FTM's and Transitioning

[Ebon]

Did anyone go to the doctor and ask to be put on T without needing a letter from a therapist? If so did they just put you on T or did you have to do some tests first and wait for the results? Can the doctor say no is what I'm asking. Also did anyone have issues with hbp and was still able to take T?

[Thinker]

Originally Posted by Ebon

Did anyone go to the doctor and ask to be put on T without needing a letter from a therapist? If so did they just put you on T or did you have to do some tests first and wait for the results? Can the doctor say no is what I'm asking. Also did anyone have issues with hbp and was still able to take T?

Hey Ebon...

I started without a letter from a therapist. I had a letter in my possession, but the doctor never asked. That damn thing is still sitting...sealed......in a file folder.

I started with a guy in DC who had a lot of exposure to the MTF community there. I think he had gotten to the point where he was pretty comfortable making that decision for himself after a couple of visits with the patient.

I don't recall the specifics, but I am almost certain he went through a laundry list of labs before I started. I remember that I did not get my prescription until around my third or fourth visit; even then, I started on a very low dose of a transdermal patch. We both wanted to ease into it slowly since I have a history of migraines that were often triggered by hormonal changes. I started injections after about 3 months, I think.

I did not have a history of high blood pressure, but I did see changes once I started on T; it was high almost always. After about a year or so, that was no longer an issue.

A doctor can certainly say no. Finding a doc who, like mine, is very familiar with the trans community and our issues/obstacles with health care is pretty important.

[Ebon]

Originally Posted by Thinker

Hey Ebon...

I started without a letter from a therapist. I had a letter in my possession, but the doctor never asked. That damn thing is still sitting...sealed......in a file folder.

I started with a guy in DC who had a lot of exposure to the MTF community there. I think he had gotten to the point where he was pretty comfortable making that decision for himself after a couple of visits with the patient.

I don't recall the specifics, but I am almost certain he went through a laundry list of labs before I started. I remember that I did not get my prescription until around my third or fourth visit; even then, I started on a very low dose of a transdermal patch. We both wanted to ease into it slowly since I have a history of migraines that were often triggered by hormonal changes. I started injections after about 3 months, I think.

I did not have a history of high blood pressure, but I did see changes once I started on T; it was high almost always. After about a year or so, that was no longer an issue.

A doctor can certainly say no. Finding a doc who, like mine, is very familiar with the trans community and our issues/obstacles with health care is pretty important.

Thanks for the info.

[Liam]

Originally Posted by Ebon

Did anyone go to the doctor and ask to be put on T without needing a letter from a therapist? If so did they just put you on T or did you have to do some tests first and wait for the results? Can the doctor say no is what I'm asking. Also did anyone have issues with hbp and was still able to take T?

According to the new standards of care for transgendered and gender non-conforming people, "an assessment is still required, but it can be done by the prescribing hormone provider."

Yes, labwork must be done, and yes the doctor can say no.

Nadeest started a thread about new standards:
http://www.butchfemmeplanet.com/foru...ead.php?t=3914

She also posted this link:
http://www.thegavoice.com/index.php/...forming-people

[DapperButch]

Originally Posted by Ebon

Did anyone go to the doctor and ask to be put on T without needing a letter from a therapist? If so did they just put you on T or did you have to do some tests first and wait for the results? Can the doctor say no is what I'm asking. Also did anyone have issues with hbp and was still able to take T?

Ebon, read this:

http://www.thegavoice.com/index.php/...forming-people

I am not certain when version 7 Standards of Care go into effect, but they came out 2 weeks ago.

What you need to know:

In version 6 (updated 2001), you had to have one letter from a therapist (of any graduate degree who worked with trans individuals), say that you should be able to receive hormones. You also needed one letter for top surgery.

NOW, although an "assessment" is needed to determine if one needs hormones, the doctor who is prescribing the hormones can do the "assessment". It no longer has to be a therapist.

I would suggest that you call all of the endocrinologists on your insurance list to see if you can find one who works with transpeople. If you find one who does, ask if they know/let them know, it can now be done without a therapist letter and see what they say.

An endocrinologist has a greater knowledge base than a primary care physician about, well, the endocrine system. :-)

Obviously, if you know anyone in your area who has transitioned, contact them to see who they go to.

