Moving further along the path, encounter with an endocrinologist

[Eryn]

It's been nearly 4-1/2 years since I found the courage to explore this part of myself. Since that time I have passed many milestones. Along the way I've had many welcome supporters like my wonderful wife Mimi, my dear friend Barbara and quite a few individuals on this forum. I've learned a lot and have tried to pass some of that along with my posts. I've grown very comfortable with presenting as a woman, to the point where it feels odd for me to present as a male outside of work.

Mimi has always been my foundation and my advisor. She has always had my back and she seems to know what I'm thinking before I do.

Counseling:
Last year Mimi suggested that I might want seek out counseling, since my gender dysphoria certainly wasn't diminishing. I was dressing more and spending much more time in girl mode. Even in boy mode I was leaking and this wasn't helped by a decision to grow my hair out. I agreed with her and we set out to find a counselor.

We asked TG friends and perused websites to find a counselor who was competent, recommended by a friend, and who was acceptable to my health plan. We finally decided on a lovely lady and I started to meet with her weekly in January.

I had never done counseling before and didn't know what to expect. The process is not much different than chatting with a bartender or hairdresser, except that my counselor was aware of my issues and knew how to gently ask very pertinent questions. She would then sit back and I'd ramble on, but in the process she helped me identify those things that were bothering me. It kind of bothered me that I wasn't really presenting any earth-shaking problems to her since being TG hadn't damaged my marriage or other relationships. To the contrary it has brought me many more friendships than I have in boy world. She said hat a lack of angst didn't concern her at all as it allowed us to concentrate better on the matter at hand.

After two months the counselor broached the subject of HRT. She knew that I wasn't ready to make a decision about it, but she suggested that I get better plugged into my health plan "just in case." Like most males I was rather neglectful of things like getting physicals, etc.

Somehow, engaging the medical machine made the possibility of HRT a lot more real to me. It had always been something I'd considered doing "someday" but suddenly "someday" could be soon. This prompted me to discuss the issue at greater length and to try and make sure that I wasn't just doing a "Me Too!" with my friends who were on the path. It slowly became apparent that this path was the correct one for me. I asked my counselor if we could review the process that led to the decision and she said "The decision has always been made, we just had to figure out what it was." Pretty deep stuff, that!

Physical Exam:
The first doctor visit (for a physical) was a bit scary. It was a new doctor (my old one retired) and I chose a young female internist with about five years in practice. I had decided that I wouldn't hide being TG, so the Jockey shorts stayed in the drawer, the polish remained on my toes, and I wore my normal male/andro weekend clothes. The doctor was busy so I had to get with the program. I screwed up my courage and I said that I had come to her because I was dealing with transgender issues. She said "I kinda figured that out!" in a friendly manner. She ordered normal blood work, spotted a mole on my back that needed the attention of a dermatologist, and told me I was 2 years overdue for a colonoscopy.

Having already paid the price of walking into a doctor's office I brought up the issue of a referral to an endocrinologist so I could discuss hormone therapy. She said "Sure, I can do that!" and typed away at her computer. I gave her the name of the endo that Barbara had been using and with whom she was happy. We chatted for very short time (they keep those doctors moving!) and she said that she had a lot more questions she'd like to ask but it would have to wait. I did get to do a bit of education but I didn't expect her to be really up to speed since mainstream doctors don't see a lot of us.

A few days passed, and the referrals arrive in the mail. Dermo, Gastro, and yes, Endo! Unfortunately the Endo referral was not to the doctor that I wanted. Luckily there is a number that you can call on the letter so I managed to get the doctor changed. I called her office and made an appointment.

In the meantime my blood work came back. Everything was in the good range except one number that was off by a tenth of a point. Darn! The doc says that it is probably just an anomaly and we'll repeat the test in a couple of weeks.

The Endocrinologist:
(Everything from here on took place today!)
So, time went by and the date of my endo appointment arrived. I had planned to see her in andro mode as I had the internist, but as I was changing something drew me to a long skirt. I went with my instinct and dressed fully in a casual skirt, nice T-shirt, and low wedges. Forms in place and makeup on, I headed out!

The endo's office was in the aptly-named Women's Health Center. I walked in about 20 minutes early, checked in, and sat down to wait. I wasn't even given any busywork on a clipboard! After just a couple of minutes the health assistant ushered me in, weighed me (I'm 2 pounds heavier with forms!), took my blood pressure (A bit high, I wonder why!) and left me to wait in the exam room.

