Susan's Place Transgender Resources

Hi everyone,

I'm suffering from a bit of name anarchy at the moment, with four versions of my name currently in use. There are three versions of my masculine name, plus one feminine name which I'm keeping secret to most people.  'C' is a safe moniker.

I'm not going to go on at length about my whole life story. I'm in my mid-30s working in research in a small city in northern Germany. I've known that I was 'not a man' all of my life; I had some modifications done in 2010; and I have lived totally without hormones since mid 2011. My gender presentation is androgynously masculine although my gender identity is closer to soft butch feminine (MtF). I started off looking very masculine, so this is an improvement. I get gendered as male 90% of the time from afar, which goes up to 100% up close. I'd like to reduce those numbers considerably. I have zero chance of ever 'passing' but I would like to go more in that direction. I'm already playing around with my fashion style and paying for laser hair removal (it's expensive!) but that doesn't get me all that far.

I have another reason for looking for E. While I like this non-binary androgynous thing and can't imagine going back to being on testosterone, it isn't too good for my health. I have been developing osteopenia, and there is no way for me to get treatment for that. Likewise, it is not clear to me that there is any way to obtain hormones, despite being post-op. I would love to start on a low dose of E to maintain my health (and to see what happens - I already dress androgynously). My general practitioner (Hausarzt) is on board, but he has no idea whom to send me to. I have been trying since April, and endocrinologists quite sensibly require letters from therapists, who themselves require a one-year "real life test" where one should perfectly pass as a woman despite having a male name, facial hair, and an almost completely male body. At least that's what they say in their writings; I have not yet succeeded in even getting an appointment with the one person at the university clinic, since he is not taking patients until further notice.

So, hi everyone. Does anyone know of a friendly therapist in northern Germany that I can talk to? Beyond that, I'm just interested in talking and meeting people. I'm still a bit surprised that I might be transitioning, with no help from the medical community.

Thanks so much,

-C

Willkommen, C, from southern California.

We have several German members here.  Perhaps one of them will see your introductory post.

You are correct to be concerned about a complete lack of hormones.  That could cause your osteopenia to progress into osteoporosis.

Viel Glück!

Hi and welcome from Australia,

I have to admit I know nothing about the European system but you are presumably under the care of endocrinologists already. They may know links to TG medics. Also Google your local area and Germany for TG help it is quite common.

Hi Jamie and Cindy,

I've lived in California before, and I loved it there. I had a chance to grow my hair out a little bit, pierce my ears, and shave my legs in peace. Oddly, in my case, those things got taken as masculine, in the way that adding a little bit of salt to something sweet adds to the perception of sweetness.

You've described my concerns exactly. The endocrinologist in the town where I live refuses to treat osteoporosis in anyone under 65, and he refuses to give me estrogen without a diagnosis of 'Transsexualität'. My GP (Hausarzt) sympathizes with me, but his solution is to send me to another endocrinologist whose specialty is adult diabetes. This isn't going to work. I need someone who has the authority to allow me access to estrogen and who knows something about gender issues. So currently I am under the care of nobody, apart from a sympathetic Hausarzt, and I've been going in circles trying to obtain hormones for the better part of a year. This has gotten so frustrating that it leads to the occasional panic attack. Osteoporosis! Stuck in boy mode!

In my part of Germany there is a clinic which has been mentioned elsewhere on these boards as particularly problematic (See Fencesitter's posts.). They're sticklers for the very long 'real life test/experience' as a man in a dress, despite my hugely masculine body, deep voice, and dark 5:00 shadow, and they're big on policing 'autogynephiles' and the gender binary. :police: If I actually transition over the longer run in small steps, that would be great, but trying to 'force' a full, binary transition now to please someone like this would be a huge mistake. Here's a list of things working in my favor and against, respectively, as I see it, holding my inability to get medical help aside:

In my favor:

