed the whole point of my post. I actually respect my primary more for not wanting to be half-a**ed about my hormones. She is very good at what she does, but she can't and shouldn't try to do everything. I do realize that I can get hormones from many places, heck, I can prescribe them myself. But I want someone who is an expert and has spent years studying and doing this to help me. I really don't care about personality either, but I want them to be competant. My point was that some folks had a great experience, but others felt he didn't help or even made them worse. I am trying to sort that out. As for the office staff, I am not worried about their reaction to me. They have had at least a few trans patients and should be professional to me, I am worried that they give bad care to any patient. If I need to ask a question or get a prescription refill it is important that the staff be reasonably responsive, I don't want to wait several days or even weeks because of them being lazy or sloppy. I am not necessarily set on this endo, he was recomended by someone who's opinion I respect, but I see there have been problems with him. This is what I am trying to work out.
As for the rest of your post, I realize that I am still early in the process of my transition, and you have much more experience than I do, but you seem to be very bitter. Perhaps you feel it is simply realistic? I am not so naive as to think everything will be sunshine and roses, but I also am not expecting total and absolute horror. I generally live my life by preparing for the worst yet hoping for the best. Usually I get something nearer to the good side than the bad, so I guess I am doing OK.
I will leave you with one thought about your hormone comments.
"The physician who treats himself has a fool for a patient". I could very easily write out the prescriptions and the lab tests I THINK I need, and hand them to my primary doc, but I would be a fool, because I don't KNOW, even with lots of internet research, what I might be missing, it is not my speciality, nor is it hers.
Good luck in your life, I wish you the best..........Stephanie

[Katesback]

I will try this again. The information for you and any doctor you choose is published ON THE internet. THis information is written by doctors (at least one being trans herself) that are experts in the field of carring for trans people. With this information ANY doctor can treat a TS patient competently.

If you still dont understand what I am saying then I really am sorry. I give up.

[Stephanie-L]

OK, I will try again. Lets say you own a Rolls Royce. It needs service. Do you take it to the Ford mechanic who says he read a book on RR service, or do you take it to the guy who is a certified Rolls Royce Mechanic? Yes the Ford guy probably understands the theory, but he has never worked on a Rolls before, do you want to be the first? Simply put, no, not just any doctor can competantly treat a TS patient, no matter how much research you or they do. If they already have a background in endocrinology or hormone therapy, then making the leap to treating a TS is not a big deal. But if the only endocrinology they have ever done is treating stable diabetics or prescribing birth control pills, then they probably do not have a background to safely treat you. There is a reason doctors have to do years of residency in thier speciality. And, now with new medicare rules, doctors are increasingly prohibited from prescribing and treating outside of thier speciality. Yes, there is a large amount of information available, much written by competant doctors, but there is also some bad information out there. I want someone who knows the difference, or even better, someone who wrote the good stuff. I work in healthcare, I treat patients every day. I would never try to do something outside of my expertise. If you want a good reason for that, I have two words, Michael Jackson. There you have a cardiologist, a heart doctor, probably very competant at that, trying to either treat a sleep disorder or perform anesthesia, I'm not sure which. He probably read about the drugs he was using, but had not used them before. You seem to think that you can print a bunch of stuff from the internet, hand it to any doctor, and they will be ready to handle totally rearrainging an increadibly complex process in your body. If you have a doctor like that, I would run, they are either so ignorant of thier own limitations they are scary, or they are so full of ego they are dangerous. A competant doctor knows that they are not capable of some things. It is not simply a matter of checking a few labs and writting a prescription. An endocriniologist will be able to spot problems with other hormones, is your pituitary getting screwed up by this, is your thyroid acting normally? The actions of all of the hormones are interrelated, changing one will affect others, and I don't want someone who took two weeks of endocrine system in med school, and read a few papers messing with mine. I really feel that your assertion that ANY doctor can treat a TS patient competantly after a little bit of reading is dangerous. You may have done well doing this, but some won't, some could even die. I hope you understand what I am trying to say.......Stephanie

[Katesback]

Dear I now totally unerstand what you are saying. I think its time I get a drink. A really strong one at that.

