Hello all,

First off, I apologize if this is in the wrong thread. First time poster.

Anyways, I find myself in need of some advice from those that know more than I do.

Here's my story.

I'm a 34 yr old genetic male but I've always felt a little bit more female than male. I've never gotten along well with other males and have gotten along much better with females. I've wrestled with GD off and on over the years to some degree or another. Not that I always knew what it was called at the time. My earliest GD memory is of around 7 and playing around with my mom's makeup and wearing nylons. (I was found and punished by my father with a very severe spanking)

About 5 months ago, I was diagnosed with Dysthymia which is a low level depression and anxiety. It was something I'd been dealing with for well over 12 years and I almost always had a constant tension headache. I was prescribed Escitalopram for it which did wonders for reducing the tension headache down to almost nothing. It also reduced my anxiety and depression quite a bit too. Not completely gone, but enough that I was able to socialize a bit better with others. Related to the Dysthymia, I have social anxiety as well.

Anyways, last week, I went on vacation where I could have some me time without distractions of work, social, etc. Basically while away I could self reflect and such. Thursday night, I was lounging in my hotel room. As I was coming out of the bathroom, I looked at myself in a full length mirror. Since I was away from home and such, I was wearing my cami and yoga leggings. As I looked in the mirror admiring how well it fit with my recent weight loss (Down to 160, lost 40 lbs over the last year), I was hit pretty hard with a sudden severe anxiety/depression attack. My tension headache came on massively enough I had to take a couple ibuprofen to bring it back down. The attack was the worst I've had in a very long time. But some good did come from it. I think I finally realized what the underlying cause of my Dysthymia was from. I believe it to be from gender dysphoria. It was like every little thing from over the years finally came together and gelled. When I realized that, I took to researching as much as I could about GD and found quite a few forum posts here that resonated strongly with my own situation and feelings.

I'm pretty sure the Escitalopram was only dealing with the symptoms and not the underlying cause.

So what I need help with is, I want to talk with my GP regarding this attack and gender dysphoria. She's been a good doctor and is pretty progressive from what I've witnessed. She prescribed me Escitalopram without needing to see a therapist, just had to fill out a depression survey. (Though I had seen one about 12 years previous for the same tension headache and was diagnosed then as well).

I do have an appointment scheduled for late June, but with this recent attack and realization, I wonder if I should see if I can move it up, or barring that, see if I can talk to her for 5 to 10 mins about this. I'm just not sure how to bring it up. Also, from my reading, I'm pretty certain I'd like to go on HRT Low Dose. I've read up on HRT quite a bit too and believe it will help me. I'm fine with the effects it would have on my body. And I don't have a SO so there's no concern there either. I just don't know how to bring up wanting to go on HRT with my GP either. I'd like to try it short term at least to see if it has any affect on my GD and Dysthymia. If it does, I'd talk with my GP about longer term options.

I guess I just need some advice on how to talk to my GP about my gender dysphoria and HRT. I'm confident it's related to my dysthymia and tension. Also if I should wait till my scheduled appt, or go in earlier. While driving home (7 hour drive), my mind definitely felt like it was in girl mode and I could feel less tension and a better sense of inner calm as I was analyzing my thoughts and research. Another reason I am looking at HRT.

Any help or advice is appreciated.

P.S. As a side note, I probably at this point do not want to go full transition. Thus why I was looking at HRT low dose. The feminizing effects of HRT I am fine with though. I'm already pretty feminine in frame even if a bit tall at 6'1". Nice hourglass frame, no adams apple showing (genetic, its there, just covered by a genetic quirk of muscle and fat), soft features, etc.

~Kamyu

Well i don't really have much to say on this one but for you to talk to your GP when you are comfortable to do so. Now when is something that you should prob think of. it just varies on how you are handling it all at the time if you can wait then go ahead. But when you do talk to him (up to you) you can either just slide it in or just come out with it. I wish you the best of luck and hope your GP can help.

