Susan's Place Transgender Resources

Greetings,

I came to terms and accepted my transgender status in January of last year. I always felt more "in touch with my feminine" side and now I am accepting it.

Here is a tentative timeline for my transition. I have done some research already into things but want some guidance from the community on it all to make sure it is reasonable and that I am not forgetting anything.

Current Transition Progress:

• 1/2017: Accepted Transgender Status.
• 4/2017: Began counseling with LCSW who works with other Transgender patients.
• 4/2017: Came out to wife and kid as questioning.
• 5/2017: Diagnosed Bipolar I, ADHD, Gender Dysphoria in Adults.
• 5/2017: Came out to family (wife/kid) as transgender.
• 5/2017: Came out to rest of family.
• 6/2017: Began wearing female clothing.
• 6/2017: Began identifying as female full-time.
• 7/2017: Decided on female name (Ashley).
• 8/2017: Wife veto's "Ashley" name.
• 9/2017: Settled (and agreed on) "Sarah" name.
• 9/2017: Scheduled 1st Endocrine appointment.
• 10/2017: Agreement made with wife. We go to her Maiden name, and she picks my middle name "Elizabeth."
• 1/2018: Began referral process for treatment of Bipolar & ADHD.
• 1/2018: Cleared by ENT for vocal therapy.
• 2/2018: Began vocal therapy (So glad insurance covers this).
• 3/2018: Began legal name change process.
• 4/2018: 1st Endocrine Appointment.

Current Weight Loss Progress:

• 7/2017: Began weight loss (Started @ 284lbs).
• 8/2017: Broke 275 lb mark.
• 1/2018: Broke 250 lb mark.
• 3/2018: Broke 245 lb mark.

Tentative Treatment Timeline:

• 4/2018: Begin spironolactone.
• Spring/Summer 2018: Begin treatment for ADHD & Bipolar I.
• Summer 2018: Begin estrogen.
• Fall 2018: Legal gender change (Will try to get this sooner).
• Fall 2018: Finish Vocal feminization therapy.
• Spring 2019: Undergo Vocal Feminization Surgery (if therapy fails to produce desired results).
  
• Spring 2020: Undergo SRS.
• Summer 2020: Undergo Breast augmentation (if needed).
• Fall 2020: Undergo Facial Feminization Surgery (if needed).

Tentative Weight Loss Goals:

• Summer 2018: Hit 225 lb mark.
• Winter 2018: Hit 200 lb mark.
• Summer 2019: Hit 175 lb mark.
• Winter 2019: Hit target weight (~150lbs).

Questions:

• When should I begin hair removal based on the above timeline?
• Is it best for laser hair removal or Electrolysis?
• How early should I begin looking for surgeons?
• How long are waiting lists for surgeons?
• How will spironolactone & estrogen impact my weight loss plan?
• Is there any weight guidelines/restrictions to begin HRT
• Is there any weight guidelines/restrictions for Surgical operations?
• Are there any questions I am forgetting to ask?
• Any recommended steps to be added above I may be forgetting?
• My lawyer is not versed enough to assist in changing Birth Certificate, any resources available (Live in Mississippi, BC is from Missouri).

Insurance Notes:

• Insurance follows WPATH guidelines.
• As far as I can tell based upon my various calls to insurance, they cover anything I may need.
• Clumping surgeries into same year will save me a ton on deductible & coinsurance fees.
  
• Deductible and coinsurance subject to change year-year due to the ACA exchange plans.
  
  • Current Plan: ACA Silver Cost-sharing Exchange Plan
  • Current deductible: $200
  • Current out of pocket max: $600
  • Current coinsurance: 30%

Welcome To Susan's Place!

So many questions!  I think I can answer a few of these.

Hair removal is best started early.  This is something that can take quite a while to complete, as the time is tied to the activity cycle of hair follicles.  Only follicles that are actively growing respond to laser or electrolysis.  The follicles in various dormant stages eventually wake up, become active, and need to be treated.

Laser works best for light skin and dark hair, as it relies on the hair absorbing more laser energy than the surrounding tissue, heating the follicle and killing the stem cells at the follicle base.  Electrolysis works well on any active hair, but is tedious.  The electrolyst inserts a fine probe along the hair into the follicle and delivers bursts of energy to destroy the stem cells and the follicle.  I've had over 190 hours of electrolysis and am down to not shaving, and needing about 90 minutes of treatment a week to remove new hairs.

I'll let others take a shot at your other questions

You might want to to hop on over to the Introductions (https://www.susans.org/forums/index.php/board,8.0.html) Thread and create a post to tell us a little bit more about yourself so we can get to know you a little better and greet you properly.

I've added some links and information below that can help you get more out of our site. Please take time to become familiar with them especially the RED one as we are always getting questions that are answered there.

Site Terms of Service & Rules to Live By (https://www.susans.org/forums/index.php/topic,2.0.html)	Standard Terms & Definitions (https://www.susans.org/forums/index.php/topic,54369.0.html)	Post Ranks (including when you can upload an avatar) (https://www.susans.org/forums/index.php/topic,114.0.html.)
Reputation rules (https://www.susans.org/forums/index.php/topic,18960.0.html)	Cautionary Note (https://www.susans.org/forums/index.php/topic,82221.0.html)	Photo, avatars, & signature images policy (https://www.susans.org/forums/index.php/topic,59974.msg383866.html#msg383866)

WOW, couldn't provide such a critique if I was NSA. 

Wow, good on the weight loss efforts.  I've been working on it myself and seems to be a never-ending battle for Truth, Justice, and shedded weight!

Welcome Home

Quote from: Michelle_P on March 07, 2018, 11:30:20 PM
Hair removal is best started early.  This is something that can take quite a while to complete, as the time is tied to the activity cycle of hair follicles.  Only follicles that are actively growing respond to laser or electrolysis.  The follicles in various dormant stages eventually wake up, become active, and need to be treated.

I've had over 190 hours of electrolysis and am down to not shaving, and needing about 90 minutes of treatment a week to remove new hairs.

