Posts Tagged ‘hormones’

Four Months In

Posted: July 8, 2016 in Uncategorized
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Three and a half, actually.

 

I’m three and a half months into hormone therapy, and so far, it’s been a relatively smooth ride.

 

I’ve remained emotionally very stable, which was a pretty concern of mine. Body hair is starting to grow in. Acne’s not as bad as I’d suspected it might be, given what the first time round was like. Voice has dropped…like, a lot. And judging by my suddenly manly thighs in the shower this evening at the gym, fat is being redistributed to other places.

 

The major bugbear so far? Periods haven’t stopped. Like seriously. FUCK. YOU.

 

Of course, it comes with consequences. Stealth mode is over. I can no longer just sneak quietly in and out of the ladies’ toilets without being clocked as an imposter–which means there’s a whole new stress to public loos, as I don’t necessarily pass enough to be in the gents’ yet either. But, the up side is that I have no nerves about the gym changing rooms anymore, so…I suppose there’s a trade off.

 

My major concern right now is travelling. Without stealth mode, I’m developing a near-fear of airports, so I’m making enquires into getting my gender changed on my passport. Which, given I have no gender recognition certificate, may be unnecessarily hard without one. But we’ll see. I want it in place before I go to the USA, though, because right now I don’t think I could handle that can of worms.

 

I’m also starting to put out more social feelers. I’ve found an LGBT specific martial arts club to try out, and I don’t stand paralysed in fear with someone says ‘y’alright, mate?’ in the gym anymore. I’m getting more comfortable at work.

 

So, the work in progress continues. With about as many ups and downs…which is better than it used to be.

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Work in Progress

Posted: April 27, 2016 in Uncategorized
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So it’s six weeks since my first T shot, and I’ve just had another.

In six measly weeks:

  • I’ve lost the upper ranges in my voice, and am speaking much more quietly than before. My colleagues and my boss have all remarked that I sound ‘gravelly’ or like I have a sore throat.
  • I had to shave my upper lip before work about four days ago. Haven’t since, but then, I hadn’t before
  • There has been a lot of growth in the downstairs department, to the point where I can just about cup myself, if you know what I mean.
  • Been a lot of growth in the fuzziness downstairs too. FYI, a beard trimmer has multiple uses.
  • I am basically a teenage boy right: ridiculous amount of energy, and eating my own body weight in food every day.
  • I’ve been hitting the gym every day and doing workouts that usually would leave my muscles crying and me curled up in a ball on the floor. It’s not happening. I don’t look any different yet, but I feel like for the lack of heart failure and death that occurs after a 10k run.

 

Work in progress, guys. Work in progress.

I hit the finish line.

I mean, I’m not finished, but I’m over the line. Today I had a nurse pull my boxers down and give me my first testosterone shot.

Which means in under a year, I transitioned.

In April 2015, I came out and socially transitioned. In November 2015, I had my top surgery. And in March 2016, I started HRT. And as HRT is a lifetime of injections…I am done.

In eleven months.

And yet…thousands of trans people in this country go years without being able to do it. Transitioning can take a decade or more — and that’s for ‘straightforward’ cases. If you’re non-binary, it may be longer. If you have other health issues, mental or physical, it may be longer. And as I’ve learned this last year, if you play by the NHS rules, it will be longer.

On a totally different note (maybe), the LGBT fiction community is up in arms at the minute. And it all boils down to erasure. Many LGBT people feel erased, marginalised and hurt in that community. Which is appalling and crazy and I’m one of them.

Because this is the consequence of erasure: waiting a decade to get help, and all the time, that help act like they’re doing you a favour. In fact, that’s very much a mirror image of the LGBT fiction community’s sad state at the moment. Ignore the LBT and any other orientation, for that matter, and when they complain, tell them they’re ungrateful.

In my battle to get hormone treatment, I was told I had to be seen on the first Friday of the month only, because that’s when the transgender clinic is. When I asked why I couldn’t have a Thursday like any other patient, nobody could answer me.

