Convincing doctors that hormones are not that complicated
Posted: May 13, 2014 Filed under: Testosterone | Tags: androgyny, coming out, doctors, gender identity, genderqueer, hormone replacement therapy, lgbt, lgbtq, medical treatment, non-binary, queer, testosterone, trans, transgender 14 CommentsI just got back from my first appointment with a new doctor at a women’s health group (unintentional!) This has been an ongoing saga, and although it’s not a perfect fit, it’s good enough, at least for now. Looking for more backstory?
Back in January, I decided I was fed up with my doctor, and that I could do better.
By the end of February, I’d found a promising candidate, only to realize she’s part of a women’s health group.
My last appointment with my doctor, at the end of March, was an absurdist performance piece.
It has been challenging to find appropriate health care where I live, but I’ve plowed ahead anyway because: 1)I know what I am trying to get, and 2)I don’t see any reason why I should not get it. This new doctor has no expertise in trans* identities, and I knew that going in. But I did find her through the local gay alliance’s resource page, so that was a start. When I told her that this is how I came to be here, she replied, “Well… yes, I am LGBT friendly, but I don’t know how I got on that list.” What does that mean???
When I told her the reason I’m here is to get more Androgel, she replied that she does not feel qualified to prescribe hormones. That was the start of the discussion, but by the end, she was giving me a prescription for exactly what I said I’ve been on for over a year already, and she was changing her tune to, “I suppose I could for the time being, but the long-term health risks are too great, and it’s not my area of expertise.”
I told her I’ve been going to the one trans* specific doctor in the area who treats adults (that I know about), and I want to switch because I do not like him. She used her laptop to confirm she knew of no local doctors, aside from the clinic that treats adolescents and young adults. She suggested I could use her as my PCP and still go to my other doctor for the hormones. I told her I was not going to do this. She then suggested she might be able to get me in at the adolescent clinic for a one-time visit, so that she can then be advised by them about my care. I told her that would be amazing. She will be following up with me on this, and I would be happy to go.
I told her how I perceive my gender identity, why I’m taking testosterone, and that it does not involve much health risk for me personally. She said, even so, she did not know enough about it. I asked her, “What if a woman wanted to take testosterone to address issues with a low sex-drive?” (Women do this.) She said that she would not use testosterone as a treatment. It’s not been proven to be effective. She continued on to say that she does have some male patients (husbands, sons, etc. of patients, who want to come here), and some have low testosterone levels, and she’s not the one to prescribe them testosterone. I found this difficult to believe.
I showed her a copy of my latest blood tests, and this is when the tables started to turn. I saw her open up. I illustrated what I knew by telling her what “normal” female and male ranges were, and where I fall within that. I told her that risks such as increased blood pressure, red-blood cell count, cholesterol, etc., are real concerns that can be monitored through blood work, but I believe I counteract those risks anyway with my lifestyle (vegetarian diet, active profession, don’t smoke, drink only moderately.)
I told her, bluntly, “It’s not that complicated.”
And, in the end, she seemed OK with it. She was asking me what diagnosis I would like her to put for insurance purposes. I told her that Gender Identity Disorder is in the DSM – “I don’t like it, but it’s there.” She responded with, “What about ‘hormone treatment for transgender patients?’ Well, you don’t identify as transgender…” I told her that I do, that “transgender” is an umbrella term, and that diagnosis works OK.
I went by this new name I’m trying out, at the doctor’s office. I figured this is a compartmentalized atmosphere, and a good place to see what it feels like. I gotta say, it didn’t feel great. I’m not sure what that’s about yet. If that means this just isn’t the name for me, or if I’d actually feel this way about any new name, because any and all would feel foreign at first. I’m sure my gut will tell me. And time. Time will tell me. I also told her I’d like to go by male pronouns. She said, “We can do our best with this. You’ll probably have to remind us, but we’ll try.” Her body language while she said this conveyed, “I don’t get it. I’m not really going to try, but feel free to try to get us to try.”
And this is where things are.
