Susan's Place Transgender Resources

 >:( Ok here is what is now happening. My therapist is on board again with trying to get me HRT ,we worked some issues out and she told me she is not trying to procrastinate. So she says that the endocrinologist that I have seen 3 times wants a letter from her and a Doctor (Psychologist). But now guess what my previous Doctor (Psych) said to me in an email as to what she is sending to the therapist?

QuoteAlso, I will be writing a letter for you therapist about my clinical impressions of your suitability for HRT. Here is basically what I will say: Unfortunately, I do not feel as though I am in a position right now to advise HRT at this time. First, it has been too long since I have worked with you in treatment so I do not have the most accurate clinical picture of you and your condition at this point in time. Second, from my limited interactions with you over the last year and a half you have fluctuated in what you have wanted. Third, I would wonder what would happen if you were to take testosterone (or if that has even been considered or tried) and how that would affect you, your sense of gender, and your androgen deficiency. Because of these points, I am not sure that female hormones would be in your best interest at this point.

If on the other hand, you and your endocrinologist have attempted a clinically appropriate and sustained male hormone treatment regimen that did not turn out to be sufficiently beneficial for you and your mood has remained stable for at least six months with proper psychotropic medication (for mood stabilization and depression) then at that point I would agree that female hormones could be effectively brought on board with the appropriate medical and clinical precautions and support in place.

So now I am really worried that all this effort and time spent with my therapist may not mean much of anything if the endocrinologist still needs another doctors letter. I thought that an LCSW by themselves could write a letter of recommendation for HRT.  What my previous doctor fails to see is that I have been struggling internally on a spiritual and emotional level about my gender. But THE LAST thing I want to do is take TESTOSTERONE! Why in the world would this be recommended for me to try.

You notice that in the email it suggests that taking testosterone will change my internal gender,that I will feel more male and correct. No that would make me feel sick and loose whatever feminine traits I already have.

So not sure what to do now.   ???

I'm not any kind of medical professional, but I'm guessing because you post that your inter sexed  that might be the reason for experimenting .I really don't know its just a guess.

From an IS friend, I hear that the default treatment is testosterone... In her case, it was a nightmare when she took T. But that may be why your previous doctor is suggesting this ( and being ignorant of gender identity ).

I don't have any suggestions or advice to give. I'm sorry to read this, and hope it works out for you.

xx

The thing is I may or may not have Mild or Partial Androgen Insensitivity Syndrome, I have had 2 different opinions from 2 different Endo's. The thinking from this one is,if I take Anti Androgens and have partial AIS they wont react as well. However if I have mild AIS,it won't be affected.

I am Transgender no matter what though. I have been spending 4 years now on dealing with this and accepting it

Any informed consent options?

I would find a different doctor or whatever.  But if you are 100% certain that you're a transwoman, no matter what you do, don't take the T.

T exaggerates the dysphoria drive. This is crazy talk. :-\

Previous Doctor strikes me as a quack.

Quote from: Shawn Sunshine on January 19, 2014, 03:16:42 PM
>:( Ok here is what is now happening. My therapist is on board again with trying to get me HRT ,we worked some issues out and she told me she is not trying to procrastinate. So she says that the endocrinologist that I have seen 3 times wants a letter from her and a Doctor (Psychologist). But now guess what my previous Doctor (Psych) said to me in an email as to what she is sending to the therapist?



So now I am really worried that all this effort and time spent with my therapist may not mean much of anything if the endocrinologist still needs another doctors letter. I thought that an LCSW by themselves could write a letter of recommendation for HRT.  What my previous doctor fails to see is that I have been struggling internally on a spiritual and emotional level about my gender. But THE LAST thing I want to do is take TESTOSTERONE! Why in the world would this be recommended for me to try.

You notice that in the email it suggests that taking testosterone will change my internal gender,that I will feel more male and correct. No that would make me feel sick and loose whatever feminine traits I already have.

So not sure what to do now.   ???

Do you have a therapist you discuss your gender identity with? How do they feel about your doctor's letter?