I was told I couldn’t be treated by my GP because of the guidelines. When I asked which guidelines, nobody could answer me.

I was told I couldn’t have surgery before hormone treatment. When I asked why, nobody could answer me.

And nobody can answer because…nobody’s actually got an answer. But because nobody has challenged this and forced them to change what they’re doing and how they’re thinking, we continue to wait and suffer and die in silence.

Yes, die.

I would have died if I had not been given my injection today. Because the other option would have been wait until mid-June, maybe even July. And I would not have made it. I would have killed myself, and I would have died because the system is constantly and systematically ignoring us.

If you like me, or my books, or heck, even the concept of a human being behind these posts, then for god’s sake stop pretending that sticking a rainbow flag on your profile picture and reading gay men getting it on makes you an ally. It doesn’t. And we need allies. We can’t change these systems, we can’t fight this oppression, completely on our own. We need to stand up and fight them, and you need to stand with us. You need to do something. You need to talk about these issues, you need to call out bigotry, you need to share stories, you need to donate to charities, you need to sign petitions. You need to act.

But if you call yourself an ally and all you ever did was read gay men screwing, then you’re no ally of mine.

 

 

 

(But I am a man now! Woohoo!)

#hormonewar 2.0

Posted: February 29, 2016 in Uncategorized
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So today I got a reply from the consultant’s office. So much for the call back.

Firstly, completely skated over the reason I am angry — that I have been separated from all the ‘normal’ patients and can only be seen one day a month because I’m transgender. Nope, that’s still all totally acceptable in their eyes. We’ll just ignore that part,  shall we?

Secondly, I will be ‘kept in mind’ if there’s cancellations. Yeah, okay, sure. Given your staff couldn’t be bothered to ring me back after typing up this letter (and it’s a paragraph long, by the way), I very much doubt you will do anything of the sort.

Thirdly, and this is the bit that really hacks me off…

“One possible solution would be if your GP were prepared to start you on testosterone treatment in advance of you attending clinic on the basis that I will be seeing you shortly and can discuss ongoing hormone treatment with you at that point in time.”

Er.

What.

Right, so…my next GP appointment is in March. I will not see this consultant until June. So potentially, I could be on T for three months before I even see the so-called specialist whose so-called expertise is supposedly ‘required’ to get hormone treatment IN THE FIRST PLACE.

And given I first approached the gender services about how to get testosterone in DECEMBER, had that been said then instead of referring me to him just to be referred right back to my GP, I could be celebrating three months on T now.

So let’s just summarise that, folks.

The doctor who has quite probably never met a trans patient in his life (the GP) has treated me with the respect.

The doctor whose expertise is in trans patients has treated me like dirt, delayed my treatment for months unnecessarily and based entirely on my status and not on my patient needs, is passing my care knowing back to a doctor with no expertise in this area of medicine whatsoever, and is still refusing to see me within the timeframe set out by the NHS.

This is not fucking over.

#hormonewar

Posted: February 23, 2016 in Uncategorized
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So right now my transition priority is starting HRT: hormone replacement therapy.

 

For a transman, that basically means taking testosterone for the rest of my life. As male hormones do their thing more-or-less irrespective of whether or not you have a bunch of female hormones floating around, the testosterone will slowly stop the production of female hormones, and take over. Then I go through puberty again, with the random hair, voice breaking, and acne. Not fun, but once it all settles down, boom. Hello, passing, no more periods, and finally being able to get on with my life.

 

Now, as I have ranted and raved before, gender identity clinics are the slowest motherfuckers on the planet. They get zero fundings, have zero staff, and thousands upon thousands of people churning through a ridiculously slow and backward-ass system. The people in the clinics are generally trying to help you, although asshats still exist, but they’re crippled by their own system.

