Dilemma...

[Keira]

So I've already talked about this before...but Im going to put it in a different way to see what you think would be my best choice.

Background Information

I've already been on a medium dose of spiro for a month. But my GP keeps saying he is inexperienced and wants me to fly to Vancouver. It seems like he is also concerned about if he is making the right decision by prescribing me hrt. Technically speaking, he should be able to work with the local endocrinologist or refer me to them. I have literally given him all the information he needs to prescribe and monitor my hrt, so him saying "I'm not qualified" is not a valid reason, it's an excuse so that he can't get in trouble if he <bleeps> up.

My counsellor read the qualifications of an assessing mental health professional according to wpath standards of care...and then told me he could technically assess me and work with me. So far, no assessment. I'm going back to him tomorrow so we'll see how that goes. But I anticipate this could get hairy fast because of the fact that he needs money, so he may intentionally draw out the assessment period.

Option #1

Get the assessment from my counsellor and talk to my doctor, who can then refer me to the local endocrinologist.

Drawbacks- Could take a long time, or my counsellor may not want the legal "burden" of advocating for me.

Option #2

Spend close to $400 on a wpath psychologist and get an assessment via Skype. Which I can then go to the endocrinologist.

The plus is that the psychologist is well known and well respected, so it shouldn't be a hassle to get the endocrinologist to prescribe/monitor hrt for me.

Drawbacks- Not cost efficient, may take more time to get an appointment.

Which one is the best?

Or is there possibly a third option?

I can't wait too much longer for hrt...my dysphoria keeps getting worse...and I feel like I'm stuck in some gender-limbo-hell where I don't quite fit anywhere...opening Pandora's box may not have been such a good idea...

So...Im just looking for the fastest option at this point, since hrt takes months to kick in...

Thanks

Skye

[Devlyn]

Are you working? $400 is a pretty small sum of money. I like option #2 Hugs, Devlyn

[Keira]

Are you working? $400 is a pretty small sum of money. I like option #2 Hugs, Devlyn

Yes, and I already have about $1600 saved up for transitioning.

Plus, here in Canada the periodic blood tests are free, and so are the doctors appointments, just not the medication (at least it isn't ridiculously expensive).

So I'm really tempted to go with option #2, it's just that the money could be better saved for laser hair removal...even though I have $1600 I'm trying to penny pinch as much as possible.

[Devlyn]

Usually, going with laser/electro is a good early step as it has no downside, but you're struggling with the feeling of being stuck, so you may be better off going with the full HRT first. Hugs, Devlyn

[Heather]

I can't wait too much longer for hrt...my dysphoria keeps getting worse...and I feel like I'm stuck in some gender-limbo-hell where I don't quite fit anywhere...opening Pandora's box may not have been such a good idea...

So...Im just looking for the fastest option at this point, since hrt takes months to kick in...

Thanks

Skye

Skye the fastest option isn't always the best way to make a major life decision. I'm sorry but if you think hrt is going to fix dysphoria it's not. Then your going to be right back on here talking about how you need ffs then srs and all the other stuff trans people do to try to make themselves better on the outside. When the answer doesn't come from hormones surgery or any other outside source. The answer comes from within and how you accept yourself not from a pill or a surgery. 

[Keira]

Skye the fastest option isn't always the best way to make a major life decision. I'm sorry but if you think hrt is going to fix dysphoria it's not. Then your going to be right back on here talking about how you need ffs then srs and all the other stuff trans people do to try to make themselves better on the outside. When the answer doesn't come from hormones surgery or any other outside source. The answer comes from within and how you accept yourself not from a pill or a surgery. 

I agree, most of us have to deal with self acceptance, myself included. And those of us that don't, eventually end up wanting every-single-surgery because they think that they are ugly.

Thanks for the counter-point!

I know for sure though that a lot of my issues are with body image/self esteem. And those won't go away without the proper medical treatment. I've thought about hormone replacement therapy for months, read about it, thought about it, and studied some of the finer points of how it works. And I did some gender therapy to sort out my gender confusion, and I'm 100% sure of who I am and what I need.

Otherwise...I probably wouldn't be so keen on the second option.

[Jess42]

Skye, have you talked with the people involved with option 2 to see what the time frame may be? What may be involved in order to get all the letters and such to start? The main reason why I am asking is that if there isn't much difference in times option 1 may be a whole lot cheaper on you.

As for the doc being careful and not wanting to mess up. Personally I have been a lot of things but guinnie pig isn't one of them. I would figure he/she would be referring to other physicians on the subject though. So you may indeed have a legitamate gripe over that and if not, I would definately quesion him/her as to why not.

Option 1 may take longer for hormones but you can start the laser, option 2 you may be able to start the hormones but take longer for laser treatments. Sorry but it seems like it may be 6 in one hand and 1/2 dozen in the other.

