The Day Is Here

I was scheduled to see the Endocrinologist on the 11th of this month however they contacted me today said they had a cancellation and asked if I could come in tomorrow. Well of course I said yes. Now I'm having second thoughts and really stressed out. I don't know if this Endo has any experience with transgenders and HRT. I have been seeing a therapist and she was supposed to have my referral ready by the 11th but since my appointment got moved up I was unable to contact her.

I'm really just going in there blindly and may just ask about informed consent, I don't know what a referral letter really does. I am so nervous, I guess I just need to be up front and say I want to start low dosage of HRT and tell him what dosages. I have been doing a lot of research and have figured out pretty much what I want. I just hope he does't think I'm crazy.

Oh well I'll see how it goes and hopefully I won't walk out embarrassed and humiliated :straightface: Any suggestions would be helpful..

From my one and only experience the referral is usually dependent on the doctor, some won’t need it but some won’t prescribe without it. Texas can be a funny State for sure.
Just FYI, I never began my meds as I decided it wasn’t for me and I’m good just being myself without them
Wish you well Veronica

Veronica, You may have preconceived ideas of how the appointment will go but it may be different. As far as knowing what you want the doctor may prescribe something different or in different dosages. My advice would be to go and ask questions and let the conversation go from there. Learning something is always good.

A little more research is probably in order. In some systems, particularly where private health insurance makes the rules, caregivers are often placed into the gatekeeper role, and may insist on the letter. Other caregivers may adopt a standard of care with similar requirements. At the other end are caregivers who will prescribe just about anything a paying customer might ask for.
It is not at all out of line to ask questions clarifying expectations, yours and theirs, prior to the visit.
My opinion, FWIW, is that the pursuit of HRT is an undertaking far more significant than is commonly acknowledged here. It's effects, and side effects, go well beyond the often romanticized feminizing effects. For those that truly need that kind of treatment to maintain their well being, there are well documented indications that should be present before such treatment is prescribed. I'd make certain that it's what I really needed before proceeding. It's not that hard, and certainly should not be viewed as an untoward requirement.

How do you propose that one be certain that hrt is what one really needed?

Veronica did you do your research on this doctor before picking them to know for sure they are trans friendly? My doctor told me she prefers to have a referral letter but no one knows one self deeper and has thought about it more than the one that wants to get on HRT. It’s not like cis people are lining up to get on HRT just for fun. If someone’s physical health permits it, they should be able to get on hormones and if it doesn’t help or improve that persons well being and GD, then they will also know it.

If this doctor is not supportive at all and it was a failure, don’t give up. Ask your local trans friendly groups where they get their hormones at and make an appointment to see that doctor. Doctors may not be able to tell anyone else about your visit, but there are still doctors out there that might let their biases, ignorance, and predjudices get in the way of what you truly believe deep inside that you need.

Go to the appointment with an open mind and low expectations. If nothing else there is the possibility that some blood work will be started and you will at least have that information available for another doc to see should this one not work the way you hope. But go is my advice. All too often we begin to make progress and let something either stop or divert us and it take the one resource we only have so much of, and that is our time.

Please insist that your treating endocrinologist has had experience with transgendered persons. If the answer is none or one or two, say thank you and leave. The first question after the meet and greet should be how many transgendered persons have you treated. Best of luck.

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Originally Posted by Nikki_P

How do you propose that one be certain that hrt is what one really needed?

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A most valid question. It would be easy toss out a glib suggestion to pursue therapy, but there's often more to it than that. On the other hand, there are those of us who've never had a doubt.
We're all different and I can only speak with authority on what it took for me. What it took was being honest with myself about gender identity. I had danced around it for years, but it took a skillful therapist to get me to say the word transsexual in relation to myself; to admit that my failure to recognize my real nature was costing me in other ways. The whole story is long, rather more complicated, and mostly beside the point, which is... It took the assistance of a professional to make that leap. She didn't lead me there, she merely held up a mirror, so to speak. When I had looked at it long enough, there was no escaping the truth. It could have gone the other way, but I would still have only been as certain by doing the work that got me to be fully honest with myself.
Wow... That's a long-winded way of saying that however one gets there, "there" should be a knowing that, stripped of all romance or rationalization, acknowledges the commitment one is making and thereby is even more resolute.

Veronica, if I understood right today is 7th and you're appointment is done, so how was it.
I was confused about your request for a low dosage. Why? What are you looking for getting into HRT?

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Originally Posted by Nikki_P

How do you propose that one be certain that hrt is what one really needed?

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How can anyone ber certain? All i can say is make sure you do as much research as possible yourself and do not rely 100% on what your doc may tell you as they may possibly know less on the subject than you do. Dont be afraid to speak up if the doc tells yoi to do something yo dp not feel comfortable with or know it is no right.