 

Way back at the end of December, I called my local clinic. The pathway on the NHS is very much real life experience to hormones to surgery to more surgery to discharge, takes up to ten years to complete, is extremely rigid, and the waiting list to even begin was three and a half years. I rang them to explain I’ve been diagnosed, so I don’t need that, I’ve had all the surgery I plan on having, so I don’t need that. I literally need hormones. And once prescribing my hormones has been safely passed back to my GP, I will wave goodbye to gender clinics forever.

 

Simple, right?

 

At first, yes. The clinic sent me a letter to explain to my GP what to do, as GPs frankly haven’t got the first clue. My GP read it, said, “Right, I’ll do that then,” and sent it to the endocrinology department that the clinic recommended, and–

 

Stop.

 

Four weeks later of hearing nothing, I rang the hospital. “Oh!” said the receptionist. “I can’t find you on our system!” You’re fucking kidding me. Actually no, several rustling noises later, she unearths my referral and says, “Oh I see, it’s from the gender clinic.” No it isn’t, it’s from my GP. “You’ll have to go the monthly clinic, the next available appointment is in June.”

 

June. Six months after the referral was sent. Well over the 18 week target to start treatment. I’m not even going to see the consultant until the 19th week, and given that apparently he can only see transgender patients once a month at a special clinic (instead of, I don’t know, seeing us and treating us like regular patients), it’ll be July or August before I get my first hormone shot.

 

In this exchange, mostly done through gritted teeth, I learned the following:

  • It’s okay to separate transgender referrals from cisgender referrals and stuff all the transgender patients into once-a-month clinics, as opposed to letting them have regular appointments like everybody else.
  • It’s okay to breach your rights as a patient — 18 weeks doesn’t matter, because your other option (going through the GIC) is worse.
  • It’s fine for staff to not actually read your referral and have no idea where it’s coming from, because hey, you’re only a transgender person, it’s not like you have a real thing needing real treatment.

 

Unfortunately for the staff at this particular endocrinology department, I managed to go from referring myself to a psychiatrist to having surgery in six months, something that usually takes year. I am not going down that easily.

So it’s not Sunday, and normal service will resume next week.

However, it is now 2016!

I actually made goals for 2016, something I haven’t done in a long time. And one of them was to start hormone treatment. Only that’s going to be way harder than writing it on a piece of paper and going ‘hey, I can totally do that.’

The thing is, hormone treatment is usually the third step, after diagnosis and social transition. But for me, it’s the last step. I have no plans at the moment to have bottom surgery, and I’ve already been diagnosed, socially transitioned, and had top surgery.

Unfortunately, NHS services really do presume that anyone accessing a gender clinic hasn’t made any steps whatsoever, so the information that’s out there is useless when it comes to how flexible they’re prepared to be. The Laurels in Exeter had all the flexibility of a plank. I hadn’t heard awesome things about Leeds either. And Nottingham was to be avoided at all costs.

I live near Leeds now, so I sent them an email detailing the situation. Imagine my surprise when I was called back the same day by the Leeds Mental Health Team! (Seriously, for the non-Brits here, NHS efficiency is an oxymoron.) Well, the first lovely fact of that phonecall:

It will currently take you three and a half years to get your first appointment at the gender clinic after being referred.

Seriously, three and a half years.

On top of that, by the way, it takes four months to be diagnosed, up to two years of social transition before an eighteen month hormone treatment plan and, two years later, surgery. That’s just under TEN YEARS to transition on the NHS right now, from that very first referral made by your GP.

Oh, and if you want help in that time? Call a hotline, NHS has no resources for you.

Ten fucking years.

Thankfully, the clinic lady was actually helpful to me. She outright admitted that going through the clinic wouldn’t be ideal for me, and offered to write a letter to my GP telling him to refer me directly to either a local endocrinologist, or one in Harrogate who has worked with their patients before. Cut out the clinic entirely, and crack on with the hormone treatment separately from the gender services.

And the waiting list for an endocrinologist right now? About two months.

Three and a half years versus two months, I know what I’m going to try.