[eli77]

For me, I saw HRT as the most time-sensitive issue and it's what I started first before anything else--I spent the $400 on a WPATH assessment. I got a lot of stress relief just knowing that my body wasn't working against me anymore. I would go with the quickest option. In terms of money, especially at your age, you may not feel the need for FFS, and it may reduce (though not eliminate) your need for hair removal. Also SRS is covered if you eventually decide you want it so that isn't an issue.

There tends to be a bit of a divide on this kind of stuff between those of us who start younger versus older. Heh.

FYI, the lady I saw was Melady Preece in Vancouver: http://www.drmeladypreece.com/Home.html. She's part of CPATH and super progressive and kind. She does fee-scaling for people in difficult financial situations (at your age she'd probably be willing to help) and I think she might do Skype consulting? I'm not positive, but I believe she does. She also didn't have a crazy waiting list when I saw her, although that was a few years ago. She's also very well connected in BC; you might send her an email detailing your issues around being in the back of beyond and see if she has any advice.

[Keira]

Skye, have you talked with the people involved with option 2 to see what the time frame may be? What may be involved in order to get all the letters and such to start? The main reason why I am asking is that if there isn't much difference in times option 1 may be a whole lot cheaper on you.

Oops...I forgot to mention that the assessment is only two (this first is 1 hour, and the second is 1-2 hours) sessions, plus possibly a one month wait for an endocrinologist.

My trans friend where I live did the online assessment and is about to get his hrt this month, and he said that he has more issues than I do and was still approved.

Vs.

Having to hmmm and haw for four sessions with my counsellor which will end up costing me the equivalent amount of $400 (and possibly no letter).

So I see what you mean, and that's part of my dilemma...it's cost vs trans friendly/faster access to care.

As for the doc being careful and not wanting to mess up. Personally I have been a lot of things but guinnie pig isn't one of them. I would figure he/she would be referring to other physicians on the subject though. So you may indeed have a legitamate gripe over that and if not, I would definately quesion him/her as to why not.

It seems like he's trying to get information from other physicians, he's currently trying to contact another GP in Vancouver, and having difficulty.

What I don't understand is that I have given him comprehensive (from actual gender clinics) documents on hormone replacement therapy, and yet he needs MORE information?!?!

Option 1 may take longer for hormones but you can start the laser, option 2 you may be able to start the hormones but take longer for laser treatments. Sorry but it seems like it may be 6 in one hand and 1/2 dozen in the other.

Yeah, I know. I don't really care about living full time immediately, so hrt is probably a better choice than laser. I'll still have money to do laser after I get my prescription (the only cost is the assessment and the pills).

[Ltl89]

It sounds like getting on hrt is your immediate goal.  If that's the case, seeing the gender therapist will probably be the best route.  It isn't too expensive, and considering the fact that you have coverage for everything else, you should be okay.  However, I would check with your current therapist beforehand and see what he says. 

[Keira]

For me, I saw HRT as the most time-sensitive issue and it's what I started first before anything else--I spent the $400 on a WPATH assessment. I got a lot of stress relief just knowing that my body wasn't working against me anymore. I would go with the quickest option. In terms of money, especially at your age, you may not feel the need for FFS, and it may reduce (though not eliminate) your need for hair removal. Also SRS is covered if you eventually decide you want it so that isn't an issue.

There tends to be a bit of a divide on this kind of stuff between those of us who start younger versus older. Heh.

FYI, the lady I saw was Melady Preece in Vancouver: http://www.drmeladypreece.com/Home.html. She's part of CPATH and super progressive and kind. She does fee-scaling for people in difficult financial situations (at your age she'd probably be willing to help) and I think she might do Skype consulting? I'm not positive, but I believe she does. She also didn't have a crazy waiting list when I saw her, although that was a few years ago. She's also very well connected in BC; you might send her an email detailing your issues around being in the back of beyond and see if she has any advice.

That's funny, Melady Preece is the psychologist I was talking about!

My trans friend did a Skype assessment with her, so I'm pretty sure it's possible.

Thanks for understanding where I'm coming from

[Heather]

I've thought about hormone replacement therapy for months, read about it, thought about it, and studied some of the finer points of how it works. And I did some gender therapy to sort out my gender confusion, and I'm 100% sure of who I am and what I need.

Skye I'm sure your 100% on this but trust me all the reading in the world can't prepare you for the emotional/mental part of hrt. I honestly didn't know someone could feel so much as I do now. Before e my emotions were very much singular I was happy sad mad but I didn't realize someone could be all that at once like I do now. Now I hear people say hrt didn't change them it has me I don't even remotely think the same way I did before. And I know the person I was before has left and will never be back. Is this new person better or worse I have not a clue. I think so I hope so but really everyday is like a new experience too me. I'm not saying this to scare you but this has been my experience with e. And I want to help people make informed decisions instead of rushing into things because it seems like the right decision. Because after you start regardless of what some may say there is something's that can never be undone. And you will never be the same person again.

