HRT or Breast Augmentation?

Ok, since I am having a ton of problems finding a local doctor who will prescribe me HRT (I found several, but none of them will return my call), should I just got with a breast augmentation? I mean, i really want to start HRT, but how can I when noone returns my calls? lol I did find a therapist 45 minutes north of me, so that's all set. I just have to find a doctor and find out how many therapy hours he/she requires.


Nevermind on this. I received a call back. I'm set to go. I see a doctor on July 29th, he'll go over hormones with me, prescribe me HRT that day and send me to a therapist of my choice. BIG, BANG, BOOM!

No matter what YOU THINK you want it doesn't work that way,, Sorry,, We all want instant gratification and instant results but this is not going to happen over night,, An I would be VERY afraid of any Doctor that would take you in for HRT OR Breast surgery without a mental health evaluation for an extended period of time to make sure your Transgender.

All of us Trans chix want to wake up in another body all our lives,, But this is not fantasy land,,lol,,, I am not being mean,, I am just telling you what the therapist you HAVE TO SEE FIRST is going to tell you. So get an appointment with a Gender therapist and start laser Face hair removal and get ready for a LONG RIDE SISTA !!!

Mackenzie,
As others have given guidance around is the need for therapy to help you determine if what you're experiencing is truly gender dysphoria, or simply an extreme case of pink fog. It is not up to any of us here to be able to assess that part of you. All we can do is provide sound advice and guidance on where you should go for help, and what others may have experienced, but YMMV.

If you are only dealing with pink fog, it will wear off, and when it does you're going to have to live with all of the rash decisions you seem to be making. You are definitely putting the cart before the horse, and I doubt you're going to find a therapist just chomping at the bit to sign off on your need for HRT, BA, or any other steps toward transition that need a letter.
You keep bringing up the concept of "how many hours" of therapy before you can do "X". To be honest, that is not how I have come to understand it to work. It's not a matter of hours. It's a matter of the therapist determining that these life altering medical procedures will in fact help you with a body that aligns more closely to the gender that you truly feel you are. There will need to be multiple sessions, a boatload of questions to be answered, and some difficult questions to be answered honestly.
Your behavior, as we see it by your posts, is extremely impulsive, and any decent therapist is going to tell you to cool your jets, take some time to seriously consider what you are looking to do, and come to a more objective decision.

Transitioning is not something that happens overnight, nor did a real need to transition happen that quickly. Any impulse decisions will ultimately lead to regrets, and possibly worse.

This doctor requires therapy, but I will go while I am on HRT. And yes, I know it won't happen overnight.

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Originally Posted by MackenzieNicole

This doctor requires therapy, but I will go while I am on HRT. And yes, I know it won't happen overnight.

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No,,No,, It don't work that way,, Sorry,, You have to bare your soul first,,lol,, If you are Trans they have ways of knowing. Maybe some places give out HRT freely but none of us here know where that is,, Maybe on the internet ? I wouldn't advise that,, That will just slow you down even more so.

There are tons of threads here about hormones,, Go back and read them and you will see. Good luck,,

I'm in Arkansas, Shasta. And I did call them back just to make sure what I heard and it was, so please don't set there and tell me that. Maybe your state is like that, but doctors here are NOT required by the state to have their patients be on therapy before starting HRT. Some doctors will require therapy before HRT, but some do not, and The doctor I am seeing doesn't require it, but will refer me to one WHILE i am on HRT. I also talked directly to HIS nurse, and she told me that they have transgenders all the time that come in, and 95% of them walk out with HRT prescriptions in there hand after the doctor goes over information, vital signs, etc. . . . .

Mackenzie, do not get your hopes too high. You are most likely seeing a licensed therapist. This person will NOT issue you a prescription for HRT with just one visit. Not in the state of Arkansas or any other State or Provence in the U.S. or Canada! I know you're anxious to get going, but this is one area where you can't shop doctors and get immediate gratifcation.
So be prepared to bear your soul to the therapist for a few MONTHS at the least. We all want you to be happy, but a licensed professional will not risk all that hard work to get that license over giving out drugs on demand.
A lot of us have been there, done that. We know the road that you must travel to find what is driving Mackensie. Good luck my friend.

