I agree with everything every one has said. I was hesitant to even bring this topic up as it is a very taboo and tough topic especially with the most understanding people on the planet.

 I finally was able to get therapy set up for a six week back to back program through the VAs mental health specialist that also deals with the LGBTQ community and specifically trans individuals. So hopefully I will be able to sort through some of this.

I do know it is not completely unheard of trans women continuing to use t-gel to maintain function while being on HRT. And I do know that both women and men have both hormones in their bodies to be normal and healthy, it's just obviously the levels are in the correct balance and ratio.

But ultimately I feel my intentions to keep my function does not come from my own personal desires and more so continuing to please and meet the expectations of the people I love and care about, which again is just more denial and self destructive behavior.

My wife and I had talked last night, another conversation where I can see all this absolutely eating her up inside. And she is hoping I have an answer for her as to what direction I am wanting to go in, by the time these 6 sessions with the VA therapist has come to an end or if I get another round of sessions added to the schedule. But it felt like an ultimatum, I know that's not how she intended it to come off, and even she said that she realized that's how it was perceived but she also doesn't want to get dragged along either. And I don't want to drag her along or waste anyone's time as well.

It's just a short amount of time to try and unpack and sort through alot of things in order to come to a decision as to what direction I want to go in (in terms of commitment to transition or not or something in-between.)

And I know how dangerous playing with my hormones can be. As of right now I'm just trying to find out all that I can about it, before committing to doing anything especially without the supervision of a professional.

Unfortunately we also just signed or renewed our lease for the rental we have. So not sure how that will play out since we both are not financially able to live on our own after this past year with the house fire and other things completely clearing out both our savings accounts. So yeah. Life is about to get difficult to say the least.

Well because I reached out to my endocrinologist inquiring about remaining functional while wanting to pursue hrt to transition she cancel all my current prescriptions for hrt and told me to discontinue everything. All bc I ask a few questions and told her what I had experienced.

And then they wonder why people decide to go the diy route...

Just another reason why I'll never use the VA again.

What is wrong with asking questions?

If you feel that you were not treated fairly, please contact the Patient Advocate. Tell them what happened. They can find out what happened and get you back on track. I understand it feels like a breach of trust, but I urge you to do not DIY. You will do more harm to yourself than good and you are less likely to get the results you are shooting for.

If not the VA, then another doctor who can supervise and monitor your hormones. Don't risk your health.

I hope you can get your desired results. 

I too think all of your meds must be managed by your physicians.  Be safe. 

Endo's can be a pain. When I started HRT, I was afraid of the endo so I went to Plume an on line doctor and received my first prescription. When I went to the Endo a few months latter, I asked a lot of questions. Many about how long before I would have trouble passing as a man or how long would I be able to hide it. Her response was, I don't think you are serious and I would not give you a prescription but since you are already on it I have no choice. I felt like I had cheated but I was on my way. Fast forward, I have had my bottom surgery, a nose job, and living as a woman. She still sees me but is much nicer now and I remind her of that first secession.  I think many Endo's don't have a lot of experience with trans people and really have no clue.

Quote from: Gina P on January 25, 2025, 08:39:14 AMI think many Endo's don't have a lot of experience with trans people and really have no clue.

This is so true. Remember that we are less than 1% of the entire population, so many healthcare providers have never met one of us.

Endos primarily treat diseases like diabetes and thyroid issues. I see a gynecologist in the Women's Health Clinic and most of her patients are dealing with reproductive issues.

Many of the older women have issues with menopause symptoms and that is what HRT was designed for. So it makes sense that they would be the ones to monitor hormone levels and prescribe HRT as needed to achieve gender-specific serum levels per WPATH guidelines.

Quote from: Robbyv213 on January 23, 2025, 01:10:32 PMWell because I reached out to my endocrinologist inquiring about remaining functional while wanting to pursue hrt to transition

Hi Robin, check out this conversation, it contains a lot of useful information that could potentially help guide you toward achieving your desired results.

I hope this helps.

LINK: https://www.susans.org/index.php/topic,130268.0.html

Thank you everyone.

@Lori Dee how do I get my patient advocate involved? I feel I should have one present for my next Endo visit which is about a week from now.

I feel if my advocate is not there I won't be taken seriously.

