Clinical Social Worker

[Michelle_K]

I checked my appointment schedule for the Veteran's health care, and saw that my appointment was with a social worker. My understanding is the social worker can not prescribe drugs. So it would appear that I have to go back to the primary care and have them refer me to a gender therapist.
Primary care did not test my testosterone due to the fact that it is a 1 hour drive, and she wants the test done within a hour of me waking up in the morning. I still have a doctor in the local clinic, and I might have to go through her to get medicare to pay for the tests.
My local senior care center told me that some people have left the veteran's health care in St. Cloud, being dis satisfied with the service.

I am a bit overwhelmed at the moment, as I just recently had a prostate MRI done, due to the high PSA reading. It turns out that I have a large bladder stone, and now I need to discuss with the urologist how to proceed. The strangest thing is that after the pelvic MRI, a notice that my mammogram is overdue showed up in MyChart.
This year, after several years without my lower denture, I now have new dentures. I'm still relearning how to eat. My eyes are still healing from the cataract surgeries. I'm still having trouble with my eyes focusing together. I still get a bit of eye strain during a long drive.
I have been watching Dr. Z videos on you tube. Something about even though I am trans, I have been taught transphobia by my parents and others.
Michelle

[Lori Dee]

Hi Michelle,

I'm sorry that you are having issues. You are correct that the Social Worker cannot prescribe drugs. That is not her job. Her job is to diagnose you with Gender Dysphoria. Once they do that, it is in your records and your Primary can prescribe them, or refer you to an Endocrinologist. It is a process, but it is free.

I went through a similar situation. My Primary sent me to a psychologist. The psychologist diagnosed Gender Dysphoria. Then back to my Primary and she sent me to an Endocrinologist who actually wrote the prescriptions. So hang in there. You are doing the right thing.

Your lab tests for hormones, including testosterone are covered by the VA 100%. If they cannot do them because they are not local, they will pay your local clinic to do them. No charge to you. If you go through Medicare, you will have to pay deductibles, copays, and coinsurance. You are a veteran and should not have to pay for VA-ordered labs. Contact the VA doctor and make sure that the VA knows they are paying for you to have the labs done locally.

Then when the clinic asks about insurance do not tell them Medicare. Tell them the VA is covering it. If you don't tell them and they bill Medicare, you will get stuck paying out-of-pocket costs that you do not need to pay. I would hate for you to have additional expenses when the VA will cover them.

[Michelle_K]

I'm thinking that I need to let the social worker know that I have had an online therapist for over a year. With his help I took all my men's clothes to the thrift shop, at the same time getting women's clothes, and getting boxes of clothes out of storage. Going through the clothes, and sending what doesn't fit to the thrift shop. Without any men's clothes, I can't go back. Did you know that while I was in the hospital with two broken wrists, I needed help from the nurses to use the toilet. I think they were thankful that I sat to pee. I later used that experience to step into the women's restroom in the stores. I still need to get to the point of using the fitting rooms.

Over 20 years ago, I realized that I could wear women's jeans and nobody would know. Or the fact that I was wearing thigh high stocking under the jeans. Of course when my mother found out I was considering a sex change, she slapped my face.
I'm working on several things with the social worker, ADHD, autism, and transgender. I think due to confusion on my part, we are working on non medical therapy. I ended up with medicine for panic attacks 20 years ago and did not like the side effects, and I forgot to refill my prescription.

Just a thought, might have happened. Sitting down to dinner during the 1950s, eating chicken chow main. Chicken that was fed estrogen to make them grow faster, getting xenoestrogen from the hot plastic Tupperware plate and adding phytoestrogens to the food with the soy sauce.
I remember a report about Mexican boys getting breasts from eating chicken that was fed estrogen. There was also businessmen getting drunk(blocking testosterone)and eating chicken(loaded with estrogen).
Michelle

[Michelle_K]

I mentioned to the social worker that I needed a diagnosis of gender dysphoria to get my hormones. I had been telling him that it was the low hormones causing my depression and anxiety. He said he doesn't know anything about gender dysphoria, but he will check with a gender therapist.
Michelle

[Lori Dee]

It is a good thing that he understands what you need and will consult with someone who can get that for you. It takes time, but once the ball is rolling you will be on your way. Hopefully, it will happen soon for you.