Chase Brexton Mismanaging my Treatment, I Feel Trapped!!! Help!!!

[Muscle Matt]

So I know I've made a similar post before (maybe a year ago max). This will be long, but I'd appreciate any help if possible. I feel trapped here and can't find a way out, I just want to do nothing but cry. TLDR at bottom.

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My current doctor's office is Chase Brexton (Mt. Vernon location) in Baltimore. I've been on T almost a year and a half now. They brag about treating Transgender patients, yet half the time I show up there, the employees call me by the wrong name and completely misgender me. I'm on my third primary care doctor there. The first one was only a part-timer (Dr. Speedy), so appointments had to be made months in advance to see her. They then switched me to the "trans specialist" there, Dr. Dunn. She's the one who upped me to my new dose of T (she increased it twice to reach this level). She has not once tested my hormones (I was only tested at my initial, Pre-T visit). I am given intramuscular shots in my arms every two weeks. She claims that the dose I am on is the maximum she is allowed to prescribe, and has also said that she can no longer allow SubQ shots for me, as they are double the amount of IM, and she says this amount would be too much for that type of shot. Ok, so I go with this amount for a good many months. I probably got on this dose 9 or ten months ago?

Then I had an appointment with Dunn, where an MA called her out of the room for a moment, and she left and never returned. Had an MA give me paperwork to leave. I still had not been given a chance to bring up my asthma, while I'm sitting there wheezing desperately in their under-construction building. So she makes me wait an hour (seems a lot longer when you're gasping for air the whole time) while she finishes her next appointment. After a few minutes of talk during this "second appointment", she finally remembers that she did, in fact, abandon me. Apparently she only wants to treat trans symptoms, and didn't even read my paperwork to see the reasons why I was there. If I'm trans, clearly I'm there for trans care, right? Can't possibly have other health conditions, too...

So now I'm with Dr. Dupuis. I went for my shot one day, and the girl administering noticed it was the last full shot left in the bottle (they're supposed to tell me before then so I can refill). I asked her if next time I came in, in case I can't afford it at the Pharmacy downstairs, I could get a half shot, then return the next week for a second half-shot. She said sure, no problem, so I made an appointment.

I saw Dr. Dupuis, she was nice. Gave me a refill, didn't say anything about the dose. She signed me up to get labs done, then told me to refill downstairs and come up and get my shot. Well, it's $50 more at their pharmacy than the one 45 mins away by my house. I pay out of pocket. So I just go back upstairs with my leftover half dose, and they tell me everyone went to lunch. So I have to wait an hour. They mentioned none of this to me, acted like someone would be there. Finally, a girl takes me back, and I explain to her that I just need a half dose today, and I'll come back next week. She tells me I'm not allowed to do that, that it would mess with lab results (that I was supposed to get that day anyway). Absolutely refused me a shot of any kind. So I leave after wasting over an hour waiting for a shot I never got.

So the entire next week until I can arrive with my new bottle, I am overheating and having hot flashes so bad, I don't know how I was able to work every day (in the middle of winter). I imagine menopause feels like that week.

I returned to Dr. Fischer's office a few weeks ago for my 1 year top surgery check-up, and they did labs. Val gave me my T shot while I was there, and said it was a weird dose I was on, and said that she usually injects a good bit more for every other patient she's seen. When the labs came back, my mind was completely blown. They said transmen should have T levels between 900-1100 (I don't know what unit of measurement that is). Mine on the 14th day were at 255. Completely female they said. They offer hormone pellets now, which last 4-6 months and are easily to regulate, but they cost $700 a piece. So, no dice.

So I looked into typical doses for IM shots, and every website that I visited claims that the highest typical dose is even higher than what I'm on. I've also yet to see a website claim that there is a point when you should stop injecting subQ based on dose size.

