Susan's Place Transgender Resources

So I recently had my PCP tell me that my testosterone is really low. When asked she told me it is at 200(?) where it should be between 264(?) and 900(?). So statistically I am at ~ 25 to 33% of what I should have in my system. She is going to give me a referral to a urologist she said. I am going to (most likely depending on location and insurance) request an actual endo. I want to be able to have real, honest conversations with the endo about both estrogen and testosterone HRT. I really don't want to do the testosterone, but would still like an expert opinion on both. My issue is how do I figure out if it is a doctor I can trust with my identity. I have no criteria I can use to judge. I live in Florida, in North Florida to be exact, just about 50 miles south of the Georgia state line, so most of my neighbors are(were) Trump supporters and I have every reason to believe that everyone I meet are as well. My therapist I contacted via phone in the beginning and had to blurt out as soon as she answered the phone that I am transgender and wanted help simply because if I would have waited even another second I would've chickened out.

So, my question here is how did everyone else here decide they could trust their doctors. What were the things that one could call green flags, and what were the red flags? How did y'all come out to them, and how many doctors did you have to go thru before you found one who would take care of you?

I hope everyone is having a great end of summer and had a wonderful week.

Love and hugs
Allison

Allison, you are asking the right questions.

First of all, your testosterone is not "low". When lab results come back, they usually have a "reference range" that helps non-endocrinologists understand what that means. The 200-900 range is for males, so that does not apply to you. Your level is actually "high" because it should be in the "female" range.

My results typically come back stating that my estradiol level is high. But consulting the reference range for "female", my level is within the "ovulation" range, which is where women of reproductive age should be.

I agree with you that you should seek out an endocrinologist or a gynecologist with experience in transgender medicine. Otherwise, they will continue to misread your hormone levels. Even endocrinologists do this until they become educated on the latest protocols, or are open to listening to people with real-world experience.

Usually, a local medical center or hospital will list the members of their staff. Look for Endocrinology or Women's Health. Often, there will be a short bio about that person's background and experience, as well as the type of patients they are interested in treating. If you are in the panhandle, try looking in the Pensacola/Fort Walton Beach area. Or maybe even across the border at Mobile, Alabama.

The way I approached my VA Primary doctor was to ask her if the VA covered hormone therapy. She asked if I meant feminizing hormone therapy, and I said yes. She said it was covered, but first, she needed a diagnosis from their mental health department. That led to a referral to a psychologist, a diagnosis of gender dysphoria, then back to my Primary, who could then refer me to an Endocrinologist or Gynecologist. Both had experience in transgender medicine, so she gave me the choice of who I wanted to see. I chose the Endocrinologist, but eventually ended up with the Gynecologist after the Endo retired.

If you do not currently have a diagnosis of Gender Dysphoria, talk to your therapist about getting one first. Then, when you find the Endo or whoever you want to start seeing, simply tell them that you were diagnosed with Gender Dysphoria and you would like to look into hormone therapy.

That way, the endo or whoever can decide if they want to treat you. If they are hostile, they may not. They may not have experience in that area and may decline, or even recommend someone else. At this point, you have not committed to treatment by anyone; you are shopping around.

I hope this is helpful. If you have more questions like this, be sure to ask. We have many members here with a wide variety of experiences that can help you make an informed decision.

Now I will get out of the way so someone else can offer their suggestions.
 

Hi, @Allison R .  I hope you are able to find a good endo and get your levels sorted out.

Finding any GP/PCP here is difficult: there just aren't enough.  As soon as a new one gets established, they move away to the big cities.  So there isn't much shopping around.  You sign up with anyone you can find that has an opening and hope they last.

I was lucky.  A neighbour recommended her doctor to ma, and the doctor was able to fit me into her practice.  Since the neighbour was a lesbian, I was pretty sure the doctor would be at least open to helping me with my transition.  My first appointment included not only all the normal getting-to-know-you stuff, but I was also asking to be referred to a mental health practitioner for a hormone readiness assessment.  It was quite nerve-wracking!  I got my referral, though.