Before putting me on estrodial and spiro, they put me on a mood stabalizer and a T booster just to rule out any other issues that could make me feel transgender. And even tho it sucks, they can do it, its mostly to cover their butts.         I have nick named it  "the incase you regret transitioning defense"     they also made me take iodine suppliments to boost by thyroid before they would put me on HRT also just to make sure it wasnt.  it was a educational learning experience, cause I guess there is tons of things that can go wrong in the body and make you feel that way, and some doctors just want to rule them out first.    Dunno what to tell you besides just ride it out till you can get your estrogen

Quote from: Thylacin on January 19, 2014, 04:42:33 PM

Do you have a therapist you discuss your gender identity with? How do they feel about your doctor's letter?

yes the therapist I have seen consistently since September 2013, and before in April same year. Not sure whats going to happen now. Will know more later. At any rate I would not want T at all, I refuse to take that.

I'm really sorry to hear this.  I remember my mom wanted me to take testosterone in order to "cure" my dysphoria.  Some people don't get it and think there is a way to correct dysphoria. 

Why won't your endo accept a letter from your current therapist?  I was under the impression that social workers were also able to write an hrt letter, though I guess it's up to the endo's discretion whether she accepts the letter or not.  Is there another endo that you could see?

Quote from: Teela Renee on January 19, 2014, 04:49:42 PM
Before putting me on estrodial and spiro, they put me on a mood stabalizer and a T booster just to rule out any other issues that could make me feel transgender. And even tho it sucks, they can do it, its mostly to cover their butts.     

"they can do it" ?  I disagree with this 100%.  No doctor can force a patient to do anything.  This is a simple matter of the patient knowing what's going on better than anyone else.  If you're absolutely certain you're a M2F TS, why in God's name would you take T?

Quote from: JordanBlue on January 19, 2014, 06:55:15 PM
"they can do it" ?  I disagree with this 100%.  No doctor can force a patient to do anything.  This is a simple matter of the patient knowing what's going on better than anyone else.  If you're absolutely certain you're a M2F TS, why in God's name would you take T?

sounds like aversion therapy  :-\

Quote from: JordanBlue on January 19, 2014, 06:55:15 PM
"they can do it" ?  I disagree with this 100%.  No doctor can force a patient to do anything.  This is a simple matter of the patient knowing what's going on better than anyone else.  If you're absolutely certain you're a M2F TS, why in God's name would you take T?

you obviously have not lived in the sticks, when I started HRT. The only hormone doctor I had was 4 hours from my home, if I wanted to see a diffrent one, It was 8 hours.  and if thats what the doctor wanted, you delt with it cause you didnt have any other choive besides his way or the highway, and i chose to ride it out instead of traveling 8+ hours one way

Quote from: Teela Renee on January 19, 2014, 07:08:38 PM
you obviously have not lived in the sticks, when I started HRT. The only hormone doctor I had was 4 hours from my home, if I wanted to see a different one, It was 8 hours.  and if that's what the doctor wanted, you dealt with it cause you didn't have any other choice besides his way or the highway, and i chose to ride it out instead of traveling 8+ hours one way

I live in the Ozark Mountains.  It doesn't get much more 'sticks' and Hillbilly than that.  I would still absolutely never voluntarily take T.  But whatever works for you.

Is it possible for you to get a psych evaluation online? I don't know myself as i've not had to investigate this avenue but surely there's a competent psych who would be willing to have sessions through a web chat due to you living in the sticks? I'm sure I read someone on here a couple of years ago saying that they had online psych evaluations.
It sound like you're being penalised for living in an isolated location with very little choice of psych's.

Here in the UK we're entitled to request a second opinion if we disagree with any diagnosis but due to the comparatively small size of the UK travelling is rarely a barrier.

I'm hypogonadic.  Initially my T was 150 on a 300-100 scale and my E2 was 80 on a 0-50 scale.

In other words, smack dab in between male and female levels for both testosterone and estrogen.

I think I also have mild androgen insensitivity too, but have not been properly diagnosed.

I took a course of testosterone cypionate injections for several years.  Six months in I was growing a very nice set of breasts.  It turns out that the enzyme aromatase converts testosterone to estradiol.   The testosterone did nothing to  make me more masculine, it just gave me my first taste of estrogen.

They say we all need either estrogen or testosterone to be healthy.  In my body either yields the same result.

Randi

Quote from: Shawn Sunshine on January 19, 2014, 05:00:33 PM
yes the therapist I have seen consistently since September 2013, and before in April same year. Not sure whats going to happen now. Will know more later. At any rate I would not want T at all, I refuse to take that.

Well, ultimately it is up to you.

The effects of estrogen on the psyche are relatively fast-acting. If it's not right, then you'll know really, really soon. That said, if you're on T, you'll know faster.

