So, first off, kind of excited because I sent in today in order to get the ball rolling on beginning HRT. I was honestly a little nervous and sort of a ball of nerves, but once I started talking to the doctor, I calmed down alot.
But the meeting wasn't exactly what I was expecting, so I wanted to see if this was normal. The doctor and I discussed options for a while, and then he wrote me prescriptions right there and gave me directions and told me to call him if there were issues. From what I had read about though, isn't there usually blood work involved prior to getting prescriptions? is it normal to not do this?
If it makes any difference, it was an Informed Consent Clinic.
I feel like the doctor was really nice and very helpful, but I just feel like this is a little outside the ordinary. And I wanted to see if this is "okay"? I'm happy I have the prescriptions, but I feel like more pre-work should have been done for dosage and what now?
Congratulations! Get in touch with your doctor, I'm sure he wants your bloodwork at some point. My doc told me five minutes into the appointment that I'd be getting hormones. Ain't informed consent great? ;D
Hugs, Devlyn
My doctor also did not do any blood work until 90 days in. This was at penn medicine which is part of the LGBT health program at University of Pennsylvania. Anyways, what she said was that their experience is it doesn't matter. What matters is getting you into the female (or male) normative range and seeing how you react. So your experience is similar to mine and other women I have spoken to in my area. I see my dr every 90 days and get levels checked a few days before that at the midpoint of my injection cycle. So far I'm still alive, have boobs-sort of, fat redistribution, changes in my face, all the normal stuff. I was waaay over the top end of female normal at my last visit so I'm temporarily on a 30 day level check until they get back in the range.
Short story: don't worry.
Wow, your description of what happened almost mirrors mine! Initially, I sought out and found a doctor who would prescribe HRT. Wouldn't take insurance and visit was expensive as far as I am concerned.
Asked a few questions and wanted me to inject the Estrodial which I opted for the pill first because I'm not very keen on needles.
No initial blood tests were taken. However, I was able to begin the HRT with the VA and the Endo doctor wanted blood work done for a base.
Depends on their policy, officially in most places there is no requirement other than you saying you want this, as it is sufficient evidence that you're trans, there's no really conclusive trans test or anything they could do to gate your access that wouldn't have tons of false negatives so most doctors will take you at your word. It's a big life change, and not something to take lightly for anyone, this is true, but the consequences for denying someone access to hormones could be deadly for them.
In other words... Yep, perfectly normal, and accepted medical practice. It's certainly not a great way to go about it, but there's no better way.
Quote from: Daniellekai on March 08, 2018, 01:20:08 AM
Depends on their policy, officially in most places there is no requirement other than you saying you want this, as it is sufficient evidence that you're trans, there's no really conclusive trans test or anything they could do to gate your access that wouldn't have tons of false negatives so most doctors will take you at your word. It's a big life change, and not something to take lightly for anyone, this is true, but the consequences for denying someone access to hormones could be deadly for them.
In other words... Yep, perfectly normal, and accepted medical practice. It's certainly not a great way to go about it, but there's no better way.
I agree with ya Kiddo! I wasn't too keen on not knowing what my blood work was or is but wanted to start the HRT. That said, being fortunate enough to obtained a helpful Endo doctor I was lucky.
Well congrats!!! This is normal most doctors will do bloodwork but, it's not a requirement. As mentioned your doctor will at some point take it to see where you levels are. I go through planned parenthood myself and they have me do bloodwork at every visit and urine in a cup. They monitor my bladder and kidneys for health and make sure they hormones are causing any ill effects. If you want an assurance as said call your doctor and talk to him or a nurse and find out.
Well, the alternative could be what I had.
18 months from my GP referral to my first appoint, followed by 6 months of therapy and then only to be talked out of transition my therapist when it came to crunch (hormone) time.
That's why I'm going private when I get home. I definitely would have preferred your experience than my own.
Also, if you're worried things are moving too fast, you can stop hormone treatment up to 3 months (some say 6 months, but I'd er on the side of caution) after starting and any changes will be reversible, so try not to worry.
Back in 2013, I started to seriously think about changing and even started seeing a therapist. I really didn't see any progress and after about three sessions and a move from Long Beach to Texas, I pretty much put Cassi back in her dark room.
After moving here to Vegas a couple of things happened, one I became aware of "Consent" which eliminated the need for continuing therapy and finding Susan's Place along with a local referral for HRT. As I have mentioned previously in other threads there were a few obstacles that I had to overcome, one being my lesbianism and the other the "sex" transsexuals that kind of misrep us.
Quote from: Cassi on March 08, 2018, 06:26:33 PM
Back in 2013, I started to seriously think about changing and even started seeing a therapist. I really didn't see any progress and after about three sessions and a move from Long Beach to Texas, I pretty much put Cassi back in her dark room.
