I'm getting a report together on what support you were able to get from therapists, endocrinologists, family doctors, surgeons etc during your transition.
Were you satisfied?
Dissatisfied?
What support?
Any of the issues you had.
Can you also say what country you are in.
I want to write this up as a report to be presented so please be specific about issues both good and bad.
Thanks
Cindy
So far everyone I have now has been supportive. The Endo left it up to me as to which option I wanted for the HRT while taking in account which would better for me due to my medical history. The current primary care doctor has been proactive at helping in anyway she can from the needed referrals to picking up the appointment slack a bit so I don't have to head over to Everett as often in the beginning to see the Endo. The therapist has been awesome. I was extremely nervous going in, but she was able to get me relaxed fairly quickly and has been a big help so far in my transition especially since my having gone full time. My first interactions with the surgeon my insurance is contracted with haven't occurred yet. I was partially satisfied and dissatisfied with my first primary care doctor who dropped me as a patient as soon as I told him of my need to transition, but he did aid in the finding of a doctor who would aid me in my transition in the office and he also ordered the hormone tests that would be needed for the HRT. The first Endo I was going to be sent to waited 6 weeks to check over the chart just to consider scheduling an appointment months down the road. After waiting a month and still not having anything scheduled I was dissatisfied enough to have the referral sent to the Endo in Everett. Otherwise I have been happy with everyone that I have dealt with through my transition journey so far. No other issues have occurred so far other than having to use skype for therapy and traveling to Everett for the Endo. No one local deals with either issue. The country I am in is the United States.
United States - Oklahoma
Therapist's - None better, fully versed in WPATH SOCs. Previous trans experience. Located at University Psychology Department.
Endo - Fantastic, accommodating and well versed in WPATH SOCs. Previous trans experience.
Pharmacist - Wonderful. No experience before me with trans people, but studied on HRT before my next visit. Double checked all meds and history and has been great.
No bad experiences with providers or their support/office personnel.
Only issue is with lack of providers who will treat trans people. This makes waiting list's VERY long as the many trans people have to wait for the few providers. We desperately need more providers.
For me at least every professional I've talked to about it has been really supportive. Even if they have no clue about Trans* issues, or what I am asking of them, they always smile and show sympathy (Female Dr's have the tendency to put there hand on me and call me a 'poor dear' and reassure me that I will be beautiful and everything will be alright every time I tell them my circumstances) :P
I really like that it makes me feel happy :P
If they have no clue about trans* issues most Dr's I've seen tend to either call someone who does, or refer me to someone who does just to make sure the drug that they're prescribing or whatever is compatible with what am taking. So yeah Im really happy about that.
In terms of specialists, all of those I've dealt with have been empathetic and understanding, and I haven't had any problems with my Endo or any of the various Psychiatrists/ Psychologists I've talked to over the years.
I live in Brisbane Australia, although I would like to point out that the GP's I visit (3 would you believe it) are all allies, and are required by their practice to be so, and I have received all my referrals from them. So my experience is probably not typical of a normal girl in my circumstances :D
Living in Sydney right now.
Most of my medical team are on board. I believe they they talk to each other more about me then to me :P. (It does actually save time, if I have a seizure I can tell one and it will generally filter through before I see them all).
The only gripe I could say is that the medical center I go to for script refills for anti convoulsants haven't asked me anything at all about my health or what if anything else I'm taking They have just wanted to get me in and out quickly.
Quote from: Cindy on September 25, 2014, 07:34:58 PM
I'm getting a report together on what support you were able to get from therapists, endocrinologists, family doctors, surgeons etc during your transition.
Were you satisfied?
Dissatisfied?
What support?
Any of the issues you had.
Can you also say what country you are in.
I want to write this up as a report to be presented so please be specific about issues both good and bad.
Thanks
Cindy
Getting competent psychotherapy was a nightmare.
* My insurance company referred me to a therapist who had minimal experience with trans people. She was not familiar with the term "cisgender". She kept talking about a "gentleman who went out dressed as a woman from time to time" as a suggestion for how I should deal with my dysphoria.
* I went to see a WPATH certified counselor who made me wait nearly 3 months for a psychiatric eval before he would see me. After that, I saw him, but the help was counterproductive. He tried to talk me out of HRT, telling me I'd be disappointed - that it would do nothing for my body hair or face (it has helped both).
* The psychiatric evaluation he sent me to was humiliating and useless. I was misgendered throughout, I was interviewed by staff with no experience, they seemed more interested in my sex life than in my gender identity, they disparaged the notion I could be transgender because I didn't pee sitting down, etc. I've posted the details elsewhere.
* I finally found a good therapist, but only after I changed insurance plans.
* I ran into blatant gatekeeping when I paid a therapist to evaluate me for a second surgery letter that the refused to write after I paid him. He wanted to see me again for another $190.00. The reasons he gave were specious and had nothing to do with my suitability for surgery.
Am I dissatisfied? Let's just say that I can see why so many of us attempt suicide if this is the sort of help we're offered.
Medical care was much better. I found a doctor who is experienced in prescribing hormones, and he's served as my general doctor as well. I'm pretty happy with the care I get from him. My surgeon was very competent and I'm happy with the job she's doing.
story from northern norway.
i sent an email to the seemingly one and only authority on non-binary issues almost three years ago. the response i got was lacking in support, meani g that as a rather depressed and anxious person, it didn't help my feeling of insecurity, and their immediate wish to have me travel almost a thousand miles to see them, made me not take their offer to "try skype". they made me feel like i didn't really matter to them at all. i simply didn't answer that third email. took too long between each, and they never even suggested just talking on the phone. i'm no good at writing to people when i'm scared, so contacting them didn't work at all.
a little later i tried a sexologist in the nearest city, but she couldn't offer any treatment because it was apparent to her that i already knew who i am, and her urologist didn't feel confident enough to try giving cross sex hormones. he probably would have given sae sex hormones though, i think he has the qualifications for that.
so i gave up. for a long time. then again tried contacting someone in yet another cityhere in the far north. he couldn't help with anything eitherand suggested i try with that first person. so i try again, but they're already too busy to fit me into their schedule, they were the one who didn't answer my last email this time. kind of disheartening.
in august this year i tried yet again, someone in yet another city. she's been really helpful, and is currently trying to find someone who has worked with trans people outside the system before. but i kind of doubt she'll be able to, the system doesn't really lile doctors who give cross sex hormones to any odd trans person, and are doing their best to monopolize all treatment of trans individuals so that they can.. uh, control that nobody gets the wrong treatment? which in their eyes is anything other than the procedure used in the 70s or something.
within the system, it would take 3-8 years to transition completely. people who are taken in can be evaluated for way past a year just to be denied treatment. they are often abusive in language and the way they treat patients. even towards the very few selected individuals who manage to fit their way outdated criteria for treatment. i don't want to go there, unless that really is the only option there exists for me. i've heard that some men who were reluctant to fiddle with their bottom have gone in to get top surgery and come out with two breasts and one uterus less than they went in with. norway really needs some international attention, the way i hear that some trans people are treated here would make for a good horror flick. good enough to give both trans and cis people nightmares for years to come, if they add the right music and lighting to it.
