The plung

[Guest Orva26]

Hello,

I haven't really been to active on here in a while. Been doing stuff that isn't online stuff.

It is exactly as the title says. Today I met an endocrinologist, I did not have a letter that was not the purpose of this visit. Its purpose was to be unclouded with anticipation. The purpose of this visit was to meet with a potential healthcare provider and assess if:

1) I like him (you can have the best Dr in the world but if your personalities don't mesh you're dead in the water)

2) I'd like him to be my healthcare provider

3) To ask about some allegations brought about by a few individuals in the local trans community.

4) Ask about practical insurance type stuff: I'm flying blind here this is not only the first time I'm looking for a Dr for cross hormone therapy but also the first time I'm looking for a Dr on my own PERIOD.

The end result, I forgot about four. But he did impress me, greatly. First off he is personal acquaintances with the endocrinologist who wrote the Endocrine Societies Guideline for Treatment of Transgendered Patients. He runs a website meant to educate healthcare givers on how to treat transgendered patients.

He talked of how he was willing to work with people on different time lines. People who want results in 6 months and people who for pragmatic reasons need to go slower. I think I may be a mixture of the two, I'd want to go slowly at first to see how my mind reacts to the mental changes induced by the drugs and then I'd probably pick things up. I even have an order for blood work.

When I got home I realized, everything I've done so far can be undone. But once I begin changing my body there will be a point at which it cannot be reversed. I also have to be ready for the point when I basically have to be out because it will be amazingly obvious based on my physicality what I am doing. I need to be ready for the point where some ask me if I'm trans when I'm presenting in "guy mode".

I don't know if there is any way to debate this, any more inner examination I can perform to clarify this. I don't know if there is any way I can sit back and think about this more. The only thing I could think to do is meet with the other health care provider in my area that administers cross gendered hormone therapy.

Practically I know the thing for me to do is plan for all of this. That is kind of scary in a way because everything I have done up until now can be cloaked. I'm going to have to talk to my therapist about this.

Thanks for reading

-Orva

[~Nova~]

Good luck in whatever you decide. I had an endo, she didn't spend five minutes with me, didn't care if I was there or not. Actually I got the impression she wished I wasn't there. Now I see an obgyn for my hormones. We talk about everything. She gives me a breast exam and then before I leave asks me if I wasbhappy with her care. She is genuinely concerned that I am happy.

Autumn

[Cyndee]

Good to see ya back here Orva.

Debate is healthy, it's your life, it's your body, it's your time, I wish you the best in your decision(s). Autumn is right finding that comfort level with your care provider makes all the difference. I go see my PCP on Wednesday, she is so nice, responds to my emails and questions, the whole staff there is great.

Cindy -

[Guest Lacey Lynne]

Orva:

Welcome aboard, honey!

Everything you say is true. My gender therapist started me out on low-dose estradiol only without an adrogen blockade for the reasons you describe ... as a cautionary measure and to gauge my reaction. I was on that regimen for 7 months. Only then did I go on full-dose HRT with a full-dose angrogen blockade. Given my age, the results are good ... better than I expected!

Insurance? The actual HRT is dirt-cheap, and from what I can gather, you're a professional making a nice income, so you can easily afford both the doctor's visit and the medicines even without insurance. Not to worry there.

Finally, your changes will not be THAT obvious, actually, for a very long time, most likely. My HRT doctor says that unless a T-girl starts HRT in her teens or twenties that achieving an A cup or a B cup is about all we can hope for. That seems to be true. There ARE exceptions, but they tend to be both rare and occurring in overweight people.

Anyway, take it at the pace YOU like. Try not to succumb to analysis paralysis and just flow into hormone replacement therapy. Tell you what though, girl. Once you start, a dollar to a doughnut (funny Southern saying for a bet) says that you'll never want to stop your hormone replacement therapy. THAT'S why they call it The Slippery Slope, The Tractor Beam, The Runaway Freight Train. In just shy of 2 weeks, I'm 1 year and 10 months on HRT.

Has that proven to be true?

YEP !!!

Peace Out, Babes!

Lacey

[Guest Orva26]

analysis paralysis

OMG! I think you just named a facet about me that has been something my therapist and I have been working on since day one.

My HRT doctor says that unless a T-girl starts HRT in her teens or twenties that achieving an A cup or a B cup is about all we can hope for.

Here's to hope!

I'm 24.

I wouldn't want breast that are too big though, heard too many friends complaining about their backs to want that.

