Hi everyone,

I am hoping to be getting my first prescription for T at my next appointment which is the end of next month, yay!!!! All being well I've heard you can get your shot there and then.

My query is I am currently on the pill (have been for nearly 25 years) and am wondering if this will affect whether I can get my T shot there and then or would be told to stop taking it for X amount of time and then come back.

Does anyone know if you can just have the shot and then not take it from then or is there a time you need to be off the pill first?

I don't really want to sound too eager or be pre-empting things to be calling the clinic to ask this so just wondering if any of you have this experience?

I could of course chance it and stop taking it at the end of this month's dose but I am on it because I can't emotionally cope with my periods so have been on it since puberty. To stop taking it scares the life out of me as it's all I've ever known ! :-/

Any thoughts, opinions or advice welcome. I'm not looking for medical answers of course just some thoughts.

Ta

Matt

Obviously talk to your doc, etc.

I stopped the pill about two months prior to T. Not because I had to, but because I wanted to make sure I could come up with some ways to handle my endometriosis pain without it. So I too was kind of terrified about stopping it.

I think it's kind of up to you (based off what my doc said), but obviously taking both the pill and T simultaneously is kind of pointless...

Quote from: ford on September 01, 2013, 07:37:32 PM
Obviously talk to your doc, etc.

I stopped the pill about two months prior to T. Not because I had to, but because I wanted to make sure I could come up with some ways to handle my endometriosis pain without it. So I too was kind of terrified about stopping it.

I think it's kind of up to you (based off what my doc said), but obviously taking both the pill and T simultaneously is kind of pointless...

Great thanks Ford. So there's no reason I could turn up while still taking it, have my T shot and then from that moment on just not take the pill.

Although I guess stopping the pill when I've been on it since puperty will be just another thing for my body to get used to. So maybe I should stop sooner so as not to do two stressful things to my body at the exact same time. Especially as if I get side effects we won't know if maybe it's from stopping the pill rather than the T.

I finish this months set this week, maybe I should make that my last.

Just I would hate to do that, turn up for my appointment all in hope of starting T and then find I couldn't for some reason. I guess it that was the case I could always go back on the pill.

Anyways, thanks for the advice

Quote from: ford on September 01, 2013, 07:37:32 PM
Obviously talk to your doc, etc.

Oh missed replyng to this bit, I won't see him again now until the appointment where I am hoping to start T. I really don't want to nag and sound like I'm completely desperate so would rather not call up to ask this. I've heard he's very reluctance to answer he question of 'will you prescribe T at the next visit' and is more of a wait and see. Although I know the reason my appointment is booked for then is because I'd have filled the criteria needed and that according to the typical schedule my next visit IS when it will be prescribed. Just I won't know results of my bloods until I go back and we discuss it in that appointment. You never know it might flag something up!!!

My doc took me off the pill a little over a month before I started T. He said it needs a few weeks to completely get out of your system before the T can be effective.

Quote from: Konnor on September 02, 2013, 08:54:25 AM
My doc took me off the pill a little over a month before I started T. He said it needs a few weeks to completely get out of your system before the T can be effective.

Ah that's great, thanks for the info Konnor.

I think I will stop it at the end of this month's pack which is in a few days time. Scary stuff for me though 

Others have answered the question about the Pill, so I thought I'd bring up your expectations of how quickly you can start T. I'm not sure whether the policy is different at your GIC and I hope you're right that you can get your shot there & then, but this isn't my experience.

The standard procedure at most English NHS GICs and private gender clinics is for the clinic to write to your GP to ask them to prescribe & monitor your T. That letter took a month to get from my GIC to my GP, and the prescription was written up within a week. I then had to take that prescription to a pharmacy, but T isn't generally kept in stock (in Boots, at any rate) so they had to order it in for next-day delivery.

Then I had to book an appointment with a Senior Nurse at my GP's practice to have it injected, because under NHS rules it has to be administered by a nurse. I had to take my T along with me for the appointment.