All positive:
1) Good therapist.
2) Easy, "informed consent" treatment for hormones at a LGBT medical clinic. Wait time to get in was a month. Then a two week wait to start the hormones.
3) Dr. Garramone in FL was my surgeon for top surgery. He is fantastic. Uses an easy check off list now as a "letter". Your therapist no longer has to write an extensive letter. It was a 2 week wait for a telephone consult. It was a 6-7 week wait for surgery. I did it in the Fall, which is his slower season.
4) I live near Philadelphia, PA in the U.S.
I am very lucky.
Midwest U.S. superior medical team same hospital.
I'm in Sydney, Oz
Doctor - supportive of helping with my depression (triggered by my gender dysphoria big time) and getting me to see a shrink. He's a gay guy, I'm not sure he is very across trans issues but willing to learn through my process.
Main shrink - nice guy and supportive but very little trans experience when I started with him, mostly with helping trans people post transition. I think I'm the first one he's ever referred to an endo. He was pretty cautious initially, overly so. I guess he was wanting to deal with my depression and I had painted a fairly dire picture of my emotional state during my first attempt at transition so he had the brakes on even more. He kept on saying things which, to me, sounded like he was trying to work out my treatment from Dealing With Trans Patients 101 and, despite not needing to, he sent me to another shrink for a second opinion before referring me for HRT. I can't complain too much though, I think it was only three months between my first appointment with him and first endo appointment (seemed like forever at the time).
Shrink #2 - referred to for a second opinion. I only needed to see him the once and he was happy to recommend I be Referred for HRT. He was one of the main therapists for trans people in Sydney. I found him friendly, didn't treat me like I didn't know what I was talking about but I did find some of his questions a bit old school and invasive.
Counsellor - I decided to also find myself a counsellor at the Sydney Gender Center. He has been very supportive and friendly without leading me into conclusions or being a cheer leader for certain treatments. I wanted someone who wasn't a shrink so I could talk about stuff a counsellor was more likely to listen to me rather than try to read something into it. Although he isn't trans (that I know of) he is very understanding and has helped me break through a few barriers (like acknowledging my internalised transphobia...a very important step for me in accepting myself). Still go to him every few months. I should add that a second counsellor there helped with my transition at work by coming in and speaking to staff.
Endocrinologist - lovely guy, very understanding and supportive. Able to take the needs of his patients into account and aims for the best possible outcome. I know a number of other Sydney people who see him and speak equally highly of him, including non-transitioners. So he would seem to be supportive of non-binary folk who want some level of HRT too.
Electrolysis - I know this wasn't on your list but to me it is an essential part of treatment - not just for my physical appearance but also positive state of mind. I go to a great place that has a lot of trans clients - the two women there are very friendly, supportive and professional. A shame I can't get at least some kind of health rebate on the process because it costs $$$.
I guess I am still early on in transition. I tried my counselor on campus (school in Texas) and that went sketchy, but she really did not know a whole lot. There was a phycologist who was really helpful, but she was only there once a week and did not see anybody on a weekly basis (she was just there for consulting/prescriptions). After dealing with that mess for a few months I kinds have up and since switching schools (I moved) I have not tried again.
Melbourne, Oz
I have been very lucky in that I have been able to see very trans-experienced service providers without much delay. They are all extremely supportive and it is only when I start listing them that I realise the talent I have managed to gather as what I call my support team. The Psychiatrist and Psychologist both have extensive connections with other trans support professionals. I do not access any support groups so these people are extremely important to me. Socially (i.e. outside the team listed), I have done this alone.
GP - referred me straight away to psychiatrist (in first 5 minutes). Subsequently (after approval for HRT), my GP has managed all my HRT. He has other trans patients and is in a practice that has other GPs with extensive trans experience. All visits are Medicare supported. I tried my existing GP who said I should go to a specialist GP. Tried one but didn't like the offhand approach to someone just beginning. Almost like they didn't expect me to go the distance! Glad I made the call as my current GP is amazing.
Psychiatrist - hugely experienced (has seen over 500 trans patients). Only a 5-week wait. Took 7 visits to finish his process but one was doing questionnaires and half of another was writing the report with me there. Time may have also reflected where I was at. Most visits are Medicare supported (if I remember to update the referral letter which I haven't bothered with lately). Will continue to see him every 3 months through the start of full time.
Psychologist - I have kept on seeing a very experienced gender specialist although the need is diminishing. This means to me that I have my thought processes sorted (a bit!). She is also full of strategies and ideas.
Voice Therapy - Psychiatrist referred me to La Trobe Uni speech pathology team. Was able to go about 5 times before funding (theirs) ran out. Then referred to a private speech therapist who has trans clients and have seen her 5 times as well. Will continue up to a few months after full time. Medicare supported to an extent (just ran out).
Electrolysis - Very important aspect of my transition and something I consider a part of the medical/psych requirement. Very experienced team that I have been seeing for almost 3 years. VERY EXPENSIVE process but it was where I started which was the best thing I have done.
Complaints? None really. Maintaining referrals for Medicare support is a bit of a pain but that support isn't critical for me. One thing that did give me pause was the warning I got about getting a mental health care plan from my GP to access Medicare support. The comment was made that some people do not want that record sitting with Medicare.
Sometimes I have felt a bit pre-judged in a negative way as though I wasn't really in need of help. I wasn't presenting with a critical health issue but with something I have lived with for decades as a constant burden. Maybe if I had waited, the need would have been more obvious.
While I try not to think of the cost, in Australia, Medicare does help and I am not even going to try and think about what going through all the services above over 3 years might cost without that support. I would love Medicare to pay for more but if they did, in all honesty, I am not where more support should be directed.
Philadelphia Pennsylvania, USA
I switched primary care to Mazzoni a LGBT primary care. I love the place and my PA. They see primarily Trans and have 8 Doctors, PA's and NP's. They see a lot of people.
Therapy, 1st therapist was fantastic, she taught and trained area trans therapists. She is queer and married to a trans*
Therapy, 2nd therapist is great and trans* male.
Group at Mazzoni, very good.
I'm in Sydney, Australia.
My endocrinologist is awesome, and obviously has vast trans experience.
