bloods are done, haven't booked to get them...

[Rafaela]

Okay, I've been putting this off for a week, and the GP has been sending me reminders and phoning and texting to get me to book a visit to evaluate the results. The last three tests I've been to showed a steadily declining T result, with the last one showing almost non-existent levels. Great! But he still doesn't know what's going on and is understandably worried. Being male outwardly is there a chance I can ask for e levels without spilling the beans? I need a rough outline of how to request the test for estrogen/estrone/estradiol levels without completely blowing my cover. I've been monitoring all the other levels myself and am reasonably happy (apart from triglycerides and cholesterol and blood sugar, but I'm working on getting them down) but guys DON'T GET TESTED FOR E.
When the next test IS ordered I plan on getting it done five days after IM EV injection, to give me a rough idea of how it's working without showing the initial spike.
Any suggestions and help and experiences are most welcome, I'm counting on y'all 

[Rachel]

Explain to your GP you are trans and on a anti androgen and plan to go on E IM.

This will do four things:

Increase your agency
explain to your GP why your T is low
Get you better HRT monitoring
start rebuilding a damaged patient doctor relationship.

[Maybebaby56]

Hi Rafaela,

Are you not telling your doctor what is going on with your life because you are embarrassed?  Is there some other reason? I'm not sure I understand the situation. Are you seeing an endocrinologist?  You had to tell him or her you are transgender, right?

I was hesitant to tell my GP that I was transgender, and seeing a therapist, and I was being prescribed hormones by an endocrinologist, but I had to tell her at some point or she could not be my "health care provider".  And it turns out she hardly batted an eye.  Actually, I was very happy to walk out of her office with a copy of my medical records that said "Transgendered" under "diagnosis"! It was official!

With kindness,

Terri

Edit: "start rebuilding a damaged patient doctor relationship". Yes, Rachel Lynn is exactly right.  There is no point going to a doctor you lie to.

[Ellement_of_Freedom]

You should really tell the doctor the truth. He is a health professional and bound by confidentiality. I think it's really important you explain your situation fully so he can do his job. You could be causing unnecessary stress both for the doctor and yourself.

This will also allow him to help you in more effective ways.

[Rafaela]

Explain to your GP you are trans and on a anti androgen and plan to go on E IM.

This will do four things:

Increase your agency
explain to your GP why your T is low
Get you better HRT monitoring
start rebuilding a damaged patient doctor relationship.

So blow the doors wide open?! We don't have a close doctor/patient relationship, but I do know that he has operated under an informed consent model with at least one other patient, although that was for a body builder who he assisted with testing T levels. Very dangerous stuff, taking anabolic steroids, but he did what he could. This is the only reason I'm even considering blabbing it, I'm a very shy, introverted person and haTe discussing even basic personal issues, let alone dropping a bomb like "oh by the way, I've been living a lie for forty years and I'm struggling with my identity..." This forum is helping me deal with my issues quietly and healthily without turning my life into a sh17 storm.

"Increase your agency"
What the huh? I'm not sure what this means.

Last time T came back even lower than usual I explained I was on finasteride for hair loss and he went wide-eyed and shocked on me like I was cheating on him. WHO PRESCRIBED IT? WHERE IS IT FROM??!! You can't trust things you buy from the internet!!! I was like a deer in headlights. So I promised to quit taking it and do another blood test. Which I did. But I kept taking the spiro and the Estradot. So that's what the latest test will show, which took a couple of months to book, and I haven't rebooked the result consultation... which is pending...

"Get you better HRT monitoring"
This is the goal, what I have currently is adequate for my peace of mind, but certainly is not the best while I'm playing God with my body. My choice, but I like to be reasonably careful.

I'm looking to 'hint' that I'm in need of an E test, without turning into a mess.

You've given me food for thought, so thank you Rachael 

[Rafaela]

Hi Rafaela,

Are you not telling your doctor what is going on with your life because you are embarrassed?  Is there some other reason? I'm not sure I understand the situation. Are you seeing an endocrinologist?  You had to tell him or her you are transgender, right?

I was hesitant to tell my GP that I was transgender, and seeing a therapist, and I was being prescribed hormones by an endocrinologist, but I had to tell her at some point or she could not be my "health care provider".  And it turns out she hardly batted an eye.  Actually, I was very happy to walk out of her office with a copy of my medical records that said "Transgendered" under "diagnosis"! It was official!

With kindness,

Terri

Edit: "start rebuilding a damaged patient doctor relationship". Yes, Rachel Lynn is exactly right.  There is no point going to a doctor you lie to.