Ouch, Ok. So seems based on my timeline, I should start hair removal like asap... Will verify once again with insurance on coverage. From what I was able to gather, they follow WPATH guidelines and pretty much cover it all. But will verify again. Any tips in case I get pushback from insurance on this?

Now to find a provider within my area... Memphis is 1.5hrs away, and if I am going to need weekly treatments that can seriously rack up the gas consumption & millage in my car. I googled and there is a few within reasonable distance... Just have to get the insurance stuff sorted out... Might end up being something I file after the fact for reimbursement...

Hopefully Cryptocurrency goes up. I have a rig that can generate $200-$300/mo in Crypto which can be used to pay for some. But at most that would only get me like 3-5 hours of electrolysis a month... And if I can expect 200 hours of treatment, that can be 3-5 years to get it all done. Will focus on the lower regions as I understand that it is required for SRS/GRS.

Well you have a good timeline just don't be to stressed on it. Yes you want to look and feel your best but, let your timeline be flexible just in case things come up as they do. I lived in Mississippi for a while and couldn't see myself transitioning in MS so I moved. As far as your birth certificate you have to go to your county court in MS and get a name change packet. Fill that out then turn it back in. You will have to pay a fee for filing and other fees in Florida I paid $400 for it. You will have to wait sometime and then they give you a court date. In MS you do have to show up for the hearing. Most judges rule in your favor. Once you have the judgement go get several copies "certified" from the clerk. You will need several copies, trust me, many things you don't think to change that need this court document. You check with Missouri on what they need from you and you send in all the requirements along with the court order. Then you wait, make a list of all accounts, documents, school, credit, and others that will need the name change. It's a lot of work.

As far as you weight loss question when on estrogen. The spironolactone doesn't really affect weight but, the hormones do. Think of any woman you have heard complain about weight and it being hard to loose. Once you start estrogen your weight coming off becomes harder like every woman. So don't be discouraged if it slows or stops. You will loose weight initially on hormones but, that is your muscle loss. Remember we as women are not really muscley. Now if you want to keep your strength then you will have to work them out. I answered a couple now for you and hope it helps!

Quote from: Chanteur on March 07, 2018, 11:12:09 PM

Questions:

• When should I begin hair removal based on the above timeline?
• Is it best for laser hair removal or Electrolysis?
• How early should I begin looking for surgeons?
• How long are waiting lists for surgeons?
• How will spironolactone & estrogen impact my weight loss plan?
• Is there any weight guidelines/restrictions to begin HRT
• Is there any weight guidelines/restrictions for Surgical operations?
• Are there any questions I am forgetting to ask?
• Any recommended steps to be added above I may be forgetting?
• My lawyer is not versed enough to assist in changing Birth Certificate, any resources available (Live in Mississippi, BC is from Missouri).

• When should I begin hair removal based on the above timeline?

ASAP as it is a long process for most of us

• Is it best for laser hair removal or Electrolysis?

They each have their place and with both you will deal with pain and regrowth. Laser works best for fair skin and ark hair and I found less painful that Electrolysis. The key to Electrolysis for me is the skill of the operator. You can get scarring along with large amounts of regrowth if the technician has a poor technique.

• How early should I begin looking for surgeons?

Research Research Research....Start looking at your options now as many of the good ones are booked for extended times

• How long are waiting lists for surgeons?

Depends on surgeon...Mine was about 6 month waiting list but it was going to be a year before I was ready. Many of the top ones can go 18 months or more

• How will spironolactone & estrogen impact my weight loss plan?

Oestrogen fro sure...when I asked my Dr what was going to be the biggest side effect she smiled at me and said "about 3-5 Kgs" I don't take spironolactone so can't really comment

• Is there any weight guidelines/restrictions to begin HRT

Not that I am aware of although it depends on you Dr

• Is there any weight guidelines/restrictions for Surgical operations?

Mine are I have to have a BMI of 30 or less...my surgeon gave me a number to aim for

• Are there any questions I am forgetting to ask?

Probably hundreds...but we are not going anywhere  ;D

• Any recommended steps to be added above I may be forgetting?

Nope I am sure anything you have missed will be addressed as you gg along...there may be things you also decide differently about as you go along.

• My lawyer is not versed enough to assist in changing Birth Certificate, any resources available (Live in Mississippi, BC is from Missouri).

Sorry I live in Australia so can't help

Good luck I hope it works out as you have planned

Take care

Liz

Quote from: Jailyn on March 08, 2018, 03:01:16 AM
As far as your birth certificate you have to go to your county court in MS and get a name change packet. Fill that out then turn it back in. You will have to pay a fee for filing and other fees in Florida I paid $400 for it. You will have to wait sometime and then they give you a court date. In MS you do have to show up for the hearing. Most judges rule in your favor. Once you have the judgement go get several copies "certified" from the clerk. You will need several copies, trust me, many things you don't think to change that need this court document. You check with Missouri on what they need from you and you send in all the requirements along with the court order. Then you wait, make a list of all accounts, documents, school, credit, and others that will need the name change. It's a lot of work.

As far as name change on birth certificate, that part is easy and I already have some of it started. I retained a lawyer who is submitting all the paperwork for the legal name change.

Only different step I must do is post the legal name change in paper for 3 weeks. Then I submit the court letter and proof of me posting in paper to vital records and it gets changed...

Gender is tougher... The links to the template forms I researched earlier all lead to a dead end now.

Quote from: Chanteur on March 07, 2018, 11:12:09 PM

• When should I begin hair removal based on the above timeline?
• Is it best for laser hair removal or Electrolysis?

Like they say, the best time to plant a tree is 20 years ago; the second-best time is now.  Similarly, the best time to start hair removal is last year; the second-best time is now.

Both laser and electrolysis hurt.  They hurt more once you start on estrogen, so get as much done as you can before starting HRT. 

Once you start on E, your skin may become light-sensitive, a condition known as melasma, resulting in new freckles from exposure to sunlight or laser.  I started laser before E, but had one session after I started E.  I now have a large freckle on my cheek the shape and size of a laser probe.  >:(  No more laser for me.