A video about taking a low dose of testosterone (w/o masculinizing changes)
Posted: March 27, 2014 Filed under: Testosterone | Tags: androgyny, gender identity, genderqueer, hormone replacement therapy, lgbt, lgbtq, non-binary, queer, testosterone, trans, transgender, transmasculine 8 CommentsLast week, I made a video using my computer for the first time. If you’ll bear with me for the first 25 seconds, I do eventually start talking. It gets off to a slow start, as I am momentarily mesmerized by my own interior decorating. 🙂
I posted this video on YouTube on a new collaborative channel called Undefine Me. The channel has a handful of people who identify in a lot of different ways, talking on a weekly basis about sexuality, gender, and similar topics. I don’t think I’ll be contributing much by way of video, but I’ve started writing on their blog. You can too, if you feel so inclined!
The reason I decided to make a video is because I feel like I have something to say. And I’ve been writing an awful lot about it here on my blog. (So if you read this blog, all the info in the video will be redundant!) But I think there are a lot of people who might be more inclined to watch a video than to read a blog post. (I am not one of those people!) So, this video is for them, and I’m putting it out there in the hopes they’ll somehow find it.
The last time I saw my doctor / I like your product
Posted: March 22, 2014 Filed under: Testosterone | Tags: doctors, gender identity, genderqueer, hormone replacement therapy, lgbt, lgbtq, medical treatment, non-binary, queer, testosterone, trans, transgender 7 CommentsI went to my doctor’s office one last time a few weeks ago, to get another prescription for testosterone. During this past year of seeing him multiple times (in the beginning, it was so many times), our values and expectations were not at all lining up. My goals and values include communication, follow-through, trust, and respect. As far as I could gather, his values involved maximizing appointment frequency ($$$$$), minimizing face-time, being the expert, and using aggression to barrel through mistakes.
Because of all these clashes, I got myself a new doctor for a couple of months from now. Plus, I have a plan B if that doesn’t pan out. I feel a huge amount of relief to never have to see my previous doctor again! Here is an anecdote from that last visit:
I called on a Friday to ask if I could come in and pick up a prescription the following week. (Because testosterone is a controlled substance, I can never get refills or prescriptions faxed to pharmacies, apparently? So even though I only need to see the doctor / get blood work every 6 months, I have to go every 3 months just to get a new script.) The receptionist asked when I’d want to make the appointment, and I had to repeatedly be clear this is not an appt. I am not due for an appointment at this time. I told her I’d like to come in Thursday to just pick up a prescription. I asked, “Should I call ahead that morning to make sure?” “Yes, that would be good.”
I called Thursday morning to ask if the script was ready. She replied that oh, no it’s still in his messages box. She told me he’d do it once I arrived at the office. I said OK. Once I got there, I waited a while to speak with the receptionist. She and a patient were in the middle of an argument about outstanding bills.
The woman asked how had she been able to see the doctor without paying? There has never been a time he has seen her unless she pays first. This is why she’s not able to see him right now – she hasn’t paid first. So how could she have a debt if he won’t ever see her before she pays? She asked the receptionist to ask him, since she can’t go ask because he won’t talk to her unless she’s paid, at any point in time. She can never talk to him. There was a question about the dates of these alleged appointments, and the receptionist just kept replying that she does not know anything because she’s not the billing department. This circular back-and-forth was making me feel dizzy (I was rooting for her in this standoff, anyway). There were other nonsensical details, but I can’t recall everything. I was focused on myself and getting out as quickly as possible.
The woman stepped aside to call the billing department, so I approached the receptionist just to be like, “Hey, remember me? I’m here now.” Haha. I sat back down and waited for a while. The doctor brushed past the entrance to the waiting room and mumbled my name (maybe?) and for me to step into room 4. My heart started racing. I knew I was about to be bullied into an appointment, and I was prepping to fight back.
I stood up and tentatively walked toward the corridor (because I wasn’t even sure he had been addressing me!) He came back through and directed me to a room. I said, “OK, just to be clear, this is not an appointment. I am just here for the prescription.” “I know, but we have to get you a new blood work form, so it is [an appointment.]” He essentially yelled this as he rushed down the hall to his office. I stood in the room to wait for him, but did not sit down or take off my coat. Once he came in, I asserted, “I had my blood work done in December. So it is not due, and I do not need an appointment at this time.”
