Finally decided to introduce myself, and have a couple questions.

[Asfsd4214]

good luck remember though even when your on them you will need someone to monitor your levels a speacialist or a gp if they can do it were you live hrt can cause serious health issues if they are out of whack
jessica

That was the whole idea of getting doctors involved rather than trying to self medicate (a taboo subject here I know), but it seems like everyone I see knows even less than I do.

One of the doctors I'm going to see, the seemingly only one who specializes in TS in this entire city, I have reason to believe may be prescribing people a typical course of contraceptive pills (as in the dosage and regimen identical to use as a contraceptive pill, leaving aside the issue of using contraceptive pills for HRT at all), AND without any medical supervision.

I've never met this woman, so hopefully she's more competent than what I've heard, but I'm starting to wonder if my own doctor isn't a better bet.

So, in short...

I have 3 medical professionals experienced in transgender issues, 2 I've seen, 1 I'll see first thing in November.

One said the standards of care dictate that you need to dress as a female before you can be offered hormones. Couldn't tell me where to find those standards, or appeared to have any copy of her own, or tell me who published them.

I have another one that also said the standards of care dictate that, referred to the standards that at least exist for my state, but don't in fact say that, and while acknowledge that the SoC may in fact not say that, said she didn't care.

And I have the doctor I have yet to meet, who has been said by two separate individuals now to also require the dressing, though in an article written by her on the transgender support website implies the opposite (that HRT is easy to get once a psychologist or psychiatrist has diagnosed you with gender identity disorder), and I've been told by someone else is prescribing people a contraceptive dosage of birth control pills without any blood monitoring.

In other words, this entire situation is officially insane. 

So far the only people remotely helpful have been the people who in no way specialize in trans issues, my neurologist and regular doctor.

[jesse]

i think your going to run into a lot of this. i just talked to an endo office today (4 Docs) after explaining for 15 mins to the nurse/receptionist what i needed and was told that the four of them dont specialize in hrt for transgenders wtf lol then they said i should go to trinadad hosp?
again wtf trinidad is where they do srs surgery. im sure they can handle hrt but its 200 miles away and since when does an endo not monitore hormones

[K8]

Asfsd4214, you have every right to be frustrated.  This whole runaround you've been getting must be driving you crazy - and it isn't even you who is crazy.

My GP prescribed my HRT and is monitoring the effects.  (I just saw him yesterday.)  He didn't require a letter, just me asking him.  But I've known him for years.  I don't think he would have done it if I just walked in the door, unknown.

The SoC is a guideine.  Most therapists and doctors will follow it because it is a good guideline and following it can minimize problems.  But it is still a guideline.  Your problem is that the quacks you've seen seem to have some fictional SoC in their head.  Other than printing out a copy and carrying it with you, I don't know what you can do.

I agree with you about the dressing.  This isn't about dressing.  It is about being the person you are and becoming the person you need to become.  Sommewhere in your area is a doctor or therapist with some sense who will help you on your journey.  Good luck!

(And friends can be very helpful.  I couldn't be transitioning without friends.  Not all of us need them, but if I could give you anything, it would be an understanding friend.  Well, after I found you an understanding doctor. )

*hugs*
Kate

[Asfsd4214]

The SoC is a guideine.  Most therapists and doctors will follow it because it is a good guideline and following it can minimize problems.  But it is still a guideline.  Your problem is that the quacks you've seen seem to have some fictional SoC in their head.  Other than printing out a copy and carrying it with you, I don't know what you can do.

I actually did bring a copy with me last time I went to see a psychiatrist, I didn't even need to produce it because as soon as I implied that the standards of care I had read did not require what she suggested, she, to her credit, at least acknowledged that the standards of care may in fact say something different to what she recalls, but that she would still require it in order to recommend me for hormones.

To say it the way she said it... "because you haven't done the other things that you would normally be doing at this stage, I'm reluctant to recommend you for hormone therapy".

So now, I need to wait a few more days to see my doctor, if she's not willing to help, that's when things really get fun.