I normally tend to shy away from the more controversial topics, especially when it seems like someone is already a little angry... It's certainly not my goal to irritate the situation, but I do have a few concerns about your post that I'd like to share: The first is right in the title... hormones and breast augmentation seem like they're being placed on the same playing field when, in reality, you're talking about 2 entirely different games. The other is that you seem willing to take on a hormone regimen WITHOUT prior therapy. This is just my opinion, so feel free to take it or leave it as you see fit, but I think the therapy SHOULD be an integral part of a more complete approach to gender transition.
However you continue along your path, I hope it works out well for you! I urge you to consider therapy prior to hrt, and also that you spend some additional time educating yourself about the sside-effects of hormones. I'm not personally on hrt, but I think most transwomen who are will tell you that it's not all sunshine and roses, and that there are some undesirable side-effects, especially if you value any "part" of being male.
Good luck!
-Jess

Mackenzie

At the risk of repeating what has been said before it does not work the way you would like it too. The issues you have are there for a reason. They are supposed to protect you.
You cant just turn up saying you want this or that. Its not wal-mart. HRT is a dangerous business some people cant take it for medical reasons.

Now if the Doctor is saying he/she will assess you for HRT then give you hormones subject to a therapist saying you need them then yes.

If that is not the case I would be very very careful.

You have indicated you have yet to step outside in the role of a female and you know that this is what you want for the rest of your life, huh? You say you can't go out in public because of your wife's job, how does you having breast augmentation not cause a similar problem? There are unscrupulous docs out there that will give a patient many drugs they shouldn't get. That doesn't make them good doctors! Read about the dangers of HRT. What effect will this route have on your ability to work? If your wife bails then what? The steps recommended came to be from previous lessons learned.
Any good therapist will read right through your charade and hopefully pull the pin on you for your own good.

You go girl. Book the breast augmentation now. Breast development from hormones is long term and
Usually marginal at best. You obviously can't wait that long.
Besides therapy is overrated. Any issues pop up I'm sure you'll handle them fine. Don't forget to bring your wife flowers for being such a great sport and fully supporting you in your transition.

Let me tell you about M2F HRT. It takes a very long time for breasts to develop. And whether you get decent breasts or not depends on your genetics. Apparently I get my breast size from my paternal grandmother. I have been on HRT for almost 4 years, and only in December did I get D cup breasts. And there are other effects - the body scent changes to that of a woman, body hair becomes a fine vellus, there is fat redistribution. There are effects with the male genitals - they get smaller, you have a more difficult time getting an erection, and the semen volume is greatly diminished.

I do feel much better with the HRT. I have been able to shake the chronic depression I have had for a long time. My wife has even told me she really prefers me on HRT. But everybody is different.

In Texas you do not have to go to a therapist to get on HRT since there is the informed consent model. All I can say if you don't like the effects of HRT I would say quit and don't keep on going. For the first three months the effects are reversible. For me is was one of the best things I have done in a long time.

I have decided to keep my masculine name and gender designation since just the HRT has satisfied me and I see no need to go beyond that step. I still have my deep bass speaking and singing voice.

John

Wow Mack you truly are all over the map here. If you are so determined there is nothing I can say to help but I wish you well on your journey. I hope you find what you are looking for.

The flowers are not a bad idea though, I am sure she will appreciate them.... :)

I can see this thread getting locked soon.
I can't pass judgement on how you do it but good luck.

It will Burn itself out ,,lol,, Like all the other ones do,, Like my Old Daddy used to say,, ( Yull find out,,lol,,,,) !!!

It may take a little time before you can convince your health care professionals to come on board with your desire to transition, but they eventually will. In the meantime, you may suffer. This is good, actually, because knowing how much you suffered before transition will help you deal with the challenges you will face later.

For good or bad, in NY state you can get a prescription for HRT without therapy, I know a few who even get them from their local Planned Parenthood which offer the HRT service for TSs (only a few do.)

Bear in mind there are health risks with any surgery, and breast implants do come with some risk. Better you not have to go through that if you don't have to. Few surgeons would do implants on a male without some kind of assurance from another professional too.

Mackenzie, there are transexuals who can't have HRT for a myriad of medical reasons. If your doctor is promising HRT prescriptions ahead of a full recommendation from a licensed therapist, he's a quack. More importantly, you don't seem to grasp the very serious nature of going on HRT. This is not popping tic-tacs. I think you have completely romanticized the process and reality will crush you.

See the therapist for several MONTHS. Come to understand what you are and what you need to do about it. You are headed for an epic fail.

Oh dear!
Well, since you obviously dont listne to good advice, here is some bad advice!

Signs that a Doc is a good choice for easy HRT:
- Doc doesnt speak english .. much!
- Sign outside office says "Number 1 Doctor for you Miss GI ... !".
- Nurse also administers free penecilin shots.
- Hotel next door rent rooms by the hour.
- For only $20 more, you get double dosis!
- There is a verbal guarantee you will have DD's in no more than 6 days! And whiter teeth too!

