Wat would be a reason an endo doctor would be someone on spiro only?

[Angélique LaCava]

Yes!!! If you even think you want to transition. Spiro seems to be a relatively safe way to stop puberty while you figure out what you want to do, but many effects of Testosterone cannot be undone later, or at the least require expensive cosmetic surgery. The sooner you shut down the T factory the better. I would give anything to have been able to do it sooner, and I mean ... anything. So much harder now. If you change your mind and stop Spiro, puberty will take over right where you left off. Estrogen will only partly reverse, mainly breast growth reversal requires surgery.

me n my mom asked my gender thArapist bout a T blocker n she told me that I don't need it cause I already look like a girl,  But my gender thArapist  said no on the T blocker

[Bex80]

me n my mom asked my gender thArapist bout a T blocker n she told me that I don't need it cause I already look like a girl,  But my gender thArapist basically said no on the T blocker

I wouldv'e thought they should base this on bloodtests and not how you look?

[Isabelle]

Angelique, that makes no sense. A gender therapist is not an endocrinologist and isn't qualified to give an opinion on the the matter, beyond being able to say you're emotionally capable of making the choice to start hrt. Hrt has precisely nothing to do with weather you or anyone else thinks you look like a girl.
Your shoulders are going to continue to get wider, your ribcage will continue to get bigger, your facial features will continue to harden and you'll develop more and more facial hair. Within the few years you may even begin to grow chest and back hair.

[Angélique LaCava]

I wouldv'e thought they should base this on bloodtests and not how you look?

my gender thArapist is a idiot. My first appointment wit her she even asked me if I was ever on hrt cause of how pretty I looked

[Angélique LaCava]

Angelique, that makes no sense. A gender therapist is not an endocrinologist and isn't qualified to give an opinion on the the matter, beyond being able to say you're emotionally capable of making the choice to start hrt. Hrt has precisely nothing to do with weather you or anyone else thinks you look like a girl.

shes been keepin me from hormones cause she thinks I'm not mature enough n she wanted my parents to give her a good report for atleast 3 months n my parents gave her a good report so now next appointments she gonna prolly write the letter but she said she was gonna talk bout writing the letter so idk but I'm pretty sure she's gonna write it

[Cindy]

There are two broad areas of concern in treating MtF Testosterone levels that are not incompatible with each other, and the decisions are usually based on the endocrinologists previous experience.

Most 'males' produce testosterone and blocking testosterone involves several steps. One is to block the production of T and another is to block T receptors.

Some endocrinologists like to block production first but other prefer to stimulate the bodies system of removing testosterone and then block the production. In the former people are usually put on oestrogen with no anti-AAs. This stimulates an increase in Sex Hormone Binding Globulins  (SHBG) which remove circulating T. Once circulating T has been removed then anti-AA can be given to reduce the production of T. The use of anti-AAs can be double edged. Androcur which is popular in Europe and Australia is arguably the most efficient  anti-AA has significant side effects, the major one being the the induction of or deepening of depression. Spironolactone has significant effects on cardiac function, and in fact that is what it is most used for clinically. It is also a diuretic, which is what it was originally sold as. So in both cases keeping people on the lowest levels of anti-AA is a desire for most endocrinologists.

So depending on the base levels of T the endocrinologist may decide to promote SHBG and see what happens and then go for anti-AA. Or reduce the circulating levels of T with anti-AA and then go for oestrogen.

The decision is, or should be made on a case by case situation.

Also, of course, this is where the relationship between the endocrinologist and the therapist becomes important.  If the therapist, in my case in Australia a psychiatrist who specialises in gender problems, decides that there patient has a gender identity complex and requires full treatment, then the endocrinologist goes for full treatment. If the therapist is unsure then the endocrinologist will be slower to go to full hormonal treatment.

As we know hormone changes can have profound and irreversible effects on people. The patient can very quickly have a dangerous response that can be life threatening. Hence we need the care of qualified people to look after us.

As a Doctor I trust my professional colleagues to look after me. There is no way I would self medicate.

[Angélique LaCava]

Well, you do write like a five year old.... Just saying...Anyway, You seem to have some really weird views on this stuff. I suggest you get a new therapist. What you look like has no bearing on your treatment.

im on a iPhone n I always write like I'm texting. So I'm sorry of I'm writing like a 5 year old

[Angélique LaCava]

Watever Idc. So yea dont worry bout how I type. On a side note my mom won't let me see a endo doctor till my gender thArapist approves of me seein one

[HthrRsln]

me n my mom asked my gender thArapist bout a T blocker n she told me that I don't need it cause I already look like a girl,  But my gender thArapist  said no on the T blocker

Okay, so this is just my opinion, and I'm just nobody special, but I would immediately find another Gender Therapist. There are apparently a bunch of people calling themselves gender therapists that don't think anyone should transition.

This is not a reason not to begin Spiro. There are no non-reversible effects from Spiro, and there are irreversible effects of Testosterone. You can probably get a friendly doc to prescribe Spiro if you just ask for it. I know mine did.

[Angélique LaCava]

Okay, so this is just my opinion, and I'm just nobody special, but I would immediately find another Gender Therapist. There are apparently a bunch of people calling themselves gender therapists that don't think anyone should transition.