Laser can do your entire face in 20 minutes, so it is fast, but it only works on dark hair/light skin.  It will quickly deal with dark hair, but it is not quite as permanent as electrolysis.  Some people get good permanent hair removal with laser, but you shouldn't count on it.  Because of the growth cycles of hair, you need several laser treatments, a month apart.

Electrolysis will only do about one square inch an hour, but will work on any hair.  I have been doing an hour a week for over a year.  I am hoping that I am close to halfway done, but I can't really tell.

Have absolutely no idea how to edit my first post. Would like to be able to edit it and update my timeline and/or questions vs having people scroll for updates.

But until I figure that out, I will just post updates here.

Updates will be in blue.

Quote from: Chanteur on March 07, 2018, 11:12:09 PM
Current Transition Progress:

• 1/2017: Accepted Transgender Status.
• 4/2017: Began counseling with LCSW who works with other Transgender patients.
• 4/2017: Came out to wife and kid as questioning.
• 5/2017: Diagnosed Bipolar I, ADHD, Gender Dysphoria in Adults.
• 5/2017: Came out to family (wife/kid) as transgender.
• 5/2017: Came out to rest of family.
• 6/2017: Began wearing female clothing.
• 6/2017: Began identifying as female full-time.
• 7/2017: Decided on female name (Ashley).
• 8/2017: Wife veto's "Ashley" name.
• 9/2017: Settled (and agreed on) "Sarah" name.
• 9/2017: Scheduled 1st Endocrine appointment.
• 10/2017: Agreement made with wife. We go to her Maiden name, and she picks my middle name "Elizabeth."
• 1/2018: Began referral process for treatment of Bipolar & ADHD.
• 1/2018: Cleared by ENT for vocal therapy.
• 2/2018: Began vocal therapy (So glad insurance covers this).
• 3/2018: Began legal name change process.
• 4/2018: 1st Endocrine Appointment.
• 5/2018: Began Estradiol & Spironolactone
• 5/2018: Began treatment for ADHD.
• 5/2018: Selected for ACLU TEAP-MS Community Empowerment Training
• 5/2018: Began Electrolysis & Laser hair removal

Current Weight Loss Progress:

• 7/2017: Began weight loss (Started @ 284lbs).
• 8/2017: Broke 275 lbs mark.
• 1/2018: Broke 250 lbs mark.
• 3/2018: Broke 245 lbs mark.
• 5/2018: Broke 235 lbs mark.

Tentative Treatment Timeline:

• 4/2018: Begin spironolactone.
• Spring/Summer 2018: Begin treatment for ADHD & Bipolar I.
• Summer 2018: Begin estrogen.
• May 2018: Legal Name/gender change.
• Fall 2018: Finish Vocal feminization therapy.
• Spring 2019: Undergo Vocal Feminization Surgery (if therapy fails to produce desired results).
• Spring 2020: Undergo SRS.
• Summer 2020: Undergo Breast augmentation (if needed).
• Fall 2020: Undergo Facial Feminization Surgery (if needed).

Tentative Weight Loss Goals:

• Summer 2018: Hit 230 lb mark.
• Winter 2018: Hit 200 lb mark.
• Summer 2019: Hit 175 lb mark.
• Winter 2019: Hit target weight (~150lbs).

Questions:

• When should I begin hair removal based on the above timeline?
• Is it best for laser hair removal or Electrolysis?
• How early should I begin looking for surgeons?
• How long are waiting lists for surgeons?
• How will spironolactone & estrogen impact my weight loss plan?
• Is there any weight guidelines/restrictions to begin HRT
• Is there any weight guidelines/restrictions for Surgical operations?
• Are there any questions I am forgetting to ask?
• Any recommended steps to be added above I may be forgetting?
• My lawyer is not versed enough to assist in changing Birth Certificate, any resources available (Live in Mississippi, BC is from Missouri).
  
  • ACLU TEAP-MS Gave me information needed for the Gender Marker change in Mississippi. Same process as Missouri (And same template forms).
• Any known providers in the following areas (Or anywhere between) capable of billing insurance for electrolysis and/or laser hair removal:
  
  • Memphis, TN
  • Birmingham, AL
  • Atlanta, GA
  • Jackson, MS

Insurance Notes:

• Insurance follows WPATH guidelines.
• As far as I can tell based upon my various calls to insurance, they cover anything I may need.
• Clumping surgeries into same year will save me a ton on deductible & coinsurance fees.
  
• Deductible and coinsurance subject to change year-year due to the ACA exchange plans.
  
  • Current Plan: ACA Silver Cost-sharing Exchange Plan
  • Current deductible: $200
  • Current out of pocket max: $600
  • Current coinsurance: 30%

Also, how do you guys get those signatures that show your time on HRT and other things? I did a quick search and couldnt figure it out, but didnt do an in-depth search yet.

Quote from: Chanteur on May 13, 2018, 11:56:03 PM
Have absolutely no idea how to edit my first post. Would like to be able to edit it and update my timeline and/or questions vs having people scroll for updates.

But until I figure that out, I will just post updates here.

Updates will be in blue.

Also, how do you guys get those signatures that show your time on HRT and other things? I did a quick search and couldnt figure it out, but didnt do an in-depth search yet.

Hi, I noticed a way that you may be able to save money when you have your surgeries; if you haven't considered it, you may be able to have your BA at the same time as either your SRS or FFS; and you wouldn't have to have general anesthesia 3 times so close together (some surgeons will do breast aug with just IV sedation though).

Quote from: Chanteur on March 07, 2018, 11:12:09 PM
Greetings,



Questions:

• When should I begin hair removal based on the above timeline?

    The sooner the better

• Is it best for laser hair removal or Electrolysis?

    I hear some folks do laser first then electro. If you're dark hair light skin. If not, laser is iffy

• How early should I begin looking for surgeons?

    Information and learning is always good, but prices will change the longer you wait.

