FTM's and Transitioning

[Greyson]

Originally Posted by atomiczombie

I have decided not to go back on T. The side effects were more stress than I want to deal with, and after my chest reconstruction I am much happier with my body. So this is as far as I am going to go. I am very much at peace with this decision, because thinking about going back on the T, even for a short while, stresses me out.

Drew, it was good to see you at the Diva Luncheon. I did not see your above post until after the lunch. T does not make the person who you are. I am pretty sure most of us know what is on the inside is the measure of who we really are. Take care.

[Leigh]

I certainly agree with Greyson, I'm taking T and the dosage will be incrased starting today but that certainly doesn't make Me who I am ~ things like My personality, My likes and hobbies, interests etc do!

Your awesome just as you are Drew :-)

[atomiczombie]

Originally Posted by Matthew

I certainly agree with Greyson, I'm taking T and the dosage will be incrased starting today but that certainly doesn't make Me who I am ~ things like My personality, My likes and hobbies, interests etc do!

Your awesome just as you are Drew :-)

Thanks Matthew!!!

[Logicaly]

So I had a 3 month checkup yesterday. I have been on T for about 6 months now. My good cholesterol has gone up a little bit, my bad cholesterol is still higher than what the doctor wants, and my triglycerides are also I guess higher than what the doctor wants. On top of that, I have gained 5lbs in the last 6 months. So, I go back in 3 months for another checkup, doctor said if my cholesterol doesn't start dropping even more than we are going to have to look into putting me on meds for it. I would still like to avoid that, so now I need to hit the gym more than ever I think, and stay focused on that, as well as continue to try and improve my eating habits.

All that being said, the doctor did feel comfortable raising my dose. I am now taking 1ml every two weeks. She said my hormone levels where at about 142, and a biological male should be around 410-600.

So far I have had a very minor amount of facial hair start to grow on my chin, you have to really look to see it. My voice is getting deeper as well. So changes are happening, and well now they should continue to happen.

[Linus]

Just saw this on one of the lists:

http://artsbeat.blogs.nytimes.com/20...-be-a-musical/
`Southern Comfort' Documentary on Transgender Friends to Be a Musical

By Robin Pogrebin
A new musical based on "Southern Comfort," Kate Davis's award-winning documentary about transgender friends in rural Georgia will be presented by CAP21 Theater Company in Manhattan this fall.
The musical, also called "Southern Comfort," features a folk-bluegrass score by Dan Collins (book and lyrics) and Julianne Wick Davis (music). The show, to be presented at CAP21's Black Box Theater on West 18th Street, will star Annette O'Toole ("The Kennedys of Massachusetts," "Smallville") and Jeff McCarthy ("Urinetown," "Beauty and the Beast"). Tom Caruso directs. Previews are to begin Oct. 5.

======


A musical? really? I don't think I can picture how such a tragedy could be a musical.

[Ebon]

I need to come out at work but of course I'm hesitant because I don't know who is a narrow minded asshole and who is not.

[Linus]

Originally Posted by Ebon

I need to come out at work but of course I'm hesitant because I don't know who is a narrow minded asshole and who is not.

Good luck! When I came out I was surprised at how positive things were overall, even from the extra-conservative born-again Christian that is a colleague. Does your work have an HR dep't?

[Ebon]

Originally Posted by Linus

Good luck! When I came out I was surprised at how positive things were overall, even from the extra-conservative born-again Christian that is a colleague. Does your work have an HR dep't?

Yeah they do. I am hoping it is the same and I will expect that. I just looked in our handbook and our policy has no protection for transgendered or even the GLBT community for that matter but one of our head bosses is gay so hopefully it will go well. I think they just care if I'm good at my job.

[J. Mason]

I hope things go well for you Ebon.

[Logicaly]

Good luck Ebon. I know it can be a bit of a nervous situation. I was hesitant too at first, but once I did honestly I was amazed at how easy it was and the great reaction that I received.

[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]

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*.

[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.

[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

[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.