Well I understand that all myself for the most part. I have always had great depression, and frequent headaches and uncommon migraines. I can't say the differences between a tension headache and a normal headache for sure... But from my slim knowledge, I've head some of those too. I've had fairly strong depression. I've never really had suicidal thoughts. The reason why is simple, but it might offense some. I guess I always thought that it was a bit cowardly, adn I didn't want to get to heaven and tell God: "Sorry, I quit" Again, no offense meant, that was how I felt and feel. I did have what's called 'Passive Suicidal Thoughts.' These type of thoughts are thoughts of death or "I wouldn't mind it if I died" or wishing to be dead but not ever wanting to do such a thing yourself. I'd find myself thinking "If we crashed and everyone got out fine but I died... That'd be fine by me." A couple years ago I went on an anti-depressant and mood stabilizers to help keep my depression down. It never worked. I might have felt a bit better in day to day, but it didn't even dent my bi (sometimes tri) weekly episode of depression where i'd be up half the night, not at all rare for my to cry during these. It wouldn't take much. My sister found some issue with me and told everyone else without ever asking me, and as a result everyone got to know about a simple misunderstanding and get mad. It was never about GD. Always unrelated topics. I didn't even know I could have had GD. I knew deep down there were some problems I had gender wise... But I forced desires to wear girls clothing, my girly feelings, etc. deep down and locked them in a small boc in the deep dark closest that was also locked. I pretended they didn't exist and only if something made me think did I think of them, before hastily locking it all back up before I could think for more than 10-30 minutes. I can see the GD now... But back then it was taking the shape of other issues.. The depression resumed the form of every other issue and thusly never got addressed. One article that reallyed helped I would link, but as I'm not sure on the linking rules...(Just go to google and type "That was dysphoria?" It should be the first or second entry, probably both.)

I have yet to figure out how to tell everyone including my endocrinologist. she's been giving me Testosterone to start puberty, so telling her I don't want male puberty might be hard. At any rate I wish you the best of luck. I know how it feels. And all I can say is to try and get over the awkwardness and say it. It's hard, but that's all i can really suggest. Sorry I can't be of much help. At least I can be a sympathetic listener.

Hi Kamyu, 

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Hey all,

Thank you for the wonderful responses.

I decided to check if I could move my appt up and surprisingly there was a cancellation so I can see my GP today in an hour or so. I'm nervous and I'm hoping they are as progressive as I think.

No clue what will come from it but I'm hoping for the best. If nothing else, I hope to feel better just talking to my GP about it.

~Kamyu

Hi Kamyu,

What you described is pretty much my experience as well, except I sucked it up until I was 43 and ended up having a major meltdown where I ended up hospitalized twice inside of 3 weeks after essentially trying to drink myself to death.  I didn't want to be trans, and I sure as hell didn't want to transition, as I tried to tell myself my entire life that I'd just end up being a big, hideous caricature of a woman. (I'm 6'2" and built for the NFL)

My personal meltdown came after going from 285 pounds to 195, and then putting on some significant muscle mass.   I believe your recent increase in dysphoria is due to the fact that body fat converts some of your testosterone into estrogen, wnich likely helped keep your dysphoria in check.  My therapist told me that her typical first time MTF client was 38-45 and had recently lost a significant amount of weight.

As soon as I got on a therapeutic dose of estrogen, my dysphoria went from a 10 down to a 2.   I had been prescribed escitalopram (among other things) prior to estrogen, all of which I no longer need nor take.  I was very hesitant to take the estrogen at first because I had no intention to transition due to fear of the unknown.  I even hoped on some level that it wouldn't work.   Fortunately, it worked so well for me that I went full time about 8 weeks later and committed myself to making it all permanent.  Turns out my fears were basically unfounded and, well, I just love being a girl.  It's so... me.  I didn't realize how much I actually hated being a fake guy until I saw it from the other side.  I also didn't end up nearly as ugly as I thought I would.  Actually, I cleaned up much better than expected and my outlook on life has since improved drastically.

I highly recommend trying the estrogen.  Worst case it doesn't do anything for you and you just stop taking it before the boob fairy arrives.

So, I saw my GP. In some ways it was good, others not. Sadly, she hasn't run into GD much. She did know of it and knew a FTM one downstate along with a local MTF doctor, but was good enough to admit she was not that knowledgeable. Very understanding though how difficult it can be to realize and talk about GD and complimented me on my coming in. Especially sooner rather than later. She is going to refer me to a Therapist and Endocrinologist in town that know more than she does. Not sure when those appts will be, but told probably within the next month. Was told the endo is pretty by the book so we'll see. I do know I want to try Low Dose HRT to see if it works for therapeutic reasons as mentioned. I'll withhold any further decisions till after.

~Kamyu