Despite my age (34) I look somewhat younger, and I apparently have a certain 'energy' about me which gets me described as 'cute'.
A year and a half totally without testosterone has had some softening effect, to the point of where people see me as masculine but not 100% so. Someone 'read' me as an FtM (lol) the other day.
My Adam's Apple is not usually visible.
I am not hugely overweight (though I have to watch out for this since my metabolism isn't all that great right now).
I have begun paying for laser treatments out of my own pocket.
My voice has a certain non-masculine lilt.
My mannerisms are not completely masculine.
I am not hugely athletic or muscle-bound, but no couch potato either.
I have full lips and expressive eyes.
I have a full head of hair.
Apparently, a number of my coworkers don't even recognize me after growing my hair out again, and one visitor commented to me that he looked over toward my office and thought that it had been given to a woman. Apparently people have picked up on something already, and the 'surfer hair' jokes have begun. This is despite never having left boy mode in my life, except for 20 minutes in Thailand and 5 minutes in the bathroom the other day.
I already have a big chunk of my 'medical issues' dealt with, through various means. I do not foresee surgery in my future. :)
I am American, so the German name-change law doesn't affect me. First I do it in the US (easy) and then it propagates to Germany.
I am highly educated and speak calmly even when frustrated, most of the time at least.
I am not the first person in my profession who would be openly trans.

Against me:

I am still 34, and my features have had some time to 'set'. Overall, my facial structure and body are quite masculine--not 100% but maybe 90%.
My chest is pretty flat.
I am over six feet tall, with hands and feet that are not huge but still 'manly'.
I have no access to estrogen.
I have no local support network (yet, working on that).
I have a very thick 5:00 shadow, so it will take quite a while before my 5:00 shadow becomes much less of an issue.
These laser treatments are expensive, as estrogen would be, were I to find some.
I live in a small city so I have to be careful going out in 'girl mode' lest I be completely outed at work.
My work has me in a semi-visible position (quoted in newspapers, publishing my own work), and I will need to undertake a major job search in a year's time.
I have to coordinate names and gender designations across two federal states and two countries, and my visa, passport, and work contract are tightly bound together.
I have a very deep voice. I have easily gotten it up to about 130 in pitch, up from 90. I have to work very hard to get it any higher.

Things which are ambiguous:

My family is ambivalent but I've heard of far worse. The bad side of this is that now they'd have our family name associated with trans issues.
I have a boyfriend who is not exactly supportive, but he's stuck with me this far.
I identify as transfeminine but outside of the gender binary. I know that the most 'feminine' I can hope for is a sort of a soft butch thing. That sounds pretty nice.

-C

Hi C, :icon_wave:

Welcome to our little family. Over 9416 strong. That would be one heck of a family reunion.

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Hi C and welcome to Susan's.



:)

Hi C, welcome to Susan's Place! I spent a week in Todendorf at the AAA firing range back in the 1980s. Glad you found us, hugs, Devlyn

Hi C,

A big Aussie welcome to Susan's family. It's good of you to drop in and say "Hi". Hope you like it here, and you stay for a while.

There is a mountain of information, resources and friendship waiting for you here, you just need to jump in start talking and ask any question you like. You're quite safe here and we are very accepting.

As the TG policies in your part of Germany are quite archaic, would access to a larger metropolitan city be any easier? Or is this ridiculous RLE requirement throughout Germany?  If you were able to source Oestrogen elsewhere, would your Endo be willing to monitor you?

Looking forward to hearing more of your story in time to come, but in the meantime, be safe, well and happy.

Lotsa huggs
Catherine

Thanks again for all of the warm welcomes!

@Catherine:

The nearest decent-sized city is Hamburg (a solid train ride away but doable), and apparently a clinic exists there which I have been trying to contact for a month. I have no idea what their policies are, and information on their policies is very hard to obtain. That is one thing that I keep trying to chip away at.

I have an endocrinologist who told me that he won't give me estrogen unless I had a diagnosis of 'Transsexualität', and that I should visit the therapist that others have had difficulties with. Otherwise the endocrinologist could only prescribe me testosterone. I don't know if that is a real offer to help or not, or whether he is hoping that I would just give up and go away. I am not completely confident that I could get such a diagnosis within a reasonable number of years, even though my medical history (I'm post-op!) should be a mitigating factor in my case, and my osteopenia suggests that I should go on hormones sooner rather than later. At any rate, the clinic is not currently taking patients, though I was told to try again after the new year.

I have no idea how the endo would react if I managed to source estrogen on my own (and it is not clear to me that there is even a way to do this). The clinic is so badly run that it's hard enough to get an appointment with anyone--the secretary is on the phone for personal phone calls all the time--and I have no idea whether the endo wants to be involved in this kind of thing.  It's safer for him to avoid me entirely than to expose himself to the slightest risk. It's better for him if I either develop full-blown osteoporosis or suffer from the complications of self-medication than if he were involved and something went wrong.