This is not a reason not to begin Spiro. There are no non-reversible effects from Spiro, and there are irreversible effects of Testosterone. You can probably get a friendly doc to prescribe Spiro if you just ask for it. I know mine did.

she has wrote the letter for other  transgenders btw

[Isabelle]

Angelique, is your mum in charge of your medical treatment? It's not her choice. Your therapist is possibly right, you need to grow up.

[Angélique LaCava]

Angelique, is your mum in charge of your medical treatment? It's not her choice. Your therapist is possibly right, you need to grow up.

i can't drive yet so yea she's in charge of where she takes me ok so I'm done talkin bout this. I'm not gonna get into a argument cause I've been workin on my anger n I'm not gonna let u piss me off

[Cindy]

 

OK lets calm down please.

There are no reasons for personal attacks.

[HthrRsln]

Watever Idc. So yea dont worry how I type. On a side note my mom won't let me see a endo doctor till my gender thArapist approves of me seein one

Did your mom pick the gender therapist? Will she let you find a better one? Have you asked this therapist how many transgender patients she has had, and how many of those she approved for transition?

Actually, I believe the newest WPATH Standards of Care do not absolutely require a therapist's letter for HRT or SRS, but only require "informed consent", meaning you have to know what you're doing, but I don't know if that's at 18 years of age, or maybe 21. I would think it would be 18, but really not sure.

I can't stand the idea that some so-called gender therapist would block even Spiro. That just makes no sense, and suggests to me that the therapist is opposed to transition.

I wish you the all the best.

Cheers!

- Heather

[Angélique LaCava]

Did your mom pick the gender therapist? Will she let you find a better one? Have you asked this therapist how many transgender patients she has had, and how many of those she approved for transition?

Actually, I believe the newest WPATH Standards of Care do not absolutely require a therapist's letter for HRT or SRS, but only require "informed consent", meaning you have to know what you're doing, but I don't know if that's at 18 years of age, or maybe 21. I would think it would be 18, but really not sure.

I can't stand the idea that some so-called gender therapist would block even Spiro. That just makes no sense, and suggests to me that the therapist is opposed to transition.

I wish you the all the best.

Cheers!

- Heather

i found her n picked her cause she's the closest. My mom already said that if she dosnt write the letter next appointment she's gonna tell her that its bull->-bleeped-<-, n  to eather write it or I won't be seein her again

[HthrRsln]

i found her n picked her cause she's the closest. My mom already said that if she dosnt write the letter next appointment she's gonna tell her that its bull->-bleeped-<-, n  to eather write it or I won't be seein her again

Good for your mom!      Sounds like she's on your side. That makes a lot of difference.

Cheers!

[Jamie D]

thats wat I'm confused bout everyone keeps saying 18 is wen u masculinnise but I havnt even noticed any masculine changes yet if anything I look more femine than I did last year but Its  better to be safe than sorry haha. I'm prolly gonna be startin hrt in February or march

My question would be, have you had your levels tested yet?  Like many others here, you may have naturally low levels.

[LilDevilOfPrada]

Ok well I keep seeing people on here sayin they wasn't on estrogen for a few months n only was on Spiro. So wat r some reasons a endo doctor would do that?

Lol I was one of those I was on spiro only for 6 months before I got on E, fact is if your young they think your crazy and dont want to have you get any permanent changes you may regret.

I am also guessing your quite young seeming she wants your parents opinions so yea, youth=spiro only with most endos for a while lol.

[LilDevilOfPrada]

Did your mom pick the gender therapist? Will she let you find a better one? Have you asked this therapist how many transgender patients she has had, and how many of those she approved for transition?

Actually, I believe the newest WPATH Standards of Care do not absolutely require a therapist's letter for HRT or SRS, but only require "informed consent", meaning you have to know what you're doing, but I don't know if that's at 18 years of age, or maybe 21. I would think it would be 18, but really not sure.

I can't stand the idea that some so-called gender therapist would block even Spiro. That just makes no sense, and suggests to me that the therapist is opposed to transition.

I wish you the all the best.

Cheers!

- Heather

Thailand has a Law that you need parents consent for 18 to 21 years of age. no one below 18 in thailand can get a SRS.

I am pretty sure most practioners of a SRS will want the letter as this is a choice which could ruin someones life so they dont risk it.

[Elspeth]

I wouldv'e thought they should base this on bloodtests and not how you look?

A therapist (unless she's a psychiatrist) is not qualified by training to make judgement calls on drugs or hormones by any stretch of the imagination. Those who attempt to do this are acting irresponsibly and it really does sound (from this one-sided version of the story) like the therapist has no clue what she's doing and may have very little real understanding of gender dysphoria or the current state of medical research.

Inconclusive as some of it is, the evidence keeps growing that this is essentially neurological in those cases where dysphoria is profound and mostly unambiguous, at least, and it's probably true in other cases too. 

As long as society continues to enforce a false gender binary, getting rid of the emotional effects of inappropriate hormones can be a huge relief. If she's only focusing on appearance she has no business treating transgendered people.  My opinion, but it's pretty strong at this point. I'd be looking for a second opinion or a therapist who actually understands gender dysphoria and is not trying to interpret it as some sort of delusional state.