I've been mulling over writing here about my latest attempt at finally getting started with the very beginning stages of attaining gender affirming hormone therapy.
I've been actively trying very hard to begin, for over five years now. Things that held me back had nothing to do with hesitation, but instead availability of competent providers. Financial issues were a problem at first, but not so much of a hurdle right now. I live in North Idaho - the largest hurdle.
Last November, I travelled to the nearest informed consent clinic. One in Renton, Washington. Just over six hundred miles round trip. Unknown to me until I had my first appointment, I had to wait until then before I was informed that I had was required to travel that distance for each subsequent appointment. I couldn't do that, do i fell back on searching for a competent therapist in my area, which there are few to none.
My options ran out, complicated by winter. Then, a few weeks ago I learned that the planned parenthood clinic in Spokane Washington was now offering transgender services. I called, asked if they had the Informed Consent Model, which they do. I made an appointment, and I was back on track.
Once I was there on the 7th, I checked in. My experience was dreadful. The provider exhibited very poor knowledge of gender affirming hormone therapy, she even said so in so many words. My worries began as I witnessed this poor performance. My blood pressure was getting high. They finally got around to checking my blood pressure at that time, and sure enough it was high, but not bad. I was asked some odd questions about my social life. If I had anxiety issues, which I said I did.
My provider left the room for over half the time spent in my appointment. She came back telling me she was worried about my blood pressure, and anxiety, and wanted to check something in my medical history, and that she was in a hurry to take care if her other patients - well, I was her patient currently, she should be working with me instead of taking off, she left again. After that, a nurse came in and led me out to finish my appointment with the billing department.
I was like... Hey - I'm supposed to get my blood drawn for lab work, or at least get a referral for lab work I was told I would have blood drawn, and I fasted for the ten hours required. The nurse said I was to make another appointment for that... Maybe.
I paid my bill, $150 for basically no services. I was very disappointed. I came to understand that the lab work should be the main determining factors initially, and go from there. I wasn't even close to that, and I felt like I was being milked for additional unnecessary appointments. Which is a VERY common practice in North Idaho.
I started making some calls, this didn't seem anywhere near right, or fair to me. It took the rest of my day, but I eventually had a conference call with the supervisor of the Spokane clinic, and the nurse who attended my appointment that day. I explained my issues, and concerns. It was universally decided that my appointment was very mishandled, and they wanted to make it up to me, and to ask for assistance with improving their services.
I made another appointment with a different provider within the same clinic. There are only two who offer transgender services. The supervisor said she will coordinate with my new provider to make sure I get the services I need, and pay for. It is another delay, in a five year long string of delays. I have mixed feelings, but I am still determined to keep going because nothing in my world matters more to me than to at least try to begin hormone therapy. Something I also told the supervisor. Something most any transgender person seeking hormone therapy has an incredible desire for, a very great need.
I believe that a provider offering services should be qualified to render services. Informed Consent is partly designed to help alleviate unwanted hurdles, and experiences. I don't think it's very good practice for a provider to make major decisions on unsubstantiated information. Then fail to understand that the lab work is where it begins, and unnecessarily draw the process out.
I apologize for the steam I let off with this writing. That day was not a good day, but it got a little better when the supervisor called me back expressing how they wanted to make things right. Before that happened, I spent a few long hours crying in my car. I have money to start, and maintain taking hormones, but I'm not made of money. The distances, and seemingly unending cycle of unqualified providers. So many obstacles. For a while I though I was cursed with bad luck. The last thing I want to do is feel sorry for myself, because it all starts falling down.
I have a new appointment, on the 20th. Another few weeks of waiting. I can do it, but I pray that no more roadblocks come my way. Keep trying. :)
Dana I so much respect your determination and persistence. I remember your posts from last fall and was wondering how things were going for you in the north part of Idaho. Some of what you said previously hit home for me - I was an undergraduate at Washington State University near the Idaho border in the 1980s. The part of the country you live in has beautiful motorcycle roads and scenery and fresh air and mountains, some very kind people but also unfortunately the type of encounters many assume are just for bad movies but are all too real. (Thinking about some of your earlier posts and challenges.)
I believe you did the right thing calling the clinic and explaining how your appointment needed to be handled better by the provider - in a constructive manner. Doing this helped get you closer to getting on track, and potentially helps others by reminding the clinic this topic is a serious matter and needs to be handled appropriately.
I am not familiar with health care in your region but I've recently become aware of Dr. Geoffrey Stiller, a surgeon at Palouse Surgeons and Linea Cosmetic Surgery in Moscow Idaho. He is the first surgeon performing GCS on a regular basis across the border in Washington State at Pullman Regional Hospital. I bet one of the clinics he operates from can prescribe HRT or may be able to refer you to additional providers.
Or the clinic you were at may be able to provide the care you need on the 20th. Whatever path you take my best thoughts are with you - and for all of us facing and conquering uphill battles. Mountains can be beautiful to experience but the climb can be very challenging.
Kendra
Dana, I feel bad for you that you're having so much trouble getting things started. I recently, just this week, decided to forego my GP referral and give Planned Parenthood a try. I posted about it in"My Progress" thread. My experience was a polar opposite to what you described. I was very pleased with how they conducted things. It was obvious that they are new to transgender services and were extra careful. I also got extra questions, which I didn't mind. I feel that the more information I can give, the better they are to provide care.
Every location and personnel is different though. You did right by calling them back about your experience. It should help them improve for you and the next clients as well.
good luck going forward.
I'm in nyc and I feel my appointments are all rushed. But they do the blood work and prescribe hrt. I'm sorry it's been so long for you to get what you need. I think speaking up is great, I know I would make sure to not leave when I'm there until I get what I came for.
That's how this system works. You're fighting for what you need. I work in health care and I'll tell you that's what people do. They'll refuse to leave the exam room without getting what they need. I haven't done that myself or needed to but it's understandable.
Best of luck on getting your hrt!
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Thank you for the words of support, everyone. Living in a place where one can feel so alone, sometimes It can feel intimidating to share how you feel in your heart. But this is a safe place, and I'm very grateful. It took me some time to open up to support. Long story that. That feeling I get here, when I feel like my life matters. It keeps me going. :)
Your life absolutely matters and you are not alone.
When I had some of my more difficult moments - although nothing in comparison to what you endured a couple years ago - I began to realize I am part of a crowd here. Hands you can reach out and almost touch any time, making any type of pain just a bit easier or at least knowing others understand exactly, or try our best.
Quote from: Dana1979 on February 10, 2018, 07:43:06 AM
Thank you for the words of support, everyone. Living in a place where one can feel so alone, sometimes It can feel intimidating to share how you feel in your heart. But this is a safe place, and I'm very grateful. It took me some time to open up to support. Long story that. That feeling I get here, when I feel like my life matters. It keeps me going. :)
Dana, We live in the CdA area. The Dr. my daughter is (kind of) seeing is in CdA. He is a 3rd year resident and is being mentored by a doctor in Spokane (who he said has tons of experience working with transgender patients and prescribing HRT). His name is Dr. James Bailey and he works in the Kootenai Clinic residency. I really like him and my daughter really likes him. Although he is in his last year of residence, he said that he will be staying in the area and that his plan is to focus on transgender care. He follows the WPATH Standards of Care very closely - perhaps too closely for my liking, but he is a really nice guy, easy to talk to and the staff in the office has always been wonderful. Just thought I would mention it to you.
I can't remember the name of the Doctor in Spokane that he told me about. I can ask for her name again if you are interested. I was also going to mention Dr.Stiller in Pullman.
Good luck.
This link might be of help:
https://www.acluidaho.org/en/node/134