After moving here to Vegas a couple of things happened, one I became aware of "Consent" which eliminated the need for continuing therapy and finding Susan's Place along with a local referral for HRT. As I have mentioned previously in other threads there were a few obstacles that I had to overcome, one being my lesbianism and the other the "sex" transsexuals that kind of misrep us.
Cassi - thanks for sharing, I'm glad you're here.
Sonja
Quote from: Devlyn Marie on March 07, 2018, 06:30:53 PM
Congratulations! Get in touch with your doctor, I'm sure he wants your bloodwork at some point. My doc told me five minutes into the appointment that I'd be getting hormones. Ain't informed consent great? ;D
Hugs, Devlyn
Dev your humor everytime just gets me and cracks a smile <3
Lol.
Just make sure you get the blood work from what ive been told its key.
Monitors if u need a upped dosage.
Liver issues etc.
General hormone levels.
Informed Consent is what it is <3
Stay strong and go get em <3
Quote from: Cassi on March 07, 2018, 08:31:55 PM
Wow, your description of what happened almost mirrors mine! Initially, I sought out and found a doctor who would prescribe HRT. Wouldn't take insurance and visit was expensive as far as I am concerned.
Asked a few questions and wanted me to inject the Estrodial which I opted for the pill first because I'm not very keen on needles.
No initial blood tests were taken. However, I was able to begin the HRT with the VA and the Endo doctor wanted blood work done for a base.
Same here. I have only started HRT 2 days ago but, My doctor said that she would call me if the blood work
showed any issues. So I got my meds without knowing anything about my blood work. I will have my next blood test in 3 months. I ask her a LOT of questions. She give me a choice also and I went with the pills. They say everyone is afraid of something and mine is needles! She had to stop the interview with me to do the blood work first because I was freaking out. lol
Hugs,
Chelsea
My doctor is also my diabetes doctor and recently put me on insulin and I hate needles. The needles are about a quarter inch and if I hold part of my skin and jab I'm okay. If I look at the needle I tend to pause and it hurts when I do it.
As for the "E", it's patches like I may have mentioned. Mine crinkle and I have a heck of a time with them. I think Laurie mentioned that the VA was having her do injections. At this point, I'd go the the inj
I went to Mt. Sinai here in NYC, which I always make a point to state because they've been great so far, and my Endocrinologist had CBC+Platelet and a Comprehensive Metabolic Panel done on my first visit when she also prescribed my E and AA. A month later in addition to those tests being redone she had Estradiol and Testosterone tests done. I wish I had those latter two done the first visit just for curiosity's sake though and if I had to do it again I would request them.
The doctor I went to didn't have me do any blood work at the start. In fact, I've only done it once, at the 3 month mark and that just checked my T levels to be sure they were suppressed.
This is all because 1 - she knows I'm healthy and haven't had any medical issues ever, and 2 - I don't have insurance & really can't afford to pay the costs out of pocket for all the testing.
I'm thinking about checking on lab costs at some other places, just so I can see what my E levels are.
With me my T was tested in December before E but after the dutastricide and aldactone where started. My T, E and progesterone are all being tested for an appointment at the end of April. Testing E before starting wasn't a requirement as it takes time to shift from male to female levels
as far as what my Doctors said. Endocrinologist here is a six month wait as only one for the entire city that does transgender. All my other endo blood work is done monthly.
I needed a therapist letter, but other than that it sounds similar to the experience of other people here. There really isn't a need for the baseline test unless the doctor is worried that hormone levels aren't as expected. The reasons I can think of are intersex people, people with hormonal/sex disorders, or people that might be taking street hormones and thus aren't in the range you would expect for someone born like them.
Some doctors like to do baselines on everyone - that's fine too. People read too much into the levels too - what matters is that you get the feminization or masculinization, not that you end up in some green zone on a chart. You don't want hormones at such a high level as to cause health issues either, which is why you should get monitored when taking them. That said, I'm always happy when my hormone levels are in the "female" range. :)
Quote from: Cassi on March 08, 2018, 06:26:33 PM
As I have mentioned previously in other threads there were a few obstacles that I had to overcome, one being my lesbianism and the other the "sex" transsexuals that kind of misrep us.
Just curious ?? :icon_confused:
How does one "Overcome" being a lesbian and why the heck would you want to lmao :icon_female:
Just joking around.
Love
Bobbie LeAnn
My first endocrinologist visit went the same. Short talk about my life and family. He read the letter from my therapist. Then he said he would start me off on a low dose and see how that effects me in 90 days. No blood work done. He said his only concern is getting T down to normal female levels. He doesn't even worry about E levels. His idea is once E is enough the T will be in normal female range and the big test is what the mental effects are. When I went back at 90 days I told him I was ready for transition dosages. That time he gave me an order for a blood test but told me to wait about a month of being on full dose before getting it done.