Quote from: Robbyv213 on January 29, 2025, 07:51:43 AMThank you everyone.

@Lori Dee how do I get my patient advocate involved? I feel I should have one present for my next Endo visit which is about a week from now.

I feel if my advocate is not there I won't be taken seriously.

For Phoenix VA:
https://www.va.gov/phoenix-health-care/locations/phoenix-va-clinic/

The various clinics are on the left. Select the clinic you use. Scroll down and below the main information, like address and phone number, is a link "Get help from a patient advocate".

Scroll down to a list of PAs and their contact info.

Good luck!

Yes, good luck!  I hope it all works out.

Chrissy

Thank you

I was able to get a hold of my patient care advocate representative. And they pretty much said that I have to wait until after the appointment to see how it goes before they'll intervene or do anything.

They said that they can only accompany me to an appointment if it was at their main building where the patient advocates are housed.

So any other time I won't ever be able to have a patient advocate with me at any of my appointments if it's not at one or two specific facilities and because my endocrinologist is not at either of those facilities I don't get to have a patient advocate with me.

That being said they definitely can get involved after the appointment if I still feel that the outcome was negative or that I'm not receiving the best care from my endocrinologist.

Currently because there is an appointment next week they said that it looks like the endocrinologist is wanting to take a step back and reevaluate and come up with a new course of action at the next appointment, and then if not or if the appointment doesn't go well that's when I can get back in contact with the patient advocate team and they will investigate or do whatever it is that they do.

Have you tried to contact your LGBTQ Care Coordinator? Mine has offered to sit in on appointments with me if I felt I needed support. It doesn't hurt to ask.

It also doesn't hurt to have an ally right there at your side.

No, not yet. I'm not sure if we even have one still. I've tried contacting them for a long time and I have not heard anything back from them since Aug Sept time of 2024.

OK, that is understandable.

Just view the appointment as the Endo is reconsidering. Maybe this time they will listen more carefully. Be prepared to explain what you want and why. Maybe they will be more helpful this time.

Good luck.

Is it practical to simply go to a low cost community health care center for gender care, or is it not that simple if you have been using VA benefits?  That is, if the cost is really low, and you can afford it, is that a practical alternative to working through the VA for gender related care?

Quote from: ChrissyRyan on January 29, 2025, 08:08:42 PMIs it practical to simply go to a low cost community health care center for gender care, or it not that simple if you have been using VA benefits?  That is, if the cost is really low, and you can afford it, is that a practical alternative to working through the VA for gender related care?

It is certainly an option. But VA care is no charge for veterans and our co=pay for medicines is a fraction of what others pay at their local pharmacy.

But if things go sideways with Trump's EOs, then we all might be seeking care outside of the VA. The important thing is to get care established through the VA first. Then if necessary take those medical records to a private physician to show you have the diagnosis and a treatment protocol established. That makes it easier for a new doctor to know where to start, instead of starting from scratch.

I'm not looking forward to tomorrows appointment with my Endocrinologist... I just feel it's going to go badly. Especially now that Trump is in office.

Has anyone heard anything official about wether the v/a will continue to cover things like hormone replacement, or laser hair removal, vocal therapy, and prosthetics? I have another laser appointment coming up this weekend and I'd hate to be charged for it, since we know how quickly the VA is with getting notices of coverage sent out.

Quote from: Robbyv213 on February 04, 2025, 02:51:53 PMI'm not looking forward to tomorrows appointment with my Endocrinologist... I just feel it's going to go badly. Especially now that Trump is in office.

Has anyone heard anything official about wether the v/a will continue to cover things like hormone replacement, or laser hair removal, vocal therapy, and prosthetics? I have another laser appointment coming up this weekend and I'd hate to be charged for it, since we know how quickly the VA is with getting notices of coverage sent out.

Hey, Robby! I was just thinking about you today.

So far, no change at the VA.
I am carefully watching for any announcements in that area. Yes, the "We serve all who served" rainbow posters have vanished from the walls, but the website is still up with no changes to coverage.

Go to: https://www.patientcare.va.gov/lgbt/

When this page goes dark, I'll know it is starting to happen.

Hang tough. Remember that your Endo is reconsidering their earlier position. They really want to help you, they just don't understand. Help them understand so they can figure out how to help you. I think it will turn out better than you think.

Hugs!