I am digging the idea of starting out slow though, kind of a final litmus test.

Tomorrow I'll try to set aside time to email my therapist about the visit. I'm also going to have to find out about what insurance can cover, sure I can dice it without it but I am paying my premiums for a reason. This caregiver doesn't accept my insurance but I see no reason why my prescription plan would discriminate between in network and out of network providers. A script for estrodiol is a script for estrodiol regardless of who writes it. [Note: I could be completely wrong with this, I'm kinda new the 'adult' world.] I also know that there is a reimbursement program but I don't know exactly how it works.

I've also talked to my brother about this. He had some questions that I answered and also asked some that I didn't think about. He's also beginning to tell me things about himself that I didn't know before. I wouldn't feel right posting them as they are personal but I will say that I think my coming out to him might draw us closer.

Right now I should really get my butt in bed though.

Orva

[Guest Mia J]

Hi Orva,

It is a great idea to check out your provider. Too many people just take whoever they are referred to without really talking to them. I lucked out. My GP is a friend of the doctor who is doing my HRT and gave me a good report on her. On our first meeting I was in her clinic for close to two hours going over things and talking about the course of treatment. They did a lot of baseline tests including an EKG to monitor for changes.

You want the best possible person to take care of your needs.

Mia

[Guest Orva26]

!!!!Small update!!!!

So now I've met with both of the potential caregivers that could administer HrT for me.

She's an advanced practice nurse who used to be the person administering HrT for a well known endocrinologist, but he stopped practicing medicine due to personal/family trauma. She has sort of continued with the HrT which isn't too far-fetched considering her area of specialty has always been endocrinology. Her office is a bit further away than the endo I originally met up with, but unlike him she would accept my insurance. Sure I might only have to see my caregiver once every three months and I can afford the endo but heck, I am paying my insurance premiums for a reason! I might as well use my plan.

I didn't really have an appointment with her, rather she was at a support group I occasionally go to doing kind of a question and answer session. I asked her some of the same questions that I asked the endo so I could kinda directly compare their knowledge. The feeling I got between the two of them is that I should be in good hand regardless of whom I see. The APN caregiver also runs her clinic on an informed consent basis, so I wouldn't technically need a letter but I want one anyway. I kinda want to cross all my Ts so no-one can potentially point at me and ask why I didn't "follow the rules".

I'm meeting with my therapist tomorrow after work. I'm going to talk with her about this, I kinda know already where she sits but I gotta do what I gotta do.

-Orva

[MackenzieB]

Congrats! I see a Nurse Practitioner. He's one of the best care providers I've ever dealt with. He has no hesitation to send patients to somebody else if he's not absolutely sure of the best treatment or in diagnosing something. Plus he's in a LGBT clinic and sees a lot of Trans Patients. I wouldn't worry about her being a nurse vs a Doc if she has the experience.

[Paula ult]

Orva, nice to see you back, i am sure either choice for a doctor would be good, but having insurance pay for it is a plus, making a plan in my opinion is a good thing, in fact having several plans in case the first one falls apart is better, that is what i did, i think you will find that nobody will ask if you are trans while in guy mode, i never had anyone ask even when i was in the in between stages, if they do it is pretty rude.

Paula

[Guest Mia J]

Thanks for the update Orva. It seems you have really tried to cover the bases here which is good. Good for you on continuing to go for the letter. Nurse Practitioners can be great to work with.

Mia

[Guest Orva26]

Gonna keep on riding this update train!

Alright, I'm all set up to see this nurse practitioner on the 2nd of November.

Funny thing is I'm not counting down the days, nor am I looking to this as the "holy grail". I expected it to be more of a big deal rather than seeming just like another medical thing. To me and my therapist that reads as a good sign.

Right now I'm sitting here thinking, remembering that November of last year was the month I made a trek into the woods, scared that someone would hear me calling the first GT I tried to meet. This past summer stood in starch contrast to last year's when I lived in a depressing semi-isolation with hours and days spent in thought dissection wondering of hormones, guilt over the desire, and a state where I was pondering my very sanity. There are times when under a lot of stress that comes back but for the most part I live in a completely different state of mind then I had then. I guess when it comes down to it November 2nd WILL really be what the past year of my life was about.

I still have two things I need to do. The first is figure out what I am doing to preserve my genetic heritage. I'm looking into a place that does it by overnight mail which would be very convenient for me. The second is make sure I don't get sick 'cause that would screw up blood work.

That's all for now.