Damned straight I'm embarrassed! I'M on a seesaw wondering if throwing it all out there is better than bottling it up, so pulling the pin on this grenade can wait until I'm good and ready and know how I'm feeling about it all. I'm having second thoughts about once every two weeks, so slowly slowly, softly softly is how I'm dealing right now. I feel more positive, more relaxed, less stressed and more comfortable in my own skin since commencing my 'trial' 6 months ago, but I'm not ready to wear a dress to work and put my hair in rollers... as long as I'm making some kind of progress I'm happy- I dread the thought of running out of E and being off the tracks.

I am not seeing an endo. this gets all very invasive and official when that happens, so I'm cruising along with CARE right now, but would be happier knowing more about my levels than a standard panel can tell me. My bloods are acceptable as far as I can see, but obviously NOT acceptable for a genetic male. Whether I'm transgender, genderqueer, a camel or whatever is something I'm gradually working out for myself. I'm literally petrified of spilling my process to a random healthcare professional.

I'm not saying the way I'm going is smart or acceptable to most, but it's how I'm dealing with it right now, sorry if this is against any special tg handbook, but I'm most of what I have right now.

[Rafaela]

You should really tell the doctor the truth. He is a health professional and bound by confidentiality. I think it's really important you explain your situation fully so he can do his job. You could be causing unnecessary stress both for the doctor and yourself.

This will also allow him to help you in more effective ways.

Thanks Elle, I am taking the suggestions on board, and you are making me consider other avenues. But I'm a chicken 

[Maybebaby56]

Damned straight I'm embarrassed! I'M on a seesaw wondering if throwing it all out there is better than bottling it up, so pulling the pin on this grenade can wait until I'm good and ready and know how I'm feeling about it all. I'm having second thoughts about once every two weeks, so slowly slowly, softly softly is how I'm dealing right now. I feel more positive, more relaxed, less stressed and more comfortable in my own skin since commencing my 'trial' 6 months ago, but I'm not ready to wear a dress to work and put my hair in rollers... as long as I'm making some kind of progress I'm happy- I dread the thought of running out of E and being off the tracks.

I am not seeing an endo. this gets all very invasive and official when that happens, so I'm cruising along with CARE right now, but would be happier knowing more about my levels than a standard panel can tell me. My bloods are acceptable as far as I can see, but obviously NOT acceptable for a genetic male. Whether I'm transgender, genderqueer, a camel or whatever is something I'm gradually working out for myself. I'm literally petrified of spilling my process to a random healthcare professional.

I'm not saying the way I'm going is smart or acceptable to most, but it's how I'm dealing with it right now, sorry if this is against any special tg handbook, but I'm most of what I have right now.

Lol, I can't seem to find my TG handbook, but since you have been on this site for a while, you know lots of people share your anxiety and concern.

I think you know how you feel about it, since you already made the decision to start taking hormones. What you need now, more than anything, is more self-acceptance.  I understand it's hard to tell yourself, "I am transgender". You are probably acutely aware of the social stigma being transgender can bring.  It does take courage, but there are really only two options: either you suppress your feelings and live with the constant dysphoria, anxiety, and self-loathing, or you accept who you are and give yourself permission to live.

There is no one way to be transgender.  You don't have to wear a dress or put your hair in rollers.  Low-dose HRT can keep the dysphoria at bay while you sort out your feelings.  Can you arrange to see a gender therapist?  That should have been your first step. 

With kindness,

Terri

[kelly_aus]

Another thing to consider..

Without the knowledge of what you are doing, your GP may recommend treatments that are contrary to what you are trying to achieve. And when you refuse those treatments, he/she has the option to stop treating you at all.

Telling your GP is really the only option for you to achieve your aims. I've dealt with several GP's now, in 2 states and I'm yet to have any issues. It's something I mention the first time I see them.

And your blood work needs to test for more than just E and T.. Prolactin.. Liver function.. Cholesterol.

It's nothing to be embarrassed about, it's a medical condition - you know, like diabetes or similar.

And there's no excuse for self-medding in Australia.. None at all. If I was starting out now, I could obtain legitimate, legal prescriptions and appropriate monitoring in a couple of weeks. No endo needed. 