[ReneeT]

Stephanie,

I am going to have to agree with Kate on some of her points (I know, I know.......). First off, the hormonal management of a MtF transexual is not rocket science. And it is knowhere near as complicated as working on a Rolls. It is as close to cookbook medicine as you can get. As Kate said, everything one needs to know about the mgt of transition is readily avaialable, and there are several excellent scholarly review articles directed towards primary care physicians. As for treating thyself, I agree that its not such a great idea. It sounds like you are a physician. I am too. If so, you are very well equipped to educate your physician and co-manage yourtreatment. In fact, more people need to do that with their healthcare.

I disagree with Kate on the office staff issue. The staff is part of the care team and has an impact on outcomes. A staff that is not supportive, or worse is judgemental, can reduce a patients confidence in the care they receive and make it less likely that e or she will adhere to the treatment plan.

I speak this from both background and experience. While i could have skipped the entire medical establishment and self-managed, I have been a good little girl and played by the rules. I began therapy, and, when the time was right, was referred to an endocrinologist that my therapist had experience with. My very first visit with her was questionable. While her nurse was friendly and compassionate, her staff was not. Example: when i made my appt and again when i arrived for my irst apt I made it VERY clear that my preferred name is Renee (i have not had a legal name change yet). Despite that, in acrowded waiting room, i was publicly called by my male name - more than once! On the clinical side, my endo recommended only an estrogen, not an antiandrogen. This seemed a bit odd to me, but she stated that if i wanted to reduce T i need an orchi!!! Really? On the first visit? WTF! Well, i played by the rules and followed her advice. However, when, at my 3 mo f/u she was still against an antiandrogen, i aaid enough is enough. I assembled a comprehensive packet of journal articles and clinical reviews, most of which i got on this site (thank you Frances, julia, Kaitlyn, and others) and paid a visit to my pcp, who i had been seeing for 7 years but had never come out to. On that day i came out to her ( interesting side note -i am a medical director for a large health plan and work closely with the administration of her large practice. I thought long and hard about coming out to her but, in the end, it ha to happen sometime), presented all the information, and asked her if she would manage my hormonal transition. While she explained that i was her first transgender patient, she said she would learn everything she could and work with me. In fact. She emailed me that evening, after having read most of the material, with questions and suggestions. As for her staff, they absolutely could not have been sweeter.

So, my recommendation to you is to find a pcp you have confidence in and are comfortable with, educate him or her, and work together. Oh - and save 2 specialist copays each year!

[ReneeT]

And another thing, while we are on the topic: primary care physicians (which i am not, i am a specialist) are extremely well equipped to manage the vast majority of health issues in this country. Unfortunately the public has been given the (wrong) impression that every condition requires a specialist. With this mindset, outcomes are often worse, due to lack of coordination with other physicians, and costs are higher. As to the training in endocrinology, all medical students take a full year of physiology and a full year of biochemistry at the graduate level. Even a lowly pcp has SEVEN years of education after college. I do agree that there is definately a need for specialty care of complex issues, but, relatively speaking, HRT is not one of them. Finally, the vast majority of endipocrinologists have less knowledge of HRT than most of us here and have never cared for one of "us"

[Kaitlyn Michele]

I use a physicians assistant to manage my hormones..

I started out by going to Dr McGinn at the Papillion GEnder Center she founded to do nothing but help ts women, they F(*#$'d it up royally...lesson learned..she is a good surgeon as far as i can tell tho..

Steph, its ok to do it your way...

the but is that you will get attitude from people for being ts, and you will get used to ...the info is really not rocket science and you are making it too complicated and precise for my taste.....

find out what t blocker you tolerate, pick your delivery method for estrogen(patch, shot, pill) and start taking the minimum dose of your chosen Estrogen...you have enough experience that you have the info you need.. after 3 months, get a blood test to make sure you are not hurting yourself, and to make sure the T and E numbers are moving..

it seems you are really analyzing the heck out of this ....this is bandit science we are dealing with, there is lots of trial and error in all of our HRT's... any doctor that knows what prolactin, cholesterol and liver function means can treat you.