He replied, “Oh, it was December? I thought it was June. OK then, you’re right. Well, take this form anyway since I already filled it out. What prescription do you need?”
“Androgel.”
“The Androgel rep is here right now. Go ahead and go back to the waiting room and tell him how much you like it.”
“OK.” ???
I went back out to wait for him to get me my prescription. A young man in a suit and black wool pea coat, with a briefcase, sat kiddie-corner to me. I thought to myself, Oh, what the hell? I like his product 100X more than I’ve liked anything else I’ve ever been prescribed. I guess I’ll tell him…
“Hey, I like your product,” I said, nodding my chin his way.
“Oh, you like it? Great. It’s a good product.”
I sat there feeling smug and tough, for some reason. I guess because everything was feeling increasingly surreal, and instead of shutting-down to it, I participated in the absurdity.
The doctor finally came out and gave me my prescription. He said, “Did you tell him how much you like it?”
“I did.”
And then I finally got to walk out the door.
One year on testosterone without physical changes
Posted: March 18, 2014 Filed under: Testosterone | Tags: androgyny, anniversary, gender identity, genderqueer, hormone replacement therapy, lgbt, lgbtq, non-binary, queer, testosterone, trans, transgender, transition 7 CommentsMy non-binary self has made it one whole year on testosterone(!!!), and it feels like there’ll be no end in sight (I wasn’t planning on there being an end). I still feel highly motivated to apply the topical gel (Androgel) daily. The benefits have been more than I could have even imagined.
If you’re a numbers person, this paragraph is for you (if you’re not, just go ahead and skip it): There are probably a lot of estimations about what is considered a “normal” range for testosterone. There are plenty of articles and websites to find info on levels, and what “free testosterone” is, etc. Also, I’m not a scientist. I’m a janitor. So I’m just going based on what my blood-work form says: Females have a general T range of 14-76 ng/dl Males have a general T range of 300-800 ng/dl. I started at 59. I’m now at 102.3.
This makes quite a bit of sense in that I am now in neither a female nor a male range. Which is how I’ve felt myself to be for a very long time, and it’s now being reflected within this potent hormone/steroid level. It’s not high enough to be exhibiting secondary male sex characteristics. But it’s high enough for me to feel much more comfortable in my skin, being someone who is non-binary in this specific way.
For reference, here’s where I’ve written a lot more info about what has changed:
– 5 months on T
– 8 months on T
– 11 months on T
Instead of repeating a lot of that info, I thought I’d go back to what I wrote a year ago. I did not yet have this blog (I started it last July); I was writing in a paper journal about what it felt like to start testosterone. Here are a few choice excerpts:
3/18/13 – My initial start level was 59. I’m hoping for about 100 or so [good guess!] – enough to feel different, but not enough to induce physical changes… Applied it to my shoulders. It was a lot more, volume-wise than I was expecting. Didn’t notice any changes, but had a dream that night that two men (strangers) were out on the street, checking out each others’ erections and making sure things were working properly.
3/19/13 – Felt just kind of increasingly calm, which can be attributed to any number of things… Toward the end of my work day, I was reclining on an inclined weight bench (I clean the weight room) listening to my mp3 player, and when I sat up, my visual field was new and improved. Everything looked sharper, brighter, more organized. I scanned the room and structured it by color for the first time. Made me wonder if I’ll be able to “see” differently.
3/22/13 – Switched to applying it to inner thighs. Makes more sense in terms of touching and potential transfer. I’ve been feeling really warm and fuzzy lately, which is the best part of this whole thing. Still feel calm, and simultaneously energized, like relaxergized!!!
3/29/13 – I need to convey more how awesome everything is. Anxiety is gone completely. I have never felt this way in my life. I’ve never been on Extacy, but I’m gonna take a guess I’m feeling similar to that. Last night, I rolled around on the living room floor like a dog. I’m just kinda reveling in my own skin over here – I feel so safe in my body.
The intensity of these feelings has, of course, diminished over time (although wouldn’t it be cool if I could feel this high for the rest of my life? Even that would get boring though haha.) But the difference between where I was and where I am, in terms of how I feel, is so great that there’s no question for me about whether I should continue.
