Becca's HRT Journey

[Becca Kay]

I'm planning to start HRT.  I'm going on monday to see an endocrinologist.  It's someone that i've been told has experience with MTF trans patients. 

It took me 5 weeks just to get the referral (required by my insurance Co) from my primary care physician.  After several weeks of back and forth on the phone i found out that because my Dr was in a Catholic health care group they were dragging their feet helping me with the referral.  I was furious... but it looks like I managed that hurdle.

I was lucky to get an appointment this month.  The specialist i'm seeing wasn't going to see any new patients until next year.  But I think the scheduling nurse felt sorry for me.  I started crying on the phone.


Going to my first appointment I'm wondering what questions i should be asking and what I should expect out of the appointment.  How does this typically go, seeing an endorinologist for HRT?  For those who are on HRT are there things you wish you'd asked or known when you started? 

I'm also a bit freaked out by this.  I'm wrestling a bit with it. I started doing face and torso body hair removal in August which i'm happy with.... no regrets.   HRT is the first thing I'll do towards transitioning that will have real ramifications that other people are eventually going to notice.   I'm afraid of getting to the appointment and not being able to think clearly due to my anxiety. 

Any advice or suggestions from you girls would be appreciated. 

[Laurie]

Hi Becca

  I'm Laurie. I am sure others will chime in soon but here is what I would want to know

   What hormones and/or drugs will they be prescribing and the plan for adjusting dosages.
   Delivery methods
   Monitoring  and intervals
   Starting dosages and planned increases and amounts
   Cautions and interactions with other medications
   Reasonable expectations of effects

[Tammy Jade]

Ironically first went to my endo for a unrelated health issue.

At the time I still had not gotten my letter so I didn't go in expecting to discuss HRT.. well I was wrong... He mostly led the conversation and Asked me a number of questions I think to gauge how well informed I was like, if I was aware what the long term effects are of HRT are, any existing conditions, my partners mindset and if I had a supportive environment, if we had investigated freezing of sperm, then he just did a general health check weight, hight ect

It was quite a pleasant experience, he went over a lot of things I had already researched so very little of it was new information but we did discussed my goals and expectations as well as how we would begin treatment and initial doses, I chose to start on a very low dose because of what we discussed.

It will depend greatly on you endo, mine had obviously done it many times before and covered off basically everything I could possibly think of and that in it self gave me a lot of confidence.

It was just a shame I didn't have my letter at the time but hey it made my next appointment really short [emoji6]


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[DawnOday]

My experience may be different than yours but it went pretty smoothly. On my first visit the nurse kind of smirked alot and she no longer works there, no worry's she was a temp. The appointment went pretty good. I have a lot of health problems (heart) so we discussed what could happen with clots. Luckily I am already on blood thinners. We talked about my past and what I was hoping for in the future. We started on a low dose and have since increased it about the 3 month timeframe. I have been on spiro for 25 years because of the heart problems so we upped the dose of spiro.  and now I also take finasteride, just starting that recently. All my blood tests have come out with good news. I now have been on HRT for almost 14 months.  Most of my information came from Susan's Links and Wiki, Also I cannot stress enough what a difference a support group makes. Even more a convention like Gender Odyssey here in Seattle where there were 1700 people like me.   There is a lot of good information on this facebook page  https://www.facebook.com/pg/genderodyssey/videos/?ref=page_internal

[Becca Kay]

Ironically first went to my endo for a unrelated health issue.

At the time I still had not gotten my letter so I didn't go in expecting to discuss HRT.. well I was wrong... He mostly led the conversation and Asked me a number of questions I think to gauge how well informed I was like, if I was aware what the long term effects are of HRT are, any existing conditions, my partners mindset and if I had a supportive environment, if we had investigated freezing of sperm, then he just did a general health check weight, hight ect

It was quite a pleasant experience, he went over a lot of things I had already researched so very little of it was new information but we did discussed my goals and expectations as well as how we would begin treatment and initial doses, I chose to start on a very low dose because of what we discussed.

It will depend greatly on you endo, mine had obviously done it many times before and covered off basically everything I could possibly think of and that in it self gave me a lot of confidence.

