Aussie Members?

[Kara Jayde]

Hi Nattie,

I am in Melbourne and have been on HRT for almost 6 months.  My thoughts somewhat thrown together follow!

Find a GP that is experienced with LGBTI patients.  It is a bit faster and a referral can get printed while you are still saying "Hi".  The 2 that specialise are Prahran Central and Northside.  I go to Northside.  When I rang for an appointment, I explicitly said I wanted a GP to write a referral to a psych and what for.  I understand that there may be a wait at Northside for new patients.  If so, either wait or go to Prahran.  Try your own GP too.  Mine pretty much declined due to lack of experience.  A referral does mean Medicare contributes. The psychiatrists seem to require one.
Psychs - I only have experience with Fintan Harte.  Only a 5-week wait and spent 7 sessions with him but the 7th was us writing and reading his report.  I am in my 50s too with marriage, family and career so he was probably being cautious.  In the end, he came up with a diagnosis but I feel like it was "extremely well informed" consent.  I am seeing him for a follow-up this Friday - he wants to stay in touch and continue to help if he can.  If you go to the Joy FM website, you may find some podcasts of Fintan talking about his approach.   The other specialist psych is Jaco Erasmus in Moonee Ponds.  Haven't met him. 

Fintan also referred me to La Trobe Uni for voice work so the specialists are useful.  I also see a psychologist just for counselling.  She too specialises in this stuff.

My GP prescribes and does all my HRT stuff.  I love him.  Spends most of our time together talking about how I am going and how my family is (they don't go there). It helps he (he says "we") hit the E ad T levels we wanted straight away.  I see him again next week so we will see where things are at.

I am sure there are other providers in Melbourne.   As Cindy said, ANZPATH is a very good place to start.  Those I have dealt with are all really nice to deal with and I feel very well looked after.

Let us know if you have any other questions.

oo0o thanks sooo much Emma, I will speak to my GP tomorrow but if they're hesitant than both Northside and Prahran are very close to me and I'll start ringing around to see which could fit me in. I'll let you know if I have any other questions after I get this organized ^_^ I'm hoping it won't take too long.

[sam79]

My experiences with Prahran aren't great. Especially for me where my body doesn't respond to spiro. Dr Strekker didn't give me a clear direction of next steps either. Plus, they were willing to prescribe dangerous amounts of Progynova (E). I'd highly recommend a proper endo who knows what they're doing. It will work out cheaper and safer in the long run.

Jaco Erasmus in Moonee Ponds is my psych. I highly recommend him, while I've not yet met Dr Harte ( although will later this year for my SRS letter ). He had a short waiting list when I started a long time ago. I was referred by a GP at Prahran... but any GP can give you a referral. My local GP now handles my prescriptions and referrals, so please don't discount other GPs out there for trans stuff. There are some lovely ones like mine.

Also ask your GP about being put onto a treatment plan with medicare. Basically that means that your visits to Dr Erasmus or Dr Harte will be partially covered by medicate. They cover up to 6 visits a year I think. But beware, you can only be on one treatment plan in a year I think.

[Kara Jayde]

Hi all, thought I'd update my visit to the GP today and see what you think ^^ I'm really happy. I went in and got a bitchy receptionist, so I was getting really nervous, but then the GP came out and called my name, and she was this lovely woman in her 30's (and I was thanking my lucky stars the GP wasn't a male). She was very friendly as we discussed my health and then I thought 'here goes, lets watch to see if she changes her behaviour with me when I tell her'. This is the first person I've opened up to outside of online socialization. 

