Sometime soon I hope to be starting up with a new GP, and in due season will be talking to them about transition issues. Does anyone know of any good writing out there on the subject of immune-deficient trans people - easy modifications to standard regimens, helpful tests to do before prescribing much, anything like that? I figure there's likely to be something but haven't had much luck searching so far.

(I do find useful advice on the general topic of warning signs against hormone use based on family history and preexisting conditions, but not on, say, likely complications from lupus and ways of dealing with them.)

It's an interesting question. I don't beleive hormones will efect the immune system.

Normally they wouldn't, no. The problem is when the immune system goes berserk and reacts to parts of the body itself as intruders - auto-immune complications can make the immune system attack parts of the blood chemistry, or lymphatic fluid, or connective tissue, or whatever. This is a big part of what makes lupus, rheumatoid arthritis, and the like so nasty to deal with - the obvious, usually good, remedy of "so get away from the source of the trouble" doesn't work. At least not without a lot of astral projection.

Sorry, Ceri, I'm very weak on this subject.

Though you may want to see an endocrinologist instead of a GP.  Most GP's do not run into trans people in the normal course of events and may be hesitant to prescribe HRT in the first place, but if you have lupus, then they may be extremely resistant to anything which mucks about with your hormonal system.

An endo, especially one who has a history of working with trans people, may be more open to allowing HRT to proceed especially if there is closely monitored blood levels and, of course, a letter from a therapist that indicates that this is a medically necessary course of action.

-Sandy

Quote from: Sandy on May 10, 2009, 01:07:54 PMAn endo, especially one who has a history of working with trans people, may be more open to allowing HRT to proceed especially if there is closely monitored blood levels and, of course, a letter from a therapist that indicates that this is a medically necessary course of action.

Definitely. But then in my experience I need to have a good GP before I'm likely to get access to an endocrinologist. And having a GP on the patient's side just does a world of good all along the way.

Ceri, I read a remarkable article about the intereactions of Aids drugs with crossgender hormone therapy in an HIV advocacy magazine at my Doctor's office. I know it's not ~quite~ on topic but the references might steer you in the right direction. I'll try to swing by there tomorrow or at latest day after and jot down the name.

Quote from: Hannah on May 13, 2009, 08:26:46 PM
Ceri, I read a remarkable article about the intereactions of Aids drugs with crossgender hormone therapy in an HIV advocacy magazine at my Doctor's office. I know it's not ~quite~ on topic but the references might steer you in the right direction. I'll try to swing by there tomorrow or at latest day after and jot down the name.

Thank you, Hannah! That's the sort of "at least in the neighborhood" thing I'd love to know about, and likely a source of good leads.

Well I couldn't find the article, I thought it was in the hiv magazine (hivplus) but there was a long wait that day and apparently I read it in something else.

The basic message though was that the use of antiretrovirals create a need for a lot more estrogen to reach desired levels, and while looking for the information I in fact found the story of a tgirl who gave herself a stroke by quitting her antiretrovirals and not lowering her estrogen dose. The information is all over the different hiv magazines, and gets kind of complicated so I won't even try to sum it up.

I'm sorry, I tried to help  It's my experience that when it comes to treating us, most doctors are ill-informed at best, and that we have to learn what we want and what to ask them for...and kudos to you for trying to do so. I think a good resource would be a doctor with experience treating hiv, rather than just any old Gp, as they would likely be better versed in immune function and cause and effect relationships it has with other things.

Quote from: Hannah on May 16, 2009, 03:17:21 PMI'm sorry, I tried to help  It's my experience that when it comes to treating us, most doctors are ill-informed at best, and that we have to learn what we want and what to ask them for...and kudos to you for trying to do so. I think a good resource would be a doctor with experience treating hiv, rather than just any old Gp, as they would likely be better versed in immune function and cause and effect relationships it has with other things.

You DID help, a lot! That's enough info about the article for me to hit up references next time I'm at the downtown library, and that "experience with HIV" is a great suggestion that simply wouldn't have occurred to me.

*hug*

A winner is you!