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

[Elspeth]

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 bears repeating, over and over. It's critical not to wind up spending tens of thousands of dollars working with someone whose mind was made up before you even walked in the door. Pretty sure my ex therapist was one of these, in his case, rooted in his being gay and more or less assuming most of us would just get better once we accepted we were gay. How he managed to keep not listening to my POV on this, as someone who had no problem with people assuming I was gay, if it had actually been something that could have worked for me is mainly a testament to my extreme passivity and desire to please others at my own expense.

[blueconstancy]

My wife's endo did it the other way around - estrogen first, then spiro if needed - on the same logic that has been cited of "try one med at a time, so if there's a reaction, you know what caused it." (Since she and I both *are* allergic to certain antibiotics, it made sense immediately why a doctor might want that!)

The endo chose to begin with estrogen because it's absolutely required to transition, whereas some women end up not needing spiro at all, since E is able to suppress T to a limited degree. My wife turned out to be one of those, actually; she's on a very very low dose of E and nothing more, and still got down to cis female levels of T right away.

[LilDevilOfPrada]

My wife's endo did it the other way around - estrogen first, then spiro if needed - on the same logic that has been cited of "try one med at a time, so if there's a reaction, you know what caused it." (Since she and I both *are* allergic to certain antibiotics, it made sense immediately why a doctor might want that!)

The endo chose to begin with estrogen because it's absolutely required to transition, whereas some women end up not needing spiro at all, since E is able to suppress T to a limited degree. My wife turned out to be one of those, actually; she's on a very very low dose of E and nothing more, and still got down to cis female levels of T right away.

Thats pretty lucky ^^ I am on the opposite end where nothing can properly supress mine. However yea most doctors like to take it 1 med at a time for safty concerns^^.

[muuu]

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[LilDevilOfPrada]

Hm... Basically here all they did was making me see a psychiatrist that wanted to know about how things were when I grew up and also doing quite a few psychological test (intelligence, personality, some other tests, rorschach test). After that it was simply waiting on their "has to be in contact with us for one year" standard, though I had some issues that made them have to hold off HRT for a bit longer because of medical reasons.

Don't they do this in the US too?

You also did those horrible long tests???

I thought it was only South Africa who did that seeming no one mentioned them on the site

[blueconstancy]

No psych tests here, anyway.  Endo wanted a therapist's letter - not necessarily a psychiatrist - saying the patient had been seen for at least 3 months, and that was it.

(And yes, my wife was lucky; not least b/c  my insurance will pay more easily for HRT if it's at accepted menopausal cis female levels/methods! I have had SUCH battles with the insurance company's mail-order pharmacy over any medication not being taken "as directed by standard practice," even stuff like allergy meds.)

[Isabelle]

Angelique, I've removed some of my comments. I'm sorry, I was in a bit of bitchy mood while I was posting and it wasn't cool of me to be snarky in your thread just cause I was having a bad day. Anyways, sorry about that x

[HthrRsln]

Hm... Basically here all they did was making me see a psychiatrist that wanted to know about how things were when I grew up and also doing quite a few psychological test (intelligence, personality, some other tests, rorschach test). After that it was simply waiting on their "has to be in contact with us for one year" standard, though I had some issues that made them have to hold off HRT for a bit longer because of medical reasons.

Don't they do this in the US too?

Not in my experience. I am sure everyone has different experiences. As I understand it, the WPATH (World Professional Association of Transgender Health) SOC (Standards of Care) previously recommended 3 mo of gender therapy before recommending HRT, and one year of gender therapy before SRS.

I have not read it fully (been meaning to, but have not yet), but I gather that in the latest version of the SOC, the requirements have been changed to only recommend that the patient be capable of "informed consent," which is to say that all the medical profession has to do to be compliant, is be confident that you understand what you are doing, and are competent to make that judgement.

That said, many medical professionals do not keep up on all the latest changes in the SOC. I know of people who have printed out a copy and taken it with them to their medical provider with the pertinent sections marked. And, the WPATH SOC does not have any legal power, it is merely the recommendation of the most widely recognized authority on the subject. Any physician is free to require whatever they choose before supporting your requests.

[Jamie D]

Actually my endo put my diagnosis code as hormone imbalance and it seemed to work

I get coded for "gynecomastia" on my T, E, and P level tests.

[TanaSilver]

That said, many medical professionals do not keep up on all the latest changes in the SOC.

This is true, and even within the same health organization you can find differences. After seeing a therapist, she issued me a letter of recommendation which I took to an endo doc. The doc wouldn't accept the letter and instead required me to see a psychiatrist from within their health organization for three months. This didn't seem right to me so I asked people in my local TG community for the name of an endo doc with more experience working with trans folk, I got a name, requested to my health provider to switch to this doc, they complied, and he accepted the letter and immediately put me on HRT on my first visit to him.

The lesson I took from this is that you may have to push and even educate docs sometimes about these things.

[mumbaigirl]

My endocrinologist feels spiro is more potent than estrogen when it comes to feminizing. He has observed better breast development with spiro and estrogen than with estrogen alone..He says he even advises some of his post-op patients to continue taking spiro..but a very low dosage!