I basically told her 'this might be uncomfortable for you, so let me know if it is' and then followed that up with how I suffer and have suffered my entire life with gender dysphoria. She didn't bat an eyelash (they're probably trained to hear weird things and not respond haha) and said, okay, well I'm not at all uncomfortable with working with you on it, but I have to tell you I have no experience with trans patients'. She wasn't aware of the procedure so I told her I would probably need to talk to a gender therapist to confirm my gender dysphoria, and then I could start on HRT and anti-androgens. She was concerned that it would be difficult to find somebody who specializes in GID as well as bulk-bills. She did an initial search on her database and was annoyed that they didn't have a transgender section (she called them and asked them why, and if they had anybody who could help with a person who 'wishes to change to the opposite gender'. I was thinking okay, binary thinking but fair enough. Afterward, she did a quick search and found the number for the Monash Gender Dysphoria Clinic and told me to give them a call on Tuesday, or to find somebody else and then let her know that I will be using them so that she can write a referral. All in all I felt pretty good about it, though I'm not really much closer to figuring out the next step, hehe.

My experiences with Prahran aren't great. Especially for me where my body doesn't respond to spiro. Dr Strekker didn't give me a clear direction of next steps either. Plus, they were willing to prescribe dangerous amounts of Progynova (E). I'd highly recommend a proper endo who knows what they're doing. It will work out cheaper and safer in the long run.

Jaco Erasmus in Moonee Ponds is my psych. I highly recommend him, while I've not yet met Dr Harte ( although will later this year for my SRS letter ). He had a short waiting list when I started a long time ago. I was referred by a GP at Prahran... but any GP can give you a referral. My local GP now handles my prescriptions and referrals, so please don't discount other GPs out there for trans stuff. There are some lovely ones like mine.

Also ask your GP about being put onto a treatment plan with medicare. Basically that means that your visits to Dr Erasmus or Dr Harte will be partially covered by medicate. They cover up to 6 visits a year I think. But beware, you can only be on one treatment plan in a year I think.

Thanks for the advice, I may look up Jaco Erasmus, however I was hoping to find one a little closer (I'm a public transport user haha) but then again it'd be closer than Moorabbin.

Do many of you have experience with the Monash Gender Clinic?

[sam79]

Hehe I use public transport too. Dr Erasmus is located conveniently close to the Essendon train station.

With the Monash Gender Clinic, many of the professionals who work privately or independently are also available through the clinic. Although the consensus I've heard from other people is that there can be a longer waiting list than going direct.

To give you an idea of cost with Dr Erasmus, each visit costs near $200. I forget the exact amount. But you will get about half of that back on Medicare assuming you setup a treatment plan with your GP. So for the usual 4 visits or so over many months required for HRT ( this will depend on you ), it will set you back by about $400.

Referrals after that to an endo ( if required ) are also covered by Medicare. For memory, each visit was about $160, with about half covered by Medicare.

Transition is not a cheap thing

EDIT: Please feel free to PM me too... I have contact details for a voice therapist ( who trains the therapists at Monash Gender Clinic ), and an image consultant. Although Dr Erasmus can make such referrals too. Both aren't expensive .

[Kara Jayde]

Hehe I use public transport too. Dr Erasmus is located conveniently close to the Essendon train station.

With the Monash Gender Clinic, many of the professionals who work privately or independently are also available through the clinic. Although the consensus I've heard from other people is that there can be a longer waiting list than going direct.

To give you an idea of cost with Dr Erasmus, each visit costs near $200. I forget the exact amount. But you will get about half of that back on Medicare assuming you setup a treatment plan with your GP. So for the usual 4 visits or so over many months required for HRT ( this will depend on you ), it will set you back by about $400.

Referrals after that to an endo ( if required ) are also covered by Medicare. For memory, each visit was about $160, with about half covered by Medicare.

Transition is not a cheap thing

EDIT: Please feel free to PM me too... I have contact details for a voice therapist ( who trains the therapists at Monash Gender Clinic ), and an image consultant. Although Dr Erasmus can make such referrals too. Both aren't expensive .

Thanks so much Sammy <3 so should I call Dr Erasmus or go back to my doc and tell her that I would like to use Dr. Eramus so I can set up the treatment plan?

Also, thanks for outlining the cost, it doesn't seem too bad. Are the AA and HRT pills very expensive as well, as that would be an additional cost on top of therapy, laser, etc? 

