Physical examination before prescribing?

[Wicked-Jester]

Hey

I'm..  Kind of new here, been reading for some time. I'm FTM. I could really use some advice. I had my first meeting with a gender specialist (NHS) a few months back, and have my next on Tuesday - but he wants to carry out a physical examination before allowing me to receive testosterone, examining to look for injection sites "or any other reason we can't prescribe HRT". I've done a few searches but never read about this? I've been waiting for this for so long, but the thought of this is enough to make me not want to continue, I'm incredibly uncomfortable with my er, top half especially. I was wondering if anyone has any advice?

[JoanneB]

Physical exams before HRT are usually diagnostic tests to first establish a baseline, or reference level, for where yours are 'Before'. Most importantly, is to determine your state of health and any underlying medical issues which may contraindicate administering whatever drug.

There are several "Typical" injection sites for sub-Q or IM shots. Some more convenient then others for self administration. Some better then others for newbies to try to use. I can't imagine how much of a physical assessment is needed  beyond a quick look of body type and for IM shots perhaps how long a needle to use to hit muscle and not bone.

[FTMax]

My experience may be way different from what you'll go through, depending on the doctor. I go to an extremely trans-friendly clinic and they anticipate there being a lot of dysphoria throughout the process, so they've modified it from a standard physical. I also go to an informed consent clinic, so that part of the process is a little different. That said, this is what they did:

- Came into the exam area
- Got vitals taken (blood pressure, height/weight, temperature, etc.)
- Waited for doctor
- Discussed medical history (mine & family's)
- Got recommendations based on the above (her recommendations: flu vaccine, HPV vaccine, pelvic exam/pap smear - I declined consent for all of them)
- Went over the informed consent form
- Discussed types of T, my preferences, and her recommendations
- She listened to my heart, lungs, and felt my lymph nodes and abdomen
- She put in the orders for my lab work and sent me down the hall
- Scheduled my next visit
- Got blood drawn
- Drank water and ate a snack before leaving

It was very non-invasive and the environment in general was very comfortable. My chest was never touched aside from having a stethoscope on it for maybe 15 seconds. I never had to take any clothing off.

T injection sites are in a few specific places. If you're primarily going to be self-injecting, I'd say you'd prefer doing them in the thigh and see if you can leave it at that. Perhaps also wear or bring with you underclothes (not underwear, but an undershirt and maybe some long underwear) and see if you can't wear those instead of stripping down if they ask you to. I know you said NHS so you're in the UK? Not sure what the attitude there is, but at least over here there wouldn't be any issues if I brought a friend/parent/significant other for support. Maybe consider having someone go with you to help you relax.

[Wicked-Jester]

Thanks for the speedy replies!
The letter states full top exposure, this is the part that has left me uncomfortable. But I think I may ask if I can get around it with long top like you said. And as far as injection sites go, at the last apoinrnent he was saying he doesn't prescribe injectable T but uses a cream to be appwhat  in small amounts. This is whats left me mildly confused

[FTMax]

Hmm have you had any blood tests done yet? That may have been what he was referencing - injection sites for blood draws so that he can figure out what your ultimate dosage should be set at.

[Apples Mk.II]

Yep, I've ended getting something similar. Bone density test, intersex genetic markers, top and bottom examinations, all performed or requested by the endo. Sometimes they go quite far with safety before prescribing.