The timeline was about a month and a half from the doctor agreeing to prescribe T, to me getting the actual shot. There's also usually a barrage of blood tests that need to be done before your first shot; the GIC will write to your doctor requesting these tests, but you can pre-empt this if you speak to both the GIC and your GP, to get them done before your next appointment. (Luckily my Therapist mentioned these tests to me so I could get my GP to run them before I saw the GIC doc. If she hadn't, the GIC doc wouldn't have agreed to prescribe T until they were done to his satisfaction).

Oh, and in case you're curious... my first GIC appointment was in April this year; I started T in August and am getting Top Surgery in October. So the timelines depend very much on your individual circumstances and the clinic's policy.

Quote from: FTMDiaries on September 02, 2013, 10:00:49 AM
Others have answered the question about the Pill, so I thought I'd bring up your expectations of how quickly you can start T. I'm not sure whether the policy is different at your GIC and I hope you're right that you can get your shot there & then, but this isn't my experience.

The standard procedure at most English NHS GICs and private gender clinics is for the clinic to write to your GP to ask them to prescribe & monitor your T. That letter took a month to get from my GIC to my GP, and the prescription was written up within a week. I then had to take that prescription to a pharmacy, but T isn't generally kept in stock (in Boots, at any rate) so they had to order it in for next-day delivery.

Then I had to book an appointment with a Senior Nurse at my GP's practice to have it injected, because under NHS rules it has to be administered by a nurse. I had to take my T along with me for the appointment.

The timeline was about a month and a half from the doctor agreeing to prescribe T, to me getting the actual shot. There's also usually a barrage of blood tests that need to be done before your first shot; the GIC will write to your doctor requesting these tests, but you can pre-empt this if you speak to both the GIC and your GP, to get them done before your next appointment. (Luckily my Therapist mentioned these tests to me so I could get my GP to run them before I saw the GIC doc. If she hadn't, the GIC doc wouldn't have agreed to prescribe T until they were done to his satisfaction).

Oh, and in case you're curious... my first GIC appointment was in April this year; I started T in August and am getting Top Surgery in October. So the timelines depend very much on your individual circumstances and the clinic's policy.

Hey thanks FTMDiaries for the info, I appreciate that you're looking out for me so I am not disappointed.

I am going down the private route while waiting for things to come through on the NHS so they can then take over. I have spoken to my GP who has point blank refused to do any kind of shared care, so all my prescriptions will be paid for privately and the clinic has everything in stock. I've already had my bloods done, again privately, and should be hearing the results at the end of this week.

My next appointment has been booked with time allowing to get everything I need done (which is actually just more counselling and the time needed to mull over the informed consent forms to be prescribed hormones) and then they are in a position to prescribe. 

I've heard from others that when the GP isn't involved they will offer to do the shot there and then. Which I guess saves travel expenses and most patients won't be local so would be a pain to have to go back to just to get jab.

I know this might not be the case, but it's looking likely. I just don't want anything to get in the way......you know how impatient we can all be when we feel this close

Quote from: Mattfromengland on September 02, 2013, 10:31:02 AM
I have spoken to my GP who has point blank refused to do any kind of shared care

This might be because you're attending a private clinic. According to NHS protocols, both doctors (the GIC and your GP) share ethical and legal responsibility for the decision to prescribe hormone therapy. If your GP hasn't heard of the GIC doctor, it's understandable that they'd refuse to take joint responsibility with them. However, if your GP is refusing for personal reasons (such as religion or other personal beliefs) they would be acting unlawfully.

Quote from: Mattfromengland on September 02, 2013, 10:31:02 AM
so all my prescriptions will be paid for privately and the clinic has everything in stock. I've already had my bloods done, again privately, and should be hearing the results at the end of this week.

Nice! Hope it all goes well.

