Complete 180 on my previous beliefs.

[I Am Paula]

A while back, when things were getting frantic, and I decided I desperately needed hormones to continue, but I had a deep seated dislike for the gatekeepers, mental health professionals, and their ilk.

I didn't need no stinkin' therapist! Just give me a letter. I've got informed consent out the yingyang. Nobody needed to tell me what gender I am, and, as a big girl, these choices are not to be made by someone else. I ALWAYS knew what was right for me.

In the end, I couldn't jump the lines, and went grudgingly to therapy. Enjoyed it, but only stayed the minimum to get my letter.

Flash forward- 3 1/2 months on HRT. The best time of my life. Now that I have discovered what an enormous impact HRT has, and what a profound difference it makes to mind and body, I suddenly get it.
This is not something to be entered into lightly. I have changed (for the better) right down to my soul, and feel that every fiber of my being is affected. But this is not for everybody. I can see a conflicted person seeking a solution that HRT cannot provide. HRT has to be administered on by a partnership of Dr. and therapist.

When I read now about self medicators, dabblers, even some who think HRT may be 'fun', or just want to grow boobs, I understand why the gatekeepers exist. Why the protocols and checks and balances are set up as they are, and why the sometimes interminable waits. They gotta sort out those who need and will benefit, from those who just read too much.

My endo, as he was handing my scrip over his desk, said something to the effect of 'You're sure now? Always remember that you're taking drugs powerful enough to change a dog into a cat.' We both laughed. I gladly took the prescription.

This is more of an essay than a question, but feels free to chime in, either pro or con, about the system as it is in place.

[Leah Lynn]

Celeste, I'm nearing that point, so I shall take heed. Thanks for the "Gibbs Slap"!

Assuming I get to HRT.

Hugs,
Leah

[gonegirl]

Hi Celeste,

I started HRT 6 months ago. My gender therapist recommended that I begin because my GD was very bad and she believed it was the correct next step for me. I was very scared of taking that step because doing so was risking everyone and everything that matters in my life, but I was desperate. I knew I had reached the point of do or die.

I chose to go ahead knowing full well the possible consequences, both good and bad. My therapist wrote my HRT letter and referred me to a very experienced endocrinologist who examined me up the yin yang (figuratively, not literally ;^) and explained to me the risks, the physiological effects I could reasonably expect, and his recommended course of treatment. I said I wanted to go ahead and he started me on a low dose of HRT meds which he steadily increased to the maximum dosage that I'm now on. He monitors my physiology and my therapist helps we with the mental aspects of being transexual and transitioning (which I'm now doing).

Taking that step was the absolute best thing I have ever done for my-self because for first time in my life I feel normal. I now know who I am and I have a feeling of real identity that was previously never fully complete. This is a life changing experience, a life saving experience, that wouldn't have been possible without the professional help that I'm receiving. My experience with the system here in the US is that it is working for me and I'm very thankful.

Another kleenex moment.... :^)

Sincerely,
Simone.

[I Am Paula]

Simone, Isn't it amazing how identity comes into play? I never really thought...what is my identity? Something on my passport that says who I am? No, it's much bigger than that. I am discovering mine.

[LeaP]

I'm perfectly happy with the system as it is. 2 reasons: I decided I needed the expertise, so didn't fight it. And the experience with my providers has exceeded my expectations. I know mileage varies for others, though.

[mikiSJ]

Celeste - Please keep shouting your comments to those who think they can simply go it alone.

I have been seeing a gender therapist and a psychiatrist for a less than a year and both are willing to give me "the letter", but it wasn't until a saw a VA "gatekeeper*" doctor did I start to discuss HRT. One of the comments he made should be printed out in bold type and taped on the fridge: "...when starting a new chapter in you life, write with a pencil and eraser, don't write in ink!"

*gatekeeper as in my initial contact with the VA for general medical reasons.

[AllieSF]

Celeste, thanks for such a well written and oh so true explanation of why you changed 180 degrees. These are the words that can help a lot of people here who profess that they do not need help from anyone. They are mature comments that can get lost in all the other thoughts and words that sometimes cloud our common sense in times of stress.

[Barbara Ella]

Celeste, now you get it, and you know that you get it. Putting those two thoughts together is a powerful tool to help with the changes our thought processes are going through also. Well done.

Barbara

[Angela Campbell]

Always remember that you're taking drugs powerful enough to change a dog into a cat.' We both laughed. I gladly took the prescription.

.

Meow.....................................!

[linda allen]

Celeste, you make a very good point, especially about those who just want to grow boobs. HRT is a life changing experience and anyone who tries it needs to be certain that that's what they want for the rest of their lives.

[Chickhe]

I get the concept, except it is not applied without discrimination and other medical procedures such as a face lift, breast augmentation, don't have it. If you have a risk of prostate cancer you can take the same hormones.

[I Am Paula]

No system is perfect for everybody every time. Getting prostate cancer is a lousy way to get anti-androgens.
Even my therapist, who I now respect said 'The standards of care can't apply to everyone, and may even be a bit cumbersome for some.'

[kimdl93]

I really believe that any person suffering from emotional distress should start with therapy and follow with chemistry, if needed. That clearly applies to antidepressants and anxiety drugs...I would think it should apply to HRT as well.

[LeaP]

I get the concept, except it is not applied without discrimination and other medical procedures such as a face lift, breast augmentation, don't have it. If you have a risk of prostate cancer you can take the same hormones.

This comment just doesn't make sense to me.

In the case of prostate cancer, there are well-established protocols for which drugs to use, under which circumstances, and why. There is no sense in which it can be said that this case is indiscriminate and transsexual HRT discriminate. The unifying principle is appropriate treatment for the condition – not free access to drugs.

The same thing applies to BA. The simple fact is that a BA on a male bodied person has social and psychological implications. The standards of care are designed to prevent harm. The implications are completely different with female bodied people. In each case, the requirements are tailored appropriately.

Face lifts are available to anyone. I'm not sure of your point in citing this one.

[Jorja]

Back in the day when I had my SRS done and before the standards of care were in their infancy. The medical profession did not have a clue how to treat transsexuals looking to transition. It was a hit or miss situation. Some like me got lucky and had doctors who were transsexual themselves and had knowledge. Others were pretty much left out in the dark to wander aimlessly. Many of us pushed for some kind of standardization. This is where today's current standards of care evolved from.

Today we call them Gatekeepers. Yesterday we called them a godsend. Before the standards of care, Many were taken into back alleys and prescribed dangerous concoctions. I remember one "doctor" (if that is what you could call him) being arrested for giving out battery acid packaged as a capsule and calling it hormones. There were many murders where back room SRS operations went horribly wrong. Realize, that you could be taken off to a hospital for the insane and be brutally abused and tortured for even suggesting you might be a little different than the normal guy walking down the street and many were.

The Gatekeepers are there to sort and filter out those that do not fit the criteria but they are also there to keep good honest doctors good and honest.

[Marleena]

I really like Jorja's answer. The gatekeepers are there to help. They are trained to identify and help the people that actually need it.

[Angela Campbell]

They are there for more than just to give letters. There is more to it than just taking hormones and they are there to help a patient to get the complete treatment and not just the chemical treatment. They are there to help guide you through all the pitfalls and all the things you need to know and do for transition. My "gatekeeper" helped me find electrologists, Md's, gives advice on name and gender change procedures, helps with the family and so much more. Like telling me that in my state a letter is required for BA unless your gender has been legally changed. He is there to help me every step of the way. It would be overwhelming without this help.