So seriously, if you’re a trans person needing something a bit different from the gender services, call them! They will try and help you get around the problem. And if they don’t? Complain the fuck out of it. It’s only by complaining we’re going to change the system, because three and a half years to wait for treatment is longer than people waiting for a cosmetic boob job on the NHS. It’s absurd.

 

 

(happy new year!!)

So what’s involved in female-to-male transitioning?

 

Generally speaking, transition can be split into two pieces: social transition, and medical transition. In some countries, legal transition could be considered its own unit but in many countries legally becoming your chosen gender is very patchy and complex, and is completely bound up in social transition, so for the purposes of clarity, I’m sticking with these two lumps.

 

Social transition is what it says on the tin: it’s transitioning as far as society and your social life are concerned. That basically encompasses going about your life like you’re already your preferred gender, as much as possible. For me, this was largely about changing my name, coming out to everyone who knew me, wearing men’s clothes, and adopting a male position in life as much as I could without medical transition.

 

Sometimes, social transition is enough. Sometimes it’s not, and people choose to also medically transition. That is, they undergo medical procedures to bring their physical body far more into line with their gender than it originally was.

 

Key point: some transgender people do not medically transition. It doesn’t make them any less transgender, and anyone who says that it does is a dick.

 

Medical transition is very different for MtF and FtM people, and my experience wholly lies with FtM transition, so that’s what this post will focus on.

 

Basically, there’s three main steps: hormone treatment, top surgery, bottom surgery. Typically, they’re in that order too.

 

Hormone treatment is basically being prescribed testosterone by a doctor. It’s known as T generally within the trans community, because it’s a long and clumsy word, and T more or less puts you through puberty. Over time, your voice drops, you grow body hair in places you didn’t before, your sex drive sometimes changes, and in the short and mid term, some people have felt very aggressive.

 

Top surgery is removal of the breasts and re-contouring of the leftover tissue and skin to create a masculine chest. It’s not quite the same as a mastectomy, but it’s very similar to us laypeeps. The procedure is a major surgery, conks you out for a while, and leaves scars. But hopefully over time the scars fade to the point you can’t see them. Google ‘topless transman’ to see some results.

 

Bottom surgery is kind of two things: one version is removal of everything feminine between your ribs and your knees, i.e your uterus, vagina, etc. The other version is lengthening of the urethra (can’t spell…) to create effectively a micropenis. Bottom surgery is actually pretty unusual and the majority of transmen don’t do it. Moreover, removal all the ladybits can have major health complications and surgeons can be pretty reluctant to do it unless your dysphoria is exceptionally bad relating to it.

 

Those are the extreme basics. Each ‘step’ is very complex and individual, can be done out of order, and is wholly dependent on the individual undergoing transition. So here’s a case study: me.

IMG_2572

Generally, I can pass okay at the minute. Except in the summer. This is a photo taken in June by the North Sea, so it was cold enough to wear a jacket. Because the problem is that I have a massive rack. Seriously, 30F. And when it came to medical transition, I knew what had to happen.

 

I was not brought up in a trans-friendly area. I don’t currently live in one. So for me, I needed to be able to switch very fast between ‘looks female’ and ‘looks male.’ In the winter, I already look male, but in the summer, there’s not a hope thanks to my chest. So I opted to have top surgery first. See this post for a rant about how difficult that was!

 

In November, I will have my top surgery. Some time after that, I will start hormone treatment. And I won’t have bottom surgery. That’s what medical transition is for me. Other guys have had bottom surgery. Some guys haven’t had top surgery. One guy I know isn’t going on hormones because it’ll wreck his singing voice and that’s more important to him than the funny looks he gets now when he speaks.

 

Medical transition is formed on the basic steps — but the journey through those steps, which ones to take and which ones to skirt around, is entirely individual.

 

 

 

 

 

(Major apologies for skipping a week — I went camping, and had no access to the online world. My bad.)