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Is there a medical exam you can have to see if you need HRT?

Started by Charlie Nicki, March 29, 2017, 10:32:20 AM

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Charlie Nicki

So the thoughts have been driving me crazy lately, I had a meeting with a therapist scheduled for Monday but couldn't go and haven't rescheduled. Deep down I feel like it won't work for me at all, I tried once 3 years ago and it didn't give me what I wanted which was reassurance. So anyway, it got me thinking if there was another way to deal with this. I've been reading here that even low dose HRT helped people feel better about their gender confusion so is there a test or something I can have at an endocrinologist that will help me know if my body "needs" the female hormone? (I'm a biological male) or if it will make me feel better? I don't know, maybe there's a hormonal imbalance or something? I hope I'm making sense, I feel it sounds crazy just typing.
Latina :) I speak Spanish, English and a bit of Portuguese.
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FTMDiaries

Quote from: Charlie Nicki on March 29, 2017, 10:32:20 AM
I had a meeting with a therapist scheduled for Monday but couldn't go and haven't rescheduled. Deep down I feel like it won't work for me at all, I tried once 3 years ago and it didn't give me what I wanted which was reassurance.

So you tried once 3 years ago & you gave up after a couple of months because you didn't gel with her. That doesn't mean that therapy won't work - it just means that that particular therapist wasn't right for you. That's OK: we don't all get on with everyone and I've had therapists that were a complete waste of my time too. So reschedule that appointment and go and see this new therapist, and if that doesn't work out just look for another one.

Also, in my experience, therapists aren't there to give you reassurance, or permission, or validation, or whatever. Rather, they listen to what you're saying and they ask you pointed questions to help you think about what is right for you. They won't tell you what you need to do; they'll help you figure it out for yourself.

Quote from: Charlie Nicki on March 29, 2017, 10:32:20 AM
I've been reading here that even low dose HRT helped people feel better about their gender confusion so is there a test or something I can have at an endocrinologist that will help me know if my body "needs" the female hormone? (I'm a biological male) or if it will make me feel better?

Whilst I'm sure this is not how you meant it here, I'm not a fan of the term 'gender confusion' because it's one that is used by anti-trans types to invalidate & demean us; as if we are somehow deluded or simply can't make up our minds. Most trans people are not at all confused about our gender.

That having been said, an endocrinologist would assess you as a biological male and would check to see whether your hormones are in the normal male range. If they're not, you may be offered medication to adjust them into the normal male range. That would include checking your oestrogen & progesterone levels and making sure they're low enough to be in the male range; if they're too high they'll want to bring them down. It's exceedingly unlikely that you'd find a reputable endo who would decide to switch your hormone profile round to the female range without a very good reason (such as a diagnosis of Gender Dysphoria).

I would strongly advise against taking any dose of HRT - which could mess up your body chemistry, damage certain organs, and cause irreversible changes to your body - without first determining whether it's the right thing to do. You need to figure that out with a therapist first before making any decisions that could permanently change your body. And then once you have a diagnosis, you need to work with a doctor to ensure you take HRT safely.

You may have heard reports of 'trans regret'. Many of them are fake, but there are some genuine cases out there of men who never actually had Gender Dysphoria but had some other reason to want to present themselves as female. So they transition to female thinking it's what they want, but they realise that it was the wrong thing to do because it doesn't solve what was wrong in the first place. That's why it's so important that you get the right diagnosis: if you have Gender Dysphoria then transitioning may be very helpful for you. If you don't, it may be very harmful... especially for a gay man. Take it from me: it's utterly heartbreaking to be a gay man moving through the world in a female-looking body. When I presented as female I couldn't possibly attract any partners because the only men who were interested in me were straight, and they wanted me for all those female attributes. Gay men wouldn't give me the time of day. Imagine how lonely and devastating that feels!

TL;DR: If you're confused rather than dysphoric, work on the source of your confusion with a therapist before making any life-changing decisions.





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RobynD

I don't believe there is. Psychotherapy is probably the best thing one can do to discern if you have GD. There are interesting online tests one can take, but i am not sure they have a lot of bearing on helping people decide.

The common wisdom pretty much says that if you have to ask if you have GD, you probably do and i think that is a good thing to go into therapy with. I think many people do try low dose HRT as a means to help figure it all out, but there is not a lot of science behind that and it does have some risks. I did it though and it immediately confirmed what i had thought all along.


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Asche

Agreeing with FTMDiaries.

Just a quick note: you don't have to have Gender Dysphoria to be trans.  I know people who never felt unhappy with their old gender, but transitioned and are really, really happy that they did.

In any case, some time spent with a therapist who has experience with gender issues will really help you settle  your mind as to whether some form of transition and/or HRT is the right step.

"...  I think I'm great just the way I am, and so are you." -- Jazz Jennings



CPTSD
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Michelle_P

Well, once you meet with an endocrinologist to start HRT, they MAY order an endocrine panel, particularly for older persons, to obtain various baseline numbers and check for possible problem areas.  That would reveal any odd imbalances that might need correction.

It will not reveal if you happen to have neuroendocrine components that would do better on estrogen than testosterone.  The easiest test for that is to simply start HRT and see if your state of mind improves over the next three months. 