Quote from: FTMDiaries on September 02, 2013, 11:04:05 AM
This might be because you're attending a private clinic. According to NHS protocols, both doctors (the GIC and your GP) share ethical and legal responsibility for the decision to prescribe hormone therapy. If your GP hasn't heard of the GIC doctor, it's understandable that they'd refuse to take joint responsibility with them. However, if your GP is refusing for personal reasons (such as religion or other personal beliefs) they would be acting unlawfully.

Nice! Hope it all goes well.

Yes, it is simply because of the 'going private' thing. I have read the NHS guidelines for mixing private and NHS care and it actually says that if a private consultant recommends a prescription and that treatment is considered clinically necessary (which as you know we do have a legal right to be treated on the NHS) then the GP is obliged by NHS protocol to prescribe on the NHS (was worded differently I think, but that was the jist of it. However, it then goes on to say that if the drug is something not usually prescribed and the GP isn't happy taking responsibility then they can say no    

The reason I'm still pursuing the NHS route is basically because one that goes through my GP will HAVE to prescribe, and will have no choice.


Thanks for the good luck. It's exciting times. I've been keep expectations low and thinking, well it should all go through by the end of this year, but after seeing the Dr last week, it looks like it will be end of Oct. yay!!!!!!!

Quote from: androidnick on September 02, 2013, 11:09:02 AM
don't obsess like I did when I got my shot! lol it's not fun.

LOL - I call it 'T paranoia'. Five minutes after you get your shot, you start getting thoughts like this...
"I have a tiny itch on my chest - OMG I WONDER IF THAT IS MY BODY HAIR GROWING!!!!1!"
"I think my throat is a teensy bit sore today - HOLY COW I'M GONNA SOUND LIKE BARRY WHITE TOMORROW MORNING!!!"

It's only natural; many of us experience this. But in all seriousness, here's my favourite: "Why on Earth does my urine smell like I've eaten all the asparagus!!!"

Quote from: androidnick on September 02, 2013, 11:09:02 AM
CONGRATULATIONS MATT! This is awesome! It seems things are moving along pretty damn fast for you. Enjoy this happiness and excitement. And just remember, don't obsess like I did when I got my shot! lol it's not fun. The mirror is not your friend! And neither is your mind when it makes you see things! In all seriousness though. It is wonderful

Hey thanks Nick. Could possibly be not long behind you. I'm obsessing over it all anyway. Seriously can't get this stuff out of my mind and it's stopping me getting on with work stuff. I chatted with my counsellor about that and he just said yes it will be on your mind, he hasn't met anyone yet for whom it's not, and that it's all consuming 24/7, but that it won't always be like that. However the Doc last week, told me I need to calm down about that otherwise your head explodes (don't think he said exactly that, but that kind of thing!!! lol). He actually put in the report/diagnoses letter "I advised not to become to bound up in everything gender related". lol

So God knows how will be once on T - but I will defo try and take your advice Nick

Quote from: Mattfromengland on September 02, 2013, 11:13:36 AM
Yes, it is simply because of the 'going private' thing. I have read the NHS guidelines for mixing private and NHS care and it actually says that if a private consultant recommends a prescription and that treatment is considered clinically necessary (which as you know we do have a legal right to be treated on the NHS) then the GP is obliged by NHS protocol to prescribe on the NHS (was worded differently I think, but that was the jist of it. However, it then goes on to say that if the drug is something not usually prescribed and the GP isn't happy taking responsibility then they can say no    

That's the old guidelines. The protocols changed in August, and GPs can now prescribe HRT without you having completed an assessment at a GIC. So it is now routinely prescribable. Might be worth pointing out these new guidelines to your GP; they might not be aware of them: http://www.cliniq.org.uk/sitebuildercontent/sitebuilderfiles/nhsenglandinterimgenderprotocolcpag12072013.pdf

Quote from: FTMDiaries on September 02, 2013, 11:17:29 AM
LOL - I call it 'T paranoia'. Five minutes after you get your shot, you start getting thoughts like this...
"I have a tiny itch on my chest - OMG I WONDER IF THAT IS MY BODY HAIR GROWING!!!!1!"
"I think my throat is a teensy bit sore today - HOLY COW I'M GONNA SOUND LIKE BARRY WHITE TOMORROW MORNING!!!"