Look online to see if there are any LGBT doctors in your area as well..

[Julia_in_Pa]

Stephanie,

First off congrat's on getting that letter!! That's a huge step!

I have to agree with what Kate is telling you here. Most of my TS friends that are on HRT have never stepped foot inside an Endo's office.
Why is that???
Endo's have a less than stellar rep in the TS community because the majority of them will not see a TS person.
Most of them have issues stemming from their perceived fear of legal problems stemming from treatment of trans women.
This is the exact reason why my friends go to a very well known nurse practitioner that deals in TS women's health.
The majority of post op women find locating an endo along with a OBGYN to also be a daunting task.
This is why you see benevolent healthcare providers of varying degrees of education and specialty forming a spotty network of " trans friendly" healthcare.

Another large problem is with general practitioners grossly under prescribing dosage amounts concerning HRT in hopes that the trans patient is pacified or goes elsewhere.
The reason seems to be stemming from ignorance of trans issues and the seemingly " one in a million shot " of having a patient that is TS.

My advice to you is to obtain a three ring binder and locate as much information concerning dosage amounts, side effects and what is achievable from HRT.
Put this together and present your case to your doctor now being armed with legitimate data.
It is now your job to sell yourself as the real deal to your healthcare provider.
Yes I know that's what your hormone letter is for but as in countless cases in the past it seems that just the letter is not sufficient enough to garner the trans patient proper care from their healthcare provider.
Sell yourself.


Julia

[Katesback]

Girls I dont think that information is what this Stepanie is really looking for. When she mentioned the extreme risks and the complexity about taking hormones she basically showed her cards. She even went on to tell me I seem bitter. Well yea I am because of crap like this. This girl is willing to overlook the fact that hundreds of thousands of trans people have taken hormones and survived. Shes overlooking the fact that real research is available to teach any doctor to be a pro on trans medicine. She apparently wants a mystic for a doctor because I am not sure how she thinks people learn if they are to ignore real professional information.

Stephanie you are not serious, your just another dreamer. Very likely your one of those people that will hang out in the support groups for 15 years talking about thier transition progress without ever really doing anything because your really not serious. I am sorry but I have been around the block dear and unlike many of the people here I tell it how it is.

Are my words hurtful? Well let me tell you a story. Once upon a time shortly before I had SRS I was talking to a long time post-op girl about working with the trans community. I was telling her about how excited I was to be able to be starting a job where I would be helping the trans community. She laughed and in my nievity I asked her why she was laughing. Her face went dead serious and she said the words I will never forget. She said the problem with the majority of the trans community is they need thier asses beat. At the time I did not understand but after having worked for a couple years with a very large quantity of trans people, I now know what she meant. I thank god I no longer work with them, you could not pay me enough money to ever do that again. I saw far more screwed up crap from the trans people that I did when I was in law enforcement.

So yes sometimes the truth hurts, but I have no more patience for people like you that are not serious.

Katie

[Kelsy]

I was refered to an LBGT clinic where I had a blood test or two that my pcp ordered for a base line. He checked my vitals mainly because of my age and opened a six month supply and basically said have at it!! The transgender community has alot people in it for a ton of different reasons. I learned early that one should not depend on support groups or the trans community, infact you had better be prepared to go it alone and if going it alone doesn't change your mind you'll be fine!

Kelsy

[Misskelly]

I know I'm new here and I'm about to step on some toes , But wow I've never seen someone so rude in my entire life . She looking for advice and all you seem to be able to do is put them down Like my mother tells me you if you have nothing nice to say then don't say anything at all. This is a forum for help and support right ? or am I mistaken on it purpose . Stephanie this is a important time in your life you need to be comfortable with the doctor you choose , take your time find someone you fit with and that you feel comfortable with it worth the time and effort put in I don't think you should go to anyone who doesn't feel comfortable doing it at all . Plus do what you think is right it your life

[Sammy777]

The reviews from patients are at best mixed. Some seem to love him, while others say he is distant, doesn't listen and doesn't know what he is doing. There is also a divide regarding the quality of the office staff, some have had no problem, others can't get any help.