[Cindy]

To be honest the most expensive and painful is laser and electrolysis.

You could give the GP the link to the anzpath site it lists the providers

[EmmaD]

To echo Cindy, all the specialist service providers are listed at ANZPATH.  I met Dr Strecker a couple of times and I got the impression he wasn't too interested.  That said, he has done a lot of trans doctoring.

A mental health treatment plan is very useful.  Things just cost too much otherwise. Your GP should be all over these things, it is just who they direct it to that is the point at this stage.  They all know what is required as it applies to a large range of mental health services.

If I look back over the past 2 years, electrolysis is by far the most expensive thing.  Electro most weeks for about 20 months and still going every 3 weeks.  As electro costs diminish, other things start up more (wigs, girly glasses, clothes.....)

Regarding Monash, I recall hearing Dr Harte talking once about how it has a huge waiting list due to limited funding.  He provides his services to it but the hours funded are really low.  If you can manage it, go private, utilise Medicare as fully as you can and you will mostly access the same people.

[Cindy]

I know Monash was having problems, and I think they got a big funding cut from the Vics.

To be honest I would get a referral to Harte or Erasmus. They are really nice guys.

I would also seriously consider Dr Ives for surgery.

[Kara Jayde]

To be honest the most expensive and painful is laser and electrolysis.

You could give the GP the link to the anzpath site it lists the providers

The more time I spend here, the more I realize how difficult the hair removal factor is. I have fairly light skin and dark brown facial hair, it is thick, but it's consistently variant shades of dark brown (except for a little red when it gets much longer, but never while short). I'm thinking of trying laser first, only because it sounds as if I am the perfect candidate for it, and also because electrolysis sounds like a very difficult process. It isn't the pain I'd be afraid of, more the fact that there is so much healing time + you need to have your beard grown out a little + it will be patchy while being grown out because of the electrolysis. It sounds like it'd be absolutely noticeable to everyone. Am I exaggerating the effect in my head?

Oh, and my GP called and told me to come pick up a list of therapist names tomorrow, so I may discuss the Dr's recommended here when I see her ^^

To echo Cindy, all the specialist service providers are listed at ANZPATH.  I met Dr Strecker a couple of times and I got the impression he wasn't too interested.  That said, he has done a lot of trans doctoring.

A mental health treatment plan is very useful.  Things just cost too much otherwise. Your GP should be all over these things, it is just who they direct it to that is the point at this stage.  They all know what is required as it applies to a large range of mental health services.

If I look back over the past 2 years, electrolysis is by far the most expensive thing.  Electro most weeks for about 20 months and still going every 3 weeks.  As electro costs diminish, other things start up more (wigs, girly glasses, clothes.....)

Regarding Monash, I recall hearing Dr Harte talking once about how it has a huge waiting list due to limited funding.  He provides his services to it but the hours funded are really low.  If you can manage it, go private, utilise Medicare as fully as you can and you will mostly access the same people.

Okay, good to know. I'll reach out to the doctors listed, thank you! As I said above, I'm a little concerned about electro and am considering laser, is this seen here as generally a waste of time and money due to the low rate of effectiveness?

[Ms Grace]

Electro is painful, time consuming and expensive - but the right type of electro will give you permanent removal. I'm having the multi-probe galvanic variety and have to say I'm very happy with the results. Just wish it was over. The pain is variable. Sometimes I don't mind it, even during a three hour treatment - but other times, each needle hurts. And wow, the top lip!

[Cindy]

May I just say to every trans*woman.

THE TOP LIP HURTS LIKE...............................................................................................a lot

[immortal gypsy]

If you're using laser make sure it is LASER and not the ipl. Laser may cost a little more but you will see results faster so it can become cheaper in the long run.

[EmmaD]

I am also the recipient of many many hours of multi-probe galvanic done with 2 electrolysists using 8 probes each - I have all the receipts and think it is now at about 90 hours mostly with 2 people zapping at the same time.  Cost?? Yeah well...At least it is over a long period. 