The endo came in, a pretty young woman with an East Asian appearance. She got right down to business, asking me what name I preferred to use. We discussed the hormone regimen that she suggests for TG people. We discussed side effects, both good and bad. We talked about the process of titrating the dose up to a reasonable level to minimize the dangers. She was very frank about what would not happen. No instaboobs, no change of voice, and no freebie beard removal. She stopped, looked at me, and said "Your face looks really good, what did you do? I told her several years of facial electrolysis. She said that was the best thing I could have done! Ironically, two of the side effects of HRT were actually good for me, shrinking of the prostate and lowering of blood pressure!

She gave me a very quick physical examination, and said that she was satisfied with my overall health. She needed to get baseline hormone levels and that would determine the dosages we'd discuss at out next meeting in a couple of weeks. She sent me straight down to the lab with a warning that they wouldn't want to draw blood for a T level because it was after 9AM but to tell them that she would accept it.

The phlebotomist did his magic and drew three tubes of blood. He didn't even mention the 9AM restriction so I thought that he had read the note on the lab order and that we were good. He asked me where I got my necklace and earring set as he wanted a similar one one for his wife.

I walked out with a real spring in my step and a breeze fluttering my skirt. It felt great to be presenting as I wanted and to not hide anything from anyone I had met. Everyone treated me great and I didn't see any double-takes even with my male name.

Barbara and her spouse were in the neighborhood and I had some time to kill so we had a nice lunch at Millie's Restaurant. We had a patty melt and a lovely grilled cheese sandwich which we shared. After that I headed home.

So far it has been rainbows and unicorns hasn't it? Well, the day didn't end that way.

Remember my blithely expecting the phlebotomist to carefully follow the doctor's instructions about drawing blood for a T test even though it was after 9AM? Well, I should have checked closer because the guy didn't draw the blood for that test and didn't bother to tell me about it at the time. He left a message on my home phone several hours later. that I would have to come back again. I called the lab and the operator wouldn't let me talk to him directly, instead relaying messages back and forth. The bottom line was that they didn't do as the doctor instructed and so I have to come in at the required time to get another blood draw. That message took me from a high to a low in just a few seconds. Ah well, after all that electrolysis another vein puncture doesn't bother me a bit.

[Suzanne F]

Eryn
I share many aspects of your story. I am married to a supportive wife and live as a woman except for the few days a week I have to appear in front of customers or the office. I am starting HRT in 8 days. I often see your posts and appreciate your upbeat attitude. I am happy for you mad look forward to sharing our journey!
Suzanne

[Kaitlyn Michele]

No matter what fighting your gender dysphoria is hard work and you are doing alot of hard work.

Therapy is always helpful but it can be tricky to find the right therapist, i'm glad you started off on the right track. It can be a very strange feeling to notice or feel things that should have been obvious to you for your whole life.

I hope things work out for you and your family.

[Eringirl]

Hi Eryn: Thanks for sharing, it is very helpful to me. I am somewhat similar, but different at the same time. No support of wife (as we probably all know by now), but have two therapists who have signed off and heading to an Endo hopefully in May - waiting for referral to go through - with HRT to start in June. So thanks for your info!!

bummer about having to go back again. But in the big picture, not really a big deal. Ride the high wave while you can!!

Keep us in the loop as you go along.

Erin

[Eryn]

No matter what fighting your gender dysphoria is hard work and you are doing alot of hard work.

Therapy is always helpful but it can be tricky to find the right therapist, i'm glad you started off on the right track. It can be a very strange feeling to notice or feel things that should have been obvious to you for your whole life.


I don't see it so much as a fight but more as a release from a prison up my own making. Being able to interact with others with no worries about maintaining an artificial image is very liberating.

I do get that "so that is what that meant!" epiphany fairly often!


bummer about having to go back again. But in the big picture, not really a big deal. Ride the high wave while you can!!

All done now! Now I just have to wait for test results and a follow-up appointment. One cool thing about my health plan is that I can actually see my test results online.

One thing that my therapist emphasized was that this should be considered a growth process, one to be enjoyed and savored. I think that this attitude is very healthy.

[Michelle789]

Eryn,

Congratulations on your next step towards becoming the woman you really are!!! I'm really glad to hear how well things are going for you. If you need to talk, I'm here for you. I hope you can make it back to Friday night trans group sometime!!!

[PaulaQ]

I don't see it so much as a fight but more as a release from a prison up my own making. Being able to interact with others with no worries about maintaining an artificial image is very liberating.


That is precisely how I felt. I'm so glad you are moving forward Eryn. I think you will find this goes smoother for you than for a lot of us. At least I hope that's the case.

The day you start HRT is likely to change your life forever in ways nothing before it ever has. I'm very glad you are pursuing this. I think you are going to do really well.

