Worried about switching physicians

[KaylaH]

Hello all, I am new here  I am a MTF transgender and am 45 years old.

 

I need some feedback back on switching physicians.  I have been seeing Dr. Powers for my HRT but the recent expiration of suspension of the telehealth law that prevents a patient from receiving care from a Dr. in another state who is not licensed in the state that the patient resides in has caused me to start seeing a local Dr.  For the most part the local Dr. is great and is flexible with my choices for what medication I want to take.  The only downfall is he tends to be conservative in the amount of Estradiol he will prescribe.  It is basically half of what Dr. Powers is willing to give.  My local Dr. uses WPATH as a guideline whereas Dr. Powers uses his own Powers method.

 

I am really concerned that I won't get the same results that Dr. Powers has a reputation of achieving.  There are a lot of transgendered people receiving care that get great results that haven't been under Dr. Powers care so I know that it is likely I will transition well but I can't help that part of me that is worried about it.

 

I know that we can’t disclose our prescription dosages but if it is allowed, I can say what my current levels are and ask if this is average for what most of you all get from your Dr’s.  I have been on hormones for 6 months, I take <anti-androgen> and Estradiol (oral & patch), my T is 21, E is 150 and Estrone is 1058.  I am one of those who convert Estradiol into Estrone at high levels.  What are your thoughts on this and my worries?  I really appreciate your feedback and it will help me relax as this has been bothering me a lot lately.

 

Thanks

Kayla

 

Edited August 13, 2021 by VickySGV
non standard drug name removed

[VickySGV]

Dr. Powers does not follow a tested set of procedures among a very large and world-wide group of other doctors, and dismisses the procedures which, while grantedly conservative keep us alive and progressing at a rate that will maximize our achievable transition goals.  Having a high amount of E in your blood, does not guarantee rapid and extraordinary development of the body characteristics you are looking for.  It is the amount of "E" that your body will put to work based on your own genetic make-up and family body characteristics.  Even there, genetics becomes highly individual in families.  Your Endo does not check to see if you have an effective level in your blood, they are monitoring to be sure you do not have a toxic level of one hormone and a dangerously low level of another.  Our experience here on these forums is that Power's "results" are exaggerated and not provable.  He has a charisma to be sure but with as many Trans women as I have met, they have found nothing as great as the hype.  If your new physician is "conservative" you will progress at a safe and supervised rate that will give you what your body can do.  I did remove the specific anti-androgen drug from your post since it is still not approved even as off-label as some others are for our transitioning purposes.  I am not implying you were in any danger, but since we are not licensed medical personnel we do have to be careful..

[Heather Shay]

I agree with Vicky. She is very knowledgeable. I've been on HRT for over a year and my NP monitors my blood every 3 months and adjusted dosages along the way by starting very conservative. Sounds like you feel good with you new doctor so trust the doctor to help you safely and your body will change as your body is supposed to based on your genetics and most importantly will change safely.

[KaylaH]

 

Thank you both for your input.  The transition process is more difficult then I thought, it is very helpful to aleviate some of the worry.  If they only had a pill to take away impatience  

[Ivy]

I'm not anything like knowledgeable on these things.   I just have my own experience to go by.

My endo started me on low (apparently) dose of E, and has been gradually increasing this over the last couple of years.  I am getting results.  Sure, I'd like them to be quicker, but I did expect this to be a process over time.

 

What Vicky has said is in line with what I have heard over the years.

 

I guess we just have to be patient, as hard as that is.  Cis girls don't "grow up" in a couple months either.

 

[BrandiBri]

I agree with what has already been said. I trust my doctor completely. She started me on a low dose on both spiro and estradial and has increased as needed I am now in the normal range for a female but it took me two years to drop below the normal range of testosterone for males. (cursed with high t). the best thing that you can and should is to trust that your endo is looking out for your safety.

[ValerieRun]

There are definitely 2 sides to Powers' approach. On one hand you will be getting as personalized treatment as possible since he looks and evaluates a lot more factors than any standard practice, on the other hand because of these new "guesses" you are a bit of test subject ?

There is nothing wrong with conservative practice that follows WPATH, unless you are not seeing/getting the results. Since there is so much variation in human physiology and genetics, conservative approach will be unable to suggest a change when you hit a proverbial wall in your medical transition timeline.

Your current numbers look perfectly fine for the safe ranges and you should just work on maintaining them and let the time do what it will.

 

Good luck.

