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Preparing first HRT appointment?

Started by ganjina, November 12, 2013, 06:26:35 AM

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ganjina

Hello girls,

I've finally got my appointment with the endocrinologist this friday! I am very excited though also feeling a bit nervous because in here these issues are rather unheard of and the proportion of "anti-LGTB crusaders" to put it somehow is very large in the population. I have no idea how the doctor will turn out to be (why did not I pick up a meeting with someone known? First I wanted to try the "free" insurance option). I've been told some doctors in this hospital have experience with these situations but that is all I know. Also, I've got clearance from a specialist psychologist. My goal is of course to get started with HRT. 

What should I do to prepare for this appointment? I just thought of a bunch of normal and/or stupid questions I could get asked to which I should not be caught off guard, but that's about it. Also, if I do not like the doctor I suppose I will go to a support group and get contact details of someone else. Thanks for sharing your thoughts!
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Robin Mack

In my case, I got a referral from my gender therapist, who has gotten reviews and feedback from area trans people.  She keeps lists of recommendations in various areas from attorneys to endocrinologists.  If you have such a therapist, that is where I would go for the information.

The second point is, if you have a letter from your therapist stating that hormone therapy is medically necessary (required by a number of endos and insurance) and you have an appointment with an endo, then it would be a breach of ethics to do anything than treat you like a woman with a hormonal imbalance (which, really, is what you are).  Endos shouldn't be concerned with genitalia other than the effects they have on hormones and vice-versa.

So, if you do have a letter, then I would suggest you not worry about it at all; if their questions get too evasive you can always say "That is confidential, between me and my therapist" and leave it at that.  You are a human being who needs medical treatment; remember that.  You are worthy of dignity and respect, despite what society and anxiety have done to you (and us) over the years.  Be polite, but be firm.

*hug*

*Edit:  If you are going to an endo without a note from your therapist, I would imagine you would need to be more forthcoming to demonstrate you know what you are doing and reassure the endo your consent to the treatment is truly informed.
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ganjina

Thanks for the good wishes, advice and the confidence boost. R. Mack, you are right!

My therapist has not given me a letter per say though he said he would if it was required, I did not want to get pushy with that until after meeting the endo "on my own" and face that meeting, I'll get the answer friday I suppose. I think I'll prepare some firm replies to those possible weird questions to not seem on the defensive with this and just let the Dr. deal with it (my reply).
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Katie

Best advice I have for you if you want to be taken seriously by the doctor (or anyone for that matter) is put together your best female presentation and go to the doctor. It is amazing when someone can actually see you are the person you claim you are.
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Robin Mack

Quote from: Katie on November 12, 2013, 02:43:11 PM
Best advice I have for you if you want to be taken seriously by the doctor (or anyone for that matter) is put together your best female presentation and go to the doctor. It is amazing when someone can actually see you are the person you claim you are.

Seconded, since you are going in without that letter.  I will be going in with a letter, because, dammit, I am *not* going to be denied.  I've spent too many years denying myself to be delayed by a failed bureaucratic step. :)

Also, while the endo will almost undoubtedly at least do blood testing without a letter, I wouldn't be surprised if they wanted one before actually starting hormones. 

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Ashey

I'd personally recommend getting the letter first. My endo didn't seem to require one (though the first one I was going to go to did) but I spent a lot of time and money in therapy to get that letter and damnit it wasn't going to waste lol! I practically shoved it in his face, but he did say it was very good that I had it and it would be a good addition to my medical records. So yeah, may or may not be required but certainly couldn't hurt, especially if you have to switch endo's for one reason or another.

Also, don't be surprised if you get your boobs groped! I was caught off guard the first time lol. Just checking for lumps I guess.
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ganjina

Alright, alright I asked for my letter!