My voice hasn’t dropped. I don’t have to shave my face. I don’t look any more masculine, in my opinion. However, I do think my face shape is morphing ever so slightly. It’s hard to know what might be due to aging and what might be due to testosterone. But here are some pics to illustrate:
Continued quest to find a new doctor (a good fit?)
Posted: February 26, 2014 Filed under: Testosterone | Tags: coming out, doctors, gender identity, genderqueer, health care, hormone replacement therapy, lgbt, lgbtq, non-binary, physicians, testosterone, trans, transgender 11 CommentsI have been seeing a doctor that I don’t like for about a year, in order to access testosterone. I’ll be going to his office tomorrow actually, hopefully for the last time. For a few weeks now, I’ve been actively trying to find a doctor that I would want to go to. My therapist thought she had a good lead on someone who works with trans* patients, but it turns out this person works with adolescents and young adults. Whoa, when did I stop being a young adult?!!!! According to this doctor, it’s when I turned 27.
I really wasn’t sure where to start. As far as I was aware, I had exhausted my resources for trans* specific health care. Ideally, what I’d have done next was turn to all my local trans* friends, and ask them who they see and who they’d recommend. But, I’ve been out of the loop for a while now, and it felt daunting to drop in on a social group or support group just to ask about this. So I turned to my local gay alliance’s resource webpage and wrote down the names of a couple of “LGBT friendly” doctors. I narrowed it down somewhat arbitrarily because, hey, I gotta start somewhere.
I called the first number and left a message. Then called again 2 days later. And again the beginning of the following week. And a 4th time the next day. My faith was waning; it hit me it was probably a really bad sign I couldn’t get through to anyone. I finally got a message back from them, but I’d started to lose interest and was already moving on to the next doctor.
I got through immediately and asked if this doctor was taking new patients? I was told that if I’m a friend or family member of a current patient, then yes. Or if I was being referred to her by a doctor of any sort, then yes. Wait, you need a referral for a primary care physician?!! I asked, “In what form should this referral take? Like a note from a doctor or an email?” “No, you just tell us their name.” I said OK thanks and hung up.
So basically, I can see this doctor through the powers of nepotism and name dropping. (Warning, I’m still highly suspicious of doctors. Doctors, please, prove me wrong!) I felt more determined than ever to see this doctor, just on principal, because I think this policy is fucked-up. She should either be taking new patients or not taking new patients. Period.
I called my therapist (technically, she’s a doctor) and asked her if she would refer me to this doctor. She said sure, she’d do whatever, and that she’s never heard of needing a referral for a PCP. She suggested that maybe I just misunderstood, and they just want to know how I heard about / was referred to this doctor. So when I called back, I gave them the benefit of the doubt, but it was reinforced that yes, I need a verbal referral.
I then said that I have a therapist who will vouch for me. (The term “vouch” was never actually used, but that’s what seems to be going on?) I was then put on hold, and they seemed to be attempting a stalling tactic. She (receptionist) said she is short staffed and busy, could I call back Thurs. or Fri. of this week? I was assured that I’d be able to make an appt. at that time, and I was directed to name-drop whoever at that time.
So I followed these directions and finally got an appointment! (For 3 months from now.) A few days later, a packet of paperwork arrived in the mail, and I immediately opened it and started to peruse. Their pamphlet states, right on the cover, “Designed by Women / Delivered by Women / For Women Like You.”
Whaaaaa? Apparently, I got myself a doctor through a women’s health group without even knowing it! I just have to take a giant step away from this situation and laugh. And laugh and laugh some more.
Is this going to be a good fit? I thought it through quite a bit, and decided that I’m going to try it. And I’m going to make my decision based on the doctor, and not the Women thing. Because really, although I am definitely not a woman, I am closer to a woman in some ways, and closer to a man in other ways. And being at this health center is not going to mess with my identity or psyche or ego.
As long as they can understand what I am saying to them, as long as they can use my preferred name and male pronouns, and as long as I’m getting good treatment, I will be proud to go here.
(And if it doesn’t work out, then it doesn’t work out.)