My psychiatrist has been great and really helped me. Really professional, and has quite a few trans patients. He's not one of the bad ones in Australia that you sometimes read about.
I visited the Gender Center anonymously a number of times more than 5 years ago, before starting HRT. Because I found a great psych, and the appointments are so slow at the Gender Center (obviously underfunded), and I can't go anonymously these days, I'm not going there anymore. I do like the current counselor a lot though.
I visited the [deleted] medical clinic in Sydney to get a couple of blood tests in the early days, but no letter means no HRT. They would have prescribed premarin anyway which is unacceptable, so I stopped going there.
I didn't see a psych for an HRT letter because I didn't want an official diagnosis of a mental disorder. I did it the other way until recently. The rules have changed though - its not a mental disorder anymore and I need more help than I used to.
I haven't told my GP anything (anyone know any good GP's in Sydney?). I do tell medical people when they might need to know (in my opinion of course), but I've been trying to leave as few records of it as possible - I don't trust computers not to get hacked and everything's on computers these days. I've been in hospital for unrelated reasons a few times and told them just in case. One doctor asked if I was post-op (I'm m2f and very obviously male) - I think he was just ignorant and curious. A surgeon started querying me about it, so I basically told him to piss off and stick to his own expertise - I could see he was going to lecture me and got rather annoyed.
Privacy and anonymity has been very important to me in the past, although less so now, and I don't feel that its adequately supported.
This site has been most helpful in finding my medical provider. The Gender Center can only provide a list of names without any opinion on them. Where else can you find out peoples experience with them? Its verging on the impossible to separate the good from bad without coming somewhere like this, and there's plenty of bad doctors around. This has been very important to me, as the medical profession does a very poor job of identifying doctor performance (and that's never going to change in Australia).
Its outside my current experience, but I've studied a lot and I don't think SRS is adequately supported in Australia. There's no way I'd go to an Australia surgeon for it, due both to their lack of practice and lack of patients speaking about their results. I don't trust a word any surgeon would say, and these are the only independent data that I have access to and that I feel its possible in any way to rely on (its not really good enough, but its not like anyone has done any peer reviewed academic studies on SRS results by surgeon...). I would like to see Australia supporting people going overseas surgeons, but I can't see that happening.
I feel fortunate to be in Sydney. If I were somewhere with less able support I think I'd be in very real trouble.
Edited to remove name of Medical Clinic. I don't need legal troubles.
I'm in Australia.. Adelaide for now.
GP: My GP is great. I'm his 1st trans patient and he's never had an issue with it. He's educated himself on the basics and is competent when it comes to drug interactions with my HRT.. He'll happily write me fill-in HRT prescriptions.. Order bloods.. Write referrals. All this from a Bulk Billing clinic..
Therapist: I had a great gender therapist. Helpful and never judgemental. I think I always presented him a challenge, as I've never had any real physical dysphoria. But after 4 years with him, he set me free a couple of days ago. We agreed that I no longer need the kind of help he can provide. And that in all honesty, I don't really need a therapist at all.
Gyno: My gyno is great.. And a post-op trans woman. Again, I've presented her somewhat of a challenge as I have not reacted to hormones physically the way either of us expected.
Quote from: AnonyMs on September 26, 2014, 10:13:14 PM
I'm in Sydney, Australia.
This site has been most helpful in finding my medical provider. The Gender Center can only provide a list of names without any opinion on them. Where else can you find out peoples experience with them? Its verging on the impossible to separate the good from bad without coming somewhere like this, and there's plenty of bad doctors around. This has been very important to me, as the medical profession does a very poor job of identifying doctor performance (and that's never going to change in Australia).
How do you rate a doctor? It's highly subjective.
QuoteIts outside my current experience, but I've studied a lot and I don't think SRS is adequately supported in Australia. There's no way I'd go to an Australia surgeon for it, due both to their lack of practice and lack of patients speaking about their results. I don't trust a word any surgeon would say, and these are the only independent data that I have access to and that I feel its possible in any way to rely on (its not really good enough, but its not like anyone has done any peer reviewed academic studies on SRS results by surgeon...). I would like to see Australia supporting people going overseas surgeons, but I can't see that happening.
From a Medicare perspective, no, SRS is not adequately supported. Some of the most practised surgeons are the also ones who make the biggest blunders. I've only heard good things about the results of the Aus surgeons. And the 2 of Simon Ceber's that I've seen looked good to me.
QuoteI feel fortunate to be in Sydney. If I were somewhere with less able support I think I'd be in very real trouble.
No, you'd cope, like others do.
Quote from: kelly_aus on September 26, 2014, 10:45:17 PM
How do you rate a doctor? It's highly subjective.
Yes, and no. I've experienced a number of instances where the doctor was very clearly in the wrong, and where they should have known better. I don't expect miracles, but these were not competent. And what about the medical center I was referred to by the Gender Center that would have prescribed premarin. Those cases are easy to judge. Where its difficult is when they don't make any obvious mistakes, but you can't tell if it could be better. I tend to reserve judgement here. My endo on the other hand, I'm pretty sure he's an outstanding doctor - he's nice too, but I try to ignore that when judging expertise. Your gyno sounds interesting and its a good recommendation if only I were in Melbourne and actually needed one - much better chance of being good than randomly picking one out of a book.
Quote from: kelly_aus on September 26, 2014, 10:45:17 PM
From a Medicare perspective, no, SRS is not adequately supported. Some of the most practised surgeons are the also ones who make the biggest blunders. I've only heard good things about the results of the Aus surgeons. And the 2 of Simon Ceber's that I've seen looked good to me.
For what its worth, I'll give you an example of my thought process here (please don't get upset). I don't know you, so I can't judge your words. I don't know how you measure good, and if its the same as my good (or better/worse). I don't know what you mean by "seen" - most results look pretty good when standing, but a more intimate view is completely different (there's some pretty shocking examples in Thailand, but I don't think these are from the big name surgeons). You've only seen/heard about a few Australian results, which have been ok, but the Thai surgeons have done thousands - if the failure rate of all surgeons was 1 in 100, then you'd hear probably about the Thai ones, and very likely not the Australian. I may be wrong on this, but I have a feeling that there are people in the Australian medical profession who are knocking that Thai surgeons, and I've met plenty of charismatic people that could convince people of just about anything, and I've met a few doctors like that too.
Against that I have to weigh up that my expertise is very limited - I'm not in the medical field, I've never see any SRS results personally, or talked to anyone post-op about it in person, and realistically there's not that many results that you can evaluate well. A few websites and forums, and while there's plenty of porn I only know the surgeons for a couple of cases and I'm not really into their artistic endeavors. I am very good at evaluating information though, and the end result of all this is nothing much of use to me.