[Rafaela]

@ Terri, I know I'm not exactly special on these pages, but in the greater scheme of things where the 'normal' people live what I'm experiencing is somewhere between heresy and insanity. I'm going to have to confront it head on at some point, but currently I'm blithely skipping along in my old life without too much stress. The fact I'm doing SOMETHING about it makes me much less depressed than I would be otherwise. I should mention my other half is an enrolled nurse and does the IM injecting. Another on the way tonight, my second. Thank you for your words of support, it does give me a warm fuzzy 

@Kelly, if my GP put me on other contradictory meds I would still have two options - tell him the whole story about trialling etc, and simply getting the script and not filling it. I know that's not right, but remember I'm petrified of opening that side publicly and on record.
My blood tests are quite comprehensive, full panel including potassium, lft, trig, cholesterol, diabetes, androgens, Etc etc. I'm not an endocrinologist, but I know my target levels and am concerned enough about my wellbeing not to do anything without understanding the consequences fully.
You say you could obtain prescriptions and monitoring in two weeks, but I have a feeling this would be more of a grenade approach than I'm willing to take- stumbling along is working for me right now, I just need to figure out what I'm going to say at the appointment. Once I make it. Thanks for your opinion, appreciate the counterpoints and different views for me to chew on 

[kelly_aus]

The several weeks approach requires nothing but honesty. I've not has a single issue with medical professionals in either South Australia or Victoria and I know others in Tasmania, Queensland and NSW.

You seem to have issues with self-acceptance, I'd suggest finding a therapist and dealing with that - because if you keep taking hormones, there will come a point where you have no choice to disclose, however, if you don't have self-acceptance at that point, well, frankly you are somewhat screwed.

And also remember, failing to disclose to your GP also removes the liability from the doctor should you have any serious issues.

[Ellement_of_Freedom]

It's a really frightening thing to say out loud to someone. But once it's done, it's done. You'll feel a weight lifted from your shoulders Rafaela! <3

He may just refer you to someone with more experience, which is even better for you again.

We are privileged to have access to highly trained health professionals in Australia - you should really make use of them. You owe it to yourself.

[Rafaela]

The several weeks approach requires nothing but honesty. I've not has a single issue with medical professionals in either South Australia or Victoria and I know others in Tasmania, Queensland and NSW.

You seem to have issues with self-acceptance, I'd suggest finding a therapist and dealing with that - because if you keep taking hormones, there will come a point where you have no choice to disclose, however, if you don't have self-acceptance at that point, well, frankly you are somewhat screwed.

And also remember, failing to disclose to your GP also removes the liability from the doctor should you have any serious issues.

Yes. It is painfully obvious that I have issues with self acceptance. A therapist? That's what you guys are for  I'm getting there. I'm not self-destructing anymore, so as ze chermans say "immerhin".
Doctors liability for what I'm doing to myself? I'm the only one I blame for anything I do.

[Rafaela]

It's a really frightening thing to say out loud to someone. But once it's done, it's done. You'll feel a weight lifted from your shoulders Rafaela! <3

He may just refer you to someone with more experience, which is even better for you again.

We are privileged to have access to highly trained health professionals in Australia - you should really make use of them. You owe it to yourself.

Thanks Elle, I know what you're saying but I'm built more like an island than an open book right now 


I still don't know what to say. Grenade? Hint? Nothing? Fall apart in tears on the floor? Not booking the consult yet 

[Deborah]

It's a really frightening thing to say out loud to someone. But once it's done, it's done. You'll feel a weight lifted from your shoulders Rafaela! <3

i agree.  Doing that with just the therapist relieved the dysphoria nearly as much as starting HRT a few months later.



Sapere Aude

[kelly_aus]

OK, now I'm going to stop sugar coating stuff..

Get a therapist, I'm not a therapist. Nor is anyone else around here, stop being a fool and get some professional help as you clearly need it.

Australia is one of the most accepting countries in the world to be trans.. Hell, Carlotta is considered by many to be a national treasure.

The fear that is eating you exists only in your head. Pull your head out of your ass. And before you dismiss me, I'll point out I came out 6 years and 1 day ago and none of the horrible possibilities of doing so actually happened.

[JoanneB]

For a number of years I was taking E and an AA. Depending on where you live (USA) it is possible in many states to get blood tests on-line. So I had a really good idea what my levels were, as well as how well the rest of the blood workups

Eventually the day came I got tired of the silliness. I had lost a ton of the shame and guilt about being trans. Plus my wife was on my case about seeing a doctor because it was ages since I last to one. (Having worked as a medical device engineer I have a pretty low opinion of doctors in general)

So during my New-Patient appoint I came clean. No big deal. I did have a bit of anxiety at first over him asking if it was OK to actually put "Transgender" on my chart. At the instant I hemmed and hawed he called away. My angels intervening I think. My initial NFW thoughts soon turned to Hey Idiot. You're here because you want to put an end to a the shame, guilt, and feeling like a freak.