A lot of what you said can go more towards the people writing the reviews then the doctor themselves. You can't please all the people all the time.
I also wonder how the cross section of reviews correlates with the number of patients with and without insurance :heehee:

He can't be an all star AND a quack at the same time so give them a try.

[Sammy777]

Ummm I would hope you realized that ALL the information for you to become an expert on HORMONES is right here on the internet.

I have a feeling you did not do your homework because if you had you would have taken the information to your doctor and asked him/her to give you the exact perscriptions you need.

the info you gatherd from doing your homework can guide any doctor on the dosages and bloods tests.


The information for you and any doctor is published ON THE internet.
With this information ANY doctor can treat a TS patient competently.


My advice to you is locate as much information concerning dosage amounts, side effects and what is achievable from HRT.
Put this together and present your case to your doctor now being armed with legitimate data.


:doh: - I guess failure really is always an option - :doh:

1) Just because a doctor is "technically" capable of doing something does not mean you can march into their office and demand they do it. Get real!

2) You spent all day Saturday "Googling" this info and are now an "Expert"

Ya Doctors just love it when you walk in and tell them what is wrong with you and what is the best way to treat it.

I did not know Google was an online accredited medical school now.
I guess I wasted several years of my life and $100K going to medical school when all I needed was an internet connection.

3) And then you Julia contradict yourself by saying:

Another large problem is with general practitioners grossly under prescribing dosage amounts concerning HRT in hopes that the trans patient is pacified or goes elsewhere.
So go tell your GP your an expert and tell them what you want
- just don't expect them to get it right.
So which is it?

[StaceyJane]

I tried finding an endo in the Austin area but couldn't so I found a great GP that would see me. Her clinic has had TS patients before and they have always treated me great.

[Stephanie-L]

OK, to reply to several at once.
First, Thank You to Renee, Julia, Kelsy,Kaitlyn, Sammy and Stacey. I realize that an endo with experience treating TS folks is going to be hard, if not impossible to find in my area. I may have to try some of the alternate possibilities suggested, but I really do want someone with experience, no it is not rocket science, but it still requires some knowledge. It does appear that some of those "trans friendly" physicians kind of fell into it simply because they were convinced as some of you did. I am going to at least give this guy a try, but as I said, money and time are both issues for most people, I don't want to waste either. I will indeed put together a book of info, but I still will not expect any physician to rely solely on that info to treat me.
Now, Katie, one question. Why are you here? You seem to have an active dislike of the trans community, at least those who aren't doing it exactly the way you did. You seem to be one of those who slams others for not being "trans" enough, I have noticed that in other threads you have posted on. You do not know me, you have no idea what other challenges I face, what I have had to go through thus far, or what I am expecting. You make a sweeping statement that I am a dreamer, essentially a fraud, on the basis of my trying to find the best, most effective and safest course of action for me. Yes, you do seem bitter, at least that is the tone of many of your posts. I would say I feel sorry for you, but I really don't, people like you have choosen to have the outlook they do.

To all the rest, thank you again. This thread strayed rather off topic and several of you helped bring it back, I appreciate the constructive comments......Stephanie

[Traci Elizabeth]

My experience was that I started with a doctor who supposedly specialized in Trans medicine. What I found after three visits was the only thing he cared about was getting as much money as he could from his trans patients and that he was a doctor who worked with overweight people which any of you who know me, know that the last ting I am is overweight. Well, I am sorry to say it took me 3 visits to see the light. He never asked me anything about being trans or why I wanted to be on hormones and he never even scheduled blood tests.

Well the good news is the my current doctor is a female gynecologist who has taken a very active interest in me. And who has arranged for me to get an Orchiectomy free. So if you are not pleased with the doctor you are seeing or feel uncomfortable, by all means find another doctor.