It's only natural; many of us experience this. But in all seriousness, here's my favourite: "Why on Earth does my urine smell like I've eaten all the asparagus!!!"

Lol.....I'm gonna be the worst at this.

Quote from: FTMDiaries on September 02, 2013, 11:20:47 AM
That's the old guidelines. The protocols changed in August, and GPs can now prescribe HRT without you having completed an assessment at a GIC. So it is now routinely prescribable. Might be worth pointing out these new guidelines to your GP; they might not be aware of them: http://www.cliniq.org.uk/sitebuildercontent/sitebuilderfiles/nhsenglandinterimgenderprotocolcpag12072013.pdf

Thanks for the link. I recently read through that doc (I think it's been posted somewhere else on this forum too) but I can't find anything in relation to private/NHS care being mixed. I personally think my GP, although supportive (after reading up on the subject and telling me to come back - my 1st visit left me quite distressed, I think she was shocked), is just too worried about the subject matter and so is making up excuses. She says she's spoken to the partners at the practice and they all agree (although I think it's come from her and they are simply backing her up) that 'if you go private, everything must be private'. I know that's not the case, I think she just isn't comfortable.

Quote from: androidnick on September 02, 2013, 11:34:54 AM
I think I have reached the point where I do look in the mirror daily but not obsessively. Just to see the little changes in hair growth.

Ha, ha understandable though!!!

I will certainly be following your progress seeing as I shouldn't be long behind you.

I have been told that things can be more problematic with settling down into a routine and side effects etc if you're older when you start and I'm 39. I'm just preying things go ok. I'm not worried about some side effects as they will be well worth it, but am worried in case of more serious things and possibly not being able to take T.

I soooooo want to legally change my name, but am holding off as apart from the fact I'n actually not yet out to many people (planning to do that with family/friends before starting T), but most importantly am worried in case my bloods come back saying I'm dying (yes I'm exaggerating) or something and can't take T.

Quote from: androidnick on September 02, 2013, 11:54:10 AM
I struggled a lot with transitioning because I was scared of the "scary" side-effects that T could have. I've read a lot of things like increased chance of cancer, liver damage, etc. But life is too short. I am hoping that I will never have to encounter any of these things.

For me, the BIGGEST and absolutely most obvious change has been my mentality. I just stopped caring what people think. I feel like it is what it is. If people don't want to be accepting, then that's on them. And it has nothing to do with me. So basically, what I did on Facebook was change my name to Nicholas. I also posted something along the lines of this is who I am. I am not a lesbian. I am trans. Blah blah blah. I don't tell anyone how to live their life and I expect the same for me.
If at this point, anyone wanted to unfriend me it was up to them. It doesn't hurt me. I did this before starting T just because I was sick and tired. But also it was good because if someone had been an idiot. It wouldn't have been while I was just starting T and ruining what would have been an otherwise awesome and perfect moment.

I recognize since you are older it must be harder. You have solid relationship and whatnot. But the biggest thing we all have to recognize is that after coming out, it's like what was the big deal. The best part I guarantee you is seeing how accepting people can be. Even when you didn't expect it from them.

Hey Nick, what a great post, with lots of great advice and insight!!!!!  Thank you!!!!

I have hidden from this for nearly 40 years, and just put a huge barrier up saying I would NEVER tell anyone or act upon my feelings. My BF, who's been the only person until recently to know, has known for 9 years and has always said to me 'no one will care'. It's taken me 9 years along with hearing a lot of people on youtube saying how surprised they were at the support they've had, to actually start believing him.

At this point, still too scared to even go to my GP as that's someone I know and will have to look in the eye again, I went to see a counsellor privately. He managed to knock down 90% of my barriers in one session. I've seen so called professionals in the past (went to a GIC at 15 due to distress going through puberty, and also had a hearing therapist for tinnitus, but they either did no good whatsoever or actually did more harm than good, literally. I had emotional problems due to the GIC 10 years later when starting out a new business). So anyway, what a relief to finally realise I can do this.