Did anybody tell you about how a blood cloth in your leg feels? Might want to check that out, it's a real blast.

Good luck to you, you are going to need it.

- Suzie

I actually found a doctor in columbus ohio that took blood, wrote a prescription for spiro and estradiol that day. Actually the first doctor I called.....Took 6 weeks to get in to see him, but c'est la vie.

There are doctors who will prescribe and monitor the HRT without a therapist.

Mine is one of them. He isn't concerned with the psychology as much as the safety and efficacy.

I personally think that Mack is making hasty decisions, but meh, who cares? She wants boobs I guess.

Word to the wise, if your goal is breasts than augmentation is the only sure way to get 'er done. HRT is a crapshoot.

Since there's so much incorrect information in this thread. Geez!

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Originally Posted by Heidi Stevens

This person will NOT issue you a prescription for HRT with just one visit. Not in the state of Arkansas or any other State or Provence in the U.S. or Canada! I know you're anxious to get going, but this is one area where you can't shop doctors and get immediate gratifcation.
So be prepared to bear your soul to the therapist for a few MONTHS at the least.

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Wrong. The only way the therapist is liable to make you do months of therapy before you start HRT is if they are trying to milk you for fees. In general, the doctors who want a letter from a therapist are looking for confirmation that you are capable of giving informed consent - i.e. that you aren't profoundly mentally ill, or otherwise incapable of making such a decision for yourself. At most you'll do a few sessions to document your gender dysphoria. (I've been crossdressing since I as 11...) Most places in the US seem to be moving to an informed consent model.

Out of all the trans people I've met, both people who did and did not transition, I've only met one who I thought wouldn't get a letter. They pretty obviously had dissociative identity disorder. That person also scared the hell out of everyone who dealt with them.

Most reputable gender therapists will give you a letter after a couple of sessions, provided this is what you really want, you are competent to decide this for yourself, and you seem reasonably sure you are ready to try this. It will probably take longer if you equivocate "gee, I think I might want to try hormones, but maybe not? Can I have an HRT letter?"

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Originally Posted by Jenniferathome

Mackenzie, there are transexuals who can't have HRT for a myriad of medical reasons. If your doctor is promising HRT prescriptions ahead of a full recommendation from a licensed therapist, he's a quack.

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OK, the first part is correct - there are medical conditions that would prevent a person from taking HRT. I've seen this before a number of times. The worst I've seen was a woman with a genetic defect that caused her to have massive embolisms when her estrogen level was elevated - it killed her mother. It was so severe that blood thinners apparently couldn't control it.

A therapist has nothing to do with any of that. I love my gender therapist. She rocks. She's helped me so much. But she has no competence to make the medical diagnosis that would argue against HRT. The prescribing doctor will do this after getting the letter from the therapist using - wait for it - a series of blood tests! Yes, amazingly enough, in this stupid process, we are finally getting to the point where a medical doctor who is being asked to prescribe physical medicine performs actual diagnostic tests. Whew!

The WPATH doesn't require absolutely require therapy for either MtF or FtM trans:

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Originally Posted by WPATH SOC

A number of community health centers in the United States have developed protocols for providing hormone therapy based on an approach that has become known as the Informed Consent Model (Callen Lorde Community Health Center, 2000, 2011; Fenway Community Health Transgender Health Program, 2007; Tom Waddell Health Center, 2006). These protocols are consistent with the guidelines presented in the WPATH Standards of Care, Version 7. The SOC are flexible clinical guidelines; they allow for tailoring of interventions to the needs of the individual receiving services and for tailoring of protocols to the approach and setting in which these services are provided (Ehrbar & Gorton, 2010).

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However, the therapeutic requirements if someone really insists on following the SOC v 7 are not so onerous:

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Originally Posted by WPATH SOC

The criteria for hormone therapy are as follows:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC outlined in section VI);
4. If significant medical or mental health concerns are present, they must be reasonably well-controlled.

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It shouldn't take very long to provide a persistent, well-documented gender dysphoria to your therapist. If your story doesn't at least suggest gender dysphoria, you probably don't need to be on hormones.

BTW, for breast augmentation, Mackenzie is probably going to need 12 months of HRT anyway:

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Originally Posted by WPATH SOC

Although not an explicit criterion, it is recommended that MtF patients undergo feminizing hormone therapy (minimum 12 months) prior to breast augmentation surgery. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic) results.

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This may not be an explicit requirement, but I don't know of a surgeon who will do a breast augmentation without at least 12 months of HRT. Although many of us don't develop much breast growth on HRT, some of us do, and if you are one of the lucky ones, you don't want implants in the way.