If she's not willing to help me, 3 weeks later I see the seemingly one and only doctor in the entire state who specializes in transgender issues.

Its been an amazing experience leading up to meeting her, this is what I know so far...

Both of the psychiatrists I've seen have said to see her.
One of them said that she too would be expecting me to dress up if I wanted hormones.
Another individual I have spoken too also said she would expect people to dress up for a year before getting hormones.
Word is even when she agrees to hormones, she's prescribing people contraceptive doses of birth control pills, without blood monitoring.

However....

The standards of care for my state, the ones that do exist, have her name on them, listed as "reviewed by", these standards of care require no such thing, and are nearly identical to the ones published by WPATH, stating either a period of 3 months RLT or 3 months counseling are required.
I've read an article supposedly written by her, in which she seems like a reasonable person, where she says hormones "are easy" to obtain once a psychiatrist or psychologist has "assessed you".

So god only knows what the truth is. Maybe my own doctor will be willing to help and I won't have to find out.

But if and when I do see her, trust me I'll have a copy of the standards that have her name on them with me, and if she requires something other than what is said by the standards and implied by her article, I'm going to want to know why these standards are not being followed by the very person likely involved in deriving them from the WPATH version.

Can't wait to see how all this turns out. 

[K8]

Why do I always hear the theme from Twilight Zone when I read your posts?

I've been crossdressing since I was 9.  Both my doctor and therapist knew about it long before I started working on my gender issues.  The only thing I can figure is that it is usually the one physical manifestation of GID that can be seen from the outside, so they're grabbing onto it.  When you talk about having to dress for a year before hormones, they can't mean that you have to walk around 24/7 in women's clothes for a year, do they?

(Darn, there's that music again... )

Good luck, sweetie.   Let us know how you do.

- Kate

[Asfsd4214]

Hey everyone, just a little update on how unbelievably, insanely bizarre and messed up my life continues to be.

Its been a pretty bad few days, depression, depression and more depression, and not just my own.

My mum's been pretty depressed lately, fighting with me, scared that I have no future, scared that she has no future, and that's brought me down too thinking she might be right. She has this entire perception of me as a guy, one I've deliberately perpetuated for years and I worry that no matter what I do, she'll never be able to see anyone else.

It might also be that my neurologist put me on a short course of Prednisone, great stuff in that within a day my MS symptoms started to feel the best they had in weeks, bad in that it's a pretty powerful drug, and can cause depression, especially now that I'm off it again.

I went to see my regular doctor, I explained to her exactly what the whole situation was. In the beginning I just told her I had gender issues and wanted to see a psychiatrist, at the time I wasn't sure what I was supposed to do. This time I simply told her everything. That I wanted to transition, the insanity that has been dealing with psychiatrists, etc. Also adding to the strangeness, apparently my psychiatrist sent my doctor a letter indicating that I didn't want hormone therapy at this stage...

Who knows what that's about, but I made it pretty clear that that's exactly the opposite of what I want. She was very helpful as usual, she said she simply didn't know enough about transgender medical care, that she couldn't at this point prescribe hormones until she had time to consult with people like endocrinologists to make sure she's not doing anything harmful. But that she was sure we could work something out to help me and gave me the impression that her prescribing hormones isn't out of the question, she just doesn't know enough about the process.

She said she'd get in contact with relevant people around and get back to me within a week or so, with what she could find out.

So it went about as well as I could realistically expect.

So now I just have to wait until she gets back to me and take it from there.

But lately I've just felt like there's no escape. I feel like maybe it's too late.

On the one hand I wonder if I could pretend to be a guy, start a life as a guy (not really having any to speak of right now). But I just think that even if I could do that, I'd be lying to myself, and in the long run I'd just end up right back here again, more depressed than ever.

On the other I worry that maybe I'm too old for transition. Greatest respect for those who transition and live their lives as openly transgender, but I'm not sure I'm strong enough to do that. I'm not sure I could handle people thinking that about me.

I just want more than anything to be able to have a normal life one day, but I feel trapped between the options of living an abnormal life being seen as a transwoman and not a "real" woman. And living as a reclusive abnormal "guy", because I just can't cope with dealing with people seeing me as a guy.