It was just a shame I didn't have my letter at the time but hey it made my next appointment really short [emoji6]


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i have my letter from my therapist!  the only thing i'm not certain about is whether my insurance plan is going to cooperate.  My plan states that they cover transition surgery and mental health care related to gender dysphoria.   I tried calling to get more info regarding HRT, but over the phone my insurer told me I would need a "code" to determine whether the proceedure/service being billed for would be covered.  So I won't know for certain until the billing is submitted. 

[Devlyn]

At my first appointment she asked what my goals were, briefly commented that starting HRT was 100% my decision and her role was making sure that I was getting what I want in a healthy manner, then asked me to tell her how I came to the point of sitting in her office asking for hormones. It was really that simple. 

Hugs, Devlyn

[Tammy Jade]

i have my letter from my therapist!  the only thing i'm not certain about is whether my insurance plan is going to cooperate.  My plan states that they cover transition surgery and mental health care related to gender dysphoria.   I tried calling to get more info regarding HRT, but over the phone my insurer told me I would need a "code" to determine whether the proceedure/service being billed for would be covered.  So I won't know for certain until the billing is submitted.

Not knowing where u live I can't comment.

Where I live (Adelaide, Australia) Medicare picks up most of it..

For me I pay $340 up front and get about $260 back so after the refund I'm only out of pocket about $80 and I can live with that.

But good luck with your insurance hopefully they cover it for you!


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[Allison S]

It's normal to feel anxious going in the first time.  I know I was and that feeling of having to wait.. it's really sad. Anyhow, my first appointment about 3 weeks ago was the same as everyone described.  I go to an informed consent clinic Callen Lorde here in NYC.  I just started hormones and I'm still wondering the same thing, "what questions should I ask?". Well I wrote some down!

I know the moment I was prescribed the hormones I felt like I had to ask questions because here I am essentially taking pills from a stranger (okay a doctor, but still). It was a very fast appointment too but I did feel optimistic at the end and I still do!

I'll never forget when I took the first dose I just thought to myself that this is a cruel life I've been given. I know it's not that big of a deal and I'll get over it, but it's a huge decision to make. Lately, I've been reflecting on my life so far; good and bad. I never thought I would be at this point in my life but I also finally see freedom from being trapped all my life.

[Bari Jo]

I remember being scared and skittish.  My doctor has a lot if experience with trans people, so she knew how to guide the conversations to get the answers she needed to diagnose, but also showed tons of empathy.  Honestly if you feel weird at all with your doctor, see another.  As far questions to ask, the ones previous in this thread cover it.

Also my doctor asked about my support structure and isolation, so we went into lengthy discussion on how to improve that do I will have a better experience transitioning and make her job easier.

Bari Jo

[Becca Kay]

Thank you all for sharing. 

My appointment is tomorrow.  Wish me luck.  I'm sooo nervous. 

[Charlie Nicki]

Just be honest, about everything. I told my endo my entire story and my thought process behind all of it. He was a good a listener and warned of the things that could happen to me (like getting too emotional/depressed). I think the best question you can ask is what to expect from the specific dose that they'll prescribe.

[Becca Kay]

the appointment went well.  my new endocrinologist is great!  that was maybe the kindest i've ever been treated during a doctor's appointment.  He has a lot of experience with trans patients.  He sent me today for blood work before he prescribes my meds.  I also spoke with a social worker in his office immediately after, and she gave me a referal for a trans friendly primary care doctor.  Mine is out of his depth with this.

[Tamika Olivia]

This isn't so much a question to ask, but a consideration to keep in mind. Your doctor might ask you what delivery you want when your blood work comes back. Keep what you know about your body in mind, and advocate for the method that works best for you.

I have extremely sensitive skin, but I let myself be talked into patches. This was bad, I had rashes and eczema after a few weeks. I eventually landed on pills, and they work for me. Others can't handle them due to liver strain. A lot of doctors get set in their ways and opinions, and you should listen to them, but if what they want you to do won't work for you,  let them know. It's scary, because they hold your HRT in their pads, but good doctors will listen.

