I'm born a female and would like to remain outwardly female and only use dht cream and a clit pump to enlarge my clitoris and then someday have metiodplasty. In my area it's hard to have a therapist approve gender dysphoria. They call mine borderline personality disorder. I live in Virginia in the US. Could a doctor perscribe DHT cream without a note from a psychologist?

Theres a difference between being a female and being a feminine guy. If you are the former then I can see why they call yours borderline personality disorder. Bottom surgeons require you to be on T for a year or two, with two letters from psychs. The DHT cream would be pointless unless you are going on T because meta won't happen without the T. There should be therapists around you. I know there are some by D.C. There is always online therapists.

Hi MasterAlec, welcome to Susan's Place! Here is a list of therapists...

https://www.susans.org/links/Healthcare/Therapists_&_Counselors/

...and a welcome pamphlet to read.    See you around the site!

Hugs, Devlyn

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Saying one would "like to remain outwardly female", while asking for advice on how to obtain a medical procedure for trans men, is a red flag. Do you really mean you'd like to retain a female appearance, or do you think you have to do that for some reason? Are you under the impression that this route would be easier, safer, or more beneficial in some way? Or is it possible you're confusing "female appearance" with a male body that's not the conventional "ideal" (the unsustainably lean and hugely muscular he-man look)? There's cause to stop and think very carefully here.

You said it is difficult to get a psychologist in your area to "approve" gender dysphoria. Have you sought out someone who specializes in transsexuality? If there's any possibility of another condition being mistaken for gender dysphoria here, it is important that you speak with somebody who understands this condition extremely well. The thing about a misdiagnosis and subsequent treatment for non-present gender dysphoria, is that it will ultimately cause gender dysphoria. I am in no way trying to say that you have, or don't have, gender dysphoria. Just that it is imperative you speak with somebody who's qualified to help you make very sure of whether or not you have it. If you have gender dysphoria, then they'll be able to help you get the treatment you need for that. If you don't, they'll help you figure out what is going on and help you get the treatment you need for that.

Setting aside whether a doctor would prescribe it, DHT has effects other than what you're aiming for. I'm not sure it would do what you're thinking, used in the way that you're thinking of, either. I've never heard of someone using only DHT and pumping, no testosterone therapy, to achieve the kind of growth needed for metoidioplasty. When it is prescribed for trans men, that is after years of testosterone therapy and after the growth on T has seemingly "maxed out". It is prescribed on the chance that it may induce further growth and improve metoidioplasty outcome. There are potential side effects including hair loss (from the scalp), increased body hair, to increased risk of certain cancers.

I thought there was partial transition for agender/androgynous non binary people to? That's what I'm talking about. I don't want to grow a beard or have a male chest, I just want a hysterectomy and a penis.

I haven't heard of someone in the middle wanting a penis. The hysto you can get no problem depending on how the doctor is. Some don't like to do that procedure on younger people while others have no problem with it. You can always get a prosthetic penis. If the hysto isn't close in your future there are forms of birth control to stop the periods.

I have already had my tubes tied so I'm sterile. I heard the uterus is what needs to be removed to stop the periods. There should be more available for non binary people. I'm just now reading up on penis implants.

I think you should really talk to a GOOD gender therapist.

My understanding with both transmen and transwomen that it can be very difficult to be hormonally and surgically reassigned and still be on a middle ground.

I know transwomen who present as male, and I know transmen who present as female, but the effect of testosterone on a natal female body is in most cases is quite dramatic.

I refer to your other post of how natal females develop body building bodies and remain a feminine look. I think you will find they need to boost E while taking T and probably do it in cycles. They are playing a very dangerous game.

The potential of liver damage, sterility, and other side effects both physical and mental are enormous.

Phalloplasty for transmen is incredibly expensive and difficult surgery. Convincing a surgical team to take you on while presenting as female I suspect would be difficult.

I'm already sterile. So are you saying it would be healthier to make the full transition into male?

I'm not saying anything beyond talk to a therapist.

I live in VA and am basically done transitioning. It is not possible to get DHT cream in the United States. You can order it online from Cyprus, but there's a good chance it will be tossed in the garbage once it gets to customs. It is also very, very expensive for a very, very small tube.

