Susan's Place Transgender Resources

Hello all.

I'm new to this board even though I have been reading it, and some of the user blogs, for quite some time. I came out as FTM in September 2015. Ever since, I've been very functional with how I handle the pre-T day to day. I'm starting a secretary course that'll last a year and a half at the end of August, then tackling a business course. Gonna be the suit & tie by day, and the guy that hits the gym and wrestling practices by night. My summer's slightly challenging mentally since I'm still on the waitlist to get an appointment with the therapist that's gonna write my recommendation letters so I can have access to HRT and top surgery, and I'm yet to get started in the ring (not ready at all for that, still getting fit) and with the school books. There's a bit of a gap where it feels my main focus is dead centered on emotional imbalances.

It's funny to me that I get so many moodswings and so many crushing urges to cry when it seems all is going well. I have slightly above average levels of testosterone and so a lot of the changes have started as soon as I stopped taking the pill. I have a pretty dark mustache and some hair on my neck. I'm getting steady and rapid muscle growth from lifting sessions and my frame is very defined masculine. I consider myself quite handsome even, I feel no dysphoria in terms of my physique. I think I'm lacking the amount of definition I need to properly pass and I need the mental stability and familiarity I know hormonal intervention can bring, but all things considered, I don't think I seem feminine on the out. I look in the mirror and see a guy. My girlfriend sees me as a man and no one in the family has been rejecting me ever since they have started coming to terms with my coming out.

Still, especially recently, I get rages that I strive to evacuate in healthy ways, but still consider as difficult to carry around with me 24 7. I get mind fog and some increasing levels of anxiety now and again, the ''Pins and Needles'' type feels. Maybe it's because I put a lot of pressure on myself to be the best version of me even though I'm dealing with some stress from knowing I probably won't see that therapist until December, and so I'm left with nothing but assumptions about how HRT and top are gonna go. Meetings have been kind of awkward and weird for me and so I don't attend. Standard free of charge therapists in the city say they're not experts so they'd rather I go to said meetings rather than talk to them about this.

I'm not sure what to do with it all except hang in there 'til December, keep doin' what I'm doing, meditate regularly, hit the gym, and strive not to be self-conscious about the inner turmoil and just trust life. Curious though, have some of you recognized signs of depression in your pre-T days, kind of similar to mine (as in, you felt confident about your outlook and how you handled the emotions - and your life was going well even in the middle of the craziness - and in spite of that you felt somewhat scared and angry)? What did you guys do to calm yourselves in moments where you wanted to swing?

Thank you and sorry for the novel.

Welcome to Susan's Place. While I was MTF, I think for most of us, it's a case of finding distractions to keep our mind busy. Mine was computers but it can be books, music or possibly in your case, working out. It's not alway effective but it's better than nothing. It disturbs me somewhat to see the delays in the medical system but unfortunately you need to work with what you have. Because I transitioned a long time ago, my wait period for HRT was about 4 years. Fortunately the wait is no longer that long.

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I actually had a really good life pre-transition. I had multiple degrees, considered an expert in my field, had a director-level position at a very young age, no issues dating, etc. But I hated myself. I was in this constant state of high-functioning anxiety and depression and no one had any idea, because on the outside everything looked stellar.

I had known I was trans for about 8 years at that point, and I no longer had any excuses to keep me in the closet. Took the plunge and came out, socially transitioned, started medically transitioning. It was like flipping a light switch on in my brain. I felt like there were finally things worth looking forward to again.

Did anything about my life actually change? No. My degrees were updated with my new name, I have the same job, I still have no issues dating. But I'm me now, and it's nice to feel connected to the life I'm living instead of feeling like an actor playing a part.

As far as coping with wait times and the anxiety in between - my biggest advice is to stay busy doing things that will make your life easier down the road. If your goals are HRT and top surgery, spend time working on your health. You will have a much better time with both of those things if you are in great shape. It sounds like you've got continuing education and hobbies lined up, which is good and what I would've recommended. I would focus on those things and make the most out of them so that you can set yourself up for success when you're done with school.

Another thing you could do in your spare time is research your local options for HRT. You may be able to skip therapy entirely if you can find a clinic or practice that follows the informed consent model. You'd still need a referral for top surgery with most surgeons, but you may be able to start T sooner than December.