• How long are waiting lists for surgeons?

   Depends on the surgeon obviously.. I think its like up to a year at least though?

• How will spironolactone & estrogen impact my weight loss plan?

   That's a great question, but its so individual it really varies. I know estrogen does sometimes make it harder to lose.

• Is there any weight guidelines/restrictions to begin HRT

   Not to start that I was aware of? Again could be wrong. There are concerns for high b/p and diabetes

• Is there any weight guidelines/restrictions for Surgical operations?

   Some surgeons definitely have a max bmi index, individual for each surgeon.

• Are there any questions I am forgetting to ask?

   Probably lol. I'm sure you'll come up with more :)

• Any recommended steps to be added above I may be forgetting?

   Voice work.. definitely start working on that. Therapy, surgery if that's an option.

• My lawyer is not versed enough to assist in changing Birth Certificate, any resources available (Live in Mississippi, BC is from Missouri).

   Now this I'm familiar with. My BC is in Missouri.  A court ordered mandate from the state I live in now (Tennessee) for Missouri to change the BC.  Considering Tennessee doesn't allow its own state to change the BC, it can still order other states to do so!! Amazingly hypocritical.  Then again MO I think you have to have surgery too to change it, because I had to leave them a surgery letter.  In retrospect I could've just argued the intersexed angle... live & learn.
[/list]

Because I'm .. really bad at doing all those quote / unquotes I just answered in your text block :) HOpe this helps.

Quote from: Doreen on May 14, 2018, 01:06:19 AM
Because I'm .. really bad at doing all those quote / unquotes I just answered in your text block :) HOpe this helps.

According to the ACLU TEAP-MS Team, "irreversible change to gender" works in both MO and MS. So my letter template I submitted to my Endo should work if she agrees to give me such a letter. There has been documentation from Missouri that people have gotten gender marker changed without surgery. And here in Mississippi they had 12 people last month use same letters to get their gender marker changed here.

So I *should* be all set on that as long as I get that letter. The ACLU did recommend that I get name & gender done at same time to lower the scrutiny on the gender part.

I will update at end of month. My court date is May 30th.

In my experience, HRT does not effect the ability to lose or gain weight at all. 

Weight loss and gain is dependent on metabolism and diet.  Diet it totally under your control.  HRT does not change metabolism in the short term.  In the long term, due to muscle mass reduction, your metabolism may get a little slower.  Since you are already losing muscle mass by losing weight you may not notice the difference. 

You can mitigate muscle loss by working out. 


Sent from my iPhone using Tapatalk

Still wish there was a way to update my first thread so I could have the current timeline as the 1st post... Does editing become available after a certain number of posts or something?

I will probably eventually move this to a separate blog to keep track of my changes. Or is there a more appropriate location on the forums for personal timelines and questions?

I hope to try and keep this updated once a month so others who might have questions can view the timeline to get an idea of how I am doing. However, everyone's timelines should be customized to their own need and should not go directly based off of mine, or anyone else's timelines. Just use this as a guide.

Changes are in blue.

Quote

Current Transition Progress: (As of 6/2018)

• 1/2017: Accepted Transgender Status.
• 4/2017: Began wearing female clothing.
• 4/2017: Began counseling with LCSW who works with other Transgender patients.
• 4/2017: Came out to wife and kid as questioning.
• 5/2017: Diagnosed Bipolar I, ADHD, Gender Dysphoria in Adults.
• 5/2017: Came out to family (wife/kid) as transgender.
• 5/2017: Came out to rest of family.
• 6/2017: Began identifying as female full-time.
• 7/2017: Decided on female name (Ashley).
• 8/2017: Wife veto's "Ashley" name.
• 9/2017: Settled (and agreed on) "Sarah" name.
• 9/2017: Scheduled 1st Endocrine appointment.
• 10/2017: Agreement made with wife. We go to her Maiden name, and she picks my middle name "Elizabeth."
• 1/2018: Began referral process for treatment of Bipolar & ADHD.
• 1/2018: Cleared by ENT for vocal therapy.
• 2/2018: Began vocal therapy (So glad insurance covers this).
• 3/2018: Began legal name change process.
• 4/2018: 1st Endocrine Appointment.
• 5/2018: Began Estradiol & Spironolactone.
• 5/2018: Began treatment for ADHD.
• 5/2018: Selected for ACLU TEAP-MS Community Empowerment Training. (Canceled)
• 5/2018: Began Electrolysis & Laser hair removal. (Ran out of money)
• 5/2018: Gender changed on Driver's License & Social Security.
• 5/2018: Name legally changed.

Hormone Replacement Therapy (Began: 5/2018)

• 2 weeks: Skin softer.
• 4 weeks: Occasional sensitivity in breasts (not much).
• 1 Month: Body fat percentage increased +1.3% (per scale).

Current Weight Loss Progress:

• 7/2017: Began weight loss (Started @ 284lbs).
• 8/2017: Broke 275 lbs mark.
• 1/2018: Broke 250 lbs mark.
• 3/2018: Broke 245 lbs mark.
• 5/2018: Broke 235 lbs mark.

Tentative Treatment Timeline:

• 4/2018: Begin spironolactone.
• Spring/Summer 2018: Begin treatment for ADHD & Bipolar I.
• Summer 2018: Begin estrogen.
• May 2018: Legal Name/gender change.
• Summer 2018: Begin hair removal.
• Summer 2018: Change gender on Passport.
• Summer 2018: Second endocrinologist appointment.
• Fall 2018: Finish Vocal feminization therapy.
• Fall 2018: Change gender on birth certificate.
• Spring 2019: Undergo Vocal Feminization Surgery (if therapy fails to produce desired results).
• Spring 2020: Undergo SRS.
• Summer 2020: Undergo Breast augmentation (if needed).
• Fall 2020: Undergo Facial Feminization Surgery (if needed).

Tentative Weight Loss Goals:

• Summer 2018: Hit 230 lb mark.
• Winter 2018: Hit 200 lb mark.
• Summer 2019: Hit 175 lb mark.
• Winter 2019: Hit target weight (~150lbs).