[Nicole Erin]

Steph, look, all Kate is saying, i think, is that to get your HRT, the doc does not need to specifically be an endo.
IF you are on other serious meds (say like other hormone altering meds like accutaine) then it might be better but let your GP doc decide that. But if you are not on other meds, your HRT should be a straight-forward simple case

If you want to go with the car analogy - Take that rolls royce -
If it needed tires, brakes, or an oil change then any mechanic will do. No need to go to the expensive hard-to-find RR dealer.
However, if it had strange intermittent electrical issues, then yeah go with the RR dealer and not the Ford guys.
With learning stuff off the web. yeah that is just silly. People act like the web is some kind of information super highway or something. Gyod if I had known how useless the web was, i would have gone ahead and spend tens of thousands of dollars at mechanics instead of digging in the web to find out how to do silly things like work on my own car when I needed to do major repairs. How to do your own divorce? My ex and I should have paid an attorney or two thousands instead of figuring it out for ourselves. Dog gone silly internet.

With transition, doctors have found ways to make big bucks off TS women. Ypu could end up spending $1,000's before seeing your first dosage. I was once gonna go to a therapist, a TS one, to get a letter. Of course she wanted $90 a session and 5 or 6 sessions before giving me a letter for HRT.
Please. She can cram it.

Also keep in mind that except for those who started HRT during puberty, those stupid pills don't do much. They don't change your face, bone structure, voice, beard, they don't reverse hair loss...
All they do is make your boobs hurt and kill off your sex drive. People get all excited about HRT but your are missing very little.

Thing with doctors in general is - they mostly push the latest fad meds. They have a pretty pamphlet, huge posters and whatever. One time I went to a doc over a knee problem and here is what I heard - "Quit lifting weights" and he gave me a fad medicine back then - celebrex. Doctors are not gonna bother with any one patient more than 5 minutes.

Pros will tell you not to try to learn for yourself because they want you to give THEM the money instead.

[Katesback]

To answer your question I am here because it is entertaining. I also am here to call people on some of the BS when I see it. You my dear exhibited BS. You might not be willing to accept professional papers published by doctors that are expert in trans medicine but I feel it important that you not spread false information. I could care less if your a doctor or not. I am intellegent enough to know the literature is gold. Why dont I list names and reference my words? Because I dont want make it easy for fruitcakes to get the information. They can do thier own homework if they are serious. To suggest that taking hormones are a direly complex thing is stupid. Brain surgery sure but hormones no. I said it before and that is hundreds of thousands of real ts women have taken them.

As far as not knowing your story. Dear I dont need you to tell me your story because its all the same. Everyone of us has the same god damm story. Theres nothing unique about it, they are all the same. Some of us just have more chapters in the story because we are serious and we progress.

How do I know your a dreamer. Because 99% of us that are serious do the research and we take the correct dosages and get our blood tests and we take the risks of taking hormones. Why do we take the risk? Because we dont have a choice we are women and thats what is nessessary to for us to be women. Otherwise put the risks are less of an issue to those of us that are serious because we would take the chance of ill effects any day of the week JUST TO BE the women we are. The other reason I know your a dreamer is your own words saying I dont know your story. Dear I have herd countless dreamers use the you dont know my story line. It is really nothing more than an excuse to justify thier inactions by saying that thier circumstanses are unique. LOL right.

I do have someone you might want to meet though. She posted a couple months ago. She claimed to have had facial surgery and even posted pictures of her sitting at home less than a week after surgery. She had some tape on her face and looked great. She looked so great that those of us that had facial surgery freaking laughed because we knew she was full of crap. You might want to look up her doctor and see if he can use his magical powers to perscribe hormones for you.

Finally I have been accused of using an approach that is how should I put it unsupportive. The irony is that for anyone who is really serious my words are very helpful because I tell it like it is and call people on the BS. It is the fruitcakes and people that need thier asses beat that call me unsupportive because I dont sit around the campfire and tell about a world of fluffy bunnies and rainbows. I should also point out that I have had over time a surprising number of people who i have insulted, chewed out, ect. come up to me and thank me and tell me my words got them to get off thier ass and make a decisions to improve thier lives instead of sitting around and making excuses.



