Thanks. I'll down load that app, and get familiar with it

Today was a bad day. Depression really has a hold on my right now. That's all.

If your thoughts are bothering you change your thoughts. Think about something else. If you are struggling with that, change your activity. Do something else and focus on that and your thoughts will shift to what you are doing. You can also change your environment. Go for a walk. Watch a movie. Play a video game.

I usually go for a walk or talk to a neighbor. That gets me thinking about other things. Before long, I feel better. Sometimes you just need to give yourself a break.

Hang in there. This too shall pass.

Hugs!

@Lori Dee thank you. You always seem to know what to say.

Are we aloud to post what our prescriptions are and the doses that the doctors want us to take on here?

Granted I haven't started my prescriptions yet. But I feel they are very low for what I was prescribed, and I know the VA and most health care will take a very slow and gradual approach to hrt. But at what point should I be worried that they are just chasing blood work numbers and giving my the basic one size fits all program that they are required to?

When I asked about the dose they said with the help of an anti androgen the dose of estrogen should be enough for feminizing effects and they're only shooting for 100-200 for estrogen levels and that they're worried about over dosing.

And I again I know they have to start somewhere and establish a baseline to see how I react once I start. But I already get the feeling that this VA clinic is and will only be doing the bare minimum and not treat me as an individual. But I guess we will see as time goes on once I actually start (which I am hoping to do so here in the very near future)

Quote from: Robbyv213 on October 24, 2024, 08:56:34 AMAre we aloud to post what our prescriptions are and the doses that the doctors want us to take on here?

It is okay to post your lab results and what you are taking, but not the specific dose.

Yes, they will start you slowly because they have found that starting high can actually hurt development. So, there will be a slow increase over the first year.

Quote from: Robbyv213 on October 24, 2024, 08:56:34 AMthey're worried about over dosing.

You can not overdose on estrogen. Period.
Pregnant women have estradiol levels ten times their baseline levels. Some recorded over 1,000.
In my opinion, 100-200 is too low.

This is a long-standing argument I have had with my endocrinologists.
What they fail to realize is that we are trying to START PUBERTY regardless of our actual age.

Estrogen levels rise during puberty. The increase leads to secondary sex characteristics like breasts and changes in overall body composition (like curves)...

Too little estrogen can lead to a low sex drive. Too much of it can cause infertility and erectile dysfunction. Excessive estrogen can cause gynecomastia, or enlarged breasts...
https://my.clevelandclinic.org/health/body/22353-estrogen

The problem is that transgender medicine is new. All of the meds that are prescribed for us were designed for cis-women. As such, the cautions are to protect the uterus. When they were handing them out, I didn't get one. So I tell my doctors to stop worrying about anything below the waist. We are focused on BREAST DEVELOPMENT. And for that, we need estradiol levels over 200 and daily doses of progesterone. That is what causes breast development.

I argued with two endocrinologists, showed them the studies, and asked them where this danger was. Do pregnant women with extremely high levels of both estrogen and progesterone develop cancer, blood clots, and strokes? No, they do not. What happens to them (ignoring the uterus) during pregnancy? Their breasts enlarge and they gain weight in the butt and hips.

I finally got my Gynecologist to listen to me. I told her I was tired of baby-stepping my levels up to where they needed to be. Get my levels up over 200 - 300 and I will shut up. I am now on weekly injections and my levels come in right around 250. I am taking progesterone three times a day. Guess what happened? Breasts are growing! No cancer, no stroke, no blood clots. Biology 101.

That said, they are wise to start slow. They need to gauge how your body reacts to it. Slowly increasing over time is the right way to go. Yes, they will be chasing numbers, but your goal is 250 and not 100-200. For now, that is fine. Six months to a year from now, if all is going well, you will want to push those up to get puberty to kick in.

Don't get impatient, but don't wait four years to get it sorted either. When you hear people say breast development starts after six months of HRT. For some yes. For most, it is not the start of HRT. The changes start when you have a high enough level in your system so that things start happening. Maybe that is at 100 for you. For me, it is 250 and truly I would prefer to be closer to 400, but I can write my own prescriptions.    Why 400? Do an internet search for normal female estrogen levels and you will see that 350-400 is "normal". Pregnancy can push those numbers up to 20,000 but that is not common.

I hope this helps.

@Lori Dee thanks. I'll have to keep this in mind for later. Hopefully I can remember all this for when the time comes.

So they gave me Spironolactone which they want me to take daily, and estrogen valerate injections every other week. And from my research the dosages for each that they want me to take especially for the ev is pretty low given its half life, and then they gave me the we only shoot for 100-200 speech, which gave me the feeling that even though they were really nice and all that they don't know what they're doing. Lol

From my initial lab work my estrogen is at 54, normal range at its highest is 44 (for normal males). They are not yet comparing it to normal female ranges yet.

Baby steps. Remember that they are just testing your reactions to reduced testosterone and increased estrogen. Your mind and body need time to adjust. See what your labs say in 90 days.

For sure. I keep reminding my self that this initial part is going to be a slow onset, but I'm curious to see how they practice their medicine once I get past this initial starting point

Excited, I have my first laser hair removal appointment consultation tomorrow 11/2/24. I'm curious to see what all is discussed as to my options for treatment since the VA is paying for it. Lol. And it would be nice to shave this 3 day hair growth that they said I would need for them to accurately determine what is best for the type of hair I have in the areas they're approved to work on. Considering I shave my entire body twice a day, everything is annoyingly prickly right now. Lol

Let us know how it goes!