Questions:

• When should I begin hair removal based on the above timeline?
• Is it best for laser hair removal or Electrolysis?
• How early should I begin looking for surgeons?
• How long are waiting lists for surgeons?
• How will spironolactone & estrogen impact my weight loss plan?
• Is there any weight guidelines/restrictions to begin HRT?
• Is there any weight guidelines/restrictions for Surgical operations?
• Are there any questions I am forgetting to ask?
• Any recommended steps to be added above I may be forgetting?
• My lawyer is not versed enough to assist in changing Birth Certificate, any resources available (Live in Mississippi, BC is from Missouri).
  
  • ACLU TEAP-MS Gave me information needed for the Gender Marker change in Mississippi. Same process as Missouri (And same template forms).
• Any known providers in the following areas (Or anywhere between) capable of billing insurance for electrolysis and/or laser hair removal:
  
  • Memphis, TN
  • Birmingham, AL
  • Atlanta, GA
  • Jackson, MS

Insurance Notes:

• Insurance follows WPATH guidelines.
• As far as I can tell based upon my various calls to insurance, they cover anything I may need.
• Clumping surgeries into same year will save me a ton on deductible & coinsurance fees.
• Deductible and coinsurance subject to change year-year due to the ACA exchange plans.
• Current Plan: ACA Silver Cost-sharing Exchange Plan
• Current deductible: $200
• Current out of pocket max: $600
• Current coinsurance: 30%

Welcome to Susan's Place. Posts lock after 24 hours and can no longer be edited. The exception is staff member have the ability to edit any post at any time. It needs to work this way as we review post for violations of the TOS and if they were constantly changing, it would be nearly impossible to maintain the site.

As for signatures and other profile modification, you haven't reviewed the links that were given to you in the second post of this tread. Again, we watch for undesirable members such as trolls and spammers. After you have sufficient posts under your belt, your profile will unlock and you will be able to customize it. Your very near being able to customize your profile so I expect to see changes to it very shortly.

By the way, the most important question is when do you expect to go full time.

Quote from: Dena on June 02, 2018, 05:19:53 PM
Welcome to Susan's Place. Posts lock after 24 hours and can no longer be edited. The exception is staff member have the ability to edit any post at any time. It needs to work this way as we review post for violations of the TOS and if they were constantly changing, it would be nearly impossible to maintain the site.

As for signatures and other profile modification, you haven't reviewed the links that were given to you in the second post of this tread. Again, we watch for undesirable members such as trolls and spammers. After you have sufficient posts under your belt, your profile will unlock and you will be able to customize it. Your very near being able to customize your profile so I expect to see changes to it very shortly.

By the way, the most important question is when do you expect to go full time.

Understand. Just figured it be better to have the 1st post have the most accurate information. But I understand. Was more of a convenience thing.

And I have been using female pronouns, using my chosen (now legal Name), using female facilities, and identifying as a female for a year now. Which is why I put in my timeline that I started full time as identifying as female full time on 6/2017. As that is when I consider myself being full time.

Just this week my name was legally changed and I updated my gender with DMV & Social Security.

So I would assume then that I have been "full time" since May/June 2017, and doing "Real Life Experience" for about a week now. But that is something we have not actually defined with my therapist.

I do know a lot of clinicians use the legal name change as the start of "full time" and as such, it would be <1 week since that.

My therapist I see each week had a medical emergency and I have not seen him in a month now. I may have to change providers as the severity of his emergency may render him unable to continue his practice.

I couldn't legally change my documentation until I had surgery 2.5 years after I went "full time". Full time meaning I was living full time as a woman in name and appearance. I know standards vary but there are still some locations that restrict modifications to your birth certificate. After surgery, my surgical letter was sufficient to change everything but my birth certificate. I went about 35 years without updating that however we now have something called real ID and without an updated birth certificate, I risk not being able to get a drivers license or needing to revert to my old name. For once in my life I had both the time and the money to update my documentation so last year I finally updated my birth certificate.

Quote from: Dena on June 02, 2018, 06:34:21 PM
I couldn't legally change my documentation until I had surgery 2.5 years after I went "full time". Full time meaning I was living full time as a woman in name and appearance. I know standards vary but there are still some locations that restrict modifications to your birth certificate. After surgery, my surgical letter was sufficient to change everything but my birth certificate. I went about 35 years without updating that however we now have something called real ID and without an updated birth certificate, I risk not being able to get a drivers license or needing to revert to my old name. For once in my life I had both the time and the money to update my documentation so last year I finally updated my birth certificate.

I have not updated my Birth Certificate... Missouri requires surgical alterations for that. Oddly enough as does Mississippi where I currently live.

I got insanely lucky this week (made my whole month). Social Security & the DMV here in Mississippi both updated my gender without requiring any documentation from a medical provider. That is definitely outside of the norm for this area.

I did present my letter stating I am undergoing changes to the Social Security, but when the agent returned he said the directive for that location was just to change the gender upon request.

I asked him for a printout to take to the DMV since they would ask if I had went to Social Security first (in reference to the name change). On the print out it listed my new gender of Female.

I took that letter and my court order name change to the DMV, presented both of those to the agent and said I am here to change name & gender. She went to her supervisor, came back, made copies of the documents and then gave me a driver's license with the female marker. Though I am sure she was supposed to ask for birth certificate, who knows.

Either way, I basically got my Social Security & Driver's License changed with little to no documentation. Definitely not the norm here. But I also pass for female over 75% of the time. When I went to these locations I was coming straight from court and so I was wearing a nice red dress and had my full makeup on.

Just an update...

Had to put transition somewhat on hold while wife and myself work on a non-trans related marital crisis. Hopefully we can move forward, dont want to lose her. But her infidelities are really getting hard to cope with. Still going to continue hormones daily. But not focusing on transition entirely during this time. Will be working on weight loss and marital crisis mainly.

Updates are in blue.