I just have to be patient and hope that something will come along before the health issues get much worse. In the meantime, I can play around with clothing and LEAVE MY HAIR ALONE.

@Devlyn:

I live in Schleswig-Holstein currently (visiting the States at the moment). I want to avoid naming the city in order to personally identify myself. It's large enough to theoretically have at least one or two trans people, but I don't know any personally--though that should change next month. :)

@gennee and Ms. O'Brien:

Thanks for the warm welcome.

Hello C,
I'm sorry you are encountering so many obstacles to good health and proper treatment.
The medical professionals you have met with are not aware of, and not in compliance with, the WPATH standards of care.

There is one member of WPATH (The World Professional Association for Transgender Health (http://www.wpath.org/index.cfm)) in Germany - I would recommend that you contact him and he could not only help you get a proper diagnosis, but also refer you to physicians who are familiar with the standards of care.

Source=http://www.wpath.org/find_a_provider_detail.cfm?individual=323 (http://www.wpath.org/find_a_provider_detail.cfm?individual=323)

Dr Hagen Loewenberg
Dr. med.
Schloss Str. 16
Muelheim,   D-45468 , Germany
Phone: 0049208-476870
Fax: 0049208-476864
h.loewenberg@t-online.de

Specialty: Psychiatry, Psychoanalysis

Good luck,
Maddie

P.S. Here is a link to download the Standards of Care.
http://www.wpath.org/documents/SOC%20V7%2003-17-12.pdf (http://www.wpath.org/documents/SOC%20V7%2003-17-12.pdf)

Hi C,
If you are post-op, could you get assistance through a gynaecologist in your area. Surely they would be more compassionate, if you presented as a female client. No mention of your transgender status.

Is your Endo aware you are post-op? Surely that must carry some weight?

Hope you can sort something out soon, particularly with the info Maddie gave you.

Be safe, well and happy
Lotsa huggs
Catherine

Guten tag!

Hi MadelineB,

The issue is that in Germany, there is a different, far more stringent, SoC. That's the SoC which regards patients' welfare as secondary to avoiding legal risk to the doctors. I much prefer the WPATH (patient-centered) approach, under which I'm sure I'd qualify for accelerated treatment given my circumstances.

Thanks for that info. Unfortunately, Mülheim is rather far from where I live, but I can go there once or twice if I absolutely have to. This week I'm trying to relax a little bit and not worry about all of these overhanging projects in my life. I'll take this issue up again when I get back to Germany from a trip. I'm meeting my first-ever German trans person after I get back! Yay! Maybe they'll have some advice.

Catherine Sarah,

My endo is aware that I'm post-op in one way, but that op was to remove certain parts of me which had become 'mysteriously' diseased and non-functional. I am not 'in the system' as trans but only as a hypogonadal male. There was a second op in Thailand which my GP (Hausarzt) knows about, but the endo does not. Either way, he'd need clearance from a therapist were he to prescribe me anything except testosterone. This is my major roadblock.

I can't simply go to a gynecologist as a male and ask for any kind of help. I'd need to be female (in a legal sense or at least in a computer system sense) in order to do that. I'm holding off on doing any kind of legal name/gender change because I'd have to coordinate all kinds of things in order to make that happen--in particular, the dependencies among my non-German passport, my German visa, and my work contract. My current strategy is to try and wait out these issues which might go away on their own in a year and a half, since if I were living back in my home country, things would be far easier. This also gives me time to work out a viable 'girl mode' to see if I really want to fully transition or just live as an androgynous male (as seen by others).

Dhenric,

Moin auch. :)

Hi C,

Certainly don't make it easy for you over there. If you're professionally qualified, why don't you immigrate to the Land of Oz and we'll look after you?

Hope things improve for you this year.

Huggs
Catherine

C, I wish you the very best.  One of my own great frustrations is the "bureaucratic" nature of the standards of care.  I am completely unfamiliar with the German medical system, so all I can suggest is perhaps finding a psychiatrist who might be able to provide both therapy and prescription medications.

