Talking with therapist about hormones?

[BoringUsername]

I've been talking with trans friends as well as a med school friend and they've all mentioned that some gatekeepers may use low dose hrt as an indicator for issues.  I had always thought that real hrt was just for the " full transition " cases.  And even before I've tried a bunch of different herbal pills which I know are frowned upon here, so I won't push that, but I did stop taking them.  After conversing with said friends I've decided I'm going to ask my therapist about different options.  But I am looking to start something, does anyone else have experience with " feeling out " starting hormones?

[adrian]

Hey,

so are you thinking about asking to start a low dose hrt to see how / if it would work for you? (sorry if I misunderstood) Do you have a sense of what your counselor's opinion on this would be?

Raising the issue of hrt with my therapist is really difficult for me because I'm worried he'll terminate me if I do. He isn't a gender specialist and I started before I even knew or had understood that I'm trans. But that seems to be a different situation from yours, so I'll stop whining now ..

[BoringUsername]

Hey,

so are you thinking about asking to start a low dose hrt to see how / if it would work for you? (sorry if I misunderstood) Do you have a sense of what your counselor's opinion on this would be?

Raising the issue of hrt with my therapist is really difficult for me because I'm worried he'll terminate me if I do. He isn't a gender specialist and I started before I even knew or had understood that I'm trans. But that seems to be a different situation from yours, so I'll stop whining now ..

Yes, that's what I meant.  But I am seeing a gender specialist and I'm definitely going to bring this up to her.

[Cindy]

No reason not to start off on low doses. I know many members who are quite happy on low dose that causes little physical change but does control their dysphoria.

[adrian]

Yes, in that case -- go for it!

[Rachel]

I originally wanted low dose but when the time came I asked for full dose. My therapist just asked I stay on the hormones for 4 months to give it a chance. After 2 months I told her I would never go off them.

[ImagineKate]

I believe what you're referring to is low dose HRT as a diagnostic tool. I've heard of it. I have tried it myself and this pretty much helped tip me into the direction of full transition.

[BoringUsername]

I believe what you're referring to is low dose HRT as a diagnostic tool. I've heard of it. I have tried it myself and this pretty much helped tip me into the direction of full transition.

How did you go about getting started on it?

Just straight away asking or?

[ImagineKate]

How did you go about getting started on it?

Just straight away asking or?

No, I self medded. It's not something I'm proud of but I did tell my family doctor (GP) and he monitored me, not my hormone levels but my general bloodwork. Not the route I would recommend.

The way you should go about doing it is asking your therapist to write a referral letter, or you can go to an informed consent clinic and ask if they can do low dose to start.

[jeni]

Raising the issue of hrt with my therapist is really difficult for me because I'm worried he'll terminate me if I do. He isn't a gender specialist and I started before I even knew or had understood that I'm trans. But that seems to be a different situation from yours, so I'll stop whining now ..

Why do you think he'll terminate you if you ask about it? That sounds unusual and massively unethical.

I was seeing a non-gender therapist for a long time, then one day came in and just flat out told him I was trans, and was going to transition. He's still my therapist, and despite having little experience with transgender issues, is extremely helpful and there has been no problem. He's even aware enough to know that gatekeeping is BS and was completely willing to write a referral letter if I needed one.

I am currently on a "low dose" of estradiol, though I think it is higher than the medically termed "low dose" treatment. (Not sure though.) Regardless though, it is very common to start with a lowish dose and increase over time, both to provide time to evaluate how one feels about it or, more commonly I think, just to let your body adapt. There's no rush to boost the dose.

[Devlyn]

How did you go about getting started on it?

Just straight away asking or?

See if there's an informed consent clinic near you: https://www.susans.org/wiki/Informed_consent

By the way, nobody frowns at what herbals have done for me.  We can talk about them all we want within site rules.



Hugs, Devlyn

[adrian]

Why do you think he'll terminate you if you ask about it? That sounds unusual and massively unethical.

He is a good therapist and I actually made lots of progress with him. But there is a possibility that he will not write the letter required for hrt for me. I have a feeling that (possibly as a result of a negative experience with another client) he is hesitant as far as hrt is concerned. We agreed that we would work through some other issues before making that decision. But for me the point to decide has come -- so I'll see what happens soon.