My doc is an endo at a major teaching hospital and associate professor at the Med School at Wash U in St Louis. He seems a bit conservative when it come to dosages of E and he won't prescribe injectables. Of the three or so providers in the whole St Louis area, I think he has the most understanding of what trans people go through.
Quote from: Bobbie Ann on March 10, 2018, 07:18:59 AM
Just curious ?? :icon_confused:
How does one "Overcome" being a lesbian and why the heck would you want to lmao :icon_female:
Just joking around.
No problem - by overcoming the lesbianism, I meant that I have and always been interested in women and never men. The problem was that in my mind why was I feeling the way I did and am a guy but internally a woman? Make more sense?
Love
Bobbie LeAnn
I had to first do my blood work before I met with the Doctor. She then prescribed a certain level of both T-blocker and E. I had to go back in 2 weeks and do more blood work. Everything looked good. She upped the dose and I had to again go back with more blood work. Again everything was good. I saw her again and she again upped the dose. When I went back in my one level was really high or she lowered my T-blocker dose. I was then on the right dose for me. I had to see her every 3 months for the 1st year. Now it will be two times in the second year. Then it is just once every year after. (if everything still looks good).
Julie (13 months on HRT)
Quote from: Julie -2010 on March 10, 2018, 08:55:47 PM
I had to first do my blood work before I met with the Doctor. She then prescribed a certain level of both T-blocker and E. I had to go back in 2 weeks and do more blood work. Everything looked good. She upped the dose and I had to again go back with more blood work. Again everything was good. I saw her again and she again upped the dose. When I went back in my one level was really high or she lowered my T-blocker dose. I was then on the right dose for me. I had to see her every 3 months for the 1st year. Now it will be two times in the second year. Then it is just once every year after. (if everything still looks good).
Julie (13 months on HRT)
Hi Julie and welcome! Wow, from your avatar you look pretty gosh darn good for 13 months.
Quote from: ToriJo on March 10, 2018, 12:30:29 AMPeople read too much into the levels too - what matters is that you get the feminization or masculinization, not that you end up in some green zone on a chart. You don't want hormones at such a high level as to cause health issues either, which is why you should get monitored when taking them. That said, I'm always happy when my hormone levels are in the "female" range. :)
The female range can be quite wide. For testosterone, 6-120 ng/dl. For estradiol, 20-1,000 pg/ml. Where in there is the ideal level for a given individual, no one really knows in advance (guesswork, arbitrary, no studies have established an ideal range) because individual sensitivity varies. Also, we aren't ciswomen, we *may* need more because our particular circumstances/genetics or certain other hormones/drugs we take (progestogens reduce sensitivity to E).
Levels also fluctuate, quite a bit!
Levels in our blood may not reflect intracellular concentrations so that they may be low in the blood but high in our cells due to conversion of weaker forms/precursors (estrone, androstenedione, dhea-s, estrone sulfate, etc.).
T is often BLOCKED by anti-androgens so that what you see in your blood, some of it is blocked and a test in unable to tell you how much.
Total T is often measured when really part of that is bound to SHBG and cannot bind to receptors. A more accurate measurement is free or bio-available T.
T may be high but if one is taking a DHT inhibitor such as finasteride, then DHT may be low.
Studies appear to also show that even high levels of estradiol are relatively safe across different populations, especially if taken non-orally, as far as coagulation and cardiovascular risks go. Pregnant women have levels as high as 75,000 pg/ml (risk of DVT is 0.1%), in men, levels as high as 1,000 pg/ml were found not to increase the risk of blood clots (and even reduce the risk) despite their cancer and advanced age, etc.
The more one reads about these things, the more one realizes stuff. ;) I try to share as much as I can with my doctor so they may become more aware.
Quote from: Cassi on March 10, 2018, 10:38:24 PM
Hi Julie and welcome! Wow, from your avatar you look pretty gosh darn good for 13 months.
Thanks Cassi. I'm pretty happy with the progress. I don't see as many changes as I thought I would, which I not totally out so that may be a good thing for now.
Julie
Pretty much the same here. Just told my younger oldest sister that she's no longer the oldest sister in the family. She asks if I'm growing boobs (she's not too versed in trans - her daughter had to explain to her) and told her they're growing a wee bit with 2 months on HRT.
Too funny Cassi. The rest of my family found out Friday after I talked to Mom and my sister who is the middle of 5 kids is so happy and overjoyed to have a big sister now. She wants to fly out and go shopping with me. I never expected that responce.