Hormone Replacement Therapy

I started HRT on June 2 with estradiol twice a day for now.  I will see my endocrinologist in a couple of months at which point he will increase my dosage.  But it's amazing the effect the hormones have had in such a short time.  It's like my emotions have been unchained.

For many years I have buried my emotions deep within me and very little affected me other than occasional anger. Deaths of very close relatives were met with just the usual day to day feeling nothing.  A lot of that was caused by being my mother's caregiver in her home for years.  In an eight year period, I probably spent less than four weeks away from the house with the biggest break being a one week trip to Ireland.  So I learned to bury my emotions including my gender dysphoria and feel basically nothing.  I'm sure I was depressed during some of that time; I mean what do you have to look forward to when your day/week/year consists of getting someone up, making sure they get dressed, fixing breakfast, getting them settled, preparing lunch, getting them settled, cooking dinner, getting them settled and finally off to bed.  My wife was still in our home in another state working so she commuted on the weekends and would give me a little break from cooking.  Thankfully I am retired from an airline and she could fly space available.  And even after mom and my brother were gone, no emotions.  Until last fall and then it was a crash.  Now with HRT, the day seems brighter plus my wife says I am much happier and more affectionate.  It's made a BIG difference.

HRT Approved

I had an appointment yesterday, May 20, with a second endocrinologist.  Earlier this year, I was turned down by another doctor who gave me a bunch of BS reasons she wouldn't approve it.  I came home that day and was laying on the bed with a pillow over my head screaming and crying.  After that, I just laid and stared at the wall for three or four hours.  It was a very dark time for a week or two.  That changed yesterday.  I had a 2:30 appointment and was called back exactly at 2:30!  Yeah, I know.  Amazing, right?  The nurse took my vitals and very shortly, a younger doctor came in.  She told me she worked with the doctor I was seeing and she wanted to get some background.  She was looking through my file, mentioned the letter from my therapist also recommended an orchiectomy.  I told her it was already done on 4/26.  So she did some evaluation of my health, then went and talked to the main endocrinologist.  I told my wife I wasn't happy she didn't mention blood tests and didn't have a good feeling.  My wife simply said a prayer.  So the older doctor comes in with the one who had evaluated me.  He sits and talks for a couple of moments and says he sees no reason I shouldn't start HRT.  When I was turned down by the other doctor, I started crying in her office and when he said he was approving me, I started crying again although for a totally different reason.  We also talked about my therapist and he seems to have a very high opinion of her plus we talked about Southern Comfort Conference which he went to last year.  So anyway I had to go down stairs to the clinic for them to draw blood to check baseline hormone levels, check kidney and liver functions.  If everything comes back ok, he will send a prescription for estrogen to my pharmacy, probably the middle of next week.  I have had both kidney and liver function tests in the last six months so I know they will be ok.  So next week, God willing, I will be on a starting low dose HRT.  I see the endo again in four months and we will up the dosage.  Look out world!

New Appointment

I have a new appointment with another endocrinologist for evaluation for HRT.  This doctor literally wrote the book.  I mean he literally co-wrote the book Endocrine Therapy for Transsexual Persons.  Hopefully he won't be as conservative as the previous doctor.  A friend of mine who is a nurse and a former patient of that doctor said she's cutting back getting ready to retire and cherry picking easy to manage patients.

On another note, I will be getting rid of testosterone for good.  My appointment with my urologist the other day, he has decided my orchalgia (pain in the left testicle) plus the extremely high cancer risk for my right testicle warrants an orchiectomy.  He does also have a letter from my therapist recommending the orchi.  I also told him at the appointment I had been in touch with a surgeon's office regarding future possibility of GRS.  I explained they recommended a horizontal incision and he thought for a few seconds then said he could understand  that to save the centerline.  The other thing I told him was the doctors office recommended he call them and he surprised me by agreeing.  He gave me his e-mail address to forward what the doctors office sent me.  I said after my first visit with him I really wasn't impressed but I did go back for a second visit and I'm glad I did.  I've been more and more impressed with him and his concern each visit.

I was turned down by the endocrinologist for HRT.

 She cited my age as the main factor and some familial factors as secondary.  The thing is, the familial factors she cited were just so much BS.  Yes, my father died of a heart attack but it was during surgery for cancer and was his third surgery in a year.  My middle brother died of what we think was a heart attack but not sure.  However he was born premature, in bad health as a child, was never expected to live to be an adult and it's amazing he lived as long as he did. So like I said it was just so much BS.  I have friends who are both trans and quite knowledgeable on HRT from a scientific end and they agree.  So my therapist has already faxed another recommendation letter to another endo here.  He actually co-wrote the book on endocrine therapy for transgender people so I'm going to get a second opinion from him.  There is also the option of informed consent.  My wife is bound and determined, come hell or high water, we are going to find a way for me to begin HRT.