[kimdl93]

I'm very happy that you are able to take this next step and that you've got Mimi's support.

[PretzelGirl]

Eryn, you are on your way! I see you handling things in a calm and controlled manner. You seem to be free of angst or other things I wish no one had so I think you will navigate this quite well. It seems that not too many of us did electrolysis earlier enough. Big advantage. That is one you will certainly be thankful for.

Hugs for Mimi!

[Eryn]

Things are moving along, albeit with a minor delay. All the tests are back except for the T test so we had to reschedule my follow-up appointment. The endocrinologist is off this week so I'll see her the week after. Mimi will be able to come along which is a comfort to me.

While I understand intellectually that there is no urgency to this I still have a sense of wanting to get on with it.

[charlenesomeone]

Eryn wishing you all the best and love your attitude in this.

[Karen62]

While I understand intellectually that there is no urgency to this I still have a sense of wanting to get on with it.

A girl wants what she wants, and sometimes that is nothing more than to simply be. I understand.

Karen

[Eryn]

One of the disadvantages of engaging the medical system is that every part of it wants a piece of you. my internist saw a small mole on my back so she sent me to a dermatologist. He's a likable but crotchety old fellow that I really don't feel comfortable with in female mode. Right after that I had an appointment with my therapist who I always see in female mode

I ended up dressing androgynously in t-shirt and khaki capris for the first appointment, then added forms, earrings and lipstick for the second appointment. Mimi said it was a very natural GG look. It's gratifying that I can function in public with such small feminine cues.

Oh, and the dermatologist said that the mole was nothing to worry about!

7 days to the endo appointment! :)

[Kris Avery]

Eryn,
Such an exciting time. Just remember, you will do better by keeping (or trying to keep) your head.
This is often impossible. Especially if there are kids in the house.

[Suzanne F]

Eryn
I am anxious for you! It won't be long. I cannot believe I have on my patches and took my spiro this morning. It all seems surreal. We should enjoy the journey. Now I want to hurry up effects. I am trying to just be now instead of rushing to the next thing. Any way I am happy for you and feel close as we share a similar situation and timeline.
Suzanne

[Eryn]

A Red letter day! Saw my endo it was as if we were both reading from the same book. What she proposed was exactly what I had in mind! Mimi was along for support and everything was great. We picked up a couple of packages and I'm off to the races! :yahoo:

[PaulaQ]

We should enjoy the journey. Now I want to hurry up effects. I am trying to just be now instead of rushing to the next thing.

Buckle up ladies, you are about to board the estrogen roller-coaster! Sit down and hang on for the ride.

Don't be discouraged if you don't see immediate results, but also don't ignore that forever - there are different dosages and different methods of delivery for these drugs for a reason, and for a given person, some are more effective than others.

[Persephone]

:cheer: :cheer: :cheer:

Hugs,
Persephone.

[Jennifer-GWN]

Eryn;

So happy for you. Yep gonna be fun. Just stay happy and healthy and the rest will fall into place.

Cheers... Jennifer

[Barbara Ella]

Congratulations Eryn. You are beginning a new step in your journey of many steps. Enjoy the steps and accept them as they come and don't get concerned when they may not seem to come as rapidly as expected. There are no guarantees on the journey, but have faith in the end result. You are on your way.

Barbara

[Leah Lynn]

Congratulations, Eryn. You are so lucky to have such a loving, understanding SO. Not to mention health care that will cover this. All I can say is move along at a comfortable pace. Enjoy the ride!

Hugs,

Leah

[PretzelGirl]

I would say that it is pretty red! :D Take a deep breath and don't imagine the changes in the morning. :heehee:

[Sometimes Steffi]

I wish you the best.

You always talk about your no-fly zone. I guess HRT will do away with that.

[Eryn]

It's been 24 hours now and I'm happy to report that I now have a 40D bust, hourglass hips, all my body hair has fallen out, my head hair is lush and full, my voice has raised an octave and my entire world is decorated with rainbows and unicorns.

Well, no. None of those things happened. Actually, I got a little dehydrated at work and paid the price by becoming rather lightheaded for the afternoon. When they say drink a lot of water with this stuff they mean a _lot_ of water. The bathroom is starting to look good as my new office. Once I got home and got some liquids and dinner into me all is well.

Patches are a pain to use, but the trick seems to be finding a place where the skin doesn't stretch or wrinkle when I move. I hit a good spot with one patch, but the other one is a bit wrinkly. Still, the patches are the safest for my liver so I'll put up with them.

Mimi helped me take some detailed body measurements so we can document whatever changes occur.