I agree with Kas. Even though my endocrinologist works with TG/TS community- he understands that different people have different goals when it comes to transition. So he can offer many options, in my case I was the one stating what I felt I needed and he either approved it or offered a better approach. For example, I didn't want spironolactone, and he didn't insist. But I am sure he has patients who are on spiro. I preferred to do my own research as much as I can and used him as overall authority.

I am a bit concerned about the concept here of how can anyone be certain that HRT is what one really needs and about starting with low doses because of a lack of certainty that this is what you really want. As Aunt Kelly says, hormones are serious business and should not even be considered unless you are 100 percent certain that this is what you need and want. There should be no room for doubt. If you have doubt hold off on the hormones until you are sure.

I agree - HRT IMHO should be after you are certain that you want to transition. In most cases I think it would be after time with a therapist but if someone is certain that they don't want to work with a therapist you should be certain about transition.

If your path is not clear to you taking hormones is only going to potentially make things worse. You don't want to be a small breasted male. YUCK. Not to mention other issues such as fertility - emotions -etc. Taking low dose HRT before you are sure is not a good plan.

In a perfect world 100% certainty would be ideal, but life is stingy with those 100% certainty events. and while one can be waiting for that absolute certainty, time marches on. sometimes you gotta jump.

There are no rules that state you can’t stop if it’s not for you...only there might be irreversible changes if one waits too long to stop.

I would say that one must be of sound mind, understand the reality of and be able to articulate the changes that are likely to result from hrt, and have a plan in place to deal with them. One should also understand the possible side efffects, including death.

I absolutely believe there can be a real physiological effect that reduces GD that results from taking E or reducing T or the combination of both, for some trans people. I do not believe this a placebo effect from taking steps or moving forward; though i suppose their could be for some people.

I also don’t think one must be committed to living as a woman before taking E and/or blocking T, as long as paragraph 2 above has been satisfied. There are people that never socially transition, people that live bi-gender, and people that may extend the transition timeline over many years, amongst other many variations of being trans and seeking medical intervention. do what works for you.

I respectfully disagree, but that is a good thing about a discussion - those reading can decide which opinion sounds right for them.

I am all for doing what makes you happy that is what this is all about = and sometimes life or you change but taking hormones does have effects = sometimes permanent. At the end of the day everyone has to make their own choice.

I find it worthwhile to continue to stay on this site and contribute because we can have actual adult discussions that are respectful and don’t devolve into interweb arguments and name calling. Thanks for being a part of that Kym. :)

hope that all went well during your visit Veronica...

To each her own, of course, But my opinion (one which is grounded in understanding the importance of considering all of the indications, contraindications, effects, side effects and risks of any given course of therapy) is that pursuing HRT, without being certain of the motivation and goal, is dangerous folly. Don't get me wrong. I have nothing against dangerous folly. For most of my life, my idea of fun involved lots of adrenaline, but courting the kind of serious long term risks involved in HRT, just to have one's own set of tiny boobs, only makes sense if one is really headed for transition. There's just not enough adrenaline, or whatever the payoff, to be worth the risk otherwise.

Where did anyone write their motivation for hrt was to develop a tiny set of boobs?

Thanks for the acknowledgment Nikki - right back at ya :hugs:

On this point I have to agree with Kelly regarding it being folly - but I have done lots of things in life you could call worse than folly - outright stupid.

I still standby my opinion that HRT should be for those that want to become as close to the opposite sex as possible but hey if you want to take goofy chances - you are an adult - but you have been advised otherwise.

Nikki, I'm in a group on kik chat and when they knew about my transition, several talked me about natural alternatives to develop boobs, hips and butt. One of them began at the same time as me. All the time shows me pics to compare before and after but honestly I don't see changes at all. When I asked about his purpose told me that look just for some enhancement as a woman but no ready for transition yet because his wife would kik him out of the house and the divorce desicion for financial would be very adverse for him that makes more money.
I don't know if those natural supplements really works. They say are stronger than hormones, so my question is how they manage to want something as look as a woman but not transition for the sake of keep being a man, and take something more stronger or effective but without any medical supervision....

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Originally Posted by Nikki_P

Where did anyone write their motivation for hrt was to develop a tiny set of boobs?

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Sorry, I did not mean to suggest that anyone in this thread said as much.
Nevertheless, that IS a commonly stated goal in this forum. No, not in so many words of course. The fantasy that one will beat the incredibly long odds and develop a luscious set of c cups, with HRT alone, clearly persists, and that goal, boobs, is often given as the primary reason for pursuing HRT, and almost as often, to the exlusion of any reasonable consideration of risk vs benefit.

One of the therapeutic reasons to take cross sex hormone therapy is for the mental relief from gender dysphoria. And it can be very effective. To the extent that there are blogs, forum topics, and hormone faqs that warn that for mtf tg people, stopping hormone therapy almost always results in the return of the dysphoria.

https://www.tapatalk.com/groups/cros...man-t1717.html

See item 6 in the following link: http://www.avitale.com/FAQ.htm#category%206

Nikki - I didn't even read the link - I do agree with you on that point because I have read it elsewhere that for some people it is therapeutic emotionally / mentally. However I also agree with Kelly that many people have 'messed up' ( just my opinion ) reasons for doing it.