OK, to reply to several at once.
First, Thank You to Renee, Julia, Kelsy,Kaitlyn, Sammy and Stacey. I realize that an endo with experience treating TS folks is going to be hard, if not impossible to find in my area. I may have to try some of the alternate possibilities suggested, but I really do want someone with experience, no it is not rocket science, but it still requires some knowledge. It does appear that some of those "trans friendly" physicians kind of fell into it simply because they were convinced as some of you did. I am going to at least give this guy a try, but as I said, money and time are both issues for most people, I don't want to waste either. I will indeed put together a book of info, but I still will not expect any physician to rely solely on that info to treat me.
Now, Katie, one question. Why are you here? You seem to have an active dislike of the trans community, at least those who aren't doing it exactly the way you did. You seem to be one of those who slams others for not being "trans" enough, I have noticed that in other threads you have posted on. You do not know me, you have no idea what other challenges I face, what I have had to go through thus far, or what I am expecting. You make a sweeping statement that I am a dreamer, essentially a fraud, on the basis of my trying to find the best, most effective and safest course of action for me. Yes, you do seem bitter, at least that is the tone of many of your posts. I would say I feel sorry for you, but I really don't, people like you have choosen to have the outlook they do.

To all the rest, thank you again. This thread strayed rather off topic and several of you helped bring it back, I appreciate the constructive comments......Stephanie

[Sammy777]

With learning stuff off the web. yeah that is just silly.
Gyod if I had known how useless the web was, i would have gone ahead and spend tens of thousands of dollars at mechanics instead of digging in the web to find out how to do silly things like work on my own car when I needed to do major repairs. How to do your own divorce? My ex and I should have paid an attorney or two thousands instead of figuring it out for ourselves. Dog gone silly internet.

<Sarcasm>
1) Maybe you should spend some of that internet research time on "Sarcasm" (http://en.wikipedia.org/wiki/Sarcasm)
because you suck at it. :lol2:

2) Don't believe everything you read on the internet though. :doh:
Because it's chock full of people who spew out their opinions as though they were fact. :heehee:
</Sarcasm> ;)


Also keep in mind that except for those who started HRT during puberty, those stupid pills don't do much. They don't change your face, bone structure, voice, beard, they don't reverse hair loss...
All they do is make your boobs hurt and kill off your sex drive. People get all excited about HRT but your are missing very little.

[Aprilrain]

Hormones seemed less risky than a bullet in my brain.

I see an Endo, he's nice enough but impossible to get an appointment with. When I finally saw him I had been self prescribing for about 6 months. I told him what I was taking and he simply wrote me scripts for what I had decided i needed. He ordered blood work and my levels were in decent ranges though T was too low and esterone was too high. He was unconcerned. I had to take it upon myself too make adjustments to my meds to get those levels where I wanted them. I'm not an old woman so I don't need off the charts esterone levels and I like sex so a little T is neccesarry. As far as he was concerned, low T and high esterone were not dangerous so no big deal but for me personally out of whack hormone levels were unacceptable.

[Stephenie S]

Remember, you all, that Kate's been there and Back, ROFLMAO!! Oh, sometimes I just crack myself up!

Seriously though, she does know what she is talking about.

S

[arbon]

Remember, you all, that Kate's been there and Back, ROFLMAO!! Oh, sometimes I just crack myself up!

Seriously though, she does know what she is talking about.

S

Well she certainly does know her stuff doesn't she. All us fruitcakes and dreamers and members of the trans community that she so despises need to heed her words and aspire to be just as crusty and mean as her one day, so we can come on here and be entertained by the idiot masses just as she is. Thank you Kate for all your wonderful service to us lowly beings and setting us all straight. It is so appreciated. Please, don't ever leave us.

[EnglishRose]

Just a quickie: My GP point blank refused to prescribe hormones and I've been seeing an endo for 5 months. Her clinic (my GP) that she is affiliated does not do HRT for menopausal cis women either. I went armed with all sorts of articles from the Journal of Endocrinology among other things, too, in an attempt to educate her.

