- [x] Blahaj Lemmy transition
- [ ] medical transition
- [ ] social transition
- [ ] legal transition
Jokes aside though, while I’m struggling to find therapists for an official diagnosis (which I need for hrt to happen) I unexpectedly got an appointment with an endocrinologist already.
While that won’t get me anywhere in the foreseeable future, it’s still nice to have this first talk, and get all the important things out of the way ahead of time.
So, what are some important infos I should give them?
- Medical history: Past illnesses and diagnoses, known allergies, medication I take
- My personal goals, what I wish to achieve
- How does my current day to day life look in terms of physical fitness and mental health
And what are some important questions I should ask them?
- Potential risks and side effects
- Does any of the info I gave them conflict with hrt
- What changes can I expect, and how quickly
- How often should I have follow-up appointments for which purpose, either twith them or with my GP
- Where do I go to freeze some of my genderfluid, in case I want to have biological children one day
- How would a change in calorie intake affect the changes hrt introduces (primarily in terms of fat gain)
- Are there any lifestyle changes I should make to ensure everything will go as smoothly as possible
- What support resources are available for further questions that may go beyond endocrinology expertise
Do any of you lovely ladies have anything to add?
I want to make the most out of this first appointment even if it won’t make the whole process go forward by much.
At least everything will be taken care of by the time I’m officially allowed to take E.
Congratulations! You’re first visit should be pretty chill. They should talk to you about how long you’ve felt this way, if you’ve taken any steps to transition, a health history, and if they’re good, they will ask about your support system.
They should go over all the potential risks and effects of feminizing hormone therapy, including what’s ‘permanent’, how long changes take. You should also be open if you smoke/vape - it won’t preclude you from taking E, but if you smoke you shouldn’t take it orally.
You should have some labs drawn for baseline levels. Usually they check estrogen, testosterone, a complete metabolic panel, a complete blood count, and they should probably do prolactin and a lipid panel (lipid is a fasting panel ideally, but if you’re not used to having your blood taken make sure you eat something before the visit).
You can usually start the medications before getting your labs back, unless you have a medical history that warrants waiting, although that’s kind of up to the prescriber.
Visits should be every 3 months the first year, then 6 months the second year, and them yearly. You may need slightly more frequent visits if you change the route of your medication, or if you’re labs aren’t in the goal range.
It’s important to look into minority stress and see if they have any resources or groups they can connect you with. Trans folks have higher rates of mental illness - that’s not because there is something inherently wrong with us. It’s because we live in a society that can be very hostile to us, even in places that are considered progressive. Start working on resilience now, and try not to do it alone. It’s a lot.
Finally, my personal recommendation is to look into voice lessons, especially if you are not socially out. Not only is it rewarding to have your voice reflect who you really are, having the space to try out your identity, name, pronouns, presentation, etc. in a safe and affirming space can be just wonderful. It really helped me figure some things out when I wasn’t sure exactly where my path would lead.
And, in the ancient wisdom of our people, just remember - you got this.
Thank you so much!
I hope I have at least a possible outlook on the diagnosis when I’m there for this first visit.
Most therapists that have anything to do with gender identity have waiting times of a year at the very least. The majority can’t even put new patients on a waiting list in good conscience.
If only health insurance would approve more therapists, at least I could then see a reason why they’re jacking up their prices every few months.
Depending on where you are, you might not need a diagnosis. In the states, any physician that works in gender care can diagnose you as long as they follow the Endocrine Society/WPATH guidelines. Planned Parenthood is a great resource to get started (if you’re US, apologies for my assumption. I’m an American on the internet, everyone else must be too, lol)
I’m in Germany, and as far as I know, an official diagnosis is required. Should include a minimum of six appointments/therapy session, after which they write out the diagnosis that they finally sign off on, officially recommending hrt.
Apparently, some doctors prescribe hormones on an informed consent basis, but I haven’t found much info supporting that this is true over here.
I don’t know what the process will be like for you at all, but I went in as a complete and utter idiot and came out absolutely enlightened because everything was explained to me without me needing to prepare or prompt at all.
For a first appointment, just knowing what your goals are is likely enough, it took me an initial consult followed by a second appointment to talk about options before a third appointment where everything was set and all the necessary tests could begin. Fourth appointment I walked out with my prescription.
I honestly think you’ve got all the main questions covered, if your endo is providing referrals to things they might also be able to offer a referral to a voice coach like mine did (but mine was all through an informed consent GP so it might be different).
Best of luck, I really wish you didn’t need that accursed diagnosis, I’m sorry you have to go through proving you exist.
I did come across an info brochure that said that some doctors in Germany do actually prescribe hormones based on an informed consent process.
But further research was not at all insightful, so I’m still unsure whether this is an actual possibility for me or not
Oh, if it’s a possibility then it’s definitely worth pursuing!
I’ll shoot the endo a quick email, I guess. Though their page explicitely states that they want an official psychological diagnosis.
Oh well, can’t hurt to ask
Perhaps they can point you to someone who does do informed consent, given how invasive and awful I’ve heard getting a dysphoria diagnosis can be, I’d really recommend you make an informed consent clinic your first preference.
When I walked in I literally just said “yeah I’m NB, I want these things” and my GP just said okay here’s how we get you there. I’ve had experiences (with an entirely unrelated medical condition) where I’ve not been believed and had to advocate to receive the care I needed, having a GP who was fully in my corner was not just better, it was a legitimately lovely experience.
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This is so amazing to know of, I’m making a note of this for the future!
I’ve used that site before, it hasn’t occured to me to look for informed consent over there.
Thanks for the reminder!
I’ve also asked at a local consultation office that already helped me out by giving me a list of therapists a while ago.
They seem informed and knowledgeable, so we’ll see what they say
Can I ask what jurisdiction you’re in? Not to Dox you, really aware that the options available vary so much from place to place and country to country!
I’m in Germany.
Healthcare is generally pretty good, but once you need certain specialists…
Well, be prepared to wait.My understanding is that healthcare administration is devolved from central government and run by individual provinces. I hope you’re in one of the good ones!
I really can’t complain as much as others, to be fair. But in some specific instances it’s just infuriating.
Medical transition sounds very daunting for me, I’m avoiding that step. Why? genetic complications : my grandmother died in response to an estrogen-based menopause treatment, but she was negative for the one genotype that is known to cause this reaction. So I have a 25% chance of inheriting a genotype that is not known, but i know it has caused a relative to die of cancer, in response to estrogen. So I need to consult a doctor that specializes in hereditary (breast) cancer, but also consult with an endocrinologist who knows about estrogen-related cancers… that’s a lot of work and if I skip it I have a 25% chance of dying within a few years of starting treatment.
Gotta be safe, especially when you know for a fact there might be complications.
I’ll make sure to check whether there is anything in my family that could prevent me from doing it, and I hope the endocrinologist will make sure to ask the right questions concerning these things.
- [x] picked a name
At least I didn’t find another one I like better, so I guess that counts^^
