You don't use an Endo??

[Jasmine.m]

So I was talking to my therapists last night and I asked her who she recommends for an endocrinologist. Interestingly enough, she said she doesn't actually work with any endos, it's all family practice or other specialist (such as a cardiologist) with interests and open minds to the community.

Huh? Now I'm all confused.

Anyone else in the situation? I was under the impression an endo was the only way to go? She said she'll write a letter to whomever I ask... So then, should I find my own endo or would I be better off with one of her non-endo recommendations?

[Hurtfulsplash]

Sounds like my therapist, in my case I'll be going with an outside endo.

[Janet_Girl]

Unfortunately, I have no medical insurance right now.  But when I did my HRT doctor was an Internist.  But he had worked with Transpeople before.

[blackMamba]

It's not too surprising, and even if you did go with a specialized doc, i.e. endocrinologist, they may have no experience with trans.  If you can work with someone who has experience, in addition to being trans_friendly, I think you'll be ok.  In any event, the best thing you can do is educate yourself about HRT and don't be afraid to question and direct your own treatment.  It's not an exact science and you need to listen to your body.

[Janet_Girl]

It's not too surprising, and even if you did go with a specialized doc, i.e. endocrinologist, they may have no experience with trans.  If you can work with someone who has experience, in addition to being trans_friendly, I think you'll be ok.  In any event, the best thing you can do is educate yourself about HRT and don't be afraid to question and direct your own treatment.  It's not an exact science and you need to listen to your body.

My doctor always went by how I thought I was doing, and would check my liver only.

[rejennyrated]

I didn't see an endocrinologist until I was over 2 decades postop, and even then that was partly for "other" reasons. In the UK it just wasn't generally done. Your GP and/or psychiatrist did the whole medical care package including the prescribing and monitoring of hormone levels.

[Vanessa_yhvh]

My therapist set me up with a Family Practice doc a few minutes after our first session. No endo.

[Dana_W]

I was initially under the same impression. I thought that only an endocrinologist would handle this. Turns out I was wrong.

I now see a GP for my HRT supervision, and she is VERY cautious. Every time she thinks any test results aren't right, she either retests me herself, or she refers me to a specialist.

Some other friends of mine also don't see an endo. Their hormone doc is an Ob-Gyn. I don't actually know anyone on HRT who sees an endocrinologist.

[Kay]

Hi Jasmine,
.
My doc is a family practice doc.  No endo.  No hormone tests at all...either before HRT, or any planned through the end of this year. (I started HRT in January)
.
For now, I'm sticking with this doc, though in the near future I'll probably be looking for an endo.  Others have done fine with this sort of set-up.  I guess I'm just a bit nervous about what seems to me as flying blind with what hormone levels are in my system.  (which probably means that they're on the low end, which may not be the best for development)
.
I've heard arguments both ways.  Some have great results without an endo, others don't.  It's a crap shoot.  In the end, it's all about what you feel comfortable with.

[Flan]

my prescribing "physician" is a nurse practitioner
labs are ordered the same way so it's easier then seeing a MD.

[Jasmine.m]

Thank you all for your replies!  As usual, I knew I could count on you!!

I was really confused b/c I thought that blood tests and specialist were kind of an essential part of the HRT process. I suppose more important is to have someone who's actually treated TG's with hormones. Is an endo with zero experience in HRT any better than a GP with tons?

I guess I'm kind of a stickler for test, test and more tests. For sake of my liver and general health, I want to make sure I'm getting maximal results with as little dosage as possible. I assumed that an endo would be the most qualified at getting it right... I definitely learned something here.

I now see a GP for my HRT supervision, and she is VERY cautious. Every time she thinks any test results aren't right, she either retests me herself, or she refers me to a specialist.

Diana, May I ask what kind of specialist?

Thanks again, girls!! This site is so valuable!!

[BrandiOK]

Tricky question...

Yes, an endocrinologist that has not dealt with TG's has much more experience and knowledge of/with HRT than a GP with "tons" of experience with HRT work on TG's.  It's their specialty..it's what they have dedicated their careers to.  That's not to say a GP can't prescribe hormones and blockers and do an adequate job of monitoring your process.  It just means that should something come up that is outside his/her scope of training it might be missed or misdiagnosed.  The odds of that? Pretty slim but when it comes to something like this I'd go with the endocrinologist.  Any endo who takes on their first TG patient can come up to speed fairly quickly on how HRT applies to transgendered people.  They already have a base knowledge on the subject that far exceeds a general practitioner or a physician who specializes in something else.  This is assuming they want to put in the effort to learn the subtle, but very important, differences in patient care and that's something you can only learn by talking to them. 

That being said, if I didn't have access to an endocrinologist who already treats TG people or one who was willing to learn, I wouldn't be overly concerned about seeing a GP.  Statistically there's a pretty small chance you will develop complications. 

[Dana_W]

Diana, May I ask what kind of specialist?

I have been referred to a liver specialist at one point. He was very good, and picked up that I was transitioning without being told based on my medications and dosages.  He was very nice and professional and treated me very well.

I have also been referred to a dermatologist for something not likely related to HRT, but she takes good care of my health in general - not just HRT issues. But I haven't made that appointment yet.

[gothique11]

I just see my family doctor. A lot of trans ppl also see him (a lot of trans ppl I've referred to him, LOL). But, he's good. I know a few people around here who have gone to endros and then ended up liking this family doc (after all, just 'cause they are an endo it doesn't mean they know much about HRT for trans folk, unless they have researched it or took a class on it... I've heard of a lot of endo's giving very low doses usually given to post-menopausal woman 'cause they didn't really know what to do).

I have only seen an endo once, who looked at what my GP doc was doing and said it looked fine to him and he didn't see a reason I needed to see him - my doctor was doing everything right.

If your doctor doesn't know what to do, There's a link on the Vancouver Health Trans page http://transhealth.vch.ca/resources/careguidelines.html  for doctor resources (there is also consumer info, there, too) I don't know if I'm allowed to link the specific PDF, since it contains doses -- but, it's easy to find the PDF for docs on the page. It also says what blood tests he or she should do. Print out a copy and give to your doctor. There are doctors out there willing to learn, and often if you give them this info, especially since it's for docs from docs, it can help them out a lot. Sometimes docs get busy and they don't always have the time to go googling for the information, especially 'cause there's a lot of different info out there to go and weed through.


Good luck!