My brain is running a thousand miles a minute

I am at the same time, excited and terrified.  I have my first appointment with an endocrinologist tomorrow and my emotions are all over the place.  I am of course excited and one line from the Phil Collins song, In the Air keeps going through my head.  "Well I've been waiting for this moment for all my life, oh Lord."  At the same time I'm terrified.  This is a big step for both Dee and myself.  Plus what if the blood  tests find some reason I shouldn't be on HRT?  Would I be able to live with that disappointment?  I don't know.  I just don't know.  I'm trying to think positive but that thought just keeps nagging me.

Urologist Appointment Monday - Orchiectomy?

I see my urologist on Monday for the first time since my therapist recommended HRT.  One thing she also recommended was an orchiectomy (castration) so that, due to my age, I don't have to take anti-androgens like spirolactone or finasteride along with estrogen and, maybe, progesterone.  She said she could refer me, with a letter, to a surgeon here in town who does orchis for trans people.  I told her what I would do first is talk to my urologist, since he has been treating me for orchalgia (testicular pain) and my insurance should cover it as an ongoing problem.  Plus I have a 10X risk of testicular cancer on one side and medical protocol calls for it to be removed.  If he's reluctant, then my therapist can refer me to the other surgeon.

My main thought is how to open the conversation with him.  When he did the nerve block back in December he mentioned removal if it didn't work.  I said something then about me not not being bothered removal and he said, "Yes, but your wife still wants a husband, not a sister."  Of course both of us burst into laughter and he was looking at my wife and I like we were crazy.  So I may start out with mentioning his joke, then moving into talking about seeing a gender therapist and go from there about HRT.  Wish me luck.

I Have An HRT Appointment

Tuesday my therapist and I wrote my HRT letter and faxed it to the endocrinologist I've chosen.  Wednesday I called to make an appointment but the doctors appointment person was busy and I had to leave a message.  Yesterday morning I got a call back from the office and I was very pleased with the person who called.  First she was very pleasant and asked if I preferred to be called by my male name or by Beverly.  She went through everything about the appointment and then told me she wanted to mail out a registration packet for new patients.  You know, all that paperwork you have to fill out at every new doctor's office?  Then she asked is it OK to mail this to your home or will that create problems?  No, no problems, send it here.  Next she asked about leaving messages on the phone.  Would that create any problems?  No, that won't be a problem either.  Finally she said the first appointment available was March 8th at 2:30PM.  Two months from today, I have an appointment with my endo for HRT!!!!!!!!!!  This is really happening!  I guess you could say I've been waiting for this my entire life or at least since I was four.  It still seems like a dream.

The Most Beautiful Gift Of All Was Just A Word

Normally my wife and I give each other little ideas about what we want for Christmas.  I had mentioned something that after my therapy and HRT referral became sort of a moot point.  My wife and I were sitting in the den talking and she was explaining her thought process.  My wife said, "So I was thinking what else would she want or need."  She!  That's the first time my wife has used a feminine pronoun in referring to me. When she said that, I jumped up and gave her a hug and a kiss before walking out in the hall to wipe off my tears.  It was just a word.  But it was the most beautiful Christmas gift of all. 

Therapy Results

Well, I had my first appointment with my therapist yesterday.  I have to say I'm still in shock!  Before I go any further, let me note that I've known and been good friends with my therapist for 15 years.   So we didn't need to do any of the "get to know you" sessions most therapists require.  Basically what she pointed out is this.  My entire life, I have put other people's needs in front of my own.  When I was a child and a teenager,  my parents both worked so I did a lot of the housework and such.  That way my mother could spend as much time as possible with my disabled brother.  When my wife and I were married, I tried to bury my transgender side (didn't work) putting her needs ahead of my own.  The same when our son was born, I put their needs ahead of my own as it should have been.  When he went to college, my wife went back as the person I took care of.  When she had surgery and ended up paralyzed, I took care of her after she spent a month in the hospital learning to walk again.  When my mother developed dementia, instead of putting her in a nursing home, I became the caregiver for her and my brother for eight years and they lived at home until they passed away within a couple of months of each other.  So my therapist said it's time I put my needs to the forefront.  She pointed out also, much of our health does depend on our happiness and "you're not happy!"  So what are we doing?  She is referring me to an endocrinologist and will write my letter to begin HRT!!!!  She also mentioned since at my age we're not planning on starting another family and so that I don't have to take androgen blockers she will also write a letter to a surgeon here for an orchiectomy.(If you don't know what that is, look it up.)  I told a friend who transitioned years ago all of this last night.  Her response was she knew it all the years she's known me, she just wondered how long I could grit my teeth. LOL

The most amazing thing is my wife.  When we sat down and talked last night and I told her the results from the session, she was fine.  I know for a fact that she has some issues that she won't talk about with me but I'm insisting on her seeing someone to talk to.  Since we belong to a very LGBT friendly church (our pastor is L) my wife is going to sit down with her and talk.