Working with a therapist is one of the best ways I know of to clarify your own thinking and determine the nature of your issues, though.  I highly recommend it.
Earth my body, water my blood, air my breath and fire my spirit.

My personal transition path included medical changes.  The path others take may require no medical intervention, or different care.  We each find our own path. I provide these dates for the curious.
Electrolysis - Hours in The Chair: 238 (8.5 were preparing for GCS, five clearings); On estradiol patch June 2016; Full-time Oct 22, 2016; GCS Oct 20, 2017; FFS Aug 28, 2018; Stage 2 labiaplasty revision and BA Feb 26, 2019
Michelle's personal blog and biography
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Charlie Nicki

#5
Thank you everyone for your quick responses. I'll try to address each one.

@FTMDiaries: Your answer is really insightful and I will try and reschedule that appointment. The term "gender confusion" is just a way for me to loosely label myself without actually using the word "dysphoria" since I haven't been officially diagnosed, I didn't want to sound offensive. The word "dysphoria" just sounds so strong for me and I guess deep down I still struggle with accepting it/owning it.

@RobynD:  I definitely have huge doubts and thoughts in my mind all the time so if what you're saying is accurate then I most likely than not, have GD at some level.

@Asche: Can you explain a bit more about people not having GD yet transitioning for whatever reason and still being happy? 

@Michelle_P: Everyone agrees that seeing a therapist is the best idea so I will listen to you guys.
Latina :) I speak Spanish, English and a bit of Portuguese.
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Charlie Nicki

Quote from: FTMDiaries on March 29, 2017, 11:50:00 AM
if you have Gender Dysphoria then transitioning may be very helpful for you. If you don't, it may be very harmful... especially for a gay man. Take it from me: it's utterly heartbreaking to be a gay man moving through the world in a female-looking body. When I presented as female I couldn't possibly attract any partners because the only men who were interested in me were straight, and they wanted me for all those female attributes. Gay men wouldn't give me the time of day. Imagine how lonely and devastating that feels!

I forgot to add, living as a gay man I have actually never felt attracted to gay men per se. Mostly to heterosexual males. I have indeed had serious stable relationships with gay men, 2 for 4 years each and the current one for a year and a half...But each time I had to "force" myself to get to know the person and to like them. It never came natural, deep down I dislike how gay relationships work and I haven't particularly fell "head over heels" in love with any of my partners. I've loved all of them but it always felt like I did because that's what I had to do. I always thought I was either crazy, or had a cold heart or just fantasized too much about being with a traditional masculine guy that would love me and let me take the feminine role of the relationship. It's only fairly recently that I've started putting 2 and 2 together and realizing this might have to do with my gender identity as well.
Latina :) I speak Spanish, English and a bit of Portuguese.
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LiliFee

Quote from: Charlie Nicki on March 29, 2017, 01:32:09 PM
I forgot to add, living as a gay man I have actually never felt attracted to gay men per se. Mostly to heterosexual males. I have indeed had serious stable relationships with gay men, 2 for 4 years each and the current one for a year and a half...But each time I had to "force" myself to get to know the person and to like them. It never came natural, deep down I dislike how gay relationships work and I haven't particularly fell "head over heels" in love with any of my partners. I've loved all of them but it always felt like I did because that's what I had to do. I always thought I was either crazy, or had a cold heart or just fantasized too much about being with a traditional masculine guy that would love me and let me take the feminine role of the relationship. It's only fairly recently that I've started putting 2 and 2 together and realizing this might have to do with my gender identity as well.

To me it sounds like you're approaching this on a very rational level. That might give you an insight, but it's only a part of the puzzle! Perhaps you should give it time and see whether you can find a therapist, and this time I'm sure it'll work. You could ask around on forums and in support groups to get names. If you really need it, it'll find it's way anyway ;)
–  γνῶθι σεαυτόν  –

"Know then thyself, presume not God to scan, The proper study of mankind is Man"
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Charlie Nicki

Quote from: LiliFee on March 29, 2017, 02:02:40 PM
To me it sounds like you're approaching this on a very rational level. That might give you an insight, but it's only a part of the puzzle! Perhaps you should give it time and see whether you can find a therapist, and this time I'm sure it'll work. You could ask around on forums and in support groups to get names. If you really need it, it'll find it's way anyway ;)

I will definitely look for one :)
Latina :) I speak Spanish, English and a bit of Portuguese.
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MarcellaJH

Hi.  Both male and female hormone levels can be measured with a simple blood test by your endocrinologist.  Being biologically male, your testosterone level should be much higher than your estrogen.  With HRT, the testosterone is going to be knocked down by the androgen blocker.  You will concurrently take estradiol either by patch, pills, or injection.  The delivery system to use for you will be determined by your endocrinologist.  Peace!