Quote from: kelly_aus on September 26, 2014, 10:45:17 PM
No, you'd cope, like others do.
You're probably right, but the prospect of it being any harder is terrifying. I've unfortunately begun to understand why some people don't make it.
Seems that Sydney, Melbourne and Adelaide are fairly well catered for, don't know about the other state/territory capitals in Oz or the regional/rural areas.
I'm particularly interested in comparing services in different countries.
I do know Qld is well catered for WA is a problem, Outback is a problem with therapy by skype being available from Adelaide and Melbourne.
How about people in the UK and other places - comments?
The U.S has a problem with not enough providers for our community. There can be VERY long wait or searches for Endo's and the SRS surgeons will not accept our Medicare assignment. Other than that the one's I have found (Endo) is very good and knowledgeable, just heavily overloaded with new patient request's.
Quote from: Cindy on September 25, 2014, 07:34:58 PM
I'm getting a report together on what support you were able to get from therapists, endocrinologists, family doctors, surgeons etc during your transition.
Were you satisfied?
Dissatisfied?
What support?
Any of the issues you had.
Can you also say what country you are in.
I want to write this up as a report to be presented so please be specific about issues both good and bad.
Thanks
Cindy
I live in Denmark where it all very difficult to get threatment. transgender here will call there threatment inside or outside the system. How your threatment works depends which way you go or how you mix them if you do that.
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Inside the system, is what it's called if you seach threatment though the main hospitals sexologic clinnic which here are seen as the only right choise. the people there got the status of "sexual experts" from some historycal background (since christine jørgensen did her surgery in denmark and became pretty famours) unfurtunate they haven't got much much better as the years passed and only upgrade there pracsis the last few years since they got a lot of critisism.
the clinnic deal with sexual problems of a wide spectum from hardness problems, handicap sex, sex with illness, people with thought of children, and so on. Because the patience are manly there due to a sexual issue transgender people are also somehow been asked to talk alot about there sexlife as a part of the obsevation period. this obsevation period or therapy have for many years not been clear to have a certain endpoint but told to last 1 year as a minimum. Now after the practise changed the minimum is half a year but theres still no clear definition how long it can take. The waiting period to get a apointment can also be very long and is 1 year for the current moment, in that way it take at least 1,a half year to figure out if you can get permission to threatment or not. If you get the permission this will be covered by the healthcare like anything ells in the healthcare system, but if not you can only go outside the system and pay for it all yourself. many people get denyed threatment if they got other dignoses beside being trans, or if the arn't binary enough, and other reasons. because of this many people are very aware of what they will say or cant say, the doctors arnt really to help you find yourself you are there to prove to them that you are trans enough and need the threatment, so they wont reject you.
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outside the system include everyone which have refused or been denyed to seach threatment for the sexologic clinnic.
not many doctors have got the knowlegde or courage to deal with transgender but theres a few which usunally you would find contact with though other transgenders. I personally have been on the sexological clinnic and did not like it and was denyed even before I came due to my background, so I find peace in finding a provat doctor outside the system which took in his own patience without this year of waiting period. the issue with being outside the system if firstly that you must pay for everything, and when it comes to surgery (and somethimes also homones) you will also need to travel alot (maybe abord) to get it. It can be very expensive for someone from one part of the country to go to a doctor living in the other part, and then travel to germany or thailand for surgery later on, specially when you consider the fact that many transgender also are unemployed, therefore its not an option to get threatment outside the system for everyone but only for those who can pay it economically.
the danish healthcare minister have been very critical of these doctors and want sexologic clinnic to be the only place where people ask for permission to transition, by that there have been alot of presure and many place are threatned or have been threatned to close down if the doctor where not to lose his job.
these are very big problematics which have gone around for a few years now, at the current moment it so that everyone who already have been threated by a doctor outside the system can continue but people who are new and havent got homones before must go to sexological clinnic. the minister are in the current moment trying to change this so everyone must go to the sexologic clinnic to ask for permission to get threatment or continue there threatment.
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trying to get to a conclusion on what suport I could get:
the system dose not work because only 1 system in the whole country which are not optimal and where people neither can complain or change to another doctor if they are unsatified are not good enough. it also means people who have been refused have no option at all unless they know one of these doctor I mention outside the system but these are few and are probably going to be illigal by the new guides.
its diffrent what transgender wants, some people want a better practise inside the system (at sexologic clinnic) while others want the threatment of transgender to be more general for more doctors to handle and insteed of psykiatry focus on informed concent.
I have been satified with my doctor, and the threatment I got when I traveled to germany for my topsurgery, I think they are very profesionel. what im not satified about is how transgender in general are threated in the healthcare system. When you are outside the system you are threated like a criminal, and when you are inside the system you must agree that you are mental ill by the dignose and they will threat you that way. I know many people which find this to be so extremly frustrating that it makes them suicidal and its a very big problem that people outside the trans/queer comunity dose not take these issues seriously.
if im to say something positive they have change the law for changing your legal gender this september.
Before you where forced to undergo sterilization and general destroy anything which could make you reproduce somehow, this low is FINALLY gone, and insteed you must sent in a paper saying your trans, and then wait 6 month and agree that you still want your legal gender changed. this is a big step.
Cindy I hope its not too long but you said you wanted it specific so im trying to point out how our system works in general before you can see it from my point of how my threatment worked.
speaking of my own threatment story:
I came out as trans when I was around 12. im 21 today but back then there where no such things for youngsters, I just had to wait to I got old enough to this. I was very depressive and my famely did not suport me back then as they do today. as I became suicidal my mom took me to the doctor and after a couple of times I was sent to the sexologic clinnic senter. before I went there they said they could never offer me any kind of threatment since I back then went on a special school, but I could get 2 lections of theray, anything ells would be seen as a obsevation threatment.
I came to my first conversation and was to answer alot of questions, I was 16-17 back then and got asked if I had ever been abused sexually or violantly, if my parrent where divorced, if I played with boy or girltoy as a kid, had most male or female friends, what my sexual orientation was, if I got a lover, if I had sex or mastrubated and how often.
I had to answer these + some more and then she said it seams there was nothing wrong with me and they could probably put me in a obsevation for a year to see if I would fullfill the requirement for permission to get homones.