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[Becca Kay]

two days ago my employer offered me a severance package.  They didn't fire me.  My VP is basically putting me on notice that he doesn't want me there anymore.  The company is going through a restructuring and in addition to eliminating hundreds of positions department heads and VPs are trying to get rid of people they can't fire for performance reasons.  I've been with this company almost 30 years.  I've never worked anywhere else.

this is a one company town.  i'm going to have to move. 

I'm afraid now to start HRT.  I don't know how I can do a job search if I'm starting to transition.   

[Dena]

If you haven't already done so, check the company LGBT policy and see if it's LGBT friendly and if so what the appeal process is.

On the other hand, the severance package depending on what it is could be to your benefit. In my case,  before I transitioned the company had a massive layoff of which I was an unfortunate member. There wasn't a severance package however I had sufficient savings to keep me afloat for a while. I had my nose and neck worked on and as soon as the cast came off and the stitches came out, I moved into the feminine role and started my job search. Yes it was a bit difficult interviewing when I was still pretty new to the role but it worked and I got my first job as Dena.

Like you, my other option would have been to find another job and put in a year or two before I could transition. The time period was far to long and I felt sooner was better than latter.

[Becca Kay]

i picked up my first HRT prescription today.  Spironolact twice a day and Estradiol once a day.  I'm lucky...with my health insurance a month's supply only cost me $8.

i have a follow up in 30 days for more bloodwork. 


finally getting the prescription freaked me out a bit.  i spent the whole day having second thoughts and worrying that i could be making a mistake.  I felt this way when I started electrolysis and lazer, but it went away after my first appointment. And i felt this way making the endocrinology appointment.  But once I met my doctor and talked to him i was happy about it.  I'm taking these steps and each one make me second guess myself a little. 

I picked it up tonight, but i have to leave for a business trip at 5am and I'm a little worried about starting it now, thinking it should wait till i get back on Friday. 


 

[Becca Kay]

close to a week now on HRT.  is it possible to notice changes already?  I swear that the last couple of days my skin is much less oily.  I've always had blotchy skin on my face and it's suddenly much clearer.

I've been going through some horrible personal issues the last couple of weeks and the last couple of days i've been incredibly weepy.  I'm not usually like this.  weird

[Bari Jo]

close to a week now on HRT.  is it possible to notice changes already?  I swear that the last couple of days my skin is much less oily.  I've always had blotchy skin on my face and it's suddenly much clearer.

I've been going through some horrible personal issues the last couple of weeks and the last couple of days i've been incredibly weepy.  I'm not usually like this.  weird

It's probably too soon to notice less oily skin, but YMMV.  I wouldn't be surprised if your nipples start hurting this early though.

Did your doctor give you a list of time and possible effects?  Mine did, and it's been fairly accurate with me.  I've been weepy at times too, not sure when it started with me,,but it's not me hardest when my e is low.

Hah, I think we have the same insurance.  I freaking love that it's so inexpensive!

Bari Jo

[Becca Kay]

It's probably too soon to notice less oily skin, but YMMV.  I wouldn't be surprised if your nipples start hurting this early though.

Did your doctor give you a list of time and possible effects?  Mine did, and it's been fairly accurate with me.  I've been weepy at times too, not sure when it started with me,,but it's not me hardest when my e is low.

Hah, I think we have the same insurance.  I freaking love that it's so inexpensive!

Bari Jo

my Endo didn't give me that much detail.  But he did go through some side effects, etc.  TBH I was so nervous at my appoitment I started crying and can't remember what he said.  Although, he was very kind to me. 

I'm so lucky with my insurance.  but in 90 days i lose my job and insurance goes away.  I want to just be happy about this for now and as long as I can. 

[Bari Jo]

my Endo didn't give me that much detail.  But he did go through some side effects, etc.  TBH I was so nervous at my appoitment I started crying and can't remember what he said.  Although, he was very kind to me. 

I'm so lucky with my insurance.  but in 90 days i lose my job and insurance goes away.  I want to just be happy about this for now and as long as I can.

I cried at my first meeting too.  No harm, no foul.  Here's a link to the sheet I was given.  I took a picture of it for another in another thread.  Maybe this is useful, maybe just noise.

https://www.dropbox.com/s/4yz6rupipnh25lq/IMAG2722.jpg?dl=0

Time to get another job quick!

Bari Jo