[VickySGV]

 

2 hours ago, ValerieRun said:

conservative approach will be unable to suggest a change when you hit a proverbial wall in your medical transition timeline.

 

Not true --

 

The  WPATH Physicians, Behavioral Health Providers and Pharmacists, are publishing and sending new information to their members on a regular basis via journals which their members and members of related medical fields publish which is the pattern of actual Scientific development.  A new Standards Of Care (proposed Version  8  ) is in the final stages of compilation even now with a deadline in the near future.

 

We cannot pick and choose our development from a catalogue to know when we have "hit a wall" in what is happening to us. The time frames for the actions of hormones actually go back many thousands of years since they are basically the same time-frames as for developing pubescent humans in known history.  Normal male development is in ages 12 to 26,  and females take it from 10 to 26 based on my observation of two sisters, two daughters and a grand daughter who are in or have been in those years, not to mention actual professional course work. 

[KaylaH]

 

Dr. Powers definitely individualized his treatment and built a specific plan based on me.  It was honestly very nice working with him and I am sad to lose him.  I am not using an endo but a family physician who himself is part of the LGBT community.  He ventures a little out of WPATH for some things but when it comes to hormone intake, he is very safe.  Since he is the Dr and knows I do trust him I just am worried to stall or take a long time to have changes happen as I am not getting any younger and am just now starting to truly live my life (the first 44 years of my life I merely existed and lived in pain) and I want to live as my true self as long as possible before I am gone.  If a Dr. takes 1 to 2 years to figure out that the dose, I am getting wasn't right and I didn't get anywhere that would be devastating to me.

 

Also can soeone help me understand about posting, will everything I post be postpond and reviewed for approval before posting it?  Is there something I can do to be able to post right away?

 

Thanks

 

 

 

[MaryEllen]

Quote

 I just am worried to stall or take a long time to have changes happen as I am not getting any younger and am just now starting to truly live my life 

 

It takes a cis-girl from onset of puberty to full maturity 4-5-6 years. It will probably take you that amount of time to reach your full potential. (if you're looking for instant boobs, forget it. It's not going to happen) To try to hasten the procedure could be dangerous to you health. Listen to your doctor. He will know what your system can tolerate and will prescribe accordingly.

 

As for posting, once you have made 5 posts, your posts will no longer have to be pre-approved by a moderator.

 

MaryEllen

[KaylaH]

Thanks for the info

 

Boobs aren't my main objective but I do understand.  I guess I don't know how to express what I mean, thanks everyone for your feedback.

[April-Showers]

19 hours ago, KaylaH said:

Dr. Powers definitely individualized his treatment and built a specific plan based on me.  It was honestly very nice working with him and I am sad to lose him.

i don't know much about Dr. Powers but did some research on the web. i watched a long video of a conference he held 2 years ago and it was very enlightening. he seems to be a pioneer in many respects, but many health-related issues have always been often changed for the better by pioneers. i have no opinion on this other than you have made a good point that you knew he was helping you and was treating you as an individual and customizing your treatment. that is always good from any physician. my experience has been with a physician who was sort of learning as she went with me and my situation. and she has done a very 'customized job' with me and i'm very happy with her. there are some comments here that are very critical of Dr. Powers because he is drifting away from a certain 'norm' of treating transgenders. i say let a person choose the physician they feel comfortable with and who is giving them good results. let's not discourage or disparage physicians just because they may not fit a 'norm'. mine probably hasn't either. thank you.  

[Ivy]

My VA endo goes by "The Plan" for better or worse.   I sometimes wonder if this is the best, but I am grateful to at least have the HRT.

[KaylaH]

2 hours ago, April-Showers said:

i don't know much about Dr. Powers but did some research on the web. i watched a long video of a conference he held 2 years ago and it was very enlightening. he seems to be a pioneer in many respects, but many health-related issues have always been often changed for the better by pioneers. i have no opinion on this other than you have made a good point that you knew he was helping you and was treating you as an individual and customizing your treatment. that is always good from any physician. my experience has been with a physician who was sort of learning as she went with me and my situation. and she has done a very 'customized job' with me and i'm very happy with her. there are some comments here that are very critical of Dr. Powers because he is drifting away from a certain 'norm' of treating transgenders. i say let a person choose the physician they feel comfortable with and who is giving them good results. let's not discourage or disparage physicians just because they may not fit a 'norm'. mine probably hasn't either. thank you.  