Later on I was denied again by the headmaster doctor due to my school and the autism dignose I had. I could not do anything about it and just had to accept it.
later on I got more open of being trans, I changed my name to a unisex one (since back then I could not change to a 100% male without undergoing a castration which I could not do before I turned 21)
I found out there where people which got homones from doctors outside the system so I went to one and had a talk with him and my parrents, He informed about homones and the worryes specially my parrents had. I got home and to read alot about it and was very clear thats what I wanted and then I got homones and went to him for years both for homones and healthcheaks. I could not get my surgery though, there was 1 doctor outside the system which had made a top surgery but he got in trouble with the goverment and had to close down, so I decided going to germany which I knew many did, I was very satified with there threatment, but my current doctor at the moment did not want to deal with me being trans so I had to change doctor and ask the other doctor which gave me homones to do some healthcheck on me which the other had refused. In general its mentally very frustrating not felling like your health is all valued. the 2 doctors I got, my main doctor and homon doctor are both okay but I know they all take a risk dealing with me. My homon doctor had to close down because of the rules which say I must go to the sexological clinnic to get permission for taking homones after 3 years, if I still cant get that permission I cant live in the country without getting the homones illigally. so its a very big issue.
--
so well I been satificed with the doctors who have helped me mostly, and specially the threatment in germany, but the general health mininster are transphobic and make rules they dont know anything about.
Fantastic replies so far but I need more!
Cindy you know the only way to attract posters is to title it like this.
My breast are so sore and large - a survey! ;D ;D
Quote from: Jessica Merriman on October 01, 2014, 03:39:36 AM
Cindy you know the only way to attract posters is to title it like this.
My breast are so sore and large - a survey! ;D ;D
So true!! I recall a thread of great titles a while back!
BTW can you pm me with the facts about not being able to access medicare/insurance entitlements. I'll speak to Gail Knudsen (President of WPATH) about it and raise some storm >:-)
I'm having dinner with her on Friday night
Quote from: Cindy on September 25, 2014, 07:34:58 PM
I'm getting a report together on what support you were able to get from therapists, endocrinologists, family doctors, surgeons etc during your transition.
Were you satisfied?
Dissatisfied?
What support?
Any of the issues you had.
Can you also say what country you are in.
I want to write this up as a report to be presented so please be specific about issues both good and bad.
Thanks
Cindy
For myself I have found the medical community to be very supportive and understanding.
They have gone out of their way to ease the fears that I have.
Satisfied? I had not thought about it like that but yes.
My GP has been the best. After almost freaking out before seeing her for the first time, she was so easy to talk to and open up. She organised my first session with the endo including all the paperwork and getting them to call me. Wow I was shocked.
Saw her today and has been so helpful I could not have asked for any more. She is great. Why can't we all have help like this?
My therapist has also been very good and has been helpful as well.
Thus very satisfied with their help
I think I'm in OZ last I looked.
Let me click my heels together.
Hi Cindy,
I live in the US, I work for a major multi-national corporation that is "self-insured". My company collects the premiums and pays the bills. Invoicing and arrangements with doctors is made by a 3rd party company. But the bills are paid by my company....
My policy states that it covers SRS, FFS, all psych visits, all medications, basically everything. I have a $1000 deductable after which I pay 10% of authorized charges in network up to a maximum out of pocket of $5400 in one calendar year. Out of network, I pay 50% of charges up to a maximum of $10,400 per year. The policy states it follows WPATH standards of care.
It took me 10 months to get coverage for FFS. Then, they would not agree to pay more than $2400 on a $73,000 surgery. They would pay $3100 on a $20,000 SRS bill. My psych visits are OK. My HRT is not an issue. They have not paid anything else.
Twice I have filed appeals of decisions to state agencies. Twice I won. They kept asking for things that were or are not part of WPATH. In the end, my company stepped in and told them to cover whatever I need. However, every surgery/procedure requires a letter from two psychologists, my general practitioner and the surgeon. Every little thing is a hassle. The third party company is being petty and playing games. But I'm winning.
I have a single nurse (a man) at the ithird party company who I work with. He told me that anything I want is covered. He further said he couldn't understand how my company could afford that. I told him that the total bill will be less than the first week of medical bills for a person who has a heart attack. In the ensuing conversation, it became clear he didn't understand that this is just as medically necessary as the care for the person who suffered a heart attack.
However, I will say this: There are 4 transgendered individuals at my company's "campus" where I work. (The campus has some 19,000 employees spread around in 27 buildings on 480+ acres so 4 is actually a big number.) It has been such a hassle to actually get money from the coverage that I am the first one who every actually got the coverage. I'm working with the others to ge the coverage extended to them.
I suppose the moral is "Even when coverage is explicitly listed, actually getting the coverage exercised is extremely difficult."
Hugs Cindy,
Jen
My struggle for treatment is well documented all over this forum but i'll try and summarise here.
When I first decided to contact a GP they "sent off a referral" for me - I assumed GIC referral (that's what I asked for) turns out they referred me for bottom surgery. Of course the reply was that I was nowhere near eligible for that. After explaining again what I actually wanted they "sent off a referral" again.
A few months of waiting later, I was told that the GIC does not have any funding for FTM's - they only provide treatment for MTF's
I wrote a letter to my MP asking why this was the case. My MP forwarded my letter to the department of health; who got back to me saying that there was no separate funding and having looked into the issue found that no referral was ever sent off for me in the first place.
I went back to see a different GP, armed with my official letters and a whole bunch of information to help them deal with me. The GP I saw flat out refused to look at the stuff I bought and wanted nothing to do with any of it, saying to me "you can't just take some pills and become a man"
This back and forth nonsense went on for a while with different GPs until I gave up and decided to go see a private doctor in London. They were happy to prescribe hormones after 2 visits. As it transpired, I was pregnant and couldn't go ahead with that.
Abridged version of my pregnancy adventure. Midwife referred me to social services the very first time I saw her. Social Services forced me to see their go to psychiatrist (the first time I'd actually been seen by an NHS doctor) she "diagnosed" me with a whole bunch of crap and wrote flat out lies about me in her report that social services used to try and take my daughter. (whilst misgendering me and acting disrespectful the whole time....at one point I was referred to as "a confused little girl")
I got a lawyer involved and saw two other independent NHS psychiatrists who gave me a clean bill of mental health (other than the GID) - legal aid also paid for me to go down to London to see Dr. Baratt at Charring Cross who was amazingly helpful. His psychiatric report is pretty much the whole reason I won my court case and got to keep my daughter.
Fast forward a bit after all that mess, I went back to Charring Cross (paid for by the NHS this time) to see Dr. Lorimer who prescribed hormone treatment.
By this point, I had moved from the Midlands to the North East and was on the waiting list to be seen at the local GIC. Once I got seen there it was all smooth sailing, I got top surgery and hysto less than a year apart and they give my GP's a poke if they mess me about with anything. I never made it past the gatekeeping to get seen at the midlands GIC but from what I've heard from other people I had a lucky escape - it only gets worse once you get in.