11 months on T without physical changes
Posted: February 18, 2014 Filed under: Testosterone | Tags: androgyny, gender identity, genderqueer, hormone replacement therapy, lgbt, lgbtq, non-binary, testosterone, trans, transmasculine 4 CommentsToday! I am happy to be able to say that I have not seen any new changes. For reference, here are posts from 5 months and 8 months – There are a lot of specifics in those posts.
The reasons I’m writing so sporadically about my changes on low-dose testosterone are because:
1. I don’t have much to report!
2. I plan on this being a long term endeavor, both this blog, and the actual taking of the testosterone. So, I mean, I can’t foresee the future, but I imagine I’ll be around 4 years from now, 6 years from now, updating about T-changes every once in a while. I do want to document the long term here.
To summarize, I started using 1.62% of Androgel, 1.25g / day. After 2 months, I was getting concerned with the changes I was seeing (however slight they were), so I asked to be lowered to 1%. And have not seen any further changes since then. I have been highly motivated to continue applying the gel every day. For about 6 days early on, I was alternating days (my doctor’s suggestion) in an attempt to slow progress, and I did not enjoy this skipping of days at all! Since then I have not missed a day.
I have been experiencing some incredible internal changes due to the added testosterone in my body. Some were expected (and were the reasons for me to seek it out) and some were a complete surprise.
1. Increased sex-drive (expected)
2. Increased sensitivity to pain, and all physical sensations, actually (surprise)
3. Increased connectedness with my body, decreased gender dysphoria (not totally a surprise)
4. Decreased general anxiety, big time (surprise)
I don’t have any voice recordings or even very many photos, which is partially due to not being tech savvy (I’m trying to learn little by little here), and partially a tactic I’m employing to help myself not obsess too much. But I do realize it means I don’t have much “proof.” *
I’m thinking about making a video at my one year mark. Maybe. If I can figure out how to do that.
I do have these pictures of my face though. I don’t see myself looking more masculine (yet) but maybe I am getting there, very very slowly… Will just have to wait to find out…
These last 2 photos are sort of to illustrate how we can look pretty different, just from day to day, from photo to photo. I could spend hours taking photos of myself and most of them I’d probably look at and say, “that doesn’t even look like me!” (Luckily I didn’t do that – it’s sort of a rush job. Also, do I think I look like myself? Not sure.)
* It’s not a goal of mine to prove anything in particular (such as, that taking T long-term without masculinizing changes is possible). But if I find that this is possible, I’ll continue to be very very happy! My main goal is to be out there with a different perspective. A different set of reasons for having started testosterone, and a different set of reasons for wanting to continue. And to see what happens along the way. And to talk with people about it! (OK, so that was more like a 5 part goal.)
I’m becoming pussified* by testosterone
Posted: December 3, 2013 Filed under: Testosterone | Tags: ftm, genderqueer, hormone replacement therapy, non-binary, pain, pain tolerance, self-injury, self-mutilation, testosterone, trans, transgender 10 Comments*I made up this word, I think (actually I just looked it up, and I totally did not make this word up), but that doesn’t mean some people don’t like it. Let me know if you don’t like it; I’ll think more about it. The root word is “pussy,” which I don’t mean to use in a derogatory way. More like it has a certain ring to it; it is an accurate descriptor for what I mean to say. I’m writing about becoming a pussy when it comes to pain, basically.
Also, trigger warning: self-injury
Before I started taking testosterone (about 9 months ago), I had a peculiar, but not really uncommon, relationship to pain. In many cases, I derived pleasure from pain. I would create sensations of pain, within my control, in an effort to calm myself. Also, when I’d hurt myself accidentally like for example, hit my arm on a doorway, I would feel alarm, followed by an adrenaline rush, followed by a pleasant soothing wave. I think in retrospect, I had a lot of potential to really get into BDSM, except for the fact that before taking testosterone, my sex drive was pretty close to non-existent, so none of that was all that appealing in a sexual context.
Now? If I hurt myself, it hurts! If I accidentally ran into a doorway, it would not be pleasant in any way, shape, or form. I remember the first few times I got hurt in little ways, in the first couple of months of being on testosterone; I was so surprised by how much pain was coursing through my body. I just felt like, aaaaaah! I’ve been swearing under my breath and feeling unnerved by how much stuff hurts.