Thank you for your replies.

Max - I can relate to your story on multiple levels. Your blog is the first I've ever read and I enjoy recognizing myself in your writing voice and strength of character.  I've been told multiple times that I'm strong and brave and that my anxiety doesn't look like it's leaving me shaken in any way, and that I just look preoccupied at most. I'm a pretty ambitious and driven man and also very straight-forward. Makes me look like I got it together when in reality the emotional vortex inside can be significant. From day to day I'd get out of the blue rages where it feels no form of venting is helping me out. Guess at this point I'm glad it doesn't lessen my enthusiasm for productivity, but I still worry at times about my lack of understanding of my own emotional patterns and how it could drive me overboard if I don't learn to manage all of it properly. I'm wary of most shrinks and don't open up very easily in meetings (I'll say that on here, it feels easier and more positive). I think that the lack of definition in my process is a strong fuel for those rages. I did some reading about informed consent this morning, and it's indeed a very reasonable option. My plan is to caffeinate and then call my doctor's clinic and ask if it would be possible to discuss a prescription based on my blood test results. She's told me herself that she doesn't know anything about trans people or the process, but she seemed curious enough to ask one of her friends that had been through all of it. I'm guessing she might be open to doing her research. Since there's a coming out wave going on (or so it seems, heh) it would be a clever avenue for this clinic to get updated on what to do if more patients come in with a similar request.

Thank you for inspiring me to look into this. I'd read about it in your blog and got curious, I'm glad I decided to start reading about other FTMs' journeys a bit more.

I'm keeping myself fit - to me it's as much a liberation mentally as it is physically. I think HRT will be rewarding in terms of muscle gain and that I'll keep a healthy weight even though I'll always be short (5''4). I made my peace with that. I'm thinking top surgery won't be much of a hassle since I'm already very flat chest and working on total washboard (not to sound too cocky ;)).

Dena - Thank you for the links. Four years is a hell of a long time and I'm interested in hearing more about how you put up with these delays. I'm curious; does this board sometimes organize chatroom sessions? Would love to be in the middle of a direct discussion with all of you now and again. Very inspired by everything I'm reading on here.

Will keep everyone updated on my process.

It was a good deal longer than 4 years that I had to put up with it. I knew at age 13 what I was but they had just opened the first treatment program in the United States, it was on the other end of the country, my family couldn't afford it and they wouldn't deal with you unless you were 18. At age 23 shortly after finishing school and working my first real job, I couldn't contain it any longer. I started therapy, moved to California where after a while I started HRT and had surgery at 30 in 1982. I wasn't always able to keep my feeling contained but it's worst when you aren't busy with something. Family, friends, hobbies, work can all be distraction that will help for a while. As this was long before the internet, all but the last 3 years pre surgical were without knowing anybody like me. That makes it extra difficult because you have nobody to ask questions of or bounce ideas off.

As for the Chat, Susan's started as a chat and then the Forum was added latter. You can access it off the top of the screen and as the site is world wide, you could be talking with somebody anywhere in the world. With 24 hour operation, I don't think they have a set time for a conversation but most of the time, somebody is there.

It's good that she seemed interested! On my blog you'll find the letter my doctor uses for informed consent HRT. Feel free to copy/paste and take that to your next appointment. I'm sure if she were to contact any of the larger LGBTQ clinics, she may be able to do a brief call with a staff person that regularly administers to and monitors HRT for trans patients. I'd imagine all she really needs to know is what tests to order, what to look out for, and how to assess whether or not a dose is good for a particular patient. I'm sure there's more to it, but I'd want to be sure that she knows all of those things before getting you started.

Wishing you luck! I think with everything you've mentioned here, T will be good for you. I've actually found it to be a myth that guys get angrier or more aggressive on T. It actually seems to mellow most of us out, which may help with the ups and downs you're experiencing right now.

I am not a medical professional and so I am not qualified to give medical advice. This is a patient to patient suggestion.