I contacted my local LGBTQ Care Coordinator and told her there is now ONE VA contractor doing electrolysis, and gave her the link you posted. I told her that since (according to her) there are none, and now I know there is ONE, she needs to submit a Travel Authorization for me to go to Phoenix to get my MEDICALLY NECESSARY treatment.

I won't hold my breath waiting for a response, but I fully intend to make them miserable until they get it done to shut me up. 

Will do, I'm here now waiting for my appointment. I will let you know how it goes. I am hopeful it will go smoothly. But realistically since it's throughout the VA, I expect it to be a hassle like everything else. Lol.

I'll be seen shortly. I'll get back on here after I'm done and give you my thoughts and how it went.

So as expected. It sounds like this contracted hair removal center is under the impression that it is face and Brazilian they had just received a few clients that also have chest and arms but they have not received anything of writing as to what all they can do other than the face and Brazilian unless you get something specifically from the VA on your referral for a specific area.

When I spoke with my endo she had said that anything that causes gender dysphoria should be covered but now it seems like I have to go back to the VA and have them specifically put down in writing what areas I'm authorized to receive.

And to cover me and the hair removal center they need something in writing for how they bill each treatment as well, and how many treatments are covered etc.

As for the actual treatments it does sound like they start with laser and then depending on how well that works then they move on to electrolysis, but it is covered both laser and electrolysis for the areas that they know they're allowed to do face and Brazilian.

So it does look like I will have to get in touch with the VA again to see exactly what they cover or tell them to put it in writing of everything that is covered in records and or the paperwork with the referral so that in the future they won't turn me down if I wanted to do something differently other than the face and Brazilian, and possibly chest and arms but the hair removal facility is double checking on that since not all of their VA patients have those areas in their referral.

Took my first dose of Spiro today. Per Endo I'm supposed to take half a pill twice a day for a week and then move up to a full pill twice day from there on out. I am not sure if I will also start estrogen this week or if I will just run Spiro for a few weeks to see how I tolerate it.

Endo said by no means do I have to start both at the same time, that I can start Spiro first and add in estrogen at a later date, but obviously to not wait too long before adding estrogen into the mix.

When I do start estrogen I'm supposed to take a dose of ev every other week, which I know is low, but I'm just starting and low and slow is the way they do it. If after 6 months I'm still on the same doses I'll be looking for a new endocrinologist lol

Received an update for laser hair removal therapy. The salon reached out to the VA and the VA told them that they are covered to do face arms chest and Brazilian anything else needs to be specifically written in the referral.

So I guess that's a start. When it's time for me to try and get my back, and legs done I guess I'll have to go back to mental health and get reevaluated so that they can  approve for laser removal on my back and legs.

I'm currently waiting for a response myself for my inquiry about laser hair removal and the current VA policy.

Quote from: Robbyv213 on November 05, 2024, 12:00:20 PMI'm currently waiting for a response myself for my inquiry about laser hair removal and the current VA policy.

Just FYI, the Directive states "permanent" and "non-permanent" hair removal. Permanent = electrolysis and non-permanent = laser.

Quote from: Robbyv213 on November 03, 2024, 01:24:12 PMTook my first dose of Spiro today...and add in estrogen at a later date, but obviously to not wait too long before adding estrogen into the mix.

Why, "...obviously to not wait too long before adding estrogen"?  Is there a medical reason?

Quote from: D'Amalie on November 06, 2024, 10:08:33 AMWhy, "...obviously to not wait too long before adding estrogen"?  Is there a medical reason?

For a few reasons. I want to see how I react once I get to the full rec dosage, and see how well or not so well I tolerate it at the full dose before adding another hormone in, I feel it will be a slow conversion by slowly lowering my t and then slowly introduce estrogen, and lastly I want to make sure I have a good warm and fuzzy. I feel like taking estrogen is the point of no return (even though anyone can stop their HRT at any time.) I just want to make sure I don't get or have anymore doubts caused by how I handle the Spiro.

I'm not sure if I will be one of those individuals who will still be able to perform or not while on HRT, I know that's one of my wife's big concerns, and since I have been on Spiro (only 4 days) I have had no erections what so ever (which means it's working yay!) and I haven't tried to see if I can still achieve one or not but at the same time I feel I have no interest in it either if that makes sense.

I'm not sure if estrogen will counter act the loss of a male libido and replace it with a female libido (of that's even a thing). I def don't want to be one of those individuals who are chemically castrated and have no desire for sex or have any kind of libido what so ever. Not sure if I am explaining what I'm thinking in a way that gets my point across.

So I guess I'm testing the waters so to speak by starting Spiro at half dose for a week and then moving to a full dose the second week to see how I tolerate it and how or how I react to it, and then the third (or maybe fourth week) add estrogen.

ED happens around the six-week mark. No more Morning Wood. But also difficulty getting it up when you want it to. Libido will drop, but if that's not a big deal for you, then not a problem. Semen output will diminish as well. For some it will diminish to a few drops, for some, it diminishes to zero.

These are things to consider because, although it might be what you want, she can get the impression that you no longer find her attractive. You can blame the meds rightly, but that can only support her argument that you should stop taking them. Just be ready for that discussion.

@Lori Dee don't I know it already lol. She has already asked if I still find her attractive. Our sex lice hasn't been the greatest for a long time due to many factors. But I did not know how much gender dysphoria can affect all aspects of one's life and relationships.