So in the UK it seems if you at the far north or south of the country you'll be treated fine. Anywhere in the middle you are screwed.
Quote from: Cindy on October 01, 2014, 04:14:26 AM
So true!! I recall a thread of great titles a while back!
OK, I initially read this as "great titties". Shows you where my mind is...
OK, Los Angeles here.
ER doctor told me that I needed a therapist right away so I didn't end up there again. I did some homework and found a gender specialist with a PhD who was expensive but didn't waste any time. She asked some rapid-fire questions and had me pegged for a severe GD case right away, even when I didn't want to hear that. She is in cahoots with a psychiatrist, endo and SRS surgeon. The psychiatrist basically concurred with the assessment, and treated me for depression and anxiety. The endo is a great, caring doctor, but he's hard to get an appointment with, often forgets things and needs to be reminded frequently. I had to wait 2 weeks between my physical and my E. My pharmacy is awesome. They compound my E as directed my my endo and are trans-friendly. I can literally walk there from my house. The surgeon who did my orchi was Dr. Gary Alter, who was Beverly Hills pricey, but did a great job. I recovered inside of a week without much swelling, bruising or having my nutsack fill up with blood. I think his bedside manner is pretty craptastic and I find him fairly obnoxious (and this is coming from me!), but he wants me back for SRS (which he still calls a "sex change", BTW) next year. I haven't heard a lot of reviews of his work, so the jury's still out. Last I heard, he doesn't deal with insurance any more, so after everything my bill would be to the tune of $41K. OUCH!!! I'm still considering Bowers and Crane up north.
Hi Emma;
I am also in Victoria. Can you PM me with the name of your Private voice therapist? Also it sounds as though you don't need a beauty therapist for anything, but if you do mine are very Trans friendly . Also depending on your dress and shoe size, I have a couple of great stores I use in Melbourne
Judith
Milwaukee, WI, USA
Primary - She's clueless on trans issues, but is supportive and respectful.
Therapist - I have had a couple because they tend to designate their interns as the LGBT specialists. Both have been fantastic.
Endo - Respectful but incompetent. I am essentially self-medding. I tell him what he should prescribe me and what tests to order and he puts them in the computer.
Therapy, speech therapy, and hormone therapy are all covered for me. Any type of surgery is not.
Although my transistion may currently be on hiatus, I hope my information can be useful...
McAllen, Texas - USA
Therapist - University system therapist(s). The only issue I have here is that I had to go through so many. Everyone has been nice and accepting, but I had to go through layers of therapy. Started off being treated for depression, when it seemed to be GID I got referred to the next one up the totem pole until I was assigned someone who specialized in the appropriate area. Said therapist is now in private practice and I have to get reassigned after yet another assessment from a completely unknown psychologist. We'll see where this is going as I have yet to have been given a followup appointment.
Primary Physician - University system health provider. She is very sympathetic and nice, somewhat knowledgeable on trans health issues (I was not the only trans person she has treated there), and eager to learn more. Sadly unable to prescribe HRT due to it being a specialty that the University system could not followup and monitor. Gave me a referral letter to specialist with no difficulty and worked with my therapists office well.
Specialty Physician - She was very nice and extremely competent. Her office was on my health insurance plan (something I have since lost), so my visits were only $30! I was most likely her only trans patient though and people seemed confused about me. An important note though - I had to go through more than 5 different endocrinologists before I found her willing to take my referral. Most endocrinologists refused to take a trans patient and the verbal abuse I suffered from the staff still makes me angry. The only good thing to come from this is I formally notified the university and have had them removed from the referral list. If any trans person after me gets a referral, they will have a much more streamlined path to care.
Pharmacists - This was rather interesting. The big box retailer I obtain my prescription from has multiple pharmacists. One pharmacist recognized my pride earrings and I ended up having a nice conversation with her about her recent marriage to her wife. We got along great and she was very knowledgeable about my prescriptions. Another pharmacist, an import, was very nice, knowledgeable, and to his credit never was anything but pleasant. Unfortunately, despite his best efforts to hide it, his discomfort was obvious. All I have to say is that it is a crap shoot, when it comes to pharmacists.
Something else that should be added in all fairness. Rolling Stone magazine has released an article where they labeled my community as one of the least LGBT friendly cities in America.
QuoteWhen it comes to being unfriendly to LGBT people, Texas' cities have the rest of America beat by a country mile. Eight Longhorn towns rank among the worst for LGBT people, with a whopping four (Lubbock, Mesquite, McAllen and Irving) receiving a zero score from the Human Rights Campaign.
Read more: http://www.rollingstone.com/politics/news/the-5-worst-states-for-lgbt-people-20141124#ixzz3Q168dOb3
To be fair, there are many other places I felt less safe than in McAllen - which is an oasis of tolerance compared to my hometown!
Hi Cindy;
Judith in Melbourne:
First time around (30 years ago)
Family Doctor; - Great Support in Newport Pagnell referred me to Charing Cross GC
Gender Clinic : Tough going, then Psychiatrist recommended seeing a Dr Russel Reed privately. Two appts changed everything. Diagnosed at TS and immediately prescribed HRT
Therapist: None sat that stage available, but Had Hypnosis Treatment - helped a lit in re-learning female upbringing and positioning as female cross dressing as male
Endocrinologist: None
Beauty Therapists & Electrolysis : Excellent. Great beauty team Helped a lot. Many weeks under the needle
Deportment Coach: Once found proved veryt helpful:
Colour Analysis and Style Coach: Fantastic - best investment I ever made. All MtF should do this as its highly recommended to get right colour for clothes and makeup to match natural skin colours
Second time Transitioning (last 2 years)
Family Doctor - Hopeless no understanding
Specialist Transgender doctor : Fantastic, good support, but will not prescribe pellets or Progesterone
Endocrinologist: None. Generally No Victorian Endo identified that will support Pellet implant
Therapist: Generally OK for first 5 visits, but would only see privately - No Medicare rebates
Beauty Therapists & Electrolysis : A fantastic team and very highly recommended. Laser Treatment has worked wonders on Upper Lip and Chin
Deportment Coach: A great step forward
Voice Therapist : Looking for Private Voice Therapist in Victoria
Surgeons - One visit to discuss possible Breast Augmentation. Very good session, but decided to give HRT more time to work.
One thing in Australia is that we now have a National Electronic Health Record (luckily its just voluntary now) where any Approved Doctor can go online and view your Health record, vista, prescriptions, pharmacists visits etc. This could be incredibly dangerous if it gets into the wrong hands
Judith
PS I may be in Glenelg in early Feb. Fancy dinner??
I live in an outlying suburb north of Los Angeles, California.