Being older means there's more people in my past that at some point I may come across, I don't suppose everything will be easy, and I am also self employed and work with children so was sooooo worried that would be no, no for transition. However I've been reassured  by both the professionals I've seen that most people don't have an issue. Yes I may lose some business and should plan for this, but long term, new people coming in won't know and even if they mix with the old people who do know, that eventually given time people kind of forget, so the gossip, or chinese whispers will die down. So long term my business, while having a bumpy patch should be fine. I've also been told it could actually go from strength to strength as I will be 'ME' and will be more driven, more confident etc, and will do more with the business to make it more successful.

So right now I'm scared of the initial reactions, but I'm sure I'll be surprised by how supportive some are (I have a good relationship with my clients, so hoping that will help) and in the long term things will be good.

Feeling more and more confident as time goes on!!!!!!

Quote from: androidnick on September 02, 2013, 12:14:14 PM
Ha believe it or not we can relate even more now. I am in my final two semesters of university. When I am done, I will go into teaching. This has ALWAYS worried me. Because I will be working with children. I was so scared that I would be passed up on opportunities because people would see me as this distraction for students. That was why I was in this sort of frenzy to start T because I knew that my time frame between finishing school and starting my teaching career was so minimal. I am hoping that now since I have started T, by next year I will be fine. I am also hoping to do the name change documentation before this Christmas ends that way I can start my new semester as Nicholas. That and I also want to be able to apply to jobs as Nicholas.

Regardless, I am very happy for you. You seem to have a wonderful boyfriend. And at the end of the day as long as you have that kind of support at home. Everything that happens outside, well it's just insignificant.

Hey I'm sure you'll be fine Nick. Don't forget we also have the gender recognition act, so you should be able to find work and be stealth. If that's what you want of course. I also think a lot of how people react is down to the individual. If you are confident, they will go with you. So if you are 'out', but have the right frame of mind things will still work out just fine.

Also if you are employed, you are covered by the laws so have rights. I am self employed so if the parents 'freak out' and pull their kids out there's nothing to stop them. I'm confident things will be fine though, even if a little bumpy.

What part of the UK are you from? I'm south east.

Do you have a counsellor? If you have a good one it can really help to talk through these things. If they are experienced in the subject they will have seen hundreds of trans people and so will be able to draw upon how others coped to let you know what to expect and how to go about things. That really helps!!!!!

P.S. Note my alteration above!!!!!! About being 'out'

Quote from: androidnick on September 02, 2013, 04:06:14 PM
Lol I'm in the U.S. so not a whole lot of protection in my state unfortunately!

Oooer, for some reason I thought you were in the UK, same as me.

Either way, I'm sure you'll work something out, even if it makes life a little harder. It will be worth it in the end

The best time to stop IMO is ASAP. At the moment you're pumping up your female hormone levels. When you stop, yes your period will likely return but you'll have to stop on T anyway and T will work much better starting out without an over abundance of female hormones in one's system. Most T doses start low so if you have too much female hormones in your system you could experience far slower results, including cessation of menses! There's going to be so many changes in your future. Being on the pill and having this fear of periods could even be something that stops the doctor giving you T that day. With everything you'll be dealing with with regards to T and transition you need to be in a good place mentally because it's a trying time. If you can't handle periods before you start T, that's going to be a little concerning to a doc. If you can't handle them without other major changes happening in your life, they might wonder how on earth will you handle it combined with major changes. Might be better to get ahead of this potential situation and find a way to cope before you start T. That would put you in a far stronger position for getting the shot. And even if it doesn't make a difference to the doctor, it would do you good to find coping mechanisms for it before things get started because trust me, once you start, it's just a rollercoaster and everything seems to step into top gear and move so fast! Being in a good place before I started was something I found prudent to hanging on for the ride.