The doc strikes me as a bit odd. What country are you in where you'd get weird-o propositions like this.

what a quack, is there no other option? I saw informed consent up there recommended, just reading that email makes me want to be violent towards the sender. seriously ridiculous. I am sorry you are having to deal with this :(

Shawn,

That sounds about right.  From my personal experience and from what others have said, if a person is IS and has been male, the first thing they do is prescribe T.   I was in therapy with a well respected therapist (PhD) who supported my going on E and I could not get it.  At endo #5,I did what I knew was wrong and I tried T.  It was a very unpleasant experience.  So, I stopped.  Then, they had me do it again, which produced the same results.  Eighteen days later I was on E.   

You can try another doctor or another psych.  I don't believe that in your case T would cause a serious physical problem.  Mentally, it wouldn't be good.  But could be a means to an end.  The last resort means to an end.  I'd try everything else first.

Hugs,

Jen       

  well ok now things have changed a bit, I sent her an email and she said this was what was sent to my current therapist. She is a good doctor, had nothing but good sessions with her and such.

QuoteI have attached a letter for you to take to your therapist or any of your other medical doctors who need to have information about your condition and my clinical opinion. I determined to NOT discourage nor endorse you getting HRT, but rather left it up to your current treating clinicians. I merely gave my clinical assessment and recommendations based on certain criteria that I feel would need to be addressed.

Quote from: Victoria Mitchell on January 19, 2014, 08:56:37 PM
The effects of estrogen on the psyche are relatively fast-acting. If it's not right, then you'll know really, really soon. That said, if you're on T, you'll know faster.

Ok, with that being said...
I've been on HRT, Spiro & E, for a full week now.  I feel more alert, have more mental clarity and focus than I have in many years.  I feel awesome.  Does that mean it's right for me? 

I would think so,I was looking for that inner peace I don't have now. I can tell when my testosterone spikes, i get angry and irritable fast. I hate that feeling of testosterone raged emotion, it fights against my gentle nature.

Quote from: JordanBlue on January 19, 2014, 06:55:15 PM
"they can do it" ?  I disagree with this 100%.  No doctor can force a patient to do anything.  This is a simple matter of the patient knowing what's going on better than anyone else.  If you're absolutely certain you're a M2F TS, why in God's name would you take T?

While I like to pontificate, I also agree with the above.

What you did not mention was something very important. You did not tell us how you are presenting to the doctor. I am going to take a shot in the dark guess and say your going there presenting a guy..............
Can you really expect the doctor to take the female thing seriously when your there as a boy??

Hell I have been for a year now telling people I am trans species and that I am actually a zebra. Strangely not one person believes me and not one person has gotten me any zebra presents either.

My point to you is if I was the doctor with a guy sitting in front of me asking for female hormones I would be suspicious just the same as your doctor is.

Katie

I have to agree with Katie on this one. When I started therapy I knew I wanted her to know I was serious about this so I started presenting as myself even though I totally completely couldn't pass. Sure it was embarrassing but every time I went out I told myself maybe this will be the time I get my letter. So if your not presenting perhaps you should give it a shot it couldn't hurt to try.

I presented as female every time I went to that Doctor, I don't present here in this small town at all,and I am not going to, its just too dangerous. My Therapist here knows why though, she even told me to just be careful. I got to read the letter my previous Doctor said, this has nothing at all to do with wearing or not wearing female considered clothing. Theres no rule really about what is exactly male and female when it comes to what to wear. Clothing doesn't make you who you are.

Quote from: Katie on January 20, 2014, 08:57:21 AM
What you did not mention was something very important. You did not tell us how you are presenting to the doctor. I am going to take a shot in the dark guess and say your going there presenting a guy..............
Can you really expect the doctor to take the female thing seriously when your there as a boy??

Hell I have been for a year now telling people I am trans species and that I am actually a zebra. Strangely not one person believes me and not one person has gotten me any zebra presents either.

My point to you is if I was the doctor with a guy sitting in front of me asking for female hormones I would be suspicious just the same as your doctor is.

Katie

What a pile of opinionated and insulting drivel! For all of my appointments with my therapist I presented as male (albeit with my ears pierced and nails painted) and told her I have no intention of presenting as female until I can pass, I had zero issues with getting my letter. Requiring anyone to 'prove' they are trans* with their presentation is total bull->-bleeped-<- and smacks of gatekeeping, not to mention potential issues with safety.

