Hi,

I started gender therapy a month ago. I've had 3 sessions and I'm going for my 4th tomorrow. Everything is going quite well so far. I'm learning to face up to many things that I've pushed deep into a dark closet for 50 years.

I've only attended my sessions dressed as a male so far. Tomorrow, I plan on going dressed female except for no make-up and my natural hair, which is about 3" long. This will be a big step for me since I've been too scared to go out in public.

Anyway, my question is has anyone here been totally denied HRT for health reasons? The topic has not come up yet in my therapy, but I'm hoping it will soon. I'm in pretty good shape weight wise and generally speaking, but I do take medication for typical older people issues. Blood pressure, cholesterol, etc. I also have to watch my diet and exercise quite closely in order to keep my blood sugar normal.

I'm really down on myself for waiting this long to seek help and now I'm worried about running into a wall in regards to HRT. That would really make me sad.

Thanks for any help or comments.

Hi Raeanne,

I can totally understand your fear and questions... the first few times (ok, the first many times) I went out in public presenting female I was pretty sure every human on the planet was staring at me.  And then I realized most were just looking at their phone or didn't care.  After getting more used to that, my first time on a city bus seemed like starting over.  Feeling self-conscious makes it more difficult to blend in.  Just takes time - relax.  Remember your first day in school, your first time driving a car, your first date, first day at a new job, all the firsts - takes time and then becomes natural.

I think you're making exactly the right decision, going to your therapist as your true self tomorrow.  And don't beat yourself up if you don't have perfect self-confidence - over time you will fine-tune the details and things become second nature.

Makeup doesn't have to be a binary decision.  Some people who present male apply a light touch of foundation/concealer under the eyes.  I prefer black eyeliner, but brown isn't as noticeable on first glance.  Consider different lipsticks including one closer to your natural lip color - a slight visual boost for times you don't want the changes to be as obvious.

HRT requires tailoring to each individual's health history, medical test results and goals.  Being honest with your doctor helps them assemble the best solution, and I wouldn't lose sleep over this... there are workarounds to many things that were barriers in the past.  I bet you'll be fine.

Kendra

Thanks for the tips and comments Kendra. I'll definitely try some of them!

My doctor explained it this way: "The decision to start HRT is yours, my job is to find a safe way for you to do that." 

Hugs, Devlyn

Hi Raeanne,

It is scary going out in public the first few times.  Shoot, I still get nervous depending on the place or situation. 
Anyway, I started HRT 1 month ago this coming weekend.  I have a rare primary immune deficiency disease that I was born with and that was diagnosed at age 3.  I was very nervous that it would either completely disqualify me, or at the very least, impact any treatment that I could get approved for.  I tried to no end to research and see if I could find or connect with anyone else with XLA (or any type of rare PI for that matter) who was trans* and taking hormones.  I couldn't find anyone, and I couldn't find any studies or anything.  So, finally, I just started down the long path to a referral to endocrinology.  After finally getting an appointment, my endo assured me that there will be no issue, and it was such a relief.  I'm taking things super slow, because I am just like that, but yeah. 
Keep going and keep doing what you are doing.  Don't let that fear or hesitation get in your way (easier said than done, I know).  Best of luck and all the love.
-Rain

Good for you, deciding to go as yourself!  You may feel self-conscious at first, but that is how you build confidence.

The therapist should only turn you down for HRT if they believe that you have some underlying mental health problem that either masquerades as a desire to change sex or prevents you from making an informed judgement.  If you don't have any mental health issues, their job is to write a letter saying that you don't have any mental health issues.

You prescribing doctor will need to make pharmaceutical judgements based on your state of health and the other medications you are taking.  Spiro can interact with blood pressure medication, for example, but it itself is a blood pressure medication.  So, expect that some sort of accommodation will need to be made there.

The primary reason HRT might be denied for health reasons would be if you have a high risk of DVTs. There are a few on the site who are dealing with this issue. It's possible they might be placed on a low dose depending on there doctors opinion. Other than that, sometimes doctors are a bit conservative depending on your age. I am on half a dose because of my age. For complex reasons, I am still seeing development though it is at a slower rate so even a low dose is not a dead end.

Hi raeanne,

I'm Laurie, 64, mtf. I have all those issues you stated except I take insulin the long acting kind, and enzymes for digestion after having half my pancreas removes and a few other things due to cancer. I take both a beta blocker and an ace inhibitor for my heart and a statin for cholesterol. In spite of my health issues I had no problem getting HRT. I take various supplements for various problems and am now on an antidepressant. My GP is aware of everything I take and prescribes my hrt too.
  You probably won't be turned down for your health issues you have stated.

Hugs,
   Laurie

   I

Thanks everyone for your help! A lot of you have been through much more than I have and I really appreciate your advice. I'm sure this won't be the last time I need help!