 

 

I agree, without pioneers we wouldn't be where we are today.  Someone pioneered the HRT process in the beginning, now someone is finding a way to challenge it and see if it is the best way or can be improved upon.  This is vital for everything in life and is why we advance.  I would bet money that through Dr. Powers diligence and putting up with the hate there will be things proven from his work that become standard and even find its way in to WPATH, or heck it might replace WPATH.

 

The biggest argument against him is "Safe” we take risk everyday against our life and health whether it is driving a car, walking down stairs, the food we eat, the vaccines we take, anything that we try because we have blind faith in someone else saying it is safe are some examples.  I am a pilot and fly for fun, that in itself has far more risks that what I am doing with HRT.  I believe in destiny and I already have a death date, who knows when that is (hopefully a long time away) and I do the things in life that keep me healthy but still partake in things that are clearly dangerous over the long run.  It’s a calculated gamble we take and hopefully we come out on the winning side.

 

At this point I only have 2 choices, start seeing my local Dr and have faith that things will go well or spend the money on 2 plane tickets a year to fly to Michigan and see Dr. Powers (that’s the requirement for me to keep seeing him is he has to see me in person at least 2 times a year).

 

[Lexi C]

Hey Kayla.

The beauty of this site is all the different perspectives you get

Vicky knows her stuff, but a lot of ladies here are also super knowledgeable via experience like me.

So here's my 2 cents:

I am on Estradiol injection  **mg every three weeks. I ask my doc for more but he assure me that ** is most you should be getting (injection wise) in a month, anything else might be problematic and will really not garner great results

I don't know if his right or wrong but i been with him for 3yrs and his has never steer me wrong.

Good luck

be safe, Be Proud and KICK ASS  

Edited August 14, 2021 by MaryEllen
Hormone dosage removed per community rule #13

[April-Showers]

21 hours ago, Lexi C said:

The beauty of this site is all the different perspectives you get

i agree. there is really no such thing as 'normal' whether it's how physicians do their jobs or how people live their lives. we are all sort of 'abnormal' in that we are all different from each other. so don't ever let someone on here try to make you feel that your decisions, medically or otherwise, are wrong because something is 'not approved'. we are adults and make our own decisions. as you said....kick ass...and i'll add..'do your own thing if it works for you'. all ideas make this forum stronger. thank you. ?

[Lexi C]

I love your name April Showers sounds like 50's movie star...way cool

[April-Showers]

1 hour ago, Lexi C said:

I love your name April Showers sounds like 50's movie star...way coo

wow. thank you. my name really is April so maybe if i ever do become a movie star i should add the Showers. love it. btw...i love old movies. much better than most of the crap today. lol thanks so much!

[Lexi C]

lol yup nothing to watch anymore

[KaylaH]

Thanks everyone for contributing and your input helped me.  I will be good switching Dr's and have my appointment with him this coming Monday and will see if he changes anything.

 

Speaking of names you all did choose pretty names, thats one nice thing with transistionin is we get to chose the name that speaks to us.  I spent a couple days looking at hundreds of names and Kayla was always the one that spoke to me and I kept going back to.  How did you all come to your name?

[April-Showers]

1 hour ago, KaylaH said:

How did you all come to your name?

i was born in april and april is a very pretty time of year (just like me lol) so April blossomed! thank you.

[KaylaH]

1 hour ago, April-Showers said:

i was born in april and april is a very pretty time of year (just like me lol) so April blossomed! thank you.

Yes it is

[April-Showers]

1 hour ago, KaylaH said:

Kayla was always the one that spoke to me and I kept going back to.

i have a very good friend named Kayla and she volunteers a lot of her free time at our animal shelter.  

[KaylaH]

1 hour ago, April-Showers said:

i have a very good friend named Kayla and she volunteers a lot of her free time at our animal shelter.  

 

Thats cool, I love animals.  My fav is mini dachshunds and cant wait to get another.  The last 2 I had stayed with me ex when we seperated :(.

 

Your pic shows you with nice long hair, I can't wait to get that.  It such a pain growing it out and the awkward phase is long.  

[April-Showers]

1 hour ago, KaylaH said:

Your pic shows you with nice long hair

thx for your comment. those photos are actually from when i was 18 years old. i posted them because i was much cuter then. lol my hair is still fairly long but i mostly wear it in a ponytail. the kitties at the shelter love to play with it when it's down so i have to be careful. lol thank you.