Not that it will help, a TG person essentially cannot be refused medical care. But that is on paper. The doctor will either turn red and be flustered when you drop the T-Bomb or simply think, "OK, one of those".

And  TBH - There has to be a reason your T was getting check to start with since that is usually not too typical either. Insurance never batted an eye over the blood work. E is often checked in association with prostate issues. HRT with Horizon is another story. Aetna was no prob

[Rafaela]

OK, now I'm going to stop sugar coating stuff..

Get a therapist, I'm not a therapist. Nor is anyone else around here, stop being a fool and get some professional help as you clearly need it.

Australia is one of the most accepting countries in the world to be trans.. Hell, Carlotta is considered by many to be a national treasure.

The fear that is eating you exists only in your head. Pull your head out of your ass. And before you dismiss me, I'll point out I came out 6 years and 1 day ago and none of the horrible possibilities of doing so actually happened.

Yes Kelly, but what do you REALLY think ? 
I've been on antidepressants most of my adult life, and all they do is put a filter on your emotions. No lows, but no highs either. MAOIs, SSRIs, the lot. It's like living in a milky bubble. I know I should be seeing a therapist, but it's just not how I'm built.
Btw happy 6 year anniversary 

[Maybebaby56]

Hi Rafaela,

I have been following this thread and a number of people have told you pretty much what I told you.  You know there is something different about yourself, and you are ashamed of it.  And you know exactly what that "it" is. All I can tell you is that is something most all transgender people go through.  No one wants to be transgender.  It is hard, it is scary, it is painful, and it is expensive should you choose to transition.  It is also not the end of your life. You are boxing yourself in with fear.

You have a loving partner who accepts you for who you are, and it is not to your credit if you cannot show her that who she loves is someone worth loving.  In contrast, my wife, whom I separated from several years ago, want nothing to do with my transition.  She is vaguely disgusted by it. She thinks it is a "lifestyle choice".  I have to put up with it because she is the mother of my children, and I try to make things work, for their sake.  You have been given such a gift of support, and yet you worry what a doctor may think of you.

If you cannot let go of your fear for yourself, then do it for her.

With kindness,

Terri

Edit: I just saw your post saying you are on antidepressants.  How can you be prescribed antidepressants without seeing a psychiatrist?  Can you talk to your psych about this?

[Rafaela]

For a number of years I was taking E and an AA. Depending on where you live (USA) it is possible in many states to get blood tests on-line. So I had a really good idea what my levels were, as well as how well the rest of the blood workups

Eventually the day came I got tired of the silliness. I had lost a ton of the shame and guilt about being trans. Plus my wife was on my case about seeing a doctor because it was ages since I last to one. (Having worked as a medical device engineer I have a pretty low opinion of doctors in general)

So during my New-Patient appoint I came clean. No big deal. I did have a bit of anxiety at first over him asking if it was OK to actually put "Transgender" on my chart. At the instant I hemmed and hawed he called away. My angels intervening I think. My initial NFW thoughts soon turned to Hey Idiot. You're here because you want to put an end to a the shame, guilt, and feeling like a freak.

Not that it will help, a TG person essentially cannot be refused medical care. But that is on paper. The doctor will either turn red and be flustered when you drop the T-Bomb or simply think, "OK, one of those".

And  TBH - There has to be a reason your T was getting check to start with since that is usually not too typical either. Insurance never batted an eye over the blood work. E is often checked in association with prostate issues. HRT with Horizon is another story. Aetna was no prob

I'm leaning more towards talking about it with the GP. Frankly I think it's going to be an informed consent model, with a question mark over my gender. As we all know things are rarely easy to pigeonhole when you're on the TG spectrum. I'm happier with no T. I'm happier on E than I have been in ages. Am I a full card carrying, shoe shopping, women's weekly reading woman? Nope. I'm somewhere in between, but closer to female than male. This I've known since I was a weird kid, from only inviting girls to my fifth birthday, through until wearing a pad over my lower regions as a teenager, and self harming 'That area' for years on and off. I've always found guy parts gross. I've always jokingly called myself a lesbian.
I'll make a list of everything I've been on and show up to discuss it with my GP, BUT I still don't know how to describe myself, as I'm still working it out!!!!
Imagine if there was a pill to make you 'normal', would you take it? I'm not sure I would, despite everything.