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Guest AllisonD

Warning About Record Keeping

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Guest AllisonD

I almost ran foul of the SOC the other day and I think there may be a noteworthy lesson in my experience. It has to do with record keeping. Last week I visited an MTF HRT endocrinologist specialist for the first time ever. This might be significant because I have been on Premarin for 35 years, and have never been seen before by an endo with MTF HRT expertise. In fact, I haven't been to an endo at all for almost 2 decades. Some recent education led me to believe I should see one so I sought one out and found one claiming 30 years experience (Stuart Chipkin, Amherst MA).

The scheduled 40 minute interview/exam/analysis/whatever lasted 2 hours. He was fascinated by my story, particularly that shrinks prescribed for me during my early years and a steady stream of ever-changing GPs kept me in Premarin for the last couple of decades post SRS. In the early days the shrinks and I experimented, having little guidelines to follow. We did what made sense to both of us, together. It worked OK, but I wouldn't recommend that now that more is known.

At the end of the interview, and exam of Stanley Biber's work, he asked me to prove I had been on hormones so long. How does one prove such a thing? Who would keep copies of old prescriptions? This was clearly a real issue for him and appeared to threaten his willingness to treat me. At the time, I was stunned. No one would ask me to prove how long I was on Metformin (controls blood sugar for diabetics). Why the trouble over something as stupid as this? Wasn't like I needed him, my current cardiologist has been prescribing Premarin for me since about 2000. All I had to do was tell him I needed thus and such a dose (not saying, not allowed here) and I would have a new script. No big deal.

He had seen my surgery, it obviously wasn't recent, he was familiar with Stanley having sent dozens (his words) of his patients to Colorado over the years, he had examined my boobs for lumps and I clearly have a female's skin &tc. So what was his problem? I am clearly a post-op MTF, hormones obviously a necessity. He even had admitted only moments before that he had to diagnose me as endo-other rather than gender disphoric as I had clearly taken care of my factory equipment issues.

A colleage had to explain to me that the profession is so uptight over the SOC that they really like to insist on paperwork from someone else authorizing the use of hormones. The fact that he could see for himself that I was correctly representing myself was insufficient, he had to cover his posterior with someone else's judgement call. How rediculous. But real, he was in a procedural quandry.

I did not know what to expect when I went to see him. I had brought bloodwork with me (and had Quest Diagnostics send it directly to his office as well) and so he could see my numbers. He had my GPs (the cardiologist is also my PCP) office on the phone. He had examined my surgery (I was warned he would). What more could he need? I brought a folder of medical records that may possibly be of interest. Sheer luck, included was my certificate from Stanley Biber. Stuart Chipkin took that and said, "Well, if you presented records sufficient for Stanley to do the surgery, that's good enough for me." He kept a copy, to cover his behind, as backup.

But if I had not included that in my packet of 'who knows, just in case' materials, I might not have received the product (recommended new dosage and a new script) from the consult that I needed. Who would have thought?

So the moral of the story is if you don't follow the current approved process, like I didn't (who knew there was one back then?) and instead get your scripts from a shrink or other non-gender-clinic type, then keep records for the Herberts (beaurocrat from Star Trek) in the world that you will undoubtedly encounter in the future. Else you may be refused service regardless of irrefutable evidence that you are representing yourself truthfully.


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Guest Joanna Phipps

Good thing I have requested a copy of my HRT auth letter, I have the copy of my carry letter (D'oh) and now I will photocopy my prescriptions so I have that record. If you have been with the same dr and pharmacy for all those years the Your med record would have a record of when you were first prescribed.

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Guest Elizabeth K

Allison - you are not a typical transperson (one in a million remember) and you just showed up and blew that Endo away!

It's an insurance issue I found out. My Endo would NOT prescribe for me (I go to him for diabetes) because he is not set up for transpeople. In fact, I think I am the first one he has ever met. I had to educate him on the condition! I guess he went golfing the day they discussed gender dysphoria in Med School!

And I had to find a prescribing physician - my going through my therapist! She had to give me a cover letter. I counted the 'hold harmless' and the 'I know what is going to happen" forms I had to sign at his office - twenty three! They are terrified we will sue them - their malpractice insurance must be very high!

So Allison - as a woman - as a post op - as a 'bonified' - you ran into beauracracy... hee hee... did you also have to educate him on transsexuality? Yikes, when I went to the hospital Emergency Room Memeorial Day - I had to educate seven people. I think they lined up outside the door to get a look. I guess we are such a rarity, and I am definately not a 'Jerry Springer" type specimen.

And I had to educate my Family practitioner. Later he told my wife, it was just crazy... ummmm. not very professional.

And the icing on the cake? My therapist wanteed me to take mood enhancement meds after the Memorial Day attempt - and I was to go to a psychiatrist - part of her requirememnts to keep me out of the State Mental Facilities for observation. I was unemployed at the time. Psychiatrist have to pay for Jaguars and Porches and things - I understand. So I went to the public health facilities here in town. I had a screening before I could see a psyhiatrist. EDUCATION of the tech. She said she had 'heard' of transsexuality.

But I go to the psychiatrist (HE was the one who needed help!) and I had to explain again! He never directly treated a suicidal transsexual, although he had referred on to a specialist once. ONCE - thanks a lot!

SO Allison - you are definately a square peg... and a rarer one that the rest of us square pegs obviously! We live in a world with round holes - or sometimes with no holes anywhere!

YIKES we have to jump through some hoops! All we need are those hormones we lack - what about menapausal women? CRAZY


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Guest Isabella

Keeping meticuluos records is always a good idea. Most Dr's are at least reasonable in my experience, but sometimes they just don't get it & you gotta keep trying until you find one that does.

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