So, now that the NHS is definitely not going to be able t help me (I'm South African on a Working Holiday Visa, and the NHS has gotten back to me with a no...  ), I was wondering if anybody could suggest private treatment options.

Basically I need to get some bloodwork done to check how the anti-androgens I've been self-medicating with are affecting me. I'm starting to worry about bone-loss, but I don't want to just go off them and risk a testosterone spike. Besides that, a sympathetic therapist would be nice too, and if financially possible, perhaps taking things further.

Unfortunately I can't budget too much for this though, so Richard Curtis is probably not gonna be my first choice. I'm really hoping there are other options. My electrologist, for example, knows a nutritionist who can do most of the bloodwork I need fairly cheaply, except for testing hormone levels, but I'd like to get those done too.

Thanks All

Strange that you were self-medicating with anti-Androgens and not also using estrogen. That would certainly stop you bone loss worries.

The T test won't help in knowing if you have bone loss.
There's a specific test for that. But, if your young and
haven't doing anti-Androgen for more than 2 years, it would
be surprising that you would have noticeable loss.

For councilling there are two councillors at Dr Curtis's clinic that charge £50 a session (much cheaper than Curtis himself).  There's also Kenneth Demsky, don't know how much he charges but I've heard nothing but good things about him.  Looking at Demsky's website, he might be able to help you with getting the bloodtests you need.

Quote from: Keira on February 06, 2008, 06:43:07 AM

Strange that you were self-medicating with anti-Androgens and not also using estrogen... That would certainly stop you bone loss worries.

The T test won't help in knowing if you have bone loss.
There's a specific test for that. But, if your young and
haven't doing anti-Androgen for more than 2 years, it would
be surprising that you would have noticeable loss.

I was only on anti-androgens as a stop-gap while I tried to get the NHS to help me. The plan was always to go through "official channels", but because I'm pushing 30 and did not know if the NHS would work out, I decided to start taking AA's in the meantime. I've been self-medicating for about 9 months. Thanks for the info Keira.

Quote from: Andra on February 06, 2008, 06:58:28 AM
For councilling there are two councillors at Dr Curtis's clinic that charge £50 a session (much cheaper than Curtis himself).  There's also Kenneth Demsky, don't know how much he charges but I've heard nothing but good things about him.  Looking at Demsky's website, he might be able to help you with getting the bloodtests you need.

Very good to know. I'll have a look right away. Thanks Andra.

Quote from: Andra on February 06, 2008, 06:58:28 AM
For councilling there are two councillors at Dr Curtis's clinic that charge £50 a session (much cheaper than Curtis himself).  There's also Kenneth Demsky, don't know how much he charges but I've heard nothing but good things about him.  Looking at Demsky's website, he might be able to help you with getting the bloodtests you need.

Kenneth Demsky is a nice guy and will help you if he can. You can find him here: http://www.drkennethdemsky.co.uk/directions.htm

Apart from Demsky and Dr Curtis there arn't many others about in the U.K.  I'm in a similar position these days since I've been running my own ship. But I am still working on my PCT who are now trying to find me an alternative to Charing Cross GIC.

If you are worried about bone loss, the easiest short term way is to just take calcium + vitamin D.

After adding E mtf people seem to be quite safe from bone loss.

Quote
Ovid MEDLINE(R) Schlatterer K. Auer DP. Yassouridis A. von Werder K. Stalla GK. Transsexualism and osteoporosis. [Clinical Trial. Journal Article] Experimental & Clinical Endocrinology & Diabetes. 106(4):365-8, 1998.


The aim of this study was to investigate whether and to what extent
our regime of cross-gender hormone replacement therapy might influence
osteoporosis development in transsexual patients. We found that after
long-term therapy the bone densities of our cross-gender
hormone-treated transsexual groups (10 male-to-female and 10
female-to-male) did not show significant differences compared to those
of the corresponding biological sex. Moreover, the bone-density during
therapy pointed out very little variability and that independent of
the gender-alteration (transsexuality-direction) and the age of the
transsexuals. Our results indicate that for transsexual patients
treated with cross-gender hormone replacement therapy the risk of
developing osteoporosis is low.

Quote
Ovid MEDLINE(R) Sosa M. Jodar E. Arbelo E. Dominguez C. Saavedra P. Torres A. Salido E. de Tejada MJ. Hernandez D. Bone mass, bone turnover, vitamin D, and estrogen receptor gene polymorphisms in male to female transsexuals: effects of estrogenic treatment on bone metabolism of the male. [Journal Article. Research Support, Non-U.S. Gov't] Journal of Clinical Densitometry. 6(3):297-304, 2003.