It's disgusting how Stephanie's original point was jumped and stomped upon by the usual loud voices, who yes have experience but also are arrogant to the point of ignoring a valid concern (someone who won't prescribe).

[Kaitlyn Michele]

All things considered, it's better to keep your shit together....

I have been there too... I've poured my heart out to wannabes and dreamers that used me, I've felt that lifeless empty feeling ...putting a gun in your mouth is terrifying..but it's not a badge of honor...

Much of the bitterness and anger some have is lashing out at a world that marginalized and demeans us...at families that leave us and at the prryhic nature of our victories....

I don't see why anyone can get upset at the op....I agree that she is over thinking it...but so what..we all deal with this differently...we all deal with it based on our nature..

[ameliabee]

I don't quite understand why people feel as though it's absolutely necessary to follow the rules line by line. A few months of DIY while titrating up will get whoever to take you more seriously.


She said the problem with the majority of the trans community is they need thier asses beat.


*Shrug*

I needed the proverbial swift kick in the rear. I received one. Now moving along smoothly. (Well, as smoothly as possible anyways.)

[Bree-asaurus]

It's disgusting how Stephanie's original point was jumped and stomped upon by the usual loud voices, who yes have experience but also are arrogant to the point of ignoring a valid concern (someone who won't prescribe).

I think the point that some people are trying to make is that if she really wants to undergo HRT, she will find a way. If her doc won't prescribe and she can't find one that will... she needs to do it herself. She needs to take some initiative. If she does the research and brings the information to her doctor, and her doctor still won't help... surprise! She has all the information needed to administer and monitor her HRT right in her hands.

I don't really like to promote self-administering of hormones because I think some people do it for the wrong reasons. But I know that I was going to do HRT one way or another. Before I even met with my doc to discuss it, I had done enough research to know what I need to be prescribed, what the risks are, what kind of bloodwork I need done, etc. Had my doctor not prescribed me hormones, I would have done it myself. I can order the required medicine over the internet, I can get my bloodwork done myself at a local lab. And like Kate says, it's not rocket science.

Hell, my doctor that does prescribe my hormones and monitor my progress doesn't actually do that great of a job. He's more than willing to help us transexuals, but he doesn't really know what he's doing. I have to take it upon myself to be responsible for what happens to me.

If there's a will, there's a way. But you kinda gotta have that WILL.

[Katesback]

And Bree that is why you are one of the ones here that I know are serious. You dont make excuses. You dont use the excuse line "you dont know what my life is like". You dont talk and talk and talk and sit on your ass with no results. You dont dismiss expertly pudlished documents available on the internet about hormones and then go on to say that the process is so complex that its akin to fixing a Rols Royce, LOL. You mention you want SRS. That my dear is how I can tell your serious.

Perhaps when I think about it part of the problem I have with the trans community is they want to lump themselves into the same catagory as real women. I am sorry but I am a very small few did what it took to be real women. We have so little in common with the trans community. We are just women.





I think the point that some people are trying to make is that if she really wants to undergo HRT, she will find a way. If her doc won't prescribe and she can't find one that will... she needs to do it herself. She needs to take some initiative. If she does the research and brings the information to her doctor, and her doctor still won't help... surprise! She has all the information needed to administer and monitor her HRT right in her hands.

I don't really like to promote self-administering of hormones because I think some people do it for the wrong reasons. But I know that I was going to do HRT one way or another. Before I even met with my doc to discuss it, I had done enough research to know what I need to be prescribed, what the risks are, what kind of bloodwork I need done, etc. Had my doctor not prescribed me hormones, I would have done it myself. I can order the required medicine over the internet, I can get my bloodwork done myself at a local lab. And like Kate says, it's not rocket science.

Hell, my doctor that does prescribe my hormones and monitor my progress doesn't actually do that great of a job. He's more than willing to help us transexuals, but he doesn't really know what he's doing. I have to take it upon myself to be responsible for what happens to me.

If there's a will, there's a way. But you kinda gotta have that WILL.

[sandra-leigh]

I don't mess around when lives are at stake.