The problem I have right now with giving a female presentation there, is mostly fear for personal safety, it is not like there is a changing room or proper toilets nearby, and crossing the city as female would be nearly suicidal... So uhmmm... I guess have a letter, prepare it well and hope for the best? Thanks for the kind advice anyway!
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FrancisAnn

I would wait & have your letter in hand. That would certainly be more credible that just talk.
mtF, mid 50's, always a girl since childhood, HRT (Spiro, E & Fin.) since 8-13. Hormone levels are t at 12 & estrogen at 186. Face lift & eye lid surgery in 2014. Abdominoplasty/tummy tuck & some facial surgery May, 2015. Life is good for me. Love long nails & handsome men! Hopeful for my GRS & a nice normal depth vagina maybe by late summer. 5' 8", 180 pounds, 14 dress size, size 9.5 shoes. I'm kind of an elegant woman & like everything pink, nice & neet. Love my nails & classic Revlon Red. Moving back to Florida, so excited but so much work moving
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Robin Mack

Quote from: ganjina on November 12, 2013, 07:18:58 PM
Alright, alright I asked for my letter!

The problem I have right now with giving a female presentation there, is mostly fear for personal safety, it is not like there is a changing room or proper toilets nearby, and crossing the city as female would be nearly suicidal... So uhmmm... I guess have a letter, prepare it well and hope for the best? Thanks for the kind advice anyway!

You know your neighborhood better than I do; all I have is my own experience to draw on, but I once thought presenting female was crazy stupid and sure to get me killed, too... but going out with friends and building confidence has been very, very helpful. 

*hug*

I'd recommend exactly that, bring the letter and a positive attitude and you should be good to go! ;)
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ganjina

Hmmm.. building confidence.. very helpful... I'll have to think about that, thanks.
Anyway, it's tomorrow morning, in 15 hours to be exact... did not manage to get my hands on the psy for the letter due to being too busy with work so I'll have to go without it and "as is"... oh god let's see what happens...!!!!!
*breathe, calm down, it will be ok!*
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Robin Mack

*hug* Either way you will be fine... you may have to wait a week or two, but you're on the road!  :)

Good luck tomorrow... I'll be eagerly awaiting your update! :)
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ganjina

Hey there :)!

Thanks for the support. It went allright, the whole team over there had obviously experience with this type of situations before, they (I saw a Dr. and 2 nurses) were very professional with their questions, kind and willing to help. Now the process is to:

1) Do a bunch of blood and physical exams and even a genetic one.
2) Check with a hospital specialist psychiatrics Dr. for clearance (which they said meant basically diagnosing gender disphoria without other mental issues so they can get started for real).
3) Come back with results of 1) and 2) to Endocrinologist to get started.

Unfortunately all psychiatrics Dr.s are full until january, so I will have to wait. Now I wonder how tough it can be to get clearance?? What could they ask me for or require from me? Am wondering if being healthy in your head and having clearance from a specialized psychologist (quite different branch in case anyone asks) who I consulted with for just like 5 months is just enough. Any advice :o ?
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Robin Mack

The world-recognized standard is WPATH, and it indicates that three months is sufficient (and, in some cases not even required) for a solid diagnosis to begin HRT.  *hug*

You're on your way!  :)
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ganjina

Thanks, it looks rather promising. I tried to look for more information about it but did not find that much, I am really wondering how tough or fast this next step would be, according to the therapist I saw before for a few months I was just fine and he would diagnose gender disphoria without second thoughts, so maybe it is reasonable to expect that I can get through this after a minimum number of visits instead of 3 months. It would make things way easier due to work schedule and SO + family being able to take care of me or not during FFS healing (which is subject to HRT start date of course)...
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Robin Mack

Here is a link to the standard "WPATH Standards of Care"... it's reasonably well written, but not exactly an exciting read... :)

http://www.wpath.org/uploaded_files/140/files/IJT%20SOC,%20V7.pdf
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ganjina

Hey Robin,

Just wanted to pop in and give you a big thanks for the support and the info provided, it has been a thorough read and am really looking forward to get to this psychiatrist appointment in jan., hoping to start soon. Cheers!
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