Quote from: SeekingMyself on January 20, 2014, 09:45:01 AM
What a pile of opinionated and insulting drivel! For all of my appointments with my therapist I presented as male (albeit with my ears pierced and nails painted) and told her I have no intention of presenting as female until I can pass, I had zero issues with getting my letter. Requiring anyone to 'prove' they are trans* with their presentation is total bull->-bleeped-<- and smacks of gatekeeping, not to mention potential issues with safety.

Exactly Seeking Myself I totally agree and my therapist would have it no other way... I lived male as long as I could and I can't just put a dress on and walk out the door to see my customers and family and say here i am...
I think therapist that do that to us are cruel...and heartless..
My therapist wants me to take it slow and transition has many options...as far as how we present..
I must admit though that I never liked my guy clothing and now that I started HRT I hate to get manned up and go out but I have to.. I just don't look in the mirror or i get upset ...sometimes..
Carrie

What a load! Did someone say "gatekeeping?" Well, that's what that first letter in your first post sounded like to me. If you know your a transgender woman you shouldn't be forced to take T. I actually can't believe I'm hearing this in this day and age. I live out in the sticks on an island in a chain of lakes here in Florida and my choices for Endo's and trans friendly doctors is slim to none.

In addition, I don't believe you should be forced to present as female if it could potentially open the door for you to be physically harmed just so you could possibly get a favorable letter. If I were in your position I know what I'd do. But I'll leave that there. Since I've been on hrt I've had a more stable peice of mind and sense of well being. No more mood swings, etc., and more energy than I've ever had.

I recommend you follow advice other have given you about finding another doctor. If your current therapist isn't the one who wrote that garbage then he/she might be OK to stay with. However I would definately discontinue seeing the one who wrote that letter. Such nonsense will do you more harm than good in the long run. Just my 2 cents. ;)

Quote from: Katie on January 20, 2014, 08:57:21 AM
What you did not mention was something very important. You did not tell us how you are presenting to the doctor. I am going to take a shot in the dark guess and say your going there presenting a guy..............Can you really expect the doctor to take the female thing seriously when your there as a boy??
My point to you is if I was the doctor with a guy sitting in front of me asking for female hormones I would be suspicious just the same as your doctor is.
Katie

That's not necessarily true.  I presented as a guy when I got my scripts for M2F HRT.  Of course, I had a therapist letter, etc.  There are no set rules on 'How To Present As A Proper Transperson'.  Each individual should do what they feel comfortable with.

Quote from: Shawn Sunshine on January 19, 2014, 03:16:42 PM
>:( Ok here is what is now happening. My therapist is on board again with trying to get me HRT ,we worked some issues out and she told me she is not trying to procrastinate. So she says that the endocrinologist that I have seen 3 times wants a letter from her and a Doctor (Psychologist). But now guess what my previous Doctor (Psych) said to me in an email as to what she is sending to the therapist?



So now I am really worried that all this effort and time spent with my therapist may not mean much of anything if the endocrinologist still needs another doctors letter. I thought that an LCSW by themselves could write a letter of recommendation for HRT.  What my previous doctor fails to see is that I have been struggling internally on a spiritual and emotional level about my gender. But THE LAST thing I want to do is take TESTOSTERONE! Why in the world would this be recommended for me to try.

You notice that in the email it suggests that taking testosterone will change my internal gender,that I will feel more male and correct. No that would make me feel sick and loose whatever feminine traits I already have.

So not sure what to do now.   ???

Shawn, you are never obligated to take a medication you are prescribed if you feel that it would work contrary to your physical and mental health.  All medications carry with them certain risks, and you have the final say.

You have found that you have an intersex condition.  That condition must be considered by your doctors, and under the new Standards of Care, the hormone regime is left largely up to you.

Quote from: Jamie D on January 20, 2014, 02:45:57 PM
Shawn, you are never obligated to take a medication you are prescribed if you feel that it would work contrary to your physical and mental health.  All medications carry with them certain risks, and you have the final say.

You have found that you have an intersex condition.  That condition must be considered by your doctors, and under the new Standards of Care, the hormone regime is left largely up to you.

Yup.

Often, we know more than our doctors.

You are not at their mercy, they are at yours. Do they want your business or not?