Under nose =    ....but I found laser hurt too, but not for an hour at a time.  I remember doing 2 hours electro on my top lip with no pain relief.  Oh my God!!!  Many times as I endured it I have thought to myself "you REALLY REALLY must want this 'cos you wouldn't go anywhere near it otherwise".  Dr Harte even mentioned this!  This is also a very big deal for me as the 5 days after electro my skin is rubbish.  I react badly and it takes most of the week after to calm down again.  Trying to present as female during this time is impossible.  As bad as I react, not a single work colleague has ever commented which is surprising as I really do look like crap afterwards.  The skin reaction hasn't really improved over time either.

I had too much brown, red, white & grey hair for laser to work very well but I did try.  Now at every 3 weeks for electro and haven't shaved for 3 months.  After tomorrow (Oh joy - another round with some brown hairs right up under my nose.  Tears!!) I expect to push the appointments out further.  This is a huge relief but I do feel I have earned it.

[Ms Grace]

Emma, have you tried using Emla numbing cream? It needs to be slathered on at least an hour before the treatment (and covered with a bit of plastic before it is wiped off and the area sterilised for treatment)...it makes a huge difference. Yes you still feel most needles and it still hurts but the pain is significantly dulled. Lasts for about half an hour after it's wiped off. Can be bought from a chemist, isn't cheap!

[EmmaD]

Tried Emla. Too water-based for me and makes the treated area go bright red for days. Got a different one made up by a compounding chemist that  that worked well for about 12 months and then I started reacting the same as for Emla.  Dr Harte offered to prescribe a stronger one than over the counter but I am almost done now so haven't bothered.

I did get a dentist to inject me once for the first top lip clearance but we only got 2/3 of it done.  Really good while it lasted.  That session was 3 hours single probe turned way up!

By way of explanation, what I was told is that for it to work well, there needs to be a moisture gradient from the surface in. Water-based creams can upset that.  I haven't bothered with pain relief for a while now. Just shed tears instead while keeping still.

[Ms Grace]

Bummer - hope it's effects don't wear off on me too!

[luna nyan]

Wow, this Aussie thread refuses to die so I better chime in from Sydney.

Nattie, the others have already given you good advice in where to go for therapy/hrt recommendations.  Medicare is very helpful, although for some people you may see, a gap fee may apply.  At least HRT costs are reasonable thanks to the PBS.

Somehow this thread has turned into one on electro.

THE. TOP. LIP. HURTS.

I would say that EMLA cream is wishful thinking.  Yes, the mix of lignocaine and prilocaine does manage to penetrate, but it's not a profound anasethetia.  EMLA is only good for taking the edge off the initial puncture for inserting something pointy for injections/catheter insertions - what little that penetrates past the dermis will dissipate quickly due to the lack of a vasoconstrictor (something to stop the blood vessels from carrying the local away).

A standard dental injection with lignocaine and adrenaline will usually give 2-3 hours of soft tissue anaesthetia at best.  If your friendly local dentist does a lot of oral surgery, there may be some Marcaine (bupivicaine hydrochloride) available.  That will give anything up to 8 hours, but there are risks involved with using it as a local agent.

[Kara Jayde]

Wow, it must hurt a lot if you're all discussing the best way to numb the pain. Not looking forward to that at all *sigh*.

How long does your facial hair have to be for them to administer electro/laser? My main concern is having to live with a patchy beard between sessions, since I think it'd be very noticeable. 

[Emily.T]

Hi Nattie. Another South Aussie here I have my first psyc appt in 3 weeks am so excited have been waiting 5 months, I hope you have an easier time and find someone soon.

[EmmaD]

When I started electro, I would shave on Wednesday morning for a saturday appointment.  After I had been on HRT for a few months (after we had cleared my whole face), they asked if I could leave it a bit longer.  This was because the hair that was left was less visible (fine and not coloured much).  So for the past 3 months, I haven't shaved between appointments that are 3 weeks apart.

Given the fashion these days for the unshaved look, it doesn't matter much if you don't shave.