It is not hard to get a diagnosis for gender dysphoria, it just depends if your mental health folks are knowledgeable about trans care. It does not sound like yours are, as BPD is very different. Depending on where in VA you are, I would recommend going to Whitman Walker Health in DC or the Fan Free Clinic in Richmond. Both would be able to get you started on testosterone with little/no mental health referrals. Neither would be able to get you on DHT, as it is not available here.

Per your question on metoidioplasty - you would need to talk to the surgeon that you want to perform this on you. The criteria from WPATH states that you need to have had a minimum of one year on testosterone unless you are otherwise unable or unwilling to do so. It is up to the surgeon's discretion whether or not they would be willing to work with you if you fall into the unable or unwilling category. Depending on your insurance as well, you may find it difficult or impossible to partially medical transition. My insurance allows the individual surgeon to explain the medical necessity of bottom surgery to them, and as long as the surgeon says it's necessary and I've met his internal criteria, insurance will pay the bill. But other plans would require you to start with mental health referrals, then T, then top surgery, then a hysto, then bottom surgery.

Quote from: blink on February 25, 2016, 10:14:09 PM
Saying one would "like to remain outwardly female", while asking for advice on how to obtain a medical procedure for trans men, is a red flag. Do you really mean you'd like to retain a female appearance, or do you think you have to do that for some reason? Are you under the impression that this route would be easier, safer, or more beneficial in some way? Or is it possible you're confusing "female appearance" with a male body that's not the conventional "ideal" (the unsustainably lean and hugely muscular he-man look)? There's cause to stop and think very carefully here.

You said it is difficult to get a psychologist in your area to "approve" gender dysphoria. Have you sought out someone who specializes in transsexuality? If there's any possibility of another condition being mistaken for gender dysphoria here, it is important that you speak with somebody who understands this condition extremely well. The thing about a misdiagnosis and subsequent treatment for non-present gender dysphoria, is that it will ultimately cause gender dysphoria. I am in no way trying to say that you have, or don't have, gender dysphoria. Just that it is imperative you speak with somebody who's qualified to help you make very sure of whether or not you have it. If you have gender dysphoria, then they'll be able to help you get the treatment you need for that. If you don't, they'll help you figure out what is going on and help you get the treatment you need for that.

Setting aside whether a doctor would prescribe it, DHT has effects other than what you're aiming for. I'm not sure it would do what you're thinking, used in the way that you're thinking of, either. I've never heard of someone using only DHT and pumping, no testosterone therapy, to achieve the kind of growth needed for metoidioplasty. When it is prescribed for trans men, that is after years of testosterone therapy and after the growth on T has seemingly "maxed out". It is prescribed on the chance that it may induce further growth and improve metoidioplasty outcome. There are potential side effects including hair loss (from the scalp), increased body hair, to increased risk of certain cancers.

I went to one therapist who said he specialized in gender dsyphoria, and I wanted to be a full male. He was hateful to me because when I was a teenager I was diagnosed with borderline personality disorder for trying to destroy my female organs. They saw that as self harm rather than gender dysphoria. Then he said they can't diagnose borderline personality disorder until you're 18, but he wanted me to go to groups for it instead. I left that counselor because he was so rude and unable to help me. I truly want the full transition, but I'm afraid of how it will affect my loved ones. I tried to live as a man for 6, months. Clothing, hairstyle and all, my family refused to call me by my male name and still treated me like a delicate female. Later in life I'm sure I'll try it again. In the meantime I know I'm really a man inside. I have a man in my live that loves me deeply as a woman and I'm hoping he'll be bisexual due to some of his other preferences that could point to that.

Quote from: FTMax on February 26, 2016, 12:43:25 PM
I live in VA and am basically done transitioning. It is not possible to get DHT cream in the United States. You can order it online from Cyprus, but there's a good chance it will be tossed in the garbage once it gets to customs. It is also very, very expensive for a very, very small tube.