IMHO there needs to be a specific goal for doing it that is seriously considered and preferably under medical supervision. As usual in my life I come down riding the fence. Some people see things in black and white - I only see shades of gray. Black and white sounds easier. LOL

Nikki I respect your opinion but I still disagree about the use of HRT until you are certain that need to transition. I agree that HRT can work wonders for dysphoria but not sure at what dose is required for the positive effects to be experienced as opposed to a placebo effect. However, the distress when you are a man with female breasts and the stress of worrying about being discovered has to outweigh the benefits especially if you are dealing with minor dysphoria, that is, dysphoria at a level where you do not feel the need to transition. But I am not an expert in the field, neither a psychologist nor an endocrinologist. I am, however, someone who has found herself in the position where I had to transition. It was not a choice or something I ever had to think about. It really felt like I either do this or I do not know how to get through the rest of my life.

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Originally Posted by Sara Olivia

I am, however, someone who has found herself in the position where I had to transition. It was not a choice or something I ever had to think about. It really felt like I either do this or I do not know how to get through the rest of my life.

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This is exactly why I believe in a gender spectrum. To Sara it was a 'have to' for me it was I have always wanted to and if I didn't I would have always regretted it. I could have made it another 5 10 or 20 years without doing it but I would have felt empty. And for those of you that are NB or in that neighborhood of the spectrum it is a thought, a consideration or maybe even not that.

As I always say - just know who you really are and then live it.

I know it's off topic but reading Sara's post just reminded me of the confidence I have in this opinion.

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Originally Posted by Vanessa Grandy

I don't know if those natural supplements really works. They say are stronger than hormones, so my question is how they manage to want something as look as a woman but not transition for the sake of keep being a man, and take something more stronger or effective but without any medical supervision....

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Natural supplements do nothing besides placebo effect. They are NOT stronger or more effective than HRT. Dont listen to those silly people.

Finally got some time to give an update on my Endo appointment. I did go and it turned out he has experience and has treated several transgender patient's. After visiting with the nurse and explaining why I was there, I was really nervous and she could tell. So she proceeded to make me comfortable and put me at ease. After several minutes the Dr. came in sat down right in front of me and looked straight into my eyes and said, well tell me how long have you felt this way. I told him what I had to say and that I had been seeing a therapist he asked for a referral and we proceeded to talk. I told him the therapist and I had discussed about starting HRT. Then he starts telling me you do know you have to live as a woman full time for a year and after that you can think about SRS and have you thought about that.

At that point I told him I did not plan to have SRS or live as a woman, he said then why do you want to start HRT, I said I need something for Gender Dysphoria. So we proceeded to talk and took me by surprise and said I need to check your testicles, we do this to document size as they will shrink. I did not know I was going to have to cough. After all that he said I need you to continue to see your therapist and I'm going to give you some documents to read about what to expect, also give you an order request for some labs and I will see you in 3 months. He also talked about what he would start me on which is sipro and estrogen.

Well in a nutshell that's how it went down, I have not gone to get the labs done yet and I'm not sure I will. I'm starting to have second thoughts after reading all the comments and trying to really dig down deep as to why I'm doing this. Like I said my goal is not to live as a woman or have SRS. Also a comment was made about about growing breast, I never mentioned anything about growing breast and this is not the reason for me to do this. I could care less about growing breast and really don't expect much. So I need to sit down and reevaluate this.

At a very young age I used to fantasize about being a woman and what it would be like so I know there is something there but at this point in my life I could not live as a woman or come out to family and friends. My wife is the only one who knows and is very supportive.

Sorry I did not post sooner just got caught up with life and work. Thank you for all the comments!

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Originally Posted by Aunt Kelly

To each her own, of course, But my opinion (one which is grounded in understanding the importance of considering all of the indications, contraindications, effects, side effects and risks of any given course of therapy) is that pursuing HRT, without being certain of the motivation and goal, is dangerous folly. Don't get me wrong. I have nothing against dangerous folly. For most of my life, my idea of fun involved lots of adrenaline, but courting the kind of serious long term risks involved in HRT, just to have one's own set of tiny boobs, only makes sense if one is really headed for transition. There's just not enough adrenaline, or whatever the payoff, to be worth the risk otherwise.

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Never mentioned anything about boobs or trying to grow boobs, I could care less..

Hi Veronica,
Your first visit to Endo is nothing like mine. If this doc is all you have, then you don't have a choice and do the best out of it. Otherwise, I will look for another.
I don't live full time. I don't want SRS. Yet, my endo didn't make this ridiculous comments. Checking the size of the testicles? That's just strange. Lab work make sense but why to wait 3 months?
This endo clearly is behind the curve when it comes to treating transgender patients.
Katya