Good Luck

ETA: Also see: http://www.wpath.org/documents/Stand...11%20WPATH.pdf

Here is version 7 Page 33 talks about criteria to receive hormones.

[Linus]

Originally Posted by DapperButch

Ebon, read this:

http://www.thegavoice.com/index.php/...forming-people

I am not certain when version 7 Standards of Care go into effect, but they came out 2 weeks ago.

What you need to know:

In version 6 (updated 2001), you had to have one letter from a therapist (of any graduate degree who worked with trans individuals), say that you should be able to receive hormones. You also needed one letter for top surgery.

NOW, although an "assessment" is needed to determine if one needs hormones, the doctor who is prescribing the hormones can do the "assessment". It no longer has to be a therapist.

I would suggest that you call all of the endocrinologists on your insurance list to see if you can find one who works with transpeople. If you find one who does, ask if they know/let them know, it can now be done without a therapist letter and see what they say.

An endocrinologist has a greater knowledge base than a primary care physician about, well, the endocrine system. :-)

Obviously, if you know anyone in your area who has transitioned, contact them to see who they go to.

Good Luck

ETA: Also see: http://www.wpath.org/documents/Stand...11%20WPATH.pdf

Here is version 7 Page 33 talks about criteria to receive hormones.

To add what Dapper posted, this seems to vary from state to state/province to province and city to city. In NYC I didn't need a letter from a therapist. I ended up having a 30 min interview with a social worker and that was it. Even then it wasn't really required as the doctor, who specialized with gender variant people, was already ok with my decision. Part of this has to do with age, life status and the experience of the doctor themselves.

Now, I will say, that prior to this I had done about 9 months of a support group so a lot of the self-exploration that is often a requirement I had done.

[Thinker]

Originally Posted by Linus

Part of this has to do with age, life status and the experience of the doctor themselves.

Yes, yes, yes... Well put.

[DapperButch]

Originally Posted by Linus

To add what Dapper posted, this seems to vary from state to state/province to province and city to city. In NYC I didn't need a letter from a therapist. I ended up having a 30 min interview with a social worker and that was it. Even then it wasn't really required as the doctor, who specialized with gender variant people, was already ok with my decision. Part of this has to do with age, life status and the experience of the doctor themselves.

Now, I will say, that prior to this I had done about 9 months of a support group so a lot of the self-exploration that is often a requirement I had done.

I was speaking to WPATH's Standards of Care. It is not a state thing, and yes, any doctor can ignore WPATH's reccomendations for hormones or any type of surgery.

[Linus]

Originally Posted by DapperButch

I was speaking to WPATH's Standards of Care. It is not a state thing, and yes, any doctor can ignore WPATH's reccomendations for hormones or any type of surgery.

It's funny. I didn't know that there was a Standard of Care or that WPATH existed until after I started to medically transition. I always thought that the Hippocratic Oath was enough but learned, as part of this process, that there is far more than just what I believe and feel I need. I would say that the best resource I had for all this stuff was Hudson's FTM Guide.

I'm glad that the standard is there. I do believe it's for those who are doing it for "fad" or because someone told them to do this. I think the challenge is because not all physicians can distinguish between the someone who really is a transsexed individual versus someone who doesn't really know and is doing this for the wrong reasons.

[The Oopster]

Originally Posted by Ebon

Did anyone go to the doctor and ask to be put on T without needing a letter from a therapist? If so did they just put you on T or did you have to do some tests first and wait for the results? Can the doctor say no is what I'm asking. Also did anyone have issues with hbp and was still able to take T?

Originally Posted by Thinker

Hey Ebon...

I started without a letter from a therapist. I had a letter in my possession, but the doctor never asked. That damn thing is still sitting...sealed......in a file folder.

I started with a guy in DC who had a lot of exposure to the MTF community there. I think he had gotten to the point where he was pretty comfortable making that decision for himself after a couple of visits with the patient.

I don't recall the specifics, but I am almost certain he went through a laundry list of labs before I started. I remember that I did not get my prescription until around my third or fourth visit; even then, I started on a very low dose of a transdermal patch. We both wanted to ease into it slowly since I have a history of migraines that were often triggered by hormonal changes. I started injections after about 3 months, I think.

I did not have a history of high blood pressure, but I did see changes once I started on T; it was high almost always. After about a year or so, that was no longer an issue.