[Ltl89]

Skye I'm sure your 100% on this but trust me all the reading in the world can't prepare you for the emotional/mental part of hrt. I honestly didn't know someone could feel so much as I do now. Before e my emotions were very much singular I was happy sad mad but I didn't realize someone could be all that at once like I do now. Now I hear people say hrt didn't change them it has me I don't even remotely think the same way I did before. And I know the person I was before has left and will never be back. Is this new person better or worse I have not a clue. I think so I hope so but really everyday is like a new experience too me. I'm not saying this to scare you but this has been my experience with e. And I want to help people make informed decisions instead of rushing into things because it seems like the right decision. Because after you start regardless of what some may say there is something's that can never be undone. And you will never be the same person again.

I think that's a good point and I agree.  However, she could still continue seeing her regular therapist after getting the hrt letters from the specialist.  Then again, we all experience things differently.  I'm still in the early stages, but I haven't yet experienced any major mental changes except for placebo happiness and euphoria.  Maybe it's because I've always been emotional, who knows.  But it's true that some people go through difficulties with their emotions in the beginning.  It's best to have someone their to help guide you through it.  Skye, I hope you are listening to Heather.  She's making a great point.

[Keira]

Skye I'm sure your 100% on this but trust me all the reading in the world can't prepare you for the emotional/mental part of hrt. I honestly didn't know someone could feel so much as I do now. Before e my emotions were very much singular I was happy sad mad but I didn't realize someone could be all that at once like I do now. Now I hear people say hrt didn't change them it has me I don't even remotely think the same way I did before. And I know the person I was before has left and will never be back. Is this new person better or worse I have not a clue. I think so I hope so but really everyday is like a new experience too me. I'm not saying this to scare you but this has been my experience with e. And I want to help people make informed decisions instead of rushing into things because it seems like the right decision. Because after you start regardless of what some may say there is something's that can never be undone. And you will never be the same person again.

As much as I loathe hearing people say things like that...

It actually makes me think about how I'm going to convince my counsellor that Im ready...

And it makes me see things in a different way. I've always been really sensitive and emotional, I just hide it behind a facade, so it will be good for me to finally be able to let that out.

[Heather]

It actually makes me think about how I'm going to convince my counsellor that Im ready...

Its not about convincing your counsellor it's about convincing yourself. If down the road you realize you made a mistake it's not going to be your counsellor that has to live with it you are. The only gatekeeper there is in life is ourself. You got to ask yourself how far are you willing to go for this. Vancouver don't seem that far too me. And if someone told me I had to go to Vancouver to get my hrt I would be in Vancouver the next day.

[Keira]

Its not about convincing your counsellor it's about convincing yourself. If down the road you realize you made a mistake it's not going to be your counsellor that has to live with it you are. The only gatekeeper there is in life is ourself. You got to ask yourself how far are you willing to go for this. Vancouver don't seem that far too me. And if someone told me I had to go to Vancouver to get my hrt I would be in Vancouver the next day.

Thank you for your concern, but...

I know all the risks and benefits of hrt etc etc.

I don't have to convince myself, I am already decided.

It's just that mental health professionals are overly cautious because they themselves have to be sure before they can advocate for a client. Otherwise they could get sued for it.

With going to Vancouver...cost becomes a major issue, so it is a last resort. Plus it's ridiculous to have to travel when we have telephones and the Internet/email. I shouldn't have to go to an endocrinologist in Vancouver EVERY time I get a check-up/dosage change, it's like shooting a deer with an RPG...totally ridiculous lol.

Plus in Wpath soc, it states that doctors and nurses can prescribe and monitor hrt if a patient lives in an area with limited access to trans healthcare (which I happen to).

Looks like the thread got derailed, back to the original topic at hand...

[Devlyn]

Thank you for your concern, but...

I know all the risks and benefits of hrt etc etc.

I don't have to convince myself, I am already decided.

It's just that mental health professionals are overly cautious because they themselves have to be sure before they can advocate for a client. Otherwise they could get sued for it.

With going to Vancouver...cost becomes a major issue, so it is a last resort. Plus it's ridiculous to have to travel when we have telephones and the Internet/email. I shouldn't have to go to an endocrinologist in Vancouver EVERY time I get a check-up/dosage change, it's like shooting a deer with an RPG...totally ridiculous lol.

Plus in Wpath soc, it states that doctors and nurses can prescribe and monitor hrt if a patient lives in an area with limited access to trans healthcare (which I happen to).