2 months on HRT and I dont really see much of a difference just yet... Though I do look more feminine in my facebook photos, just cannot pinpoint what causing that. Might be a lighter glowing skin?

Current Transition Progress: (As of 6/29/2018)

• 1/2017: Accepted Transgender Status.
• 4/2017: Began wearing female clothing.
• 4/2017: Began counseling with LCSW who works with other Transgender patients.
• 4/2017: Came out to wife and kid as questioning.
• 5/2017: Diagnosed Bipolar I, ADHD, Gender Dysphoria in Adults.
• 5/2017: Came out to family (wife/kid) as transgender.
• 5/2017: Came out to rest of family.
• 6/2017: Began identifying as female full-time.
• 7/2017: Decided on female name (Ashley).
• 8/2017: Wife veto's "Ashley" name.
• 9/2017: Settled (and agreed on) "Sarah" name.
• 9/2017: Scheduled 1st Endocrine appointment.
• 10/2017: Agreement made with wife. We go to her Maiden name, and she picks my middle name "Elizabeth."
• 1/2018: Began referral process for treatment of Bipolar & ADHD.
• 1/2018: Cleared by ENT for vocal therapy.
• 2/2018: Began vocal therapy (So glad insurance covers this).
• 3/2018: Began legal name change process.
• 4/2018: 1st Endocrine Appointment.
• 4/2018: Began Estradiol
• 4/2018: Began Spironolactone
• 5/2018: Began treatment for ADHD.
• 5/2018: Bipolar I diagnosis ruled out.
• 5/2018: Diagnosed Bipolar II.
• 5/2018: Gender changed on Driver's License & Social Security.
• 5/2018: Name legally changed.
• 6/2018: Spironolactone dose doubled. .
• 6/2018: Began Lithium for Depression/Bipolar.

Hormone Replacement Therapy (Began: 4/2018)

• 2 weeks (4/2018): Skin softer.
• 4 weeks (5/2018): Occasional sensitivity in breasts (not much).
• 1 Month (5/2018): Body fat percentage increased +1.3% (per scale).
• 2 months (6/2018): Breasts beginning to be tender (rarely though).

Current Weight Loss Progress:

• 7/2017: Began weight loss (Started @ 284lbs).
  
• 8/2017: Broke 275 lbs mark.
• 1/2018: Broke 250 lbs mark.
• 3/2018: Broke 245 lbs mark.
• 5/2018: Broke 235 lbs mark.
• 6/2018: Broke 230 lbs mark.

Tentative Treatment Timeline:

• Summer 2018: Begin hair removal.
• Summer 2018: Change gender on Passport.
• Summer 2018: Second endocrinologist appointment.
• Summer 2018: Resolve marital crisis
• Fall 2018: Finish Vocal feminization therapy.
• Fall 2018: Change gender on birth certificate.
• Spring 2019: Undergo Vocal Feminization Surgery (if therapy fails to produce desired results).
• Spring 2020: Undergo SRS.
• Summer 2020: Undergo Breast augmentation (if needed).
• Fall 2020: Undergo Facial Feminization Surgery (if needed).

Tentative Weight Loss Goals:

• Summer 2018: Hit 230 lb mark.
• Winter 2018: Hit 200 lb mark.
• Summer 2019: Hit 175 lb mark.
• Winter 2019: Hit target weight (~150lbs).

Questions:

• How early should I begin looking for surgeons?
• How long are waiting lists for surgeons?
• Is there any weight guidelines/restrictions for Surgical operations?
• Are there any questions I am forgetting to ask?
• Any recommended steps to be added above I may be forgetting?
• Any known providers in the following areas (Or anywhere between) capable of billing insurance for electrolysis and/or laser hair removal:
  
  • Memphis, TN
  • Birmingham, AL
  • Atlanta, GA
  • Jackson, MS

[/list][/list][/list][/list][/list][/list]

Oh my goodness, I love your organization! I hope your martial crisis is resolved with a happy resolution

Sent from my SM-N950U using Tapatalk

Quote from: cluck1992 on June 30, 2018, 12:40:12 PM
Oh my goodness, I love your organization! I hope your martial crisis is resolved with a happy resolution

Sent from my SM-N950U using Tapatalk

Thanks. I am a bit OCD about organization... Though you wouldnt know that from my computer desk...

And I do believe the marriage issues will be resolved soon. She is her own critic and feels bad for what she did. We have made some plans going forward.

I see a LCSW twice a week. Once by myself, for transgender and marital stuff. And then with wife to work together.

Going to add my kid to his own sessions to get rid of some inappropriate behaviors before school starts back up. And to make sure he is ok with my transition. He is 9, almost 10 so figured he is now old enough to make some decisions on his own. Not going to stop my transition for my son. But hopefully seeing the counselor might help with anything he may have underlying. Doubt much issues with him and my transition. But I want to cover all my bases and make sure he is ok.

It really great to have such a detailed time line. But I do hope you realize that once you start nothing will follow the time line. There are so many variables. If the doctors follow WPath  there are specific guideline. Your body will react at its own pace typically ffs and augmentation is not addressed for three years after HRT.
Wait lists can fluctuate for procedures. Once you start living full time what will happen at work.
The list goes on and on. I'm not trying to be negative but please don't lock yourself in solid or you could be in for a big impact when things start happening differently. Eg weight and body mass can impact surgery choices as some require a certain body fat mass minimum. Your physiological report and diagnosis.
You have to leave time for discovery and coping and all the other great things that are coming, wait for the hot flashes. I stopped T blockers in 1996 due to not being able to handle them, now they are not an issue.
Please stay open and flexible to changes and best of luck moving forward

Indeed I am open to changes...

And with me starting hormones this year (End of April was the start of that), my endocrinologist said to wait 2-3 years before surgical alterations. 2020 would be the soonest on that timeline. But I don't think I will need much work, if any. I am already at a 40C breast size (Though I suspect my band has since dropped to 38 size from weight loss).

