When I first started Estrogen, I was given a very low dose.  This was done for the first month, then I was given an anti androgen on top of it and a slight increase in the estrogen which was still on the lower end.  It wasn't until I was 4 months in or so that I actually recieved a therapeutic dose.  I'm not a doctor, but it seems many are cautious and watch how you do slowly.  They also seem to look at whether you can progress with a smaller hrt dosage.  For me, I need a higher dose, but it took time.  To be honest, I've rarely seen someone start out on a high dose.  And I know people that start with an anti-androgen before being prescribed estradiol.  It's actually fairly common.  Believe me, I know you would like to go faster than this, but at the very least I can say it doesn't sound too out there considering what most of us put up with in the beginning.   

Princess Joules of YouTube fame started at a strong dose.

Look where she is now

Those Canadian endo's really let you jump into the deep end.

Quote from: Evelyn K on April 30, 2014, 11:05:39 PM
Princess Joules of YouTube fame started at a strong dose.

Look where she is now

Those Canadian endo's really let you jump into the deep end.

Oh I'm sure that happens, but it seems very rare in the states from most that I've interacted with.  Of course, this is only from my own limited experience.  How I wish I could have started on my current dose.  Things would be so much different now and the first few months wouldn't have been a waste. 

Starting HRT is something to get use to. I was started with a low dose Spiro, finasteride and a little lower dose of E than at present. The first 2 months were a real change. I am at a maximum dose of E now but I have had three blood panels and I did well on my original dose. I had to promise not to smoke or drink to get the higher dose. I am very satisfied knowing I have a doctor that after successful blood panels was willing to increase my dose.

I just want to chime in a little my my personal experience with Cyproterone. I take Cyproterone (even though it's not officially available in my country, long story...) once a day at the lowest dose you can take (without splitting pills). Two months after starting it, my testosterone levels were within the normal female range, and they have stayed there ever since. Cyproterone is one of those drugs that people can respond to very differently. For some you can get away with a low dose and have great results, but for others you may need a high dose (that comes with a serious risk of complications) to accomplish basically the same thing. I think your endocrinologist was right to start you with a low dose, because if it is effective then you should get great results without having to worry too much about things like liver damage. If your testosterone levels are still above the normal female range in two months, and your doctor refuses to increase the dose, then you might want to consider trying to find another doctor. But even then, keep in mind that Cyproterone is actually know to increase effectiveness over time (due to testicular atrophy), and the estrogen you take should also act as an anti-androgen. And taking a higher dose of Cyproterone may interfere with feminization since Cyproterone is a form of progesterone, a hormone that competes with estrogen.

One of the main reasons they don't want us talking dosages is because there isn't only one way to achieve the desired results.  And if this endo really does mainly MTF cases, then he definitely knows what he's doing.  He's treated a lot of different people, and tracked their results over time.  He may be more conservative than some, and he probably has some red tape and country-specific guidelines to deal with.  But it sounds like the combination of gatekeepers and legal issues means you've got to just stick it out.

I read recently that HRT is still working its magic 10 years down the road.  Most of us early in transition are looking to get quick results, but this is a marathon, not a sprint.  Give it a couple months and talk with him then.  If you're not seeing any results, then have a serious talk with him. 

Doctors like their patients to be well informed, but they also don't appreciate being questioned or challenged.  They all hate treating other doctors for this very reason.