The effect of chronic administration of estrogens on bone and mineral
metabolism in men is not known. We have studied the effect of chronic
administration of estrogens on bone mineral metabolism in a group of
transsexual (TS) Canarian men, who were taking estrogens for a minimum
of 3 years. This is a cross-sectional study of cases and controls and
we studied biochemical markers of bone remodeling, bone mineral
density (BMD), and selected biochemical and hormonal features. TS
subjects had shorter stature than controls, and after adjusting for
height and weight, we found that they had lower values for serum-free
testosterone and higher values for BMD, both in the lumbar spine and
in femoral neck. Biochemistry, bone remodeling markers, and
calcitropic hormone values were similar in both groups. Finally, the
distributions of vitamin D receptor (BsmI) and estrogen receptor
(ER-Pvu and ER-Xba) polymorphisms were also similar in both groups. We
conclude that the chronic administration of estrogens in men may
produce an increase in serum estradiol, a decrease in free
testosterone levels, and an increase in BMD-both in lumbar spine and
in femoral neck. We found no association between the transsexual
phenotype and the distribution of vitamin D receptor (BsmI) and
estrogen receptor (ER-Pvu and ER-Xba).

Quote
Biological Abstracts van Kesteren, Paul [Author]; Lips, Paul [Reprint author]; Gooren, Louis J. G. [Author]; Asscheman, Henk [Author]; Megens, Jos [Author]. Long-term follow-up of bone mineral density and bone metabolism in transsexuals treated with cross-sex hormones [Article] Clinical Endocrinology. 48(3). March, 1998. 347-354.


OBJECTIVE: It is unknown whether long term cross-sex hormone treatment
affects the human skeleton. We monitored bone mineral density and
biochemical markers of bone turnover for 28-63 months in 20
male-to-female transsexuals (M fwdarw F) treated with anti-androgens
and oestrogens, and 19 female-to-male transsexuals (F fwdarw M)
treated with androgens. They underwent gonadectomy 13-35 months after
the start of cross-sex hormone administration.

DESIGN: Bone mineral
density (BMD) and the markers of bone turnover osteocalcin, alkaline
phosphatase, fasting urinary calcium/creatinine and
hydroxyproline/creatinine, were measured at baseline, after 1 year and
after 28-63 months of cross-sex hormone administration.

RESULTS: In
oestrogen-treated M fwdarw F, variables of bone turnover decreased
significantly with consecutive measurements. BMD had increased
significantly after 1 year, but decreased again to baseline levels
after 28-63 months of cross-sex hormones. In F fwdarw M, alkaline
phosphatase levels increased during the first year. BMD did not change
during the first year but had decreased significantly after 28-63
months following ovariectomy. In both M fwdarw F and F fwdarw M, the
change of BMD correlated inversely with serum LH and FSH levels. Of
all biochemical variables LH levels appeared to be the best predictor
of loss of BMD; in the long-term LH levels were more elevated in
testosterone-treated F fwdarw M than in oestrogen-treated M fwdarw F
transsexuals.

CONCLUSION: In M fwdarw F, oestrogen treatment prevented
bone loss after testosterone deprivation. In F fwdarw M the
testosterone dosage used, associated with a decline in serum
oestradiol levels, was unable to maintain bone mass fully in all
subjects in the longer term. The inverse relationship between BMD and
serum LH levels suggests that the dose of hormone replacement has been
too low in subjects with a decline in their BMD. Its cause might be
underdosing or non-compliance in some patients. We propose that serum
LH levels may be used as a measure of the adequacy of replacement with
sex steroids.

Calcium levels alone is not enough unless E is also there.

E stops both loss even in males, part of T is aromatised to E in the bone and
it is that that stops bone loss.

So, its only indirectly in male that T stops bone loss by its conversion to E.

If T levels are too low, or T receptors are occcupied by anti-androgens, this
action is stopped and there can be bone loss.

In women, with E falling at menopause, the T that remains is to low to compensate
for this and they have bone low.

Just to update on this thread: I started full HRT about 7 weeks ago now, so the bone loss thingee shouldn't be a concern any longer.

~Simone.

Hey, I am currently getting treatment with Dr Curtis himself.. he is a good doctor and he is very sympthetic.. he treats MTF aswell. You might want to give him a call. He does cost a bit though but he is a good doctor.

Quote from: Jay on April 17, 2008, 03:36:49 AM
Hey, I am currently getting treatment with Dr Curtis himself.. he is a good doctor and he is very sympthetic.. he treats MTF aswell. You might want to give him a call. He does cost a bit though but he is a good doctor.

Dr Curtis is a FTM as well and as he has been through it has more insight into the whole transitional process..