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Daniellekai

Quote from: Charlie Nicki on March 29, 2017, 10:32:20 AM
So the thoughts have been driving me crazy lately, I had a meeting with a therapist scheduled for Monday but couldn't go and haven't rescheduled. Deep down I feel like it won't work for me at all, I tried once 3 years ago and it didn't give me what I wanted which was reassurance. So anyway, it got me thinking if there was another way to deal with this. I've been reading here that even low dose HRT helped people feel better about their gender confusion so is there a test or something I can have at an endocrinologist that will help me know if my body "needs" the female hormone? (I'm a biological male) or if it will make me feel better? I don't know, maybe there's a hormonal imbalance or something? I hope I'm making sense, I feel it sounds crazy just typing.

If such a quick and easy trans test existed, and it said that you shouldn't get HRT, would you be disappointed?


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Charlie Nicki

Quote from: Daniellekai on March 30, 2017, 01:37:17 AM
If such a quick and easy trans test existed, and it said that you shouldn't get HRT, would you be disappointed?

I would. I honestly get tired of coping with my own thoughts...Like some other people here have said, it's like "constant psychological warfare" and it's tiresome. HRT (in my mind) seems like a good answer at some point.
Latina :) I speak Spanish, English and a bit of Portuguese.
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Charlie Nicki

Just wanted to let you guys know that I did listen to you and had my first therapy session yesterday.

I really liked it, the therapist is a trans guy (I think) and he has a lot of experience dealing with other trans people. He told me we should meet weekly and after the first 4 sessions we'll talk if I have made any advancements.

The only thing that bothers me is that I need to figure out how to do it weekly without my boyfriend finding out and also it's a bit pricey but is worth it.
Latina :) I speak Spanish, English and a bit of Portuguese.
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FTMDiaries

Congrats, and well done! :)

You see how much easier it is when you find the right therapist for you? I bet it felt like a completely different experience to the last time you tried.

You're right that it's worth it. One way or another, it's worth investing in finding out the answers you seek. It sounds like you may have some answers in as little as a month's time. After all these years of confusion, surely that's worth investing in?

And you could always be honest with your boyfriend: just tell him you're seeing a therapist. You could tell him that it's to work on your gender issues, or you could say it's about something generic like anxiety or depression. But honesty is generally the best policy. ;)





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Charlie Nicki

Quote from: FTMDiaries on April 03, 2017, 08:54:09 AM
Congrats, and well done! :)

You see how much easier it is when you find the right therapist for you? I bet it felt like a completely different experience to the last time you tried.

Completely different but I must admit that the week has been an emotional rollercoaster after the first visit. He gave me homework to write every trans related thought I had for half an hour every day and that has really made me realize that I'm struggling with accepting it more than I thought. I'm still at the point where I wish this would go away even though deep inside I *know* it's impossible.

Quote from: FTMDiaries on April 03, 2017, 08:54:09 AMYou're right that it's worth it. One way or another, it's worth investing in finding out the answers you seek. It sounds like you may have some answers in as little as a month's time. After all these years of confusion, surely that's worth investing in?

Totally right!

Quote from: FTMDiaries on April 03, 2017, 08:54:09 AMAnd you could always be honest with your boyfriend: just tell him you're seeing a therapist. You could tell him that it's to work on your gender issues, or you could say it's about something generic like anxiety or depression. But honesty is generally the best policy. ;)

Yeah I hate lying but the thing is that my boyfriend is super nosy...Like extra nosy. So I'm just afraid he'll keep pressing me about it until I crack and end up telling him the truth before I'm even ready. Also, on my last relationship I came out as trans to my then boyfriend and it went horrible, so I just don't want to go through it at the moment.
Latina :) I speak Spanish, English and a bit of Portuguese.
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Charlie Nicki

Had my second therapy session yesterday, I really enjoyed it :). I got homework, need to collect images of women I want to look like just so I can show my therapy the type of woman I imagine myself to be. 
Latina :) I speak Spanish, English and a bit of Portuguese.
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DawnOday

Quote from: Charlie Nicki on April 07, 2017, 11:27:05 AM
Had my second therapy session yesterday, I really enjoyed it :). I got homework, need to collect images of women I want to look like just so I can show my therapy the type of woman I imagine myself to be. 

I chose Meryl Streep and Sally Field. Two beautiful, skilled, funny, confident women.  At 70 years old, Sally is still a vision of youth that others would die for.
Dawn Oday

It just feels right   :icon_hug: :icon_hug: :icon_kiss: :icon_kiss: :icon_kiss:

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First indication I was different- 1956 kindergarten
First crossdress - Asked mother to dress me in sisters costumes  Age 7
First revelation - 1982 to my present wife
First time telling the truth in therapy June 15, 2016
Start HRT Aug 2016
First public appearance 5/15/17



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AnneK

QuoteI got homework

No TV 'till your homework's done!  ;)
I'm a 65 year old male who has been thinking about SRS for many years.  I also was a  full cross dresser for a few years.  I wear a bra, pantyhose and nail polish daily because it just feels right.

Started HRT April 17, 2019.
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Devlyn

Quote from: AnneK on April 07, 2017, 12:32:45 PM
QuoteI got homework

No TV 'till your homework's done!  ;)

No funny posts until you eat your vegetables!   ;)
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kittenpower

As far as I know, the only tests that are done are to make sure you are healthy enough to start HRT; and then regular follow up appointments to check your estrogen levels, testosterone levels, and other lab values.
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