Is it possible to transition at 21 and for all visible purposes pass as female? I guess that's what I want to know. Or will close inspection (from sight) always reveal the truth of my male puberty?

I just feel so trapped, like I'm in a cell in my mind able to look outside but not GET outside. And I worry that I'm just delusional about everything.

BTW, I'm not sure advising me to see a therapist will do much good, I've been there and done that and I've only ever felt worse when I've left than when I went in.

Anyway, thanks for listening to me ramble on. As always any replies are appreciated.

[Miniar]

Therapy can feel worse before it starts feeling better.

And 21 is very young.

[Asfsd4214]

Therapy can feel worse before it starts feeling better.

And 21 is very young.

I'm just not sure I can take feeling much worse than I do already.

I know 21 is young, but it still feel's like it's too late, that nobody will ever see me and think I'm female as opposed to "a guy who's transitioned to female". Which is funny because I was at breakfast with my mum the other day, and some woman looked over and said "excuse me but I just had to say you two ladies have the most gorgeous skin tone", threw me for a bit of a loop.

There's just constant nonstop questioning in my mind, I can't think a single thing without part of my mind questioning it, then questioning the questioning, and I can't escape thinking about it. I haven't been able to think about anything else for more than a few minutes every waking moment of my life for months, and it's just getting to the point where I don't know if I can cope with it anymore.

The only thing keeping me sane is the idea that maybe all my doubts are just chemical crap going on in my brain, that I'm not seeing things the way they really are but some depression induced shroud over everything. That things aren't nearly as bad as they seem. I said that to my mum but she seems closed to that idea and seems pretty confident things are every bit as bad as they seem.

[K8]

Hi asfsd.  It's good to hear from you again.  I'm sorry you've been so depressed lately.  Drugs will do that to you, and trying to transition but not being able to start will do it to you – double for nothing!

She was very helpful as usual, she said she simply didn't know enough about transgender medical care, that she couldn't at this point prescribe hormones until she had time to consult with people like endocrinologists to make sure she's not doing anything harmful. But that she was sure we could work something out to help me and gave me the impression that her prescribing hormones isn't out of the question, she just doesn't know enough about the process.

She said she'd get in contact with relevant people around and get back to me within a week or so, with what she could find out.

That's pretty much what happened when I went to my regular doctor.  He warned me that he didn't know much about it and would have to research it.  A week later I went to see him and he prescribed HRT for me.  I hope this is how it works out for you.

I started transitioning at 65, so 21 is so long ago I can't remember much about it other than be amazed that I survived those years. 

One of my big fears was that I would get stuck in-between.  That stopped me for a long time.  I also didn't want to be a "->-bleeped-<-" – I wanted to be a woman.  Still more blockage.  (We do build up a lot of barriers within us. ) 

I'm less than 6 months full time, just over 6 months HRT.  At least 1,000 people in town and nearby towns know I am transsexual or at least that I used to present male and now present female.  My transition is hardly a secret.  But I still get treated as a woman by strangers.  If I can usually pass at my age and only 6 months HRT, just think what is possible for you at 21!

On the one hand I wonder if I could pretend to be a guy, start a life as a guy (not really having any to speak of right now). But I just think that even if I could do that, I'd be lying to myself, and in the long run I'd just end up right back here again, more depressed than ever.

Start your life as a person – male or female makes no difference.  It doesn't do you any good to remain on hold like this.  Starting your life (guy or gal) will help you develop skills you will need whatever you do.  Trying to transition with no social or professional skills will make it that much harder.  And transitioning is hard enough as it is.

The only thing keeping me sane is the idea that maybe all my doubts are just chemical crap going on in my brain, that I'm not seeing things the way they really are but some depression induced shroud over everything.  That things aren't nearly as bad as they seem.

Doubts are very normal.  Even without chemicals, you will have doubts.  This is a big thing.  Of course you will have doubts.