Steffi, this experience has put some dents in my NFZ since I go to my therapist and most of the doctors en femme. I'm not planning on making any proclamation as there is little need in my life for that. If I start to see big physical changes that need might become more urgent. Time will tell and I have plenty of that.

Funny story:
We were down in the next valley after my endo appointment and we stopped at our pharmacy on the way home at the end of the evening. It's in my NFZ but nobody else was around at that time so I went in en femme. I went to the pharmacist's counter and told the man that I was there to pick up a prescription for [Male Name]. He asked for birth date and address and I gave the correct answers. He brought out the prescription and said that I had to sign a waiver so that I could pick up someone else's prescription! I scribbled a signature, paid, and off I went! The pharmacist apparently didn't realize that I was the person for whom the prescription was intended! :)

[Mimi]

Those patches are something else! Definitely a trick to keeping them adhered properly. Well, let's see what the next visit brings!

[Eryn]

One Month Update

I had my 1-month followup with my endo today. My levels are headed in the right direction but are still (barely) in the male range. She had been conservative and I didn't expect instant results. She adjusted both my S and E upward and now I have to wear three patches. :( I also switched to twice-a-week patches as the once-a-week patches got pretty ratty toward the end of the week so I wanted to be able to freshen them more often.

The bad news was when Mimi stopped off at the pharmacy to pick up my prescriptions. The clerk said that the E prescription was held pending verbal confirmation by the endo. The clerk said to Mimi "This is a huge dose...and this is a man...what is the diagnosis, anyway?" Apparently that clerk needs a little education, both in dealing with prescriptions for transgender clients (the dose wasn't huge in TG terms) and with privacy. In any case, I'll have to wait for tomorrow to get my new patches.

I'm feeling pretty normal which isn't a surprise as my levels are still in the male range. The only physical manifestation is that my bust has grown 1.5 inches incrementally over the last four weeks and I'm officially an....drum roll.....A-cup! :) This really surprised me as I understood that I shouldn't expect any development for months, if at all, at my age. I'm also experiencing a tiny bit of soreness behind the nipples but that is about it. Mental effects are hard to quantify since I can't separate the biochemical effect from the psychological effect. I feel somewhat calmer than usual, but it might just be because the "should I or shouldn't I" internal debate is now over.

That's about it, the next month should be interesting!

[Michelle789]

Eryn,

Congrats!!! I'm really happy for you!!! I went to see my endo after two months HRT, and he said that my hormone levels were dead center between male and female. This was based on a blood test I took after a month and a half on HRT - the doctor appointment was two weeks later.

[Nancy Sue]

Hi Eryn. I am so happy for you, and thank you for posting your progress here. I have been looking forward to hearing this news ever since we met last January. You talked about it then, but had not started. And I followed your (and Barbara's) lead, after fighting it for a while, and I recently started talking with a counselor, too. Not sure where that will go, but wherever it is - it will be forward from where I have been, and where I am right now.

I wish you well my friend, and I will continue to follow your progress through your posts here, and when we meet up again. Please give Mimi a hug for me, and thank her again for being such a wonderful partner and wife to you, and good friend.

[Kaitlyn Michele]

It's good that you are being careful and smart about the hormones.

the levels are numbers, how you feel is important too, i am glad it seems to be working for you!

[Suzanne F]

Eryn,
Congratulations on your progress. I have been on the patches since 4-20. We are about the same age!
Suzanne

[Eryn]

Went in for my 3rd monthly checkup. Everything is going well. My levels are good and my blood pressure dipped into the normal range for the first time in years (love those side effects!). My endo bumped up my S a bit and kept everything else the same. As before, I'll have blood work for potassium in a week but she said she wanted to wait two months for my next visit. Since things seem to be stable I agreed.

My endo is a very nice young lady who has a cautious attitude that I like. It's taken a while to get things where we want them, but we've kept a close eye on things and now have a good idea of how my body reacts.

[Debb]

I've been reading the thread with interest. I just started HRT myself, on a very low, safe dose. Thanks for keeping it updated.

[Leah Lynn]

Glad to hear that things are going well. Going on two years and the endo has me on a six month interval.

Hugs,

Leah

[Eryn]

Some good news on the medication front. I refilled both of my prescriptions without any delays from the insurer or the pharmacy! :)

[Kaitlyn Michele]

That's excellent news!

and its good you are taking care of yourself...good health to you

[LeaP]

... my blood pressure dipped into the normal range for the first time in years (love those side effects!). ...

I love it too! My BP started off at appx 160/110 before starting blood pressure medication. I dropped that med a year into Spiro and now routinely test around 115/80 or so. Amazing.

I'm glad things are going smoothly.