I was able to make an appointment with a well known gender therapist in L.A. She had me pegged as a transsexual within 30 minutes of my butt hitting her couch on the first visit. She is a very cut-the-BS-and get-to-the-point kind of person which is exactly what I was looking for since I was paying out of pocket for her services amd I didn't want to fool around. She has a PHD and is very knowledgeable, and keeps herself up to date with trips overseas to the major transgender events and with constant research of medical publications. She follows WPATH.
I am thankful for her wisdom and advice as I navigated these uncharted waters - it was invaluable. Every time I tried to BS her about something that I didn't want to talk about she called me on it, and everything she told me would happen - happened - so I learned to trust what she said. She found out on my first visit that I had been self medicating and she immediately sent a request over to the endo for a script for HRT.
The endo she works closely with is a very knowledgeable, nice guy that's been around the block a few times and knows his stuff. He stays quite busy.
So - therapist - top notch - endo - top notch - Pocket book - empty!! :laugh:
I already answered earlier, but I have something to add.
So I'm in Sydney and I like my privacy. I don't like leaving records anywhere. My GP doesn't know, but I do tell doctors when I think it might be important.
I've been in hospital a number of times and told the doctors there, but its never actually been relevant to my treatment. Better safe than sorry though. I always ask them first not to write it down, which they have been perfectly happy with. I guess they are expecting drugs.
In the interests of managing my health better I recently got full copies of my hospital records and what do I find - every time they write it down.
I'm pretty annoyed with that and it certainly erodes my trust in them, although admittedly it wasn't very high to start with. Not sure what I'll do next time, but I'll be lot less likely to tell them anything.
Perhaps because of my trans issues, privacy and trust are very important to me. They way the medical system works here has caused me a great deal of stress, and is what made me go outside it for so many years. This is only going to get worse as records get more and more computerized and shared, and I'm just hoping that I can get past my own issues before things get worse.
I'm curious what people doing illegal drugs are supposed to do. Die?
Quote from: AnonyMs on January 29, 2015, 04:11:03 AM
I already answered earlier, but I have something to add.
So I'm in Sydney and I like my privacy. I don't like leaving records anywhere. My GP doesn't know, but I do tell doctors when I think it might be important.
I've been in hospital a number of times and told the doctors there, but its never actually been relevant to my treatment. Better safe than sorry though. I always ask them first not to write it down, which they have been perfectly happy with. I guess they are expecting drugs.
In the interests of managing my health better I recently got full copies of my hospital records and what do I find - every time they write it down.
I'm pretty annoyed with that and it certainly erodes my trust in them, although admittedly it wasn't very high to start with. Not sure what I'll do next time, but I'll be lot less likely to tell them anything.
Perhaps because of my trans issues, privacy and trust are very important to me. They way the medical system works here has caused me a great deal of stress, and is what made me go outside it for so many years. This is only going to get worse as records get more and more computerized and shared, and I'm just hoping that I can get past my own issues before things get worse.
I'm curious what people doing illegal drugs are supposed to do. Die?
Compassionate and trust worthy care are reasonable to want as is your desire for privacy. I cannot stick up for your doctors trustworthiness but it is important to have an accurate history about you to help avoid mistakes, complications or dosage calculation problems. Nobody wants you to die, we get there soon enough naturally. If someone acknowledges doing illegal drugs it is a doctors imperative responsibility to offer support and the help one may need. I don't know what drugs are legal down under in OZ but laws are changing here in the US. Pot will be legal in Oregon next July, for example. Sorry about the mini derail
Quote from: AnonyMs on January 29, 2015, 04:11:03 AM
I'm curious what people doing illegal drugs are supposed to do. Die?
My experience is that OD's get treated and released.. Unless it's an obvious suicide attempt - then the psych department gets called for a consult..
And as to writing it in you patient records, perhaps you should check what's legally required to be recorded..
I'm being taken care of by a team of doctors in a hospital network that brought me back from the gates of hell and are probably the most professional in the universe.
Quote from: Cindy on September 25, 2014, 07:34:58 PM
I'm getting a report together on what support you were able to get from therapists, endocrinologists, family doctors, surgeons etc during your transition.
Were you satisfied?
Dissatisfied?
What support?
Any of the issues you had.
Can you also say what country you are in.
I want to write this up as a report to be presented so please be specific about issues both good and bad.
Thanks
Cindy
New York City NY, USA (I live in NJ but I get my care in NY)
Therapists - had one not so good one and now I have a great one who is very knowledgeable, caring and competent and is also a committee member of WPATH. Extremely satisfied with this one.
Endo/family doc - my old family doc was supportive but really not knowledgeable about trans care. I switched to a new family doc and nurse practitioner. It is a LGBT specific program so they are well versed. I am extremely pleased. Full support for my transition. Cost is minimal, copay with insurance is small, $15 per visit on my insurance plan. Medications are almost fully covered except for estradiol which I get discounted at Walmart for $10. The rest range from $0-$5 copay. Extremely satisfied.
Electrologist - very satisfied. She is trans, she is caring and understanding and does good work.
Can't speak for surgeons yet as I haven't embarked on any surgery.
Overall things are going swimmingly.
Seattle, WA - not a bad place to be transgender
therapist - found his website, contacted him saying I was transgender from the get-go in the first email, scheduled a session, he would have given me names of doctors for HRT without another session, but I wanted to do therapy for other reasons. He did require that you meet with him once for informed consent before giving you a referral, so in essence if you didn't want therapy you were just paying for the referral from him, but w/e I understand the reasons for it. It was not gatekeeper-like. WPATH was not discussed.
getting on testosterone - first doctor I found here before I looked up therapists wanted a letter. So, I contacted the therapist above. Then, the referrals I got from the therapist basically did informed consent. I went two different places, as the first place did not work out because it was a clinic that operated out of a woman's health center, and that was too weird to deal with.
The second doctor is now my PCP and is fantastic. Dealing with her office is great, she is very laid back and informed. She helped me work out some initial issues I had starting injections, and she really helps me stay on top of my health. I've had to go to her for a couple of other issues, and it is so nice having a primary care doctor that I don't have to worry about being trans with.
There are several top surgeons in this area I am considering that seem not bad, and at least one I know who doesn't require any letters.
pharmacy - I order T from an online pharmacy in Oregon. They send needles and supplies with the T. It is really easy - you call in the refill, they ship it, you get it within a couple of days, and it lasts ~6 months.
other doctors - I had to change my dentist and a psychiatrist because they were awkward and weird about the issue when confronted with it. Not rude or anything, just obviously uncomfortable when confronted with the issue. Both were in areas outside Seattle proper, so I purposefully picked new doctors in the LGBT friendly part of the city, and so far so good.