It is not hard to get a diagnosis for gender dysphoria, it just depends if your mental health folks are knowledgeable about trans care. It does not sound like yours are, as BPD is very different. Depending on where in VA you are, I would recommend going to Whitman Walker Health in DC or the Fan Free Clinic in Richmond. Both would be able to get you started on testosterone with little/no mental health referrals. Neither would be able to get you on DHT, as it is not available here.

Per your question on metoidioplasty - you would need to talk to the surgeon that you want to perform this on you. The criteria from WPATH states that you need to have had a minimum of one year on testosterone unless you are otherwise unable or unwilling to do so. It is up to the surgeon's discretion whether or not they would be willing to work with you if you fall into the unable or unwilling category. Depending on your insurance as well, you may find it difficult or impossible to partially medical transition. My insurance allows the individual surgeon to explain the medical necessity of bottom surgery to them, and as long as the surgeon says it's necessary and I've met his internal criteria, insurance will pay the bill. But other plans would require you to start with mental health referrals, then T, then top surgery, then a hysto, then bottom surgery.

Thanks for the info. When I'm able to travel that far I will start the process. The main thing is if the man in my life won't leave me because of this.

Well that makes more sense then. If your family refuses to accept you and you need to live as a male then sometimes you have to cut them out of your life. It could be a hit or miss with your boyfriend. You have to decide if he or transition will make you happiest in the end. What if he leaves for some other reason in 20 years? Then where will you be and will you be as happy if you would have transitioned now and taken a chance that he would leave now. Based on trans people's experiences the dysphoria usually always wins and it makes it more difficult for everyone once kids are on the table. Especially to pay for transition or if divorce comes into the picture.

Quote from: Alexthecat on February 27, 2016, 12:45:12 AM
Well that makes more sense then. If your family refuses to accept you and you need to live as a male then sometimes you have to cut them out of your life. It could be a hit or miss with your boyfriend. You have to decide if he or transition will make you happiest in the end. What if he leaves for some other reason in 20 years? Then where will you be and will you be as happy if you would have transitioned now and taken a chance that he would leave now. Based on trans people's experiences the dysphoria usually always wins and it makes it more difficult for everyone once kids are on the table. Especially to pay for transition or if divorce comes into the picture.

There won't be any children and he's already a senior. So I was suspecting he had about 20 years left to live, and if he didn't approve I would wait until after he was dead to start. I would be in my 40s by then and I hear that a lot of these people have transitioned later in life.

Those relatives may not live another decade. They're very old and require help. They would love me anyway, but still not take it seriously. Right now I have to live in close quarters with them, but that will be temporary.

Getting here late, but yeah actually I think this would be possible, if you could manage to find a bottom surgeon who does surgeries for people who aren't transitioning. Unfortunately I don't know of any who don't require therapist letters or time on T, esp in the states.

Metoidioplasty is complicated in that you need to have a certain amount of growth in order to be eligible. DHT is actually what causes dick growth. A certain amount of the testosterone most guys take is naturally converted into DHT, and that results in penis growth. So theoretically, someone probably could just take DHT and experience growth. Whether it would be enough for meta or if it would cause other unwanted side effects is a question. This is all just theoretical of course, I've never heard of anyone who's done this.

I know for a fact it causes hair loss, which can sometimes be very serious. And that's only for the 3 month recommended time frame that guys on T take it for. You may need to take it longer than that, which could really do a number on your hair.

I think to be safe, you would also want to be in contact with a doctor for blood work, to make sure no bad side effects of the DHT are happening. I'm no doctor, so I really don't know what those could be, but I imagine too much build up of it in your system can't be good for you.

Pumping on the other hand, totally safe. Go for it. I've had success with pumping myself, but to be honest I doubt you would ever achieve enough size for meta with just pumping.

Phallo is a different story. You may want to consider that as well.

Unfortunately non binary transitions are sort of new territory in the medical world and the trans world. It's all pretty much up in the air, with very little support from medical professionals.

Your best bet though, is probably to check out one of those lgbt clinics in DC. You'll probably be able to find non-binary friendly doctors there who can help get you the information you need. And find a therapist that actually specializes in gender therapy. I found mine through psychologytoday.com if that helps.