The mandated requirements are the same as for HRT:

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Originally Posted by WPATH SOC

Criteria for breast augmentation (implants/lipofilling) in MtF patients:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.

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There isn't a requirement for HRT - but most docs seem to follow the recommendation for it for MtF's.

By the way, for those of you who go "You mean someone can see a therapist for a couple of times, get hormones, and then 12 months later get implants? OMG, that's crazy!" should bear in mind that FtM's can, and often do, get top surgery (i.e. a mastectomy and nipple graft) with no HRT - just a recommendation letter from a single therapist that they've visited twice. They can do this rather quickly. I know someone who did this last month.

I would also recommend, highly recommend actually, that Mackenzie reach out to the local trans community - there is one in her state - and find the therapists and doctors who have a good deal of experience with the trans community and with administering HRT to trans people. I feel fairly certain that someone has given her pointers to the local trans community in her area.

In states like Texas and Arkansas, it is not surprising that it is difficult to find providers who will perform trans healthcare. Such providers are generally only in major metropolitan areas, and there are generally not many of them who will deal with us. Most medical doctors get NO training in HRT for trans patients, and are reluctant to prescribe stuff they don't understand well and have training on. Further, many medical providers don't want to deal with us at all - sometimes refusing care on a trans patient for routine medical issues that have nothing to do with the patient being transgender.

I know you are impatient MackenzieNicole, but please, please, please do your homework, and find people with experience. If the doc you choose isn't experienced with HRT, odds are, they will provide you with much too low of a dose to be effective - often on par with what they'd prescribe for a post-menopausal woman, which will be too low for you.

By the way, please don't think that my statements about the therapeutic requirements for HRT and stuff are anti-therapy. I've been seeing a gender therapist on a regular basis for two years, in addition to doing group therapy. Especially early on, I think a therapist can be invaluable to a successful transition. I'd highly recommend this for Mackenzie. I'd also recommend visiting a support group at least a few times.

One last thing. If a doctor doesn't call you back - try again before giving up. Some of the folks who'll deal with us do not run gigantic practices with large staffs.

BTW, why are you asking about this, Mackenzie, on the CD forum, rather than the trans forum? I love the girls here, but the level of knowledge about transition related medicine from everyone but those of us in transition is pretty low. No offense to my CD friends, but it really does help to have gone through this yourself recently.

Paula gave good advice but all I can really say is there is a progression. You can't hop scotch all around because you are impatient. HRT isn't benign. There are risks and side effects. Don't let anyone tell you it is easy.

So far I have seen posts from you that scare me because it seems you want it all now. That you are willing to side step medical professionals or find medical people who may not have YOUR best interests at heart.

What you do is up to you. I would really consider getting some counseling and get a road map of where you need to go. Endos can Rx whatever they want when they feel like you require that medication. I know no ethical doctor who will do it without knowing a lot more about you and your health first. It would be a malpractice suit waiting to happen, so most MDs will tread a careful line. WE in the medical field have ethics and oaths, the primary is "above all do no harm" they won't be Rxing anything until they are sure that is what you really need.

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Originally Posted by Lorileah

You can't hop scotch all around because you are impatient. HRT isn't benign. There are risks and side effects. Don't let anyone tell you it is easy.

So far I have seen posts from you that scare me because it seems you want it all now. That you are willing to side step medical professionals or find medical people who may not have YOUR best interests at heart.

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So I'm going to agree with Lorileah here to an extent. Here's the thing. I've gone through my transition thus far as fast as I've been able to do so, limited largely by resources and delays built into the system. I'm not quite at two years yet, and I live fulltime, work fulltime, I've legally and socially transitioned. I have medical stuff that lags because I was going through a nasty divorce last year, and because money and waiting lists are issues that I can't just make go away. I'll be at about 3 years from the time I came out to myself (as opposed to the few months that elapsed before I started transition) by the time I get GRS.

I was in a terrible hurry - I was desperate, miserable, and suicidal - I attempted suicide back in May two years ago. I have good reason to hurry. I'm still somewhat nervous about hanging in there until I get GRS - my dysphoria is BAD, and I'm getting above average results from HRT.

So believe me when I tell you that I understand your desire to get through this. I really get this.

But I would like for you to hear two things I'm going to tell you that concern me:
1. It's understandable that you want to hurry. But realistically, it's hard to go a lot faster than I have, and even if you could, you are still talking 18 months to two years. I know you feel desperate - I certainly did. But understand that it's going to take a little bit before you start to get real relief.

2. That said, the main thing that worries me for your sake is that you don't seem to have a plan. What happens if your marriage blows up and you get kicked out and you find you are unable to continue HRT? What happens if you get fired from your job when they find out you are trans? What I hope you'll do is take a little time and figure out how you'll transition if you lose support from your wife, family, and job. You probably won't lose all that - but you could - many of us in fact do.