And don't worry about your mum.  She is worried about you because you are stopped and depressed.  You want to travel a road that has a lot of unknowns and potential hazards.  That's hard for a mother, seeing her child in this position.  If you can get going on your life, transition or no, your mum will start to feel better about you.

Get going!

*hugs*
Kate

[Asfsd4214]

Hi asfsd.  It's good to hear from you again.  I'm sorry you've been so depressed lately.  Drugs will do that to you, and trying to transition but not being able to start will do it to you – double for nothing!

That's pretty much what happened when I went to my regular doctor.  He warned me that he didn't know much about it and would have to research it.  A week later I went to see him and he prescribed HRT for me.  I hope this is how it works out for you.

I started transitioning at 65, so 21 is so long ago I can't remember much about it other than be amazed that I survived those years. 

One of my big fears was that I would get stuck in-between.  That stopped me for a long time.  I also didn't want to be a "->-bleeped-<-" – I wanted to be a woman.  Still more blockage.  (We do build up a lot of barriers within us. ) 

I'm less than 6 months full time, just over 6 months HRT.  At least 1,000 people in town and nearby towns know I am transsexual or at least that I used to present male and now present female.  My transition is hardly a secret.  But I still get treated as a woman by strangers.  If I can usually pass at my age and only 6 months HRT, just think what is possible for you at 21!

Start your life as a person – male or female makes no difference.  It doesn't do you any good to remain on hold like this.  Starting your life (guy or gal) will help you develop skills you will need whatever you do.  Trying to transition with no social or professional skills will make it that much harder.  And transitioning is hard enough as it is.

Doubts are very normal.  Even without chemicals, you will have doubts.  This is a big thing.  Of course you will have doubts.

And don't worry about your mum.  She is worried about you because you are stopped and depressed.  You want to travel a road that has a lot of unknowns and potential hazards.  That's hard for a mother, seeing her child in this position.  If you can get going on your life, transition or no, your mum will start to feel better about you.

Get going!

*hugs*
Kate

Believe me there's nothing I'd rather be doing more than living my life, I just don't think I can do it without transitioning. The primary reason I don't have a life now is because I simply chose to stay detached and separate from any friends I made because I felt like I couldn't be apart of their world as a guy.

This time last year I was in TAFE (similar to community colleges in the US) doing a diploma, I made quite a few friends there but I simply went out of contact with them because I didn't feel like I could act naturally around them, I can't really explain it. But I felt like I couldn't be around people as a guy. After that I tried going to university, technically I'm still enrolled but on deferred leave. I quickly broke down and couldn't keep attending because I just couldn't stand feeling this way, and most of all, seeing so many other people all the time doing what I wanted to be doing.

I just can't be a guy, I can't do anything feeling like I'm trapped in this body just pretending to be like other guys because being around people makes me too depressed at what I feel like I can't have.

And I think my mum's just worried because she only knows this weird guy roll I've played as for years. For years I would intentionally not say what I was thinking and not show any emotion I wanted to keep up the appearance that everything was normal, but I've gone so far with that I don't know if she'll ever be able to believe I'm anything else.

I want so badly to be able to talk to her about everything that's been going on with me all this time, all this stuff she doesn't know about me, but I worry that she won't be able to believe it. And right now I can't say anything to her without her getting angry with me, so until she feels better I don't know if she's willing to even hear it.

[jesse]

how about just dropping her a note saying mom i need to talk to you about my life and whats been going on with me when you feel better and can talk to me w/o getting angry with me ill be waiting

just a possible way to open the door i dont know if others might have a suggestion or two
jessica

[Asfsd4214]

You aren't doing yourself any good this way.  Transition is not the answer.  It is an answer but not the answer.  Putting all your eggs in one basket is never a good idea, especially in such a complex basket as transition.  You are putting too much stock into this one thing – this one thing that for now you can't do.  OK, you can't do it.  Do something else!

For now, live your life as though you will never transition.  Then, when you do transition it will be like a gift from the gods and you will love it even more.

Sweetie, you need to help yourself.  Get some help.  Please.