Hallo :)
I m from Germany too, but sadly from southern germany, around the salzburg area, almost in austria :D
At first, from what I ve read and heard from other transpersons, I thought too, that you'd need atleast 1 year RLT to get a recommendation for HRT here.
This is NOT true, the requirement is not 1 year RLT but rather 1 year of psychotherapy! you can get the recommendation from a psychiatrist then who specialises in gender issues.
It's really stupid to wait one year but better than having to do RLT and beeing unpassable.
So then I finally got the permission shortly before my 20th b-day and started then a few days after :)
But you really have to watch out, not all psychiatrist are good and trustworthy, I ve had some bad experience with my first and then switched to another from whom I ve got my recommendation.
Hope this helps a bit ;)
Hugs
Chris23

Hi everyone,

I'm back in Germany now catching up on sleep and work. It was nice being back in the US for a while but the travel has driven me a bit nuts. Glad to be back at home (home is where my couch is) resting.

At least one more year without hormones would probably turn my osteopenia into full-blown osteoporosis, if it hasn't already. It's also particularly hard to find any sort of trans-specific help that isn't tied to one particular place which specializes in 'autogynephelia'. I do finally get to meet my first trans person in Germany next weekend. Maybe she'd have some advice. Otherwise I'm at a complete loss for someone within 300km.

I did somehow discover that some makeup had made its way into my shopping basket when going out to get something mundane. Finally, some time to myself to play around a bit. Hehehehe. For a while this evening I looked totally ridiculous but felt great.

While flying a lot recently, security officials have uniformly given me a double-take when looking at my passport. They tell me that I look different from my photo, followed a few seconds later by, 'It's the hair'. (I've got it done in a mid-length, androgynous way.) Someone on my PhD committee in 2008 failed to recognize me when I walked past her on the street last week. Yet another friend tells me that I look 'the same but different'. And this is all while still looking rather masculine, not leaving boy mode.

Australia would be nice if I could find someone to actually hire me. My publication record isn't that good. I do have an almost-certain job search to contend with in a year's time.

Off to sleep.

Aaaaaaaaaaaaaaaand, I have hormones. It wasn't through the university clinic here, which is universally regarded as horrible. It was instead through a separate (but legal and above-board) channel that is far less known.

Now I hope that the dinner I treated myself to will go to the right places. :)

-Claire

Dear C

I am also living in Germany. There is no need for a 1 year RLT to get the prescription for hormons. My therapist offered my during the first sessions the referral to an endo to get the presecription for hormons. It is even fully legal to prescribe estrogens to a male without seeing a therapists first. But only a few endos are doing that. And there is no law which states that you have to do a one year therapy first to get the referral or the prescription for estrogens.

So you should change your therapist to get the referral.

There are legal requirements to change your name and official gender. And there are rules for the social insurance to the SRS which require the RLT and a least to be at least for one year in therapy.

Everythink else is just plain wrong. I even now a transgirl who got the estrogens from an endo without having any therapy. This is legally because every MD is free to prescribe any legal medicine. This is the "freedom of therapy". But not many docs want to take the risk.

You can contact me for any further information. There are also some basic information on www.dgti.org (http://www.dgti.org) (German Transgender Organisation).

Lara

Quote from: RandomWalk on June 12, 2013, 01:49:04 PM
Aaaaaaaaaaaaaaaand, I have hormones. It wasn't through the university clinic here, which is universally regarded as horrible. It was instead through a separate (but legal and above-board) channel that is far less known.

Now I hope that the dinner I treated myself to will go to the right places. :)

-Claire

Okay then - good news!  I am happy for you, Claire.   :D

Dear RandomWalk

welcome here !

I am also living in Germany. Berlin here.  I have once met a post-op woman, 
who had osteoporosis. She suffered a lot and was very unhappy.
I  truly hope you solve your hormones and health problem as soon as possible.

The TG policies in your part of Germany seem really to be quite archaic.
I have a different experience with TG policies in Berlin, Germany.

My therapist send me to a gynecologist for a genetic and hormonal screening
and was willing after that to start hrt after that.
The therapist wanted only a medical overview about my genetic and hormonal status.
So my experience is you can start hrt in Berlin quite easy.

I wish you the best.

Quote from: Lara1969 on June 12, 2013, 04:23:13 PM
Dear C

I am also living in Germany. There is no need for a 1 year RLT to get the prescription for hormons. My therapist offered my during the first sessions the referral to an endo to get the presecription for hormons. It is even fully legal to prescribe estrogens to a male without seeing a therapists first. But only a few endos are doing that. And there is no law which states that you have to do a one year therapy first to get the referral or the prescription for estrogens.