I do know I want to possibly get rid of a small ridge on top my nose, my double chin, and lower my hairline. But will see how the fat gets redistributed and the underlying bone structure. I have a BMI hovering between 34-35 so pretty overweight right now.

I don't think my cheeks will need any alterations. Growing up I needed glasses but never got them so I was squinting a lot and it built up muscle/fat in the cheeks. But will see how things go.

I put vocal surgery sooner on the list than the 2-3 year wait since estrogen will not effect voice.

As I mentioned earlier, the official start of my full time is open for debate. I began using my female name, presenting myself as female all the time and using female pronouns and facilities in May of last year.

However, WPATH mentions (I believe) that official name change is what a lot of clinicians use as the official start. Which would mean I have been full time for about a month now.

I kept the future plans labeled tentative as things will be added and removed, or moved up or back on the list as things change and as I get new information. But if there is anything I missed with anything, please let me know. I am open to ideas and suggestions. I do understand a lot of it will be based on my body reactions to the hormones.

Wife so far only objects to the actual Gender Surgery. That is still a long ways away so we will cross that bridge as things get closer. I suspect she is a closest asexual. But I am willing to compromise and not do that surgery, even though I want to. We shall see how things are in 2-3 years.

She also has an issue with society thinking she is a lesbian. Nothing unfortunately I can do to prevent her from being seen as such. Society has not separated gender identity and sexual orientation yet. But I believe this is more of an internal issue as everyone is overly critical of themselves.

It does feel that a lot of things right now is just in wait and see mode. Nothing major coming up I think this year, and probably not really much next year. Other than keeping up with hormones and letting them do their work.

I do know I need to practice and learn makeup skills. I am pretty good now with eyeshadow, but have not even touched mascara, eyeliner, eyebrows, eyelashes... And not confident in my contouring skills yet. I was going to go to the Sephora transgender class, but they swapped the dates around at last minute at our local store and I missed the class. But I do go often to my local JCPenny location and get quick tips and things every now and then.

Keep Up the positive outlook. My wife hates the lesbian factor that creeps in so when anyone asks she just says we are cousins and anyone that knows us knows better. Name change date and living FT are so close together it's not an issue. Surgery is a 4 years wait here after getting in for your two sign offs after getting your initial diagnosis and after finding an HRT doctor which can be a 30 month wait. Lots of wait time to get things figured out

My wife is 4ft 11in... so she small...

I keep getting called her mother. Just a few days ago, we were at bank applying for a loan and they called her my daughter. lol.

She is 1 year older than me. But I think that works for her, to some extent. Though she calls me her spouse, not wife. I present myself as her wife.

And name change for me was 1 month ago (May 30th, 2018). Yet when I identify as being full time was May/June 2017. So a difference of a year. However, with how long it takes with hormones, I really don't think it will matter which start date we use...

I probably could get my LCSW and my Psychiatrist to sign off on gender surgery now if I wanted to (and if I were to get the surgery done this year it would cost me $0 as I have hit my out of pocket max). Will surgeons take a letter from a LCSW or must it be from an MD? I intend to wait til the 2021 timeframe but knowing ahead is a good thing.

Besides, we have to give wife time to cope and decide if the GRS is a dealbreaker for her. Her concerns are more related to intimate activities (will leave it there to avoid getting into stuff not good for this forum section). But I do believe she is an asexual so I am trying to figure out exactly what it is about it. But I have told her I don't mind being non-op trans. But I do hope she comes around.

My wife was originally dead set against bottom surgery other than an orchi.
She now understands I have to go further but what further is is still an Unknow in my head.

Minor update.

Marriage issues are getting better. Hope to get back on track with transition. This lithium and spirolactolone combo is definitely drying my whole body out. I need to drink like 120 ounces of water to stay hydrated.

Speech has been finished as of next week. We would continue speech, but she doesn't want to push it with insurance. So glad it has covered things so far.

Fundamental frequency is at 270-ish with my top range just below 300.

Speech pathologist really likes the praat application but they use a different program. But given what we have seen with my practice and outputs of praat she likes it.

I took a photo of the book she uses for exercises and definitions.

Still need to work on my ease of onset and forward resonance. But I am able to pass 90% of the time now in phone. Believe my female name now is what made the key difference however.

Getting my "head voice" isn't hard. It's the ease of onset that's my biggest hurdle.

I am looking into praat scripts to give me more of a real-time analysis of my speech versus analyzing afterwards. But using the two books, and internet resources I can finish up the speech on my own easily enough.

I haven't posted na update in some time now. Have been busy with my marital issues... Still ongoing but somewhat getting to resolution.

Had a bump in the road as my LCSW I have been seeing was suddenly dropped from my insurance without notice. Have not found another one. However the recent release of the transgender southern guide shows there is one nearby (still a 45min drive though).

As always, new and updated information is in blue.

Quote from: Chanteur

Current Transition Progress: (As of 1/24/2019)

• 2017
  
  • 1/2017: Accepted Transgender Status.
  • 4/2017: Began wearing female clothing.
  • 4/2017: Began counseling with LCSW who works with other Transgender patients.
  • 4/2017: Came out to wife and kid as questioning.
  • 5/2017: Diagnosed Bipolar I, ADHD, Gender Dysphoria in Adults.
  • 5/2017: Came out to family (wife/kid) as transgender.
  • 5/2017: Came out to rest of family.
  • 6/2017: Began identifying as female full-time.
  • 7/2017: Decided on female name (Ashley).
  • 8/2017: Wife veto's "Ashley" name.
  • 9/2017: Settled (and agreed on) "Sarah" name.
  • 9/2017: Scheduled 1st Endocrine appointment.
  • 10/2017: Agreement made with wife. We go to her Maiden name, and she picks my middle name "Elizabeth."
• 2018
  