Quote from: SeekingMyself on January 20, 2014, 09:45:01 AM
What a pile of opinionated and insulting drivel! For all of my appointments with my therapist I presented as male (albeit with my ears pierced and nails painted) and told her I have no intention of presenting as female until I can pass, I had zero issues with getting my letter. Requiring anyone to 'prove' they are trans* with their presentation is total bull->-bleeped-<- and smacks of gatekeeping, not to mention potential issues with safety.

Agreed 100%.  I also have no intention of presenting as female until I can pass comfortably.  My therapist believes the exact same thing.  It's up to the individual person. No rules on 'being trans'.

I wish we could sue dr's who don't do their job correctly, or specifically make it harder for the t-community, like said earlier what a bogus dr, you have access to an informed consent dr.? I have another option but I'm not going to post it here if you want to pm me you can.

Quote from: Katie on January 20, 2014, 08:57:21 AM

Can you really expect the doctor to take the female thing seriously when your there as a boy??

Um, yes, yes he should take her seriously.

That is not at all an important question, and your comparison to thinking you're an animal is so extremely insulting.

Quote from: Thylacin on January 20, 2014, 04:29:07 PM
Um, yes, yes he should take her seriously.

Agreed. That email is actually the worse attempt at gatekeeping I've seen in a while. I thought in this day and age our society was past that.

Well see,one thing that is happening, is that I am being told that because I am Bi Polar, I could be experiencing temporary dysphoria due to manic episodes. However I know that is not the case.

I have always felt gentle and feminine, even before when I didn't accept myself. Honestly I do feel both male and female,but I do not want to keep looking more male. It makes sense that I am intersexed and feel in between. I am most certainly genderfluid but have never really been comfortable or have been scared to express it. I am sure I am not alone in my fears.

have you tried online doctors

Quote from: Katie on January 20, 2014, 08:57:21 AM
What you did not mention was something very important. You did not tell us how you are presenting to the doctor. I am going to take a shot in the dark guess and say your going there presenting a guy..............
Can you really expect the doctor to take the female thing seriously when your there as a boy??

Hell I have been for a year now telling people I am trans species and that I am actually a zebra. Strangely not one person believes me and not one person has gotten me any zebra presents either.

My point to you is if I was the doctor with a guy sitting in front of me asking for female hormones I would be suspicious just the same as your doctor is.

Katie

Some of the most womanly women I've ever known didn't wear makeup, wore blue jeans & boots, and the gender racks their shirts came from was irrelevant to them.

But they would never speak to another woman the way you just did.

Thus, I beg to differ.

Shawn, are able to travel very far for your counseling and doctor appointments. If I recall, you don't live far from me, and I have the best in the business I go to. PM if you need their names.

Quote from: Nikko on January 20, 2014, 07:02:17 PM
Some of the most womanly women I've ever known didn't wear makeup, wore blue jeans & boots, and the gender racks their shirts came from was irrelevant to them.

But they would never speak to another woman the way you just did.

Thus, I beg to differ.

Shawn, are able to travel very far for your counseling and doctor appointments. If I recall, you don't live far from me, and I have the best in the business I go to. PM if you need their names.

Ditto that Nikko.. everyone's situation is different... my therapist warned me to take it slow.. I may not present female until after two years and FFS....and that is my plan.    In fact there are different degrees to which we can transition.  I may just choose to be a tom boy most the time and doll up when I want..
All depends on how I feel after HRT for a couple years and FFS.
Carrie

Quote from: Shawn Sunshine on January 20, 2014, 09:43:51 AM
I presented as female every time I went to that Doctor, I don't present here in this small town at all,and I am not going to, its just too dangerous. My Therapist here knows why though, she even told me to just be careful. I got to read the letter my previous Doctor said, this has nothing at all to do with wearing or not wearing female considered clothing. Theres no rule really about what is exactly male and female when it comes to what to wear. Clothing doesn't make you who you are.

As someone that lives in a small town and basically had one shot at finding a decent local therapist, I'm going to chime in here. The first time that I saw my therapist, I wore a women's longsleeve top that was just a plain, solid color. Along with a pair of plain women's jeans and women's sneakers. The guy knew damn well that I wasn't presenting as a "man". I don't like skirts, dresses, etc. I think I look stupid in them. Frankly, if any douchebag, elitist transchick told me that I was "presenting as a man" on that or any day, I would tell them to get stuffed. Anyone that would say that to another transchick is a complete and utter prick.