Looks like the thread got derailed, back to the original topic at hand...

https://www.susans.org/forums/index.php/topic,142744.0.html

This is a ridiculous cycle, you need to listen when people offer you advice. Hugs, Devlyn

[Heather]

Thank you for your concern, but...

I know all the risks and benefits of hrt etc etc.

I don't have to convince myself, I am already decided.

It's just that mental health professionals are overly cautious because they themselves have to be sure before they can advocate for a client. Otherwise they could get sued for it.

With going to Vancouver...cost becomes a major issue, so it is a last resort. Plus it's ridiculous to have to travel when we have telephones and the Internet/email. I shouldn't have to go to an endocrinologist in Vancouver EVERY time I get a check-up/dosage change, it's like shooting a deer with an RPG...totally ridiculous lol.

Plus in Wpath soc, it states that doctors and nurses can prescribe and monitor hrt if a patient lives in an area with limited access to trans healthcare (which I happen to).

Looks like the thread got derailed, back to the original topic at hand...

That's cool with me Skye its your life and since my advice is unneeded I will depart this thread hope you find what your looking for.

[eli77]

That's funny, Melady Preece is the psychologist I was talking about!

My trans friend did a Skype assessment with her, so I'm pretty sure it's possible.

Thanks for understanding where I'm coming from

Okay, then I would definitely go with that option! I found her really easy to work with. I'd also ask her about scaled-fees or a repayment schedule. Given how young you are, I definitely think she'd be responsive.

You'd also be able to talk with her about the endo issues and see if she has any ideas. It might be possible to have a specialist in Vancouver talk to your local doctor, for example, if that would reassure them.

I think you'd probably find some relief in just having someone who is definitely on your side and can help figure out a solution for your situation with you.

[Ltl89]

https://www.susans.org/forums/index.php/topic,142744.0.html

This is a ridiculous cycle, you need to listen when people offer you advice. Hugs, Devlyn

I second this.  Skye, as a girl whose a few years your senior and has gone through teenage anxieties, I hope you will consider the advice others give you.  The future is not as futile as you make it seem.  We all have challenges in our lives, but we can overcome them.  I don't mean to repost anything, but I think my post in your latest thread is the best advice I can offer you.  Please consider it and think deeply about your options; otherwise you're going to continue a vicious cycle of inaction which will lead you to the same place you're currently in a few years down the road.  Believe me, I know: I planned on transitioning at 19 and failed because of my fears and anxieties.  Well, here I am at the age of 24.  Please consider the advice you have recieved because we all have tried to help as best as we can.  And for what it's worth, I think you have gotten fantastic advice in the past few weeks.  Having said that, here is my latest post, because I really want you to consider a few things.  Wishing you well.

"Skye,

No one thinks anything bad about you.  This is a support site and venting can be a helpful way to get feedback or unleash really bad feelings to get them out of one's system.  Doing that doesn't make you a bad person.  I will say, however, that you have gotten some really great feedback in your latest couple of threads.  It's up to you to decide what to do, but I think you have some decent options available to you.  Are they ideal?  No, probably not.  But it's the same for everyone.  It is challenging for all of us.  Being trans has it's difficulties in many ways than one.  Transitioning brings about a whole new set of problems.  It can be overwhelming (I know it has been for me).  Yet, if this is what we want, we have ways to make it work.  Think about the fact that you are lucky to get to do this in the modern age.  Imagine if you wanted to transition, but there was no medical means to do so and society was even more against you.  Things could be (and were in the past) much harder.  It sucks that it isn't easy, but this is what you need to do.  In that event, you are going to have to go through the challenges and overcome them.  You have a few options available to you.

1.  Continue with your therapist and inquire about hrt letters.
2.  See a gender therapist (in person or online) and get the letters
3.  Go to a clinic and start through informed consent.

All of these options have their flaws, but they can get you where you need to be.  They are worth giving an adequate shot.  And I know that the doctors are expensive and the clinics are far.  The thing is that is true for almost all of us.  We all need to travel to some degree and pay more cash than we would like to part with for our medical care (I'm an American, I know).  And it seems like you have a friend on here who is familiar with your situation and geographical location who can help you network to find more inexpensive care.  I think that would be wise to follow her advise and see where that takes you.

In any event, no one hates you or thinks poorly of you.  You are an important member of the community here and we all want to see you thrive.  But in order for that to occur you are going to need to fight for it like everyone else here.  Giving up is not an option.  It's the cowards way out and you are too good of a person to do that to yourself, your family and your friends.  It's time for you to stand up for yourself and meet these challenges so that you can be happy with your life.  And once you do this, and you start to live the life you've always dreamed, everything will be so amazing that you will kick yourself for ever having these negative thoughts.  You can do this Skye, but you gotta meet the challenges and not give up.  I believe in you. "