A doctor can certainly say no. Finding a doc who, like mine, is very familiar with the trans community and our issues/obstacles with health care is pretty important.

Originally Posted by Ebon

Absolutely agree 100%! I have researched this other stuff and I do appreciate everyone's input, but I was looking for more of other people's experiences rather than information that I already had. Thinker (and now I know why you have that name) I am exactly the same way. I am in my body no one else is. This is my life I have to deal with any consequences of any decisions that I make. I have to walk my own path. I don't need someone else telling me when I am ready to do something and when I'm not. The only reason it's taken me this long is because of the whole going to a therapist that probably isn't even transgendered that is going to tell me if they think that I'm ready. I only recently found out that quite a few guys didn't even need to go to a therapist. The medical aspect I understand but when it comes to my emotions and my body it's up to me.

Thanks again everyone for your input.

Ebon

Originally Posted by Thinker

The EXACT same thing was true for me, Ebon.

I totally get that...and respect it.

You can do this your way; it's just a matter of finding the right doctor.

Originally Posted by Linus

It's funny. I didn't know that there was a Standard of Care or that WPATH existed until after I started to medically transition. I always thought that the Hippocratic Oath was enough but learned, as part of this process, that there is far more than just what I believe and feel I need. I would say that the best resource I had for all this stuff was Hudson's FTM Guide.

I'm glad that the standard is there. I do believe it's for those who are doing it for "fad" or because someone told them to do this. I think the challenge is because not all physicians can distinguish between the someone who really is a transsexed individual versus someone who doesn't really know and is doing this for the wrong reasons.

I was also hesitant about doing what I needed to take care of my body the way I saw fit and having it have to be approved by a therapist. I'm not against therapy. I have done therapy for areas of my life that needed it but by the time I was ready to make changes there was no need to brood it over with a therapist. However my path was slow. I used other avenues of support to come to my decisions. If anything I'm the type of person who needs a prod at doing something versus doing first and thinking second.

In fact I even feel life gave me the prodding. My T levels were low. So my normal physcian put me on the cream. I had other health issues and actually the higher my T level went on the cream the stronger I seemed to get. After a couple of years of this I was as high as the cream could go and be effective. At this point I already had 2 jobs that accepted me as male. Again another prodding by life. The first job my boss wondered, asked his therapist what he should do, and his therapist said to just ask me. From that point even though my government id still has the "F" my jobs have let me be Koop. The second job was funny because they started out calling me she, I rarely saw the people and it just wasn't worth going into but by the time I left everyone called me he. They figured it out. The only reason they called me she is they had seen my gov't id and knew. They realized all the clients didn't see my id so they didn't know and they called me he. In fact it's cool cause my id for that job has koop on it. It actually helped me get my mail at the post office. The guy was hesitant, and I said if you had this name, my birth name, would you want anyone else to know it? hence if somebody mails me something it's going to say Koop. "He said, you got a point, and let me sign for the package."

When it was time to go on the shots and to have my top surgery any of the drs I've seen just asked questions and could observe that I've been doing this for awhile and it's not a whim. I'm also in a recovery program and a lot of my self examination came through that program. If I wasn't i may have needed therapy. But I have changed in front of hundereds of people and again the professionals know that someone doesn't do that on a whim.

Now with that said there are drs here that are well established in the community that still expect that stuff, no exceptions. I chose not to go to those drs.

Now all the blood work and stuff I did have done and is monitored. That is important. It is also important to have it monitored by someone familar with ftm patients. My experience is everyone wants to blame every health issue that comes along with me on the T. Having a dr. who has dealt with lots of people I can get a proper assessment to whether that is a possibility or not.

[DapperButch]

Wow, Hudson's Guide has really expanded since I looked at it last! Yes, a great resource.

[J. Mason]

I am very glad this thread is around!

Now to get the ftm cock thread going!

[Thinker]

I never bought into the "standards" for my personal path. I always saw them as ways for doctors to tell you why they could NOT do something.....sorry, you'll need two letters and one year with a therapist.......nope, can't do that without a letter that says x, y, and z.

I am NOT saying the standards of care are a bad thing; I think they're a nice little framework. But I do feel as though they've been used to gatekeep by many physicians and therapists.