Have you had your hormone levels evaluated lately? Your symptoms sounds like you have elevated levels of male and female hormones. Elevated female hormones will cause the kind of mood and cognitive symptoms that you are describing. It could also be that your levels are fluctuating wildly throughout the month, which means that a single blood draw would not capture what is going on. This is the sort of thing that you need to explore with a trusted doctor such as a gynecologist or endocrinologist with whom you have a good relationship. It is possible that the pill calmed down your endogenous hormone production and stabilized it but now that you are not introducing exogenous hormones your endogenous production is showing its true colors. It's also possible that starting T could again stabilize your hormones the way the pill did by shutting down your endogenous production.

Good luck.

Quote from: FTMax on August 02, 2016, 09:22:17 PM
I had known I was trans for about 8 years at that point, and I no longer had any excuses to keep me in the closet. Took the plunge and came out, socially transitioned, started medically transitioning. It was like flipping a light switch on in my brain. I felt like there were finally things worth looking forward to again.

This. So true.

I took a bit to answer this since my anxiety has been through the roof, but it went down a bit due to a lot of awesome things happening in my life and that's kept my mood up. Enrolled in school, got engaged on Saturday. Things are looking up in big ways.

Replying directly to what's been mentioned on here - I called my doctor as I said I would the very day I posted this. She came back to me with a straight ''no''  - she didn't do any sort of research or call any specialized clinic. I didn't get specific reasons for her refusal. I'm assuming the lack of knowledge of the topic made her decide she wasn't qualified; I think some more digging could have been an option. I was angry and felt rejected, but I quickly got over it. I contacted Trans Health and asked for some ressources in Montreal, where the trans culture is most recognized and respected. Turns out there are many ressources there, I got a list of clinics that follow the IC model. However, most of their wait lists extend further than December. I tried one place that has cheap rates and will sometimes write recommendation letters within 2 to 3 appointments without too much waiting time. They basically said I could Skype with a therapist a few times without an elaborate follow-up. They're yet to answer my emails though, which I think doesn't seem to lead to much promise in terms of real online presence. I got told a new doc was setting up shop in the city next month as well, and that if by then I found no other solution, I could contact him and ask about his process. This might be my next route.

If not, I guess I will wait until winter rolls in. I have a lot to keep busy with, and a lot of the changes have already started for me, as I've mentioned. What I need is the extra definition.

Which brings me to the input about my hormonal patterns - I agree that there is major imbalance and there are raging peaks and valleys. I think my levels of T are considerably higher though. That's a form of inner conflict I've been feeling in trippier and trippier ways ever since I stopped taking the pill. I'm receptive to it and very aware of what's going on as it happens and I'm glad I'm learning quickly to get acquainted with it. I've always been more manly (bit of an obvious under-statement) and I'm coming more into my own, although some of my moods and anxious thoughts have been feeling like shock therapy.

In other words, I'm more myself, but kranked up to 11. It's a mix of my body striving to get to homebase already, and my own mental impatience to progress to where I need to be.

I didn't get blood tests done in a long time as I figured it'd be wise to do them right at the time I can see a specialist to get my prescription. However, I do think that if I have to settle for a long wait until December...I will go check it out for myself, if only to perhaps clarify a few things on my own and with the right amount of independence I need in this process.

Thank you all by the way for your awesome support. I spend more time in the chatroom of late and it's helped me figure some things out. I'll be around.

My recommendation would be to actually get appointments at all of those places and ask to be placed on the cancellation list if you're able to travel with relatively short notice. Sure, you may be able to start T earlier if your plan from the original post pans out. But they may actually be able to get you in sooner, in which case you could cancel your other appointments. In my experience, it's better to have as many options as possible in case one particular route doesn't work out or doesn't work as fast as you'd like.

For labs, most places are actually going to have you do labs prior to giving you a prescription, so you may not have to check your levels on your own. My doctor had mine checked on our first visit, and on the second I got my prescription. During the first year, I had to go back in every quarter to have them looked at again. If you're curious about your T levels in particular pre-T, make sure to ask that they include testosterone and estradiol tests with the introductory lab work. Some places don't.

Know what, that's actually really smart. You're real good at lighting a fire under my ass.

Gonna start looking into that and going down the damn list. Nothing to lose and everything to gain heh.

And besides you're added on Facebook. I don't do that a lot but I'm just really positively inspired here.