There is, yes, a fair bit of information about doses and possible side effects and so on on the 'Net. A lot of the studies involved small sample sizes. Most of them. And they almost all studied individuals who were believed to be fairly healthy and have normal biochemistries. The papers were thus not especially relevant to me, as it was known from previous testing that my biochemistry is not normal in some respects (or if it was "normal" then it was several standard deviations from the mean.)

Can someone learn a lot by doing 'net research? Certainly. I do it all the time. I've lost count of the number of different PhD degrees or PhD-level subject specializations that people have assumed I have. However, one thing that is starkly obvious to me as a I learn about all these different fields, is how much I do not know. The tricks-of-the-trade, the permitted simplifications, the one-in-a-thousand situations that are rare but have such clear signatures that you can tell exactly what is wrong without hearing the details. The complications when you start getting in to atomic-level interactions; the specialized materials that contradict the well-known "laws". Learning to "sight-read" differential equations the way musicians sight-read a score, and using that information to be able to predict obscure failure modes.

I do not confuse the map with the territory, do not confuse the equations with the practice, do not assume that any one text said everything there was to say on a subject. If I'm going outside my specialty and the matter is one where approximations are not good enough, I research first but then I consult with the people who know the topic well.

[Kathryn Martin]

I must admit this is again one of those discussions that has turned useless. I am under treatment by my GP.. I provided him with the papers regarding the standard of care, specifically the work done in British Columbia which sets out in every detail the bloodwork necessary and the treatment regimen found to be most effective after extensive research. My GP started the treatment and after six months made a referral to a TS specialized endo in Halifax. She told him it would be waste of time since she was following the same standard of care.

Never the less if the OP feels uncomfortable then she should simply find an endo and go that route.

But consider for a moment that the people you are dissing have actually completed the process and know of what they speak.

And sandraleigh what you say is not correct. the paper published are peer reviewed papers that are the standard of care for endocrine treatments of transgendered adults. These were written by specialists for general practitioners.

[Bree-asaurus]

I don't mess around when lives are at stake.

There is, yes, a fair bit of information about doses and possible side effects and so on on the 'Net. A lot of the studies involved small sample sizes. Most of them. And they almost all studied individuals who were believed to be fairly healthy and have normal biochemistries. The papers were thus not especially relevant to me, as it was known from previous testing that my biochemistry is not normal in some respects (or if it was "normal" then it was several standard deviations from the mean.)

Can someone learn a lot by doing 'net research? Certainly. I do it all the time. I've lost count of the number of different PhD degrees or PhD-level subject specializations that people have assumed I have. However, one thing that is starkly obvious to me as a I learn about all these different fields, is how much I do not know. The tricks-of-the-trade, the permitted simplifications, the one-in-a-thousand situations that are rare but have such clear signatures that you can tell exactly what is wrong without hearing the details. The complications when you start getting in to atomic-level interactions; the specialized materials that contradict the well-known "laws". Learning to "sight-read" differential equations the way musicians sight-read a score, and using that information to be able to predict obscure failure modes.

I do not confuse the map with the territory, do not confuse the equations with the practice, do not assume that any one text said everything there was to say on a subject. If I'm going outside my specialty and the matter is one where approximations are not good enough, I research first but then I consult with the people who know the topic well.

I agree, safety is important. Which is why I see a doctor. The problem is that there aren't very many doctors that really KNOW this stuff. Here in San Antonio, the one doctor we have doesn't know much. The self-educating and researching educated me to a higher degree than my doctor about this particular subject. No, I'm not a doctor and no, I don't think I know everything there is to know about HRT by a long shot. But I know enough to get by... and the getting by part is what's important to me. I can't speak for everyone, but my life was at stake before HRT. Regardless of the risks, HRT significantly reduced my risk of death. Honestly, I didn't even really care what the risks were... because it didn't really matter to me. I'm being as safe as I can given the circumstances, but I'm not about to fly across the country to find an expert that will most likely tell me what I already know. And FYI, it didn't really matter how many of the changes I was actually going to experience from HRT. I just needed to get that horrid testosterone out of my system and replace it with what should have been there all along.