[Starling]

Authenticity is good for your health.

:) Lallie

[Eryn]

Wow, I can't believe that it has been six months already! The first half of that was spent in monthly blood testing and getting my dosages correct. My T level is great (7!) but my E levels are still stubbornly lower than I would like, around 100. My endo said that this will likely improve as my body adjusts to the lack of testosterone and develops a subcutaneous fat layer that will make it easier for the patches to do their jobs.

For those who like data, I have been taking weekly measurements of chest (above bust), bust, ribcage (below bust), and hips. At my age (late 50s) I didn't expect much physical change. I'm not turning into Christina Hendricks, but there have been significant changes.

Oddly, my bust measurement hasn't increased all that much, but the chest and rib cage measurements have gone down considerably. I'm apparently losing muscle mass which is masking breast growth. I was warned about this, which is why I have always kept track of all the measurements.

On the graph below, the raw data bounces all over the place so I have added trendlines. Click on the chart to see a larger version.

251912

The top red curve is the bust which is trending slightly upward. The blue and yellow curves are the chest and rib cage and they are trending significantly downward. The result is that I have gone from being completely flat to having two small round breasts, enough to make some cleavage if I so desire. I have noticed that my forms are now fitting differently and soon I will have to address that issue. Bigger bras or smaller forms, that is the question!

The dark red curve is the hip measurement and it's the big changer. The green curve is my waist and it has progressed upward a little.

My face has also changed. I used to have a deep wrinkle in one cheek that is much less noticeable now. Body hair has become a bit finer and grows slower. Head hair is in good shape, and hopefully will stay that way as I was showing early signs of baldness.

Mentally, I feel calmer and have less anxiety. I don't feel quite as "sharp" as I was previously. Rather it feels as though the "edges have been rounded off" of everything. My GD is somewhat improved and will continue to improve as I make other changes.

All in all I have been happy with my results so far. My endo wants to see me in four months and I'm now on long-term prescriptions. It's very nice to have things stable!

[PretzelGirl]

Late 50's? Really? I think you wear that very well! I used to do the measurements. Had my wife doing it. Used the measurements at badtranny.com as a guide of what I would measure. First, there were months where my wife wasn't available and I couldn't take measurements that were close to her's. Even with just her's, it was obvious it was hard to be consistent. I saw the changes over months but month-month was variable. I like the way you flattened the line out to just get to the trend. All in all, pretty good for six months. I saw more from 6-12 months than 0-6 I believe. Or maybe it is a result of that being recent memory. Here's to the E getting right!

[jenniferinsf]

what an exciting and anxious time it must be for you...wishing you all the best but with your support group you are in good hands by the sound of it

[Eryn]

I learned the measurement techniques from this site:

http://www.transgendercare.com/medical/resources/tmf_program/tmf_program_7.asp#brst

Their rationale is this:


while most measurements are taken no differently than for a genetic female, we have noticed that a crucial body measurement needs to be taken differently for the transgender woman.

The measurement area of concern is the breast. Often the medical literature as well as physicians not familiar with transgender practice will suggest measuring the breast itself. This technique calls for measuring each breast—taking a measurement of the breast along the horizontal and vertical axes. While treating the breast as a hemisphere and taking measurements accordingly works well for the genetic female, it offers little for the transitioning female. Let's take a look at why:

For the genetic female, no de-virulizing takes place. The muscles in the upper body do not diminish as they do in the transgender woman and breast growth is normally significant. So for the genetic female, taking a measurement of the breast, itself, is the most telling. But, this traditional technique is not very useful for the transgendered woman.

For the transgender woman, breast growth occurs along with the diminishment of upper body muscle mass. So the traditional technique which measures only the breast area does not take into account the competing forces of breast growth and decreasing upper body mass, and provides little in the way of useful information.

I'm very glad that I came across this information, otherwise I would have been very puzzled with lack of increase in bust measurement even though I now have small breasts where everything was boy-flat before. That half-inch increase in bust measurement is actually a two inch increase in differential between bust and measurements above and below.

[Mimi]

Even though the numbers haven't been changing all that much lately, I think there's been a pretty big change in how you look since you started HRT!

[Eryn]

Just received my latest blood work. E went up a bit, to 111, and P is a bit high, at 28. BMP looks good. Haven't received T results yet but I've never had a problem keeping that down. Endo appointment is this Friday! :)

[pamela7]

have you written this whole story up?, would be interesting to see.

[Eryn]

(Written on 2-27-16 and copied to a new post in order to avoid violating the double posting rule):
Well, I have documented it here! :)

My appointment went well. My T was 12, up a bit, but negligible. BP was excellent (with Spiro I no longer fear The Machine!) and blood work checked out, so I'll see her in 6 months, with blood work at 3 to keep an eye on levels.