All in all, I got on T and had it in my hands within 6 weeks of making the first phone call to a doctor, and I really only had to talk to a therapist once. I did wait for awhile after starting therapy, but that was my own choice.
my insurance covers my doctor visits and my blood work. possibly part of top surgery.
Quote from: Tessa James on January 29, 2015, 04:31:18 AM
Compassionate and trust worthy care are reasonable to want as is your desire for privacy. I cannot stick up for your doctors trustworthiness but it is important to have an accurate history about you to help avoid mistakes, complications or dosage calculation problems. Nobody wants you to die, we get there soon enough naturally. If someone acknowledges doing illegal drugs it is a doctors imperative responsibility to offer support and the help one may need. I don't know what drugs are legal down under in OZ but laws are changing here in the US. Pot will be legal in Oregon next July, for example. Sorry about the mini derail
I think this is on topic, as these decisions do affect health care. Mine at least.
I agree about having the history which is why I told them even though I didn't think it relevant. I'm not a doctor so I didn't want to risk it. The small chance that the information would be important against the small risk of it being more widely disclosed. Rightly or wrongly I believe being outed would have serious consequences, and they are in complete ignorance of what it could cost me. It's my choice and my responsibility and they stole it from me. And if there's ever a next time they have increased the risk of me making the wrong decision.
To look at it another way, I gave my consent to a certain course of treatment, but they lied to me about what it was. I got something I didn't didn't consent to.
Perhaps this kind of thing would help other people, but I'm not other people and this is not the kind of society I like living in.
Quote from: kelly_aus on January 29, 2015, 04:37:45 AM
My experience is that OD's get treated and released.. Unless it's an obvious suicide attempt - then the psych department gets called for a consult..
And as to writing it in you patient records, perhaps you should check what's legally required to be recorded..
What if OD's got treated and then sent to jail? That's kind of how I feel. You could make an argument that its only right to do that, and I'm sure many would. It would probably even save some lives, at the cost of others. I don't agree with it though.
I see your point about the records, but it doesn't really matter if its legally required or not. Either way I don't agree with it, its just a question of where the blame lies. And if they had told me they were going to write it down perhaps I would still have told them, but it becomes my choice again.
I may be out there by myself on this, but I don't trust other people with my life if I can help it. There's no choice sometimes, and I won't be doing SRS on myself anytime soon, but I'm careful to keep records and double check whatever I can. I've seen quite a few mistakes and I don't hold the medical profession as a whole in very high regard. I tend to think of them more like highly educated plumbers.
Quote from: stephaniec on January 29, 2015, 06:53:07 AM
I'm being taken care of by a team of doctors in a hospital network that brought me back from the gates of hell and are probably the most professional in the universe.
I don't want to seem like I'm down on all of them as its not true. My endo and psych have probably saved my life. But the good people don't somehow make the bad ones acceptable.
I see parallels with informed consent for HRT, and SRS for that matter. Who gets to make the decisions about your life?
Quote from: Ms Grace on September 27, 2014, 01:03:16 AM
Seems that Sydney, Melbourne and Adelaide are fairly well catered for, don't know about the other state/territory capitals in Oz or the regional/rural areas.
For what it's worth, Hobart has a gender /sexual dept of Royal Hobart Hospital and so far am getting really positive reactions from them. ^-^
An addition I feel is relative,
My G.P. is lovely but will have to have a word or two if she persists in addressing me as "Sir" , other than this had no trouble telling her in detail everything about myself and even after she told me that Tasmania has no-one who can help me ,when I finally accessed info to the contrary she was happy to write a referral .
The general practitioners down here really are not aware of the excellent services available.
Quote from: Cindy on September 25, 2014, 07:34:58 PM
I'm getting a report together on what support you were able to get from therapists, endocrinologists, family doctors, surgeons etc during your transition.
...
Cindy, I'm in the U.S.
TherapistsI had an early experience with "therapy" from someone who presented themselves as qualified, but turned out to be sketchy. After about 3 months I decided I was OK without therapy anyway, and haven't felt the need since. I do plan to see a therapist to get my SRS letter, but that's it.
EndocrinologistsI started off with by seeing an endo who did implants, but after a few very expensive months, I decided to ask my doctor to manage the HRT. She prescribed estradiol and progesterone in pill form, dissolved sublingually, which ended up being much cheaper and seemingly just as effective. I don't feel the need to go back to an endo at this time.
Family DoctorsI've worked only with Family Practice doctors who specialize in transgender issues. Not hard to find where I started (California) and surprisingly easy to find where I am now (South Florida). Both have been women, and both very attentive and supportive.
Also in both cases, the doctor's office has also been able to draw blood. That has been convenient - and saved me from potential embarrassment later in the transition, when I presented as female but still had male ID. I have found the reception staff at the local blood-draw labs to be kind of clueless.
SurgeonsSo far, I've had FFS and BA.
For FFS, I read the boards here extensively, and decided on a well-known FFS surgeon in South America. A major factor was saving money.
He performed several procedures for me. Some went very well, but others required corrective work a few months later. I didn't feel comfortable going back to that surgeon, so I had the corrective work done here in South Florida, by a regular plastic surgeon.
I don't know if things would have gone better if I'd chosen a more expensive FFS surgeon to start with - maybe you do get what you pay for. In the end, I probably ended up paying even more due to the corrections.
For BA, I used the same South Florida plastic surgeon. He specializes in sub-fascial implants, and I've been very happy with the results and follow-up.
Hope this is helpful!
I'm in the UK
Still at the very start of my transition, but my experience so far hasn't been all that fantastic. The first time I went to my doctor he asked me to go away and think about it, because "being a man might just seem easier at times". Think about it! I'd done nothing but think about it for a couple of months before booking the appointment. It was obvious that arguing with him wasn't going to help, so I finally built up the courage to go back and tell a different doctor. She's referred me to where I need to go now, without any fuss.
Think my main complaint is the length of waiting lists. When I first saw a GP for depression in July last year I was told to try and online course. It might have helped me a bit writing down what my "issues" were, but because it only ever reads back exactly what you put in and try to teach you techniques, it's impossible for it to pick up what you're not saying. When I went back I was referred to a talk therapy service, but the waiting list was six months! This wasn't even an NHS based one, but an organisation they partner with because the real waiting lists are so long. I knew I couldn't wait that long so finally, around November, I found myself a therapist privately. He's been brilliant. I mentioned my gender issues to him right away and that's given me a lot of confidence to explore. It really annoys me that I could have had a similar experience months before.
My understanding now is that I'm currently on a waiting list to see the local psychiatry team (around 4 months) who then refer me to the GIC (currently 15 months) So another year and a half then!