Getting and Starting Hormones

Early on, I was always thinking about the future and what I might be heading towards. It was always on the top of my mind (honestly, it was at or near the top for months). During most of those thoughts, my mind would eventually go to timing and how everything fits together. When I started leaning towards the path of transitioning, the timing of what will change, when and how I had to make sure some things get started and finished in time, overwhelmed my thoughts.  I was up early constantly thinking about it.  I lost a lot of sleep.

There are a lot of things to consider when you want to present as a different gender. When you really stop to think about it, there are dozens of major and hundreds of minor differences between the genders that you discover as you take this journey.  As you go further in life, these developments become more and more difficult to change. Some you can’t change and just have to live with. Some are only changeable by paying thousands of dollars to fix. By the way, this is an excellent reason to support teens and twenty year olds experiencing gender dysphoria. If you can start your transition young, there are things that don’t develop. Many of these developments are very costly to reverse and are what prevents people from really finding their true self. But I digress.

Source of Dysphoria

I’ve always had a list of major items in my mind that cause me the greatest dysphoria and they are ones that I knew I had to act on as early as possible. For me, the top 3 were/are my very thin hair on my head (ok, my baldness), my voice, and body & facial hair.  Sure, there are many others (primary sex organs, body shape, facial features, height, Adam’s apple, muscles, the list goes on) but many of these can get addressed through hormone replacement therapy (HRT). Some can only be dealt with by major surgery or can’t be addressed at all. Every transitioning person will have their own list and very few are the same.

When I thought about the timing, I really couldn’t line it all up until I knew when I would start HRT.  The clock started there for me. I decided early on that I would suffer in man mode for a while longer so that I could progress and work on my feminine self a little more before coming out fully. This allowed me to put a plan together. For anyone that knows me, it would be no surprise that I worked it all into an Excel sheet that automatically plotted when things needed to happen based on actual events. This solution helped Cathy as well as she was always curious when things were going to happen and when we needed to start sharing our news.

The Challenge to Get Hormones

The next step really was finding out how to get on hormones.  Where we live, there are very few resources that cover how to do this, particularly for adults.  There is a health center nearby that primarily helps transitioning people younger than 25. There’s also a nurse practitioner that works remotely that you need to book online for appointments. Other than that, there’s a slim chance your family doctor may be able to help you if they are familiar enough with the regimen. I tried the nurse practitioner and got an appointment 3 months out. That’s not bad from what I hear in other parts of the world, but when you’re already 45, you need things to start moving. So, I tried my family doctor. It was a response that was what I expected.  Something similar to “well, you’re the first patient who’s ever come in here for that”. That was not a great sign.  The next comment was that he fully supported me, but he was just not familiar with what to do. He offered me a referral to an endocrinologist. My response was, “I agree that would be the normal path, but I’ve heard that those appointments are a year out, is there not another way?” I’m glad I pushed because it turns out that the endocrinologist, is a close colleague and friend of my family doctor. He told me to leave it with him and let him see if he can find a solution.

Lucky Break

Some people complain about the health care in our area, and there is plenty to complain about. Sometimes, it all has to do with luck. A week after my appointment with my doctor, I got a call from the endocrinologist’s office. They’d like me to come in for a conversation the following week. As luck would have it, that was also the day that I had booked some bloodwork to get a baseline level and to check if there may be any concerns with my current health.  The meeting with the endocrinologist, turned out to be more of a mental health session and grilling set of questions about my plans and desire to transition. I was committed by this point, and I think that came through. Also, I had a prepared letter from my therapist that explained how I got to my decision and his diagnosis that HRT would be the correct path. The plan that my family doctor had worked out was for me to continue to see him for treatment, with the endocrinologist acting in support. Answering questions and analyzing bloodwork so that my family doctor could prescribe the HRT and communicate any concerns as things progressed.  I was very fortunate. My family doctor is much more accessible and helping him learn about the process made me encouraged in our health care system. The fact that the information was getting to more people to help the next patient who has the same needs, made me proud.

It did not take long after my first appointment with my family doctor until I had my first prescription for hormones. The dose was small to start. No changes were really expected at first.  This was a trial run of the medication to make sure that there wouldn’t be any complications or changes to my bloodwork. But I got my first step in.  The path was a little clearer knowing where the start line was.  As for that nurse practitioner’s appointment that was to be online in 3 months.  I kept it just in case things fell through with the family doctor.  It wasn’t until about 1 month before the scheduled time that it was cancelled by the nurse due to scheduling conflicts. If I had not been so lucky with my doctor, who knows when I would have been able to start the journey.