She also scheduled me for a mammogram and told me to see my GP for a general checkup.

So far I am pleased with my progress. My mental attitude is good, emotions flow more freely, and physical changes are coming along slowly. I'm doing better than I expected. My only complaint is fatigue, but that is to be expected when I lose muscle mass.

Written on 4-6-16:

Mammogram Day!

We had some time off, so Mimi and I scheduled our mammograms back-to-back to save us a trip to the radiologist. We went down first thing in the morning. Mimi was called first and was out 15 minutes later.

A couple of minutes later I was called. The tech escorted me to the changing room where there were small lockers for my purse and clothing. I put on a paper gown and followed the tech to The Machine. Yes, the fabled machine so hated by GGs and i was going to put some tender parts of my own body into it.

First was the paperwork. The tech shot questions at me. Phone number?, birth date?, Family history of breast cancer?, was it my time of the month? was I pregnant? was I taking any hormones? etc. I told her that I was taking estrodiol and spironolactone. She said "what's spironolactone?" I said "it's a T-blocker." "Huh?" she says. I say "Testosterone blocker, it stops me from producing testosterone." Suddenly the light dawns in her eyes. "Oh!" She says. She goes back to the top of the form and asks "Are you now male or female?" I replied "medically, I'm still male." She changed the checkmark and off to The Machine we went.

Now, as pleased as I am with my development, I'm not very well-endowed. 38A. The tech fussed about quite a lot getting the machine to the proper height and getting all of me stuffed onto the platform and squished under the transparent side of the vise. The measurements on the machine went up to 8 and I was barely a 3. My breasts were at the tech's eye level so she spent some time on tiptoe getting things lined up. She apologized for handling things so much and I told her that I didn't mind as long as the pictures were correct!

As she was taking the first picture I was struck with a wave of weakness and nausea. This isn't normal at all for me and I asked if I could sit down for a minute and compose myself. She fanned me with a magazine and slowly the feeling passed. It was probably caused by the fact that I hadn't eaten anything that morning. I felt better and stood for the remaining three pictures. She kept having to rearrange the paper gown and I asked "Do you mind if I just take this off and make things simpler? She agreed and her job was much easier without the added complication.

When she was done she said "Congratulations, your first mammogram is done! See you in a year!" I got dressed, retrieved my purse, and rejoined Mimi in the waiting room.

We then went to a nice breakfast with my sister in law, daughter, and her boyfriend!

[jentay1367]

Eryn, You're the poster child for the results I'm looking for. I guess we're roughly the same age. Also, I have a loving supporting wife. Lucky us..... Congrat's woman! Keep ripping it up. Lisa

[PretzelGirl]

"medically, I'm still male."

This is an interesting response. Medically, I am not male. I might have the wrong genitals, but I don't have T going through me in anything but really minor amounts and I have a good level of E. That isn't male to me. It is interesting you can say that as I would assume most couldn't as it would cause a level of dysphoria.

[pamela7]

congrats Eryn, i have a question: why the annual mammogram?

[Eryn]

This is an interesting response. Medically, I am not male. I might have the wrong genitals, but I don't have T going through me in anything but really minor amounts and I have a good level of E. That isn't male to me. It is interesting you can say that as I would assume most couldn't as it would cause a level of dysphoria.

Practically, the physical structure of my body is male and my genetic makeup is XY. So, for medical purposes I'm male. Now, I have a few female things going on too, like estrogen and breasts. I'm an amalgam of both sexes and always will be. Unfortunately, "Amalgam" is not a choice on the form.

For me, dysphoria is not really triggered by practical matters, but by how I am socially perceived.


congrats Eryn, i have a question: why the annual mammogram?

I'm in my 50s and on HRT. That makes me higher risk for breast cancer, just as it would a GG in the same position.

[LeaP]

Anyone on HRT eventually needs mammograms. There doesn't seem to be an agreed standard on when to start them, though. My doctor says after 5 years on hormones.

[Heidi Stevens]

Eryn, let me be the first to congratulate you on your first year of HRT! From what I've been reading the last few days, you have a great team looking after your wellbeing and you are doing great! I just had my first anniversary and things are going just fine. Keep us posted on your progress.

[Kate T]

Practically, the physical structure of my body is male and my genetic makeup is XY. So, for medical purposes I'm male. Now, I have a few female things going on too, like estrogen and breasts. I'm an amalgam of both sexes and always will be. Unfortunately, "Amalgam" is not a choice on the form.