So you should change your therapist to get the referral.

There are legal requirements to change your name and official gender. And there are rules for the social insurance to the SRS which require the RLT and a least to be at least for one year in therapy.

Everythink else is just plain wrong. I even now a transgirl who got the estrogens from an endo without having any therapy. This is legally because every MD is free to prescribe any legal medicine. This is the "freedom of therapy". But not many docs want to take the risk.

You can contact me for any further information. There are also some basic information on www.dgti.org (http://www.dgti.org) (German Transgender Organisation).

Lara

Hi there, Lara!

Now that I have more time on my hands, let me explain the situation in the city where I live.

Where I live, there is a gender clinic by the local university which is universally regarded with horror. They're big on policing " ->-bleeped-<-" and insist on the one-year RLT, which is in the German standards of care. They and the endo there are part of a team, and (thankfully) it's almost impossible to get an appointment. So if you're to go the official route here, you have to live for one year with a male name as a man in a dress in order to even get hormones (plus get lumped in with sex offenders). No way am I doing that. Otherwise, in the state where I live, there are no "official" options.

But, there is a separate secret channel through which one can talk with a sane therapist and an endo. The trick is finding that channel because they don't make themselves known. I had to find by asking as many trans people I could find where they were able to actually get care--and I only found other trans people by questioning a gay activist friend. It turns out that there's a psych here who treats trans people on the side. She's humane, sympathetic, and actually helpful in dealing with things like stress (my big thing). She's not that organized, but she's a good person, and that's the important thing. And there is an endo who is actually respectful and helpful. The problem is, nobody gives any guidance on what to do--who examines you for what, who sends a letter to whom for what, that sort of thing. I had to wing it and to rely on the endo for guidance, since he's the one who gets to prescribe hormones. I played the part of a manager and coordinated the endo and therapist.

So, I've spent the past 5 months going back and forth between the therapist and the endo. I'm post-op and already part-time presenting as female (and going to go full-time once I get my presentation together a little better and let hormones work). I'm obviously trans, and my health situation can at least be helped by hormones. (Getting preventative care to prevent a bone fracture--that's another story.)

Last week I found myself ferrying letters across town and making people fax things to each other (watching to make sure they didn't fat-finger the wrong number). It worked. That problem is solved after 14 months, although I would still like to do something about my bone health if I could, since I have osteopenia morphing into osteporosis.

Already, after a week, I know that E is right for me.

Now to figure out how to do my name and gender change as a foreigner. I come from a place in the US where I can easily get a new name, gender marker, birth certificate, the works. The law of my home country governs this issue. This is good. I will do that sometime in the 12 months depending on how things proceed. Now to figure out which Amt here in Germany I take what to (my guess: the Einwohnermeleamt, and every piece of paper I've ever touched) after I get back from my big trip to the US. :)

(Not to complain so much. The name change procedure works in my favor, despite its complicated nature, since I'm foreign.)

Quote from: angelats on June 12, 2013, 07:52:52 PM
Dear RandomWalk

welcome here !

I am also living in Germany. Berlin here.  I have once met a post-op woman, 
who had osteoporosis. She suffered a lot and was very unhappy.
I  truly hope you solve your hormones and health problem as soon as possible.

The TG policies in your part of Germany seem really to be quite archaic.
I have a different experience with TG policies in Berlin, Germany.

My therapist send me to a gynecologist for a genetic and hormonal screening
and was willing after that to start hrt after that.
The therapist wanted only a medical overview about my genetic and hormonal status.
So my experience is you can start hrt in Berlin quite easy.

I wish you the best.

Ugh, sorry to hear.

I've got the hormone problem dealt with by finding a "secret" but fully licensed therapist. Now to find a way to rebuild lost bone.

Berlin seems a really good place fpr transgender people. I easily get legally hormons und medical supervision. I am really surprised to hear about the difficulties in other towns.

Luckily you found a legal way to get your hormons.

Lara

Quote from: Lara1969 on June 19, 2013, 03:21:39 PM
Berlin seems a really good place fpr transgender people. I easily get legally hormons und medical supervision. I am really surprised to hear about the difficulties in other towns.

Luckily you found a legal way to get your hormons.

Lara

Hello Lara,
i agree
I consider Berlin as a real good place for transgender.

with kind regards
Angelats