When I’ve been feeling particularly upset or depressed, I will still have the urge or flash-image to self-injure myself, but there is no real desire to follow through with it whatsoever.
I haven’t self injured since last winter, which is so incredible to me. I hated that it was such an effective coping strategy. Probably my most effective coping strategy, for about 13 years or so. I’ve had such a long, complex relationship to self-injury, both as a concept and as it relates to my body. And I’m so glad to see it changing.
Is pain tolerance a gendered thing? I’m sure the way people experience pain is all over the map, but are there generalities between genders? Such as, females have a higher threshold for tolerating pain. I have no idea, but I’m really curious about it.
And seriously, how cool is it to be living through such a transformation on so many different levels? Like when I started testosterone, it never occurred to me that I might feel differently about pain and be cured (so far at least) of my self- injuring tendencies!
8 months on T without physical changes
Posted: November 18, 2013 Filed under: Testosterone | Tags: genderqueer, hormone replacement therapy, libido, non-binary, sex drive, testosterone, trans, transition, voice dropping Leave a commentI’m continuing to walk this fine line between experiencing incredible internal changes, which makes the decision to continue taking T a no-brainer, and feeling concern about long-term physical changes. So far, this line is still in place, and all is well.
I’ve been posting about progress on testosterone super infrequently. There’s a couple of reasons for this: 1. I’m definitely feeling like I’m in it for the long term (both taking T and writing this blog), so it’s more like spurts of data over a lot period of time, rather than data overload and then burnout, or something like that. 2. There’s really not a whole lot to report! I mean, I’ve been experiencing a ton of internal changes. But things are feeling pretty stabilized, and there’s not a ton of exciting new information. Here’s a recap / rundown:
I’m using Androgel 1%, 1 pump (1.25g) daily.
Physical changes: what I have noticed has been sooooo minimal, which I’m so psyched about. And these changes happened within the first 2-3 months, and I’m not seeing much new here since. I noticed a slight filling out of my mustache, a few longer light-colored hairs on my chin, a slight broadening of my shoulders with some muscle growth in my pecs, biceps, and shoulders. My clitoris got bigger over the course of a few days about 2 months in, and hasn’t changed since then. I’ve gotten a little sweatier and smellier (feeling the desire to shower more frequently), and I seem to have a higher tolerance for cold, which is awesome! There is one physical change that I’m noticing more recently: I’m seeing slightly darker hairs at the application site. I apply the gel to my upper thighs, and there’s definitely some slight hair growth. The one change I’m feeling ambivalent about and unsure of is voice dropping. I keep being hyper aware and concerned. No one else seems to be able to tell there is any difference. So far, I haven’t made vocal recordings because I don’t want to obsess over it any more than I already am. I think the difference is so slight, and that voices are moving, dynamic, changing things anyway, that there’s really no cause for concern. Largely, I worry that certain changes plateaued soon and were pretty negligible, but that perhaps my voice will keep dropping the longer I’m on T. I’ll just have to wait to find out. I may start making voice recordings, if I think it’ll help.
Internal changes: The internal changes I talked about at 5 months included drastic decrease in anxiety, increase in sex drive, feeling grounded and connected and warm and fuzzy, and changes in sensations of pain. I’m still reveling in all of these things. It is still plenty of reason to keep taking T, despite my concern over experiencing physical changes. For about 6 months, my anxiety levels were at 0, which I have never experienced before in my entire life. Now they’re fluctuating, like life tends to cause, but at a much lower, more tolerable level, than I was experiencing pre-T. Increased sex drive feels sustainable, and has allowed me to explore new (dormant?) areas of my sexuality I hadn’t been able to tap into before. Sensations of pain and feeling connected to my body have been starting to dwindle in awesomeness, I think because I’m getting used to it, and can’t recall what it used to feel like, to compare then and now, as much. Everything is dwindling in awesomeness, and I keep trying to remind myself how different in a negative way, my bodily experiences were, pre-T.
The effects of T have been a dream come true for me. I’ll be back with a T update in a few more months! (These photos are from 5 months and then 8 months. I guess I’m looking at whether there’s a change in my face shape over time. So far, I can’t notice anything. This pleases me.)








