I don't understand how my Endo is a doctor

[skin]

I gathered early on that my endo pretty much just read the VA guide to transgender hormone therapy once and that is the extent of his knowledge. It wasn't a big deal because he just listened to whatever I told him to do. But now 11 months in and my T is still above the reference range and I can't get him to raise my doses. He just said that when he tries to put it in the computer, a warning appears that is higher than the recommended dose. I try to explain that the warning is because that medication is in the system for menopausal women, not trans women, but he is still scared off by the silly warning message. I don't have a point to this, just arghh.

[awilliams1701]

Any other doctors available? I don't have any in my area, but since I have to go to Atlanta I have a decent selection to choose from. Mine came highly recommended from a woman my parents met that transitioned like 30-40 years ago.

[skin]

I go to the VA. I can go to the patient advocate but I would feel guilty.

[awilliams1701]

VA?

I go to the VA. I can go to the patient advocate but I would feel guilty.

[skin]

Veterans Affairs. I don't have health insurance other than my veterans care.

[Laura_7]

Veterans Affairs. I don't have health insurance other than my veterans care.

You might look up a few recommendations from reputable sources.
There are even some powerpoints for med personnel out there. So you could have something to show him.
I'd do that in writing, like having it printed. There are printing shops which can print texts from files, for example. You might say that you are simply not treated the way it should be.
There should be a way for him to enter in his computer which overrides his settings.
He might make a treatment plan for you with limits other than the ones he used until now, there should be a way to enter user defined therapies. Or he might do it as it was done in the good old days, with notes and folders. You might even provide a table where he can enter lab results, or ask him to keep one. I'd talk about it with him, to find a way he is reassured its all within the bounds it should be.

[suzifrommd]

I go to the VA. I can go to the patient advocate but I would feel guilty.

Asking for decent care is within your rights and not something to be guilty about. You deserve it. It's not a favor they're doing you, it's something you're entitled to.

[JoanneB]

You might look up a few recommendations from reputable sources.
There are even some powerpoints for med personnel out there. So you could have something to show him.
I'd do that in writing, like having it printed. There are printing shops which can print texts from files, for example. You might say that you are simply not treated the way it should be.
There should be a way for him to enter in his computer which overrides his settings.
He might make a treatment plan for you with limits other than the ones he used until now, there should be a way to enter user defined therapies. Or he might do it as it was done in the good old days, with notes and folders. You might even provide a table where he can enter lab results, or ask him to keep one. I'd talk about it with him, to find a way he is reassured its all within the bounds it should be.

There are plenty of professional level peer reviewed papers out there on the hormonal treatment for trans people that cite suggest regimes as well as blood work levels. Pretty much a no brainer.

No brainer is pretty much how I would describe most "doctors". I've worked as a medical device designer and had to work with them as well as seeing it from the patients end. Also a few nurses in my family. Most do what I call "Cook Book Medicine". Exactly the same thing a lay person can do and get yelled at for... likely by that same doctor.

Actual hormone levels and other blood work will indicate how well the regime is working and its affects on other body systems. And then there are the Red-Lines in the sand with meds you should not cross. Doing so may lead to bad outcomes... for my medical license and insurance rates. An even more important consideration if I have no clue about what I am doing.

Oh.. did I mention I have very little respect for most doctors?