I've just seen a lot of trans people get themselves into horrible jams because they didn't have even a rudimentary plan that allowed for anything to go wrong along the way. And things always go wrong along the way for us. I'm not saying you'll lose it all - some of us do, but most of us don't. But virtually all of us lose SOMETHING.

Think this stuff through. Get guidance. Get help. Make a plan. Then execute that plan as efficiently as you reasonably can.

Once again, PaulaQ said almost everything I was going to. There are LOTS of Doctors, and gender clinics who will prescribe on informed consent alone.
However, any time somebody starts a thread about 'Should I start HRT, or get implants' it SERIOUSLY makes me question their motives. Getting hormones cause you want breasts is totally wrong. Nowhere in your post does it mention being transgender, or feeling a need to transition. You will not be able to pick and choose the effects of HRT.

Before you get either, buy yourself a bra and a good set of breast forms and wear them all day, every day. Wear them to work, to the store, to the church. You will see what having female breasts is like and how people react to you. Do this for six months or more, then decide if this is where you want to go.

When I first found out that I'm diabetic the doctor wouldn't prescribe any thing for me until I changed my diet and had a lot of blood work done. The process is ungoing but originally it was well over a month before anything was prescribed.

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Originally Posted by Krisi

Before you get either, buy yourself a bra and a good set of breast forms and wear them all day, every day...

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To be more realistic to contemplate going on HRT, start gradually with a bra with small breast forms and gradually increase the bra cup size and breast forms.

With my gradual breast development I have had no negative reactions with my breasts which are at a D cup size. Only my wife as gone so far as to call me "Titty Boy".

John

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Originally Posted by JohannaH

With my gradual breast development I have had no negative reactions with my breasts which are at a D cup size. Only my wife as gone so far as to call me "Titty Boy".

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Well, ...um, with all due respect. I don't think there is any way a dude can walk around with D cup breasts'eses and not attract attention. I'm attaching a pic of me in a tank top and I'm a 38D.

I couldn't hide these things under a burka.

Attachment 247672

I have learned a lot from the members here and most of their opinnions are from hard won experience, although I like to let my mind wander and imagine what it would be like to be a full time woman right down to srs, I also fully realize from the members here that such a journey is long and sometimes painful both emotionally and physically

1. be careful of what you ask for you may get it and sadly regret it later .
2. as mentioned go slow the changes you are seeking are most likely gong to be permanent .

in your minds eye you may wish today for breasts , always a nice thought ,others here have suggested a bra and forms at least you can put them back in the box unlike the real thing once you have them and you regret your choice you are stuck with them , myself I have been told by my dr that I have gyneco mastia so I have some small ones thye may leave later as my weight is now reduced as to hrt there are many here who will tell you unless you are fully prepared to be a full time woman don't do it these are not to be played with and there is a very valid reason for them to be prescription . I wish you well on your journey and hope you make conservative well thought out choices so that it will be a positive change for you
hugs phylis anne

Hi Melissa,

I have to win the Battle of the Bulge in order to have such a nice figure as you have. I have to lose about 35 lbs to look as nice as you do. And that is my goal!

And yes, I am starting to attract attention. I was buying cigarettes for my wife and spoke to the clerk with my deep masculine voice. I still got ma'amed by the clerk. I do attract attention, but I don't feel that it is negative.

Now it is very interesting when I go to a men's restroom to relieve myself. Some dude who has not seen me use the urinal might look at me then look at the sign on the restroom door. And then I tell him in my bass voice, "This is the men's room". This has happened a number of times. But the strangest situation was when there was a couple in front of the restrooms. The wife saw me coming out and started to go in the men's restroom, while her husband was approaching the women's restroom. I had to call out, "This is the men's room".

John

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Originally Posted by Alexandria Lynne

Ok, since I am having a ton of problems finding a local doctor who will prescribe me HRT (I found several, but none of them will return my call), should I just got with a breast augmentation? I mean, i really want to start HRT, but how can I when noone returns my calls? lol I did find a therapist 45 minutes north of me, so that's all set. I just have to find a doctor and find out how many therapy hours he/she requires.


Nevermind on this. I received a call back. I'm set to go. I see a doctor on July 29th, he'll go over hormones with me, prescribe me HRT that day and send me to a therapist of my choice. BIG, BANG, BOOM!

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Sometimes I wish I had real boobs (especially for sexual purpose). But when I'm "asexual", i no longer want them and prefer to just wear breast forms when I crossdress.