I think, Ok, Maybe Dr. Dupuis can fix this problem and get me on a more appropriate dose. SHE DOESN'T HAVE AN OPEN APPOINTMENT FOR ME UNTIL JUNE 5TH (I will also be out of T before this point, and will need to see a doctor there to get a refill, so I have absolutely no idea how they're going to handle this situation). I shredded the appointment card when they gave it to me and left it in their patient room because that's just absurd and I'm not even going to humor that idea.

My insurance company's website won't work, and doesn't let me access a list of doctors who accept my insurance (my friend has had the same issue on there). I called and asked to be sent a pack of papers with said list. They have yet to do so. I have Medicaid from the state, so I have very few options as to where to go.

TLDR;
I feel beyond trapped in this situation. I'm traveling 45 mins each way every other week just to get a shot. My hormone levels are completely female by two weeks out (I'm actually noticing symptoms that the hormones may be almost completely gone by the end of the first week). My insurance JUST decided they will start covering my Testosterone Cypionate, but what other methods are available here?!?? Are there any other doctors in the area that accept Medicaid that offer trans care? How do I look for such doctor? What the EFF do I do for the time being at my doctor's office? They don't care one bit about their patients, so it doesn't seem to matter how much I ever bitch at them for their shenanigans.

I'm almost a year and a half into T AND MY VOICE HAS NOT DROPPED. THIS IS NOT RIGHT AT ALL. I've had virtually no visible changes.

My puppy is the only reason I'm not trying to kill myself right now.

[Alexthecat]

I can only partially comment on this. You need to file a complaint about those doctors and the office as a whole. I would never leave a place until they do what they are suppose to do. If you have to stand there and be obnoxious sometimes that is the only way to get what you need. Why aren't you doing your own shots at home? There's no reason you can't get subQ done and a shot in the arm sounds painful. If I were you I would get my shots done at home, get subQ shots, get onto a shot every week cycle, and they should be able to refill prescriptions without seeing you.

[kings joker]

To be honest. It sounds like they either are intentionally resisting your transition or they are GROSSLY incompetent to how to successfully aid in a transition. This sounds like something you can press for legal charges. They are not only not treating you the correct does, they are not doing frequent enough blood testing, lying to you about how treatment can be administered and also restricting you from getting the best possible care by making you come in for a shot every 2 weeks.

I do subQ shots by myself once a week. I was also given a choice to go on the max injectable does of T which is the exact same as Inter muscular. Also, I've never heard of anyone getting IM shots done in the arm...

I feel so angry and completely disgust at the way you have had treatment for the last year and a half. This sounds grossly suspicious of doctors who are stunting your transition. I wouldn't be surprised if they have been treating you with a dose that would be suitable for females with low T not FTM trans-guys. I am so so so sorry that you are being put through this. I really do hope you find some resolution in this and go see another doctor.

[green27]

Also, I've never heard of anyone getting IM shots done in the arm...

I do my I'M shots in my arm because I'm on my feet all day and I am a runner. the thigh injections were giving me a lot of muscle soreness/pain. My doctor also has other patients that do them because they have really bad dysphoria and taking off their pants is a no go. So that's totally a legit way of getting an IM injection.

But tbh the rest of your treatment sounds horrible. I would definitely have a trusted friend go with you to your next appointment. A lot of times doctors will treat you way better with a chaperone than if you are alone.

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[CMD042414]

Look into general doctor's offices. Sometimes you can find a gem that doesn't advertise much but is well versed in trans medicine and health issues. Is there an LGBTQ center in your area that can make a recommendation? I know you're in Baltimore but as far as DC they may know of someone in your area.

[RaptorChops]

My Endo is in Rockville,MD. Dr. Michael A. Dempsey. He was recommended to me by my therapist and I've been going to him since. The staff are extremely nice and professional. They are pretty flexible with scheduling and always get me in when I ask. The only thing is they didn't take my insurance (just needed to file a claim with my insurance company). It might be a drive for you but perhaps look into him. I live in Richmond, VA but I still go to him every 6 months.