I consulted with a plastic surgeon for my top surgery long before I started testosterone. Truthfully, when I had that procedure done, I had no intention at all of starting T. This surgeon had done a number of chest reconstructions and felt comfortable talking with me and making that decision for himself. I appreciated that; my body, my decision.

The therapist I had seen off and on was there for me for life and relationship stuff.....not gender identity.....even though that obviously came up from time to time. When I did make the move to consult with a physician about hormones, I had my therapist there as a back up in case a letter was required. Again, the doctor made the assessment on his own.

I just never liked the idea of jumping through hoops for something that is so damn personal and life-changing and critically important. It's not that I don't value the input of professionals. I just believe that I know me, my body, my wants, and my needs better than any itemized list that tells me what I need to do first and for how long.

This is obviously just my 2 cents. I'm certainly not trying to talk anyone into or out of anything.......just offering up how it all came together for me with hopes that maybe one or two things I say might clear up someone else's fog.

This is heavy, important stuff. One might argue that rejecting the "standards" is indicative of taking it all too lightly. It was quite the opposite for me. It was so scary and so *permanent* that I just *had* to do it my own way.....a way that felt safe and right *for me*.

[Ebon]

Originally Posted by Thinker

I never bought into the "standards" for my personal path. I always saw them as ways for doctors to tell you why they could NOT do something.....sorry, you'll need two letters and one year with a therapist.......nope, can't do that without a letter that says x, y, and z.

I am NOT saying the standards of care are a bad thing; I think they're a nice little framework. But I do feel as though they've been used to gatekeep by many physicians and therapists.

I consulted with a plastic surgeon for my top surgery long before I started testosterone. Truthfully, when I had that procedure done, I had no intention at all of starting T. This surgeon had done a number of chest reconstructions and felt comfortable talking with me and making that decision for himself. I appreciated that; my body, my decision.

The therapist I had seen off and on was there for me for life and relationship stuff.....not gender identity.....even though that obviously came up from time to time. When I did make the move to consult with a physician about hormones, I had my therapist there as a back up in case a letter was required. Again, the doctor made the assessment on his own.

I just never liked the idea of jumping through hoops for something that is so damn personal and life-changing and critically important. It's not that I don't value the input of professionals. I just believe that I know me, my body, my wants, and my needs better than any itemized list that tells me what I need to do first and for how long.

This is obviously just my 2 cents. I'm certainly not trying to talk anyone into or out of anything.......just offering up how it all came together for me with hopes that maybe one or two things I say might clear up someone else's fog.

This is heavy, important stuff. One might argue that rejecting the "standards" is indicative of taking it all too lightly. It was quite the opposite for me. It was so scary and so *permanent* that I just *had* to do it my own way.....a way that felt safe and right *for me*.

Absolutely agree 100%! I have researched this other stuff and I do appreciate everyone's input, but I was looking for more of other people's experiences rather than information that I already had. Thinker (and now I know why you have that name) I am exactly the same way. I am in my body no one else is. This is my life I have to deal with any consequences of any decisions that I make. I have to walk my own path. I don't need someone else telling me when I am ready to do something and when I'm not. The only reason it's taken me this long is because of the whole going to a therapist that probably isn't even transgendered that is going to tell me if they think that I'm ready. I only recently found out that quite a few guys didn't even need to go to a therapist. The medical aspect I understand but when it comes to my emotions and my body it's up to me.

Thanks again everyone for your input.

Ebon

[Thinker]

Originally Posted by Ebon

The only reason it's taken me this long is because of the whole going to a therapist that probably isn't even transgendered that is going to tell me if they think that I'm ready.

The EXACT same thing was true for me, Ebon.

I totally get that...and respect it.

You can do this your way; it's just a matter of finding the right doctor.

[Ebon]

This is why I tried to go the natural way but it was taking too long. I have to go through all of this crap to align my body with my soul. Apparently the new standards of care don't mean shit.

[GPS]

Originally Posted by Ebon

This is why I tried to go the natural way but it was taking too long. I have to go through all of this crap to align my body with my soul. Apparently the new standards of care don't mean shit.

Its really hard doing the natural transitioning. you need to put your body first and in that instance you feel the slower end of the transition.

i have a very good friend that does it naturally for the most part, although he's finally on T. i think after top surgery you just seem to want to push forward and not feel "stuck" in that same routine.

good luck to you.