  • 1/2018: Began referral process for treatment of Bipolar & ADHD.
  • 1/2018: Cleared by ENT for vocal therapy.
  • 2/2018: Began vocal therapy (So glad insurance covers this).
  • 3/2018: Began legal name change process.
  • 4/2018: 1st Endocrine Appointment.
  • 4/2018: Began Estradiol
  • 4/2018: Began Spironolactone
  • 5/2018: Began treatment for ADHD.
  • 5/2018: Bipolar I diagnosis ruled out.
  • 5/2018: Diagnosed Bipolar II.
  • 5/2018: Name legally changed.
  • 6/2018: Spironolactone dose doubled. .
  • 6/2018: Began Lithium for Depression/Bipolar.
  • 6/2018: Driver's License gender updated. (Got lucky).
  • 6/2018: Social Security gender changed (Lucky again).
  • 7/2018: Received out of network exemption approval for endocrinologist
  • 7/2018: Second Endocrinologist visit.
  • 7/2018: Spironolactone dose increased
  • 7/2018: Estradiol dose increased
  • 8/2018: Lithium discontinued
  • 9/2018: LCSW Dropped from insurance network (no prior notice)
  • 9/2018: Prescribed Guanfacine for Bipolar II
  • 9/2018: Discontinued speech therapy
  • 10/2018: Third Endocrinologist appointment
  • 10/2018: Spironolactone dose increased
  • 10/2018: Received information on potential Gender Surgeon (in Birmingham)
  • 10/2018: Prescribed Unison for sleep issues.
  • 10/2018: Filled for disability due to Bipolar, Social Anxiety and other ailments
  • 10/2018: Septic Tank overflows
  • 11/2018: Wife totals primary vehicle (no *major* injuries)
  • 11/2018: Plumbing issues resolved ($2000 bill, ouchies)
  • 11/2018: Floor breaks (Hole in floor)
  • 11/2018: Retain lawyer over car accident
  • 11/2018: Received (and lost) letter from Endocrinologist supporting medical need for hair removal
  • 11/2018: Received letter from Psychiatrist supporting medical need for hair removal (didn't lose it)
  • 12/2018: Wife graduates collage
  • 12/2018: Floor fixed (Bartered for fix)
  • 12/2018: Sent inquiries to surgeon over GRS
  • 12/2018: Began laser hair removal (They were having a BOGO so got face & Brazilian for $1200)
  • 12/2018: Decided on surgeon for GRS (In Birmingham)
• 2019
  
  • 1/2019: Submitted name change paperwork to State for Birth Certificate update
  • 1/2019: Continuing laser hair removal. Noticeable results already after 2 visits
  • 1/2019: Prescribed Lamotrigine for Bipolar II

Hormone Replacement Therapy (Began: 4/2018)

• 2 Weeks (4/2018): Skin softer.
• 4 Weeks (5/2018): Occasional sensitivity in breasts (not much).
• 1 Month (5/2018): Body fat percentage increased +1.3% (per scale).
• 2 Months (6/2018): Breasts beginning to be tender (rarely though).
• 3 Months (7/2018): Breasts begin to show a bud forming (super small)
• 5 Months (9/2018): Skin incredibly soft. Thinned out and bruise easier
• 7 Months (11/2018): Breasts incredibly tender... Even sleeping causing pain sometimes
• 7 Months (11/2018): Cheeks much fuller in appearance
• 8 Months (12/2018): Lips appear much fuller/plump.
• 8 Months (12/2018): Breasts are now 38C (natural, down from 42D however due to weight loss)
• 9 Months (1/2019): Breasts more pointed shape
• 9 Months (1/2019): Can definitely tell fat redistributed to waist & hips
• 9 Months (1/2019): Breasts budding bigger, can be felt when touched.

Current Weight Loss Progress:

• 7/2017: Began weight loss (Started @ 284lbs).
• 8/2017: Broke 275lb mark.
• 1/2018: Broke 250lb mark.
• 3/2018: Broke 245lb mark.
• 5/2018: Broke 235lb mark.
• 6/2018: Broke 230lbs mark.
• 7/2018: Broke 225lb mark
• 9/2018: Broke 215lb mark
• 10/2018: Broke 210lb mark
• 1/2019: Broke 200lb mark (Hope it holds, just hit it)

Tentative Treatment Timeline:

• Summer 2018: Begin hair removal.
• Summer 2018: Second endocrinologist appointment.
• Fall 2018: Finish Vocal feminization therapy.
• Spring 2019: Undergo Vocal Feminization Surgery (Speech Therapy produced desired results).
• Spring 2019: Change gender on Passport.
• Spring 2019: Resolve marital crisis.
• Spring 2019: Establish new counselor.
• Summer 2019: Change gender on birth certificate.
• Summer 2019: Finish laser hair removal
• Summer 2019: Per surgeons discussions, begin process of GRS (getting paperwork and establishing myself a patient)
• Summer 2019: Submit to insurance for reimbursement for Laser Hair Removal
• Spring 2020: Surgically remove excess skin caused from weight loss
• Spring 2020: Undergo SRS.
• Summer 2020: Undergo Breast augmentation (if needed).
• Fall 2020: Undergo Facial Feminization Surgery (if needed).

Tentative Weight Loss Goals:

• Spring 2019: No longer be classified Obese (~195lbs)
• Summer 2019: Hit 175 lb mark.
• Winter 2019: Hit target weight (~150lbs).

Questions:

• How early should I begin looking for surgeons?
• How long are waiting lists for surgeons?
• Is there any weight guidelines/restrictions for Surgical operations?
• Are there any questions I am forgetting to ask?
• Any recommended steps to be added above I may be forgetting?
• Any idea on how to keep these estradiol patches on, I have tried waterproof bandages & tegaderm patches?
• Any known providers in the following areas (Or anywhere between) capable of billing insurance for electrolysis (To finish off when done with laser):
  
  • Birmingham, AL
  • Atlanta, GA
  • Jackson, MS

As you can see, lots of progress...

I have more definitive plans in the future as far as transition. I just hope to find another counselor asap.

Any advice would be greatly appreciated.[/list][/list][/list][/list][/list][/list][/list][/list]

Chanteur, I don't have any advice for you, but I did want to say that your progress is just awesome!  You have accomplished a tremendous amount in the past year.