[Muscle Matt]

Thank you everyone for the replies. I don't like to mention it, but my sister was a heroin addict, she was the reason I lived with endless amounts of stress and ultimately decided to become homeless and lived in my car for a year. I cannot allow needles in my home--even the idea of it gives me intense stress and anxiety. This is why I don't just treat myself at home. I will kill myself before allowing needles in my house.

With shots done in the butt, how long would soreness usually last? I normally prefer to do leg workouts almost exclusively, so I've worried about this aspect before, but I am starting to wonder if this might make a difference, even if it's just slight?

I'm going to look into general doctor's offices if my incompetent insurance company would ever send me the list of doctors...I've pulled up a list of doctors before and started cold calling them...they all either didn't take my insurance, or weren't accepting new patients...and not one of them (according to the front desk) was even aware of how to administer trans care...I actually live in Bel Air, 30 mins north of the city, so going much further south than that would be difficult every two weeks...Rockville would certainly be a trip, although I'm not ruling it out, honestly.

I really would like to try a different method of T at this point, but that would rely on my insurance deciding to cover it. I'm not sure exactly what their policies are, or why they finally decided to cover my T-cypionate recently, so I'm not sure what other methods they might be willing to pay for.  I'm planning to stop by Dr. Fischer's office next Monday after my shot to talk with them and see how much they can work with me/my insurance for hormone pellets.

In the meantime, I need a really good lie about some medical problem so that I can get an appointment with SOME doctor at that hellhole before June. Ideas are welcomed.

Looking back, I think it's absurd that she would even send me for labs, but then not have any appointments so that she could discuss them with me...

[Alexthecat]

Pellets are for those on an appropriate dosage. Your dose has been too low so they aren't going to put a semi-permanent thing in your body until that is correct. I think I read on here someone was told his dose needed to be stable for a year before pellets were even considered.

That needle issue seems like a pain but I would try to work around it just for convenience sake in the future. Why not buy a safe and keep the needles in there? Walmart sells nice small affordable ones. Then you will have the security of the needles not just being in the house but locked up.

You can request copies of the labs that are done. The lab reports that I get are common sense and flag anything that is not in the correct ranges. The T level will depend on when the blood is drawn but even then it's not hard to tell that it is in a good range.

[kings joker]

If you were approved for cypronate than you can do Sub-Q. The only difference is the needle size. Thats what I'm on and I do Sub-Q in the butt. It doesn't hurt after at all, no pressure, no bruise, nothing. I'm not sure about IM in the butt though.
I know you have issues with your insurance but would cream be a possibility for you?

[green27]

I tried IM in the Butt and thigh before settling on my arm. If you're a smaller flexible guy you can twist yourself around enough to self inject in the butt, but if you're a bigger guy you have to rely on help. The other option is in the top of your thigh which is the easiest place to self inject IMO. I usually do my injections in the evening because they stress me out haha and when I was doing them in the thigh/glute I was having soreness for a few days after the injection. I also hit a nerve or had a muscle spasm a few times and ended up with bad bruising and longer lasting soreness. I think if you did it earlier in the day and were able to not work out legs hard for a few days it might not be bad though.

A good doctor will work with you in order to figure out what works best for you though. I would say finding someone who you can work with in that way is the most important part

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[macabremitch]

brother, you need to switch doctors and go somewhere you'll be taken care of. have you looked into other surrounding informed consent clinics/doctors. if you're near the baltimore area and willing to drive about 1.5 hour into philadelphia theirs mazzoni center. look into planned parenthood some clinics deal with hrt/transgender care.

[FTMax]

I would definitely check out the doctor in Rockville that RaptorChops mentioned. If that doesn't work out, I go to Whitman Walker Health in DC and they've always been great. I think getting the provider handled first is the most important thing to get your levels back to normal. Do you have any friends who might be willing to hang onto your stuff and do your shots for you once a week?