My transition doctor was chosen for me by my psychologist, once she decided I was ready for HRT.  There was really only one suitable doctor available.  When it came time to go for GRS, again there was only one surgeon available, so that's where she sent me.

Once my hormones were stable and my surgery was done, I asked if my GP would be comfortable managing my HRT prescriptions.  The doctor I was initially referred to for HRT was an hour-and-a-half drive away in the city, so someone local was preferable.  She was fine continuing my prescription as long as my levels remained stable, which they have done.

So, really, I didn't exercise much choice in doctor selection.  The one I've got is working out okay.  If I'd run into one who was transphobic, I would have had a problem, but that didn't happen.  And in my country, it is unlikely that I would have.

Quote from: Allison R on October 10, 2025, 02:08:51 PMSo I recently had my PCP tell me that my testosterone is really low. When asked she told me it is at 200(?) where it should be between 264(?) and 900(?). So statistically I am at ~ 25 to 33% of what I should have in my system. She is going to give me a referral to a urologist she said. I am going to (most likely depending on location and insurance) request an actual endo. I want to be able to have real, honest conversations with the endo about both estrogen and testosterone HRT. I really don't want to do the testosterone, but would still like an expert opinion on both. My issue is how do I figure out if it is a doctor I can trust with my identity. I have no criteria I can use to judge. I live in Florida, in North Florida to be exact, just about 50 miles south of the Georgia state line, so most of my neighbors are(were) Trump supporters and I have every reason to believe that everyone I meet are as well. My therapist I contacted via phone in the beginning and had to blurt out as soon as she answered the phone that I am transgender and wanted help simply because if I would have waited even another second I would've chickened out.

So, my question here is how did everyone else here decide they could trust their doctors. What were the things that one could call green flags, and what were the red flags? How did y'all come out to them, and how many doctors did you have to go thru before you found one who would take care of you?

I hope everyone is having a great end of summer and had a wonderful week.

Love and hugs
Allison

Ha! I just posted about this very issue over here: https://www.susans.org/index.php/topic,252160.new.html#new

Cis females do have a little Testosterone in their system. I take a micro-dose of Testosterone in the form of Testogel. A really tiny amount but about a month ago I reduced it even further (think petit-pois) because I didn't want it clashing with my Estrogen, nor to push body hair which I've been having removed.

The results were horrendous. The worst brain fog of my life. Like the air just went out of my balloon. Feeling faint, feeling like I would keel over, no energy for anything. Terrible.

In consultation with my GP, who is excellent, I've returned it to the prescribed amount and I can feel my energy surging back.

This is a red flag issue for some ladies on here, but cis females do have some testosterone in their system and many UK GP's also now prescribe it to ladies on HRT.

If you go down this route you need to hit the sweet spot. Just enough to increase energy and libido, but not so much that you start getting masculising effects. @Lori Dee is spot on about levels. What you should be aiming for is a cis female range of Testosterone, not male levels. It's a very small amount. Some cis females  on HRT take it every other day rather than daily.

Good luck finding the right Dr to help you navigate this. It sounds pretty horrendous in the US right now :(

xx

p.s. This post assumes you are post-op, which would mean you have no T generated in your body. If you are pre-op you still have a form of naturally occurring testosterone in your system then this is a very different issue and you need to find an endo who can regulate the right level through anti-androgens. So if that's the case disregard everything I've written about micro-dosing T. xx

Allison,

I went to the local LGBT support organization and asked for recommendations. I know you are in
Florida but there should be some support organizations that you can reach out to.

Ellen

Quote from: EllenW on October 11, 2025, 10:50:05 AMAllison,

I went to the local LGBT support organization and asked for recommendations. I know you are in
Florida but there should be some support organizations that you can reach out to.

Ellen

This is good advice! Thanks, Ellen.