For medical purposes you are actually closer to female than male. The genetics is frankly marginally relevant, any sex linked genetic disorders should have well and truly shown up by your age (my apologies for saying "your age") and most of the old diseases and disorders that were presumed to be "sex linked" are actually most likely associated with risk factors associated with previous gender stereotypes that are just no longer relevant in modern society. The biggest sex linked factor that a physician needs to consider with regards to disease diagnosis and treatment is your hormonal physiology which if your Endo has got it right should be principally female.

The only other obvious impact sex markers have on medical health are internal organs i.e. prostate in birth sex male individuals and uterus / ovaries in birth sex females. Even those are quite variable. Consequently the principal reason for sex markers on medical records is ACTUALLY a social one and as such you are well within your rights to mark it as female. If you need to advise a doctor of your genetic and / or anatomical variation then that is something that is in confidence between you and the doctor, not for general medical records.

In Australia once you have your letter of recognition from a registered medical practitioner then you can change your gender on your Medicare card (we have a universal health care system) and from then on any hospital and medical records will record your preferred gender identity.

[Eryn]

I've just received my “between visits” blood work. Everything seems to be where I want it with these results:

Basic Metabolic Panel: All in the normal range
Estradiol: 102 (down from 111)
Prolactin: 13.8 (down from 21.8, definitely good news)
Testosterone: 14 (up from 12, but still a trivial amount)

I'm pretty happy with these readings. My E has always seemed a bit low, but I am seeing good physical results. 100 is actually in the middle of the normal range for a GG.

I'll meet with my endo at the end of July for a regular checkup.

I'll be updating my measurement data soon and I will post it when it is ready!

Life is good! :)

[Mimi]

Tracking the measurements has been interesting. I've met the endo, and she seems very competent.

[Eryn]

It's been a while since I've posted data, so here is my measurement chart covering the last 19 months.

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The curves that are probably of most interest are the red curve (bust) and the yellow curve (underbust). The difference between them determines the prominence of the bustline. I started out with a bit under 2 inches of difference and now have 4-3/4 inches. It makes a difference in appearance and I am now definitely feminine in a light sports bra.

It looks like I will top out with a 40-1/2 inch bust, and I really didn't expect to do better at my age.

Unfortunately, the only bras that I can now wear are unconstructed sports bras. Bras with a 38 band size don't come with cups smaller than a B. I am supposedly a B cup according to most fitting charts, but I get lost in my pre-HRT 38-Bs when I try one on. They worked fine with forms, but the forms don't work well with my breasts.

I've been considering BA, but I don't want large breasts and I'm not sure if I can justify the costs for a just couple more inches of bustline.

The dark red curve is my hips which have grown more than my bust. I stared off with very little, so the difference really isn't noticeable in clothes.

Unfortunately, the green curve is my waist, which is growing more than I would like. Weight is an issue with HRT and I'm not too anxious to limit my food intake while I am still developing. Eventually, the tummy has to go, though!

[MarieTS]

Eryn, your numbers are encouraging and somewhat resemble mine, especially up top. I am trying to understand your bra issue. Ditch the forms. With those numbers I would think you'd be good. That is what I did and it works out fine at 38b, but I've found 36C to be better in certain style bras. It is so nice how the spiro/estrdiol reduced muscle and my corresponding band size, which gave my budding boobies seemingly more size.

As for the waist, you have to be brutal. Ditch the sweets and drink primarily only water.

Congrats on your developing figure! :-)

[Eryn]

I went into the lab for a blood draw today in anticipation of visiting my endo next week. I went in early because the draw for T has to be done before 9:00AM. My experience at the lab was pleasant, with my proper name and pronouns being used. As usual I checked to make sure the proper tests were scheduled as minor mistakes have been made in the past. Everything seemed to be in order and I was in and out within 15 minutes.

[Pat]

I went in early because the draw for T has to be done before 9:00AM.

Not to sidetrack the discussion too much, but why is that? I've never been given a time restriction on blood tests for T. Is it something I should have been aware of? (Oh, God, did everyone get the memo but me? :o )

[Heidi Stevens]

Believe it or not, I'm sitting in the OB/GYN office right now waiting to have blood drawn for my visit next week. It's also almost 11 am! I never heard of the "before 9" rule either?

[Eryn]

That's the rule with the lab I use. If they draw the blood after 9:00, they won't run a T test on it, period. Here's some insight:

https://www.trihealth.com/dailyhealthwire/miscellaneous/Checking-Testosterone-Levels--Why-the-Time-of-Day-Matters.aspx

Since most T tests are done on men with erectile dysfunction they want to test levels when they are highest, early in the day. It probably doesn't make a heck of a lot of difference with transpeople, but the system is designed for ED sufferers so if I want my numbers, I play their game. One time I found that my doctor hadn't entered my lab order and the 9:00AM deadline was looming. Luckily, the folks in the lab know me and since I knew what would be ordered they drew the blood before they tracked down the doctor to straighten out the order.