- Kate

I know you're just trying to help, I asked for advice and as always I appreciate it, but this time all I can say is I can't follow it. You're not me and I'm not you, but I have to trust in what I believe is the right thing for me, and this is what it is.

And I can't live life as a guy, I don't need to try it because I've already been there and done that. Lets say I called up the friends I haven't seen in months, or went to university. All that will happen is I will be pretending again. I'll do the whole acting like a guy thing, feeling like a pretender, like I'm an observer just watching the whole male side of things but not really being apart of it. And eventually I'll just get to a point where I'll fall into a depression again, only this time it will be so much worse because I'll know I could have been so much further in my life than I had been.

I wasn't that far away from suicide this time, if I get to that point again I'm afraid I might just give up all together.

I can't keep living this way, and that's exactly why I HAVE to transition.

You said I should stop living so much in my head, but that's all I have ever lived. Even when I was acting like a guy I was living in my head. And I feel like the only way to get out of it is transition.

Maybe you're right, and transition isn't the answer. But my life experiences have brought me to this place, and all I can do is trust in what I believe. And what I believe is that there's no reason to think not changing anything will change anything.

I appreciate the advice, but I can't attack my isolation separately from my GID. Could I go out, meet people, make friends as a guy? Sure. But would I stop being isolated? No. The only reason to not transition now is if I could be happy as a guy, feel like a guy. And I don't think I can. If I could, it would have happened back when I didn't understand my feelings and was trying to be like a guy. If it didn't happen before even I realized, why should I expect it to happen now that I do?

EDIT: I'd just like to add that to me, this IS me helping myself. Not getting help is what I did for 10 years. I felt like I couldn't do anything as a male, and I still do. I want more than anything else to have a life, but I can't do that in a way that would feel real for me pretending to be a guy. I don't like being isolated from society, I hate not getting to be around people. But even at the most social times in my life, I felt like I was this outsider looking in. Like I was female getting to see how males live. I'm being totally honest in saying that. Now that I understand that transition is possible, I can't keep living that way.

So I hope you understand that, from my perspective, there is no helping me before transition, only helping me with transition.

And maybe I'm wrong and don't even see it. I don't believe I am, but if I am, at least I'll know I did the best I could. If I were to not transition now because "maybe" what I think is right is wrong, and it turns out I was right after all, I might end up killing myself.

So I understand where you're coming from, but from where I'm standing, I have to follow what seems right to me.

Post Merge: October 19, 2009, 01:41:41 AM

So, mini (and possibly last) update time.

Spoke to my doctor about an hour ago, she referred me to an endocrinologist with experience in trans issues and she says is potentially willing to start me on hormones sooner rather than later, but also recommends I see a psychiatrist. She told me what the psychiatrist had told her, and my impression is that she too won't recommend me unless I'm presenting as female already, and expressed concern that I'm doing this so young (21).

We had a nice chat, she demonstrated what she herself confessed is her complete ignorance in trans issues (asking me if I was homosexual, stuff like that), and I made the point that the moment I feel that obtaining hormones legally in a reasonable time frame is a lost cause, I will get them from somewhere else. Yes, I know, taboo subject here in susans. But I have tried everything within my power to do this legally, I have seen 2 psychiatrists, 1 general practitioner, have an appointment with another psychiatrist, an endocrinologist, and a 2nd general practitioner. And if the endo and 2nd GP don't work out, then that's it, pretty much out of any option that doesn't require indefinite public humiliation which benefits me in no way whatsoever. So anyway, her response was that if I decided to do she will simply cease to be my doctor, I told her that I understand her decision, that I hoped it won't come to that, but that the situation is what it is.

So yeah, that's pretty much my situation. Either the endo is willing to help (possible), the 2nd GP is willing to help (from what I'm hearing, unlikely), or I'm pretty much out of options except for self-medication or being stuck like this.

And no K8, I am NOT starting a male life of unhappiness and mental distress as an alternative. Either this will work out, or it won't. But doing nothing is simply not an option for me.

Hopefully I'll find a legal avenue, but if I don't, I guess this is it for my participation on susan's. Thanks to everyone who offered advice, whether I agree with it or not.