[ImagineKate]

I was terribly gun shy about asking for HRT in the beginning from my therapist. Then I just really broke down and had to ask if her plan was to get me on HRT... because in truth I was ready to do really drastic things. She then said there are places to do it and I can just go. Okay then, had I known I would have just gone!

I mean this therapist could have killed me.  I just couldn't stand a day longer as a male and honestly leaving my kids behind is the only thing that saved me from jumping off a bridge or something.

I eventually got another therapist, because this one and I mutually separated, which is great. I felt I wasn't getting out of her what I needed and this new one is extremely good, is savvy and a committee member of WPATH among other things.

My dysphoria is very much managed now and I am much happier, people can see it in me, all my friends, my mom and reluctantly even my wife who does NOT support me one iota, yet wants me around for the kids.

I have zero thoughts of anything suicidal now, I am doing GREAT and I go full time soon.

SO the moral of the story is if you want something, ask. If you're not getting it, keep looking. Don't give up.

[FTMax]

You'll never know if you don't ask! Personally, I'd phrase it just like you did here. Be honest and willing to dialogue about your intentions and goals with the low dose HRT.

Also be aware that many doctors will start you on a low dose automatically when prescribing HRT. So if you're not comfortable asking from a diagnostic standpoint, you could ask from the "I'm ready to start HRT but I want to ease into it" angle.

[awilliams1701]

Your Endo (or other doctor) will determine low dose or not. Mine started me on low dose for 2 weeks and full dose afterword. It was to give my body a chance to adjust. I'm glad she did it too. That was a rough month for me. I felt sick and I'm certain it was part of the adjustment. For the first week and a half I felt nauseated at first all day long and later on only about an hour after taking the pills for several hours later. It went away by the end of the second week, but it came back when I got the full dose. Fortunately the second time around it wasn't nearly as bad. It only took me a week to get over it and it was an hour afterword for only about an hour.

[ImagineKate]

Your Endo (or other doctor) will determine low dose or not. Mine started me on low dose for 2 weeks and full dose afterword. It was to give my body a chance to adjust. I'm glad she did it too. That was a rough month for me. I felt sick and I'm certain it was part of the adjustment. For the first week and a half I felt nauseated at first all day long and later on only about an hour after taking the pills for several hours later. It went away by the end of the second week, but it came back when I got the full dose. Fortunately the second time around it wasn't nearly as bad. It only took me a week to get over it and it was an hour afterword for only about an hour.

In my case I didn't get that just body temp adjustment (I felt cold), a slight headache and some night sweats. Subsided in a couple of days.

[jeni]

He is a good therapist and I actually made lots of progress with him. But there is a possibility that he will not write the letter required for hrt for me. I have a feeling that (possibly as a result of a negative experience with another client) he is hesitant as far as hrt is concerned. We agreed that we would work through some other issues before making that decision. But for me the point to decide has come -- so I'll see what happens soon.

I see, but "terminate" sounds like he'd stop treating you? That is what I don't understand. If it's just not help you get the HRT, you could go to a more sensible therapist (or go the IC route directly to an endo) and stick with him for other issues if you thought he was still helpful. But honestly, if he unreasonably blocks you from HRT, you probably don't want to be seeing him anyway.

[adrian]

I see, but "terminate" sounds like he'd stop treating you? That is what I don't understand. If it's just not help you get the HRT, you could go to a more sensible therapist (or go the IC route directly to an endo) and stick with him for other issues if you thought he was still helpful. But honestly, if he unreasonably blocks you from HRT, you probably don't want to be seeing him anyway.

Well, "terminate" in the sense that he will suggest that I see another therapist if I want hrt. He would likely not refuse treating me for "other issues", but I don't want to have two therapists (and couldn't afford them either). He and I, we will sort it out . We don't have IC in Germany. I need a therapist to write the letter and it has to be someone I have seen for at least six months.

We will sort it out, my t and I . Thank you for your concern, jeni! (and sorry to the op for jumping on the thread!)

[BoringUsername]

Well I set up my next appointment for Tuesday.

Going to ask about it then as well as discuss the usual stuff

[adrian]

That's great! Crossing my fingers