I received my BMP results today, all normal as usual. Still waiting on E, P, and T.

[jentay1367]

Hi Eryn,
So is that insinuating that t levels go up while were asleep? That would certainly explain the morning problem that occasionally pops up. I thought t levels were static.
If thats so I guess it would be best to have my test done b4 9. Maybe it would be more efficacious to take the spiro right before bed. Or even wake at 3 am and take it?

[Heidi Stevens]

My test was about 11:15 this morning. Every thing is looking good to me, but I'll see what the Doc says on Tuesday.
Here's the graphics on my 21 months on HRT. Latest are E at 160 and T at 10.
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[JessiFoxx]

Beautiful story Eryn, I too just saw my Endo today and while no blood was drawn it was great to meet with her and discuss the process. I'm on Spiro (3 weeks) now. I just need my therypist to sign off on starting the HRT. Hopefully at next weeks session.

Eringirl, I feel that I will be on the same boat soon as yours as my wife years ago told me she wants no part of living with another woman. But now that I am getting serious about transitioning I still need to sit down with her and have the real "talk". It sucks but I still love her deeply.

[Mimi]

It's been really interesting seeing the changes. We'll be taking another set of measurements soon.

[Eryn]

As promised, here are the latest measurements. They have really settled down and, unless I get another growth spurt, it seems that what I see is what I'm going to get. I'm not too disappointed considering my age.

The red curve is the bust trendline, which seems to be of the most interest. However, the apparent bust is actually the difference between the bust (red) and rib cage (yellow) trendlines. That difference has gone from 1.75 inches to nearly 5 inches, a considerable improvement that looks feminine even without forms. My old forms don't fit comfortably any longer as their backs are flat. I use add-a-size enhancers when I want a little more bust.

This is about two year's worth of data and I'm amazed that the time has gone by so quickly!

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[Kate T]

Hi Eryn,
So is that insinuating that t levels go up while were asleep? That would certainly explain the morning problem that occasionally pops up. I thought t levels were static.
If thats so I guess it would be best to have my test done b4 9. Maybe it would be more efficacious to take the spiro right before bed. Or even wake at 3 am and take it?

Testosterone levels in humans are diurnally variable typically with peaks at around 1-3 hours before dawn probably due to FSH and LH inductions via the pineal gland which detects and assesses light. This is likely an evolutionary construct as the increased levels of testosterone slightly increase alertness and activity level in males.

[Eryn]

Things have been going smoothly for me medically. Pills twice a day and a new patch each evening. My endo visits are mostly "nothing to report" and most of our communications are about renewing prescriptions. I can get three months at a time, but I had to change health plans and Anthem drags their feet even in trans-friendly California. The more they question, the more patients give up and that's money in the bank to them.

[jentay1367]

For whatever its worth, Anthem has turned down everything that submitted. I live in Missouri and they've made it quite clear that if I want any kind of compensation from them, a lawsuit would be my only recourse. Consequently, I'm not willing to throw good money after bad while residing in this crappy little redneck State.

[Eryn]

After asking about a few other mature transwomen's physical development it seems that my results are probably the least of the group. Such is the luck of the draw!

[Mimi]

Unfortunately many of us GGs also deal with development that is less than what we would like it to be. Hence the breast augmentation business is alive and well for GGs and TGs alike!

[Eryn]

I've had smooth sailing medically. All my levels have been in the groove and my endo is happy.

My body changes pretty much ceased a year or so ago. Not as much development as I wanted, but that's to be expected when adolescence takes place at age 58

I was pleasantly surprised that my latest 3-month supply of patches and Spiro were shipped without Anthem delaying the refill. I'm not sure that they convinced that the meds are appropriate, but at least they did a good job this time.

I'm also pretty happy with Costco's mail order pharmacy. On my last refill they automatically called my endo to get the prescriptions renewed! My box of GD relief arrived right on schedule!

[susie evans]

Eryn
Glad things are going well for you thanks for the up dates wishing you the best
Susie

[Devi SM]

Eryn,
It's been 2 years since you began this thread and your hrt.
Interestingly I'm 58 too and have my first endocrinologist appointment this coming Monday.
I don't expect great changes it may be in the psychology in my mind I could feel better with myself.
I thank you for this thread and id you're interested a out my journey I just open a new one here with my first endocrinologist appointment asking advuce.