I said I’d keep my transition topics to Tumblr, but this one’s kinda big so… here goes!
I spoke about this before but last month I made an appointment for August 10th to finally see someone professionally about going on HRT. HRT is Hormone Replacement Therapy, and in my case this would combine the use of estradiol with an anti-androgen. This is to block the creation and effects of testosterone in my body, and to instead have estrogen bind to cells. The human body is kind of incredible, really.
Consider your DNA to be like blueprints of your house. However… you can still make additions, modifications, paint the walls, arrange furniture, etc. XX and XY are the simplest, most basic way of teaching children introductory to biology and are definitely not the only instances of sex chromosomes out there–even in humans. And even then, you can’t go and readily check someone’s chromosomes.
Depending on the person, of course, with enough time and levels of particular hormones their cells will express certain traits. In my case, eventually they’ll all express more feminine traits. With a little genetic luck I may someday recognize the image reflected in the mirror.
We went to Planned Parenthood for the appointment, and I got to answer a bunch of checklist style questions on this tablet of theirs. It was nice because I only needed to answer a few things for insurance, and the rest was for their records and my comfort. That said, putting down on an official document that I’m a woman gave quite a few notable firsts for me.
To start with, like yeah I’m a girl and I like girls. Okay! For sexual health though this meant I clicked the homosexual box, which for those of you who follow my Twitter I think this had more of an “wow, I’m gay AF” impact than any other picture I’ve ever RT’d. Then there was the confirmation that I’ve never been and am not currently pregnant. I understood at this point that these were just routine questions for the system for anyone who clicks the Female checkbox, but as someone not equipped for that I just kind of stared at it for a while.
A few minutes after giving the completed tablet over to front desk, I was called back by their trans health care manager. She personally handles the intake process here, and it is their policy to take everyone back individually at first–so Nikki had to stay behind for a bit.
A Healthy Soul Dwells Within…
The reason for the patient going back alone is confirming that you’re safe, first and foremost. As well as answering any personal questions that whoever you’re with might not know yet, if you’re not ready to tell them. Aside from things that I am sworn to not tell, I am an open book to Nikki–so no worries there. We’ll go ahead and call the lady we were speaking with ‘M’ for the sake of brevity.
M handed us a copy (from 2016 dang!) of their informed consent paperwork as well as a copy of the chart on the general reported effects of HRT for many people. A lot of things I’ve seen from others weren’t listed, but as old as these sheets are and as limited as trans health research is I’m not surprised. M needed to go over with us the usual effects as well as my medical history. She noted that someone like me, young (…really?) and healthy, with limited to no genetic issues in my family history that she’d be surprised if we ended up having any issues in the medical follow-up.
Estradiol and spironolactone work together pretty well. The side-effects are mostly countered by each other, along with ensuring that you have good health as a patient. M noted to watch out for any dizziness or any other strange occurrences beyond about twenty-four hours. As well as to generally keep them informed of what I’m doing with my choices in the medical transition process. Another thing she covered was fertility, with Nikki there with me. We definitely don’t plan on having kids for the time being, but you never know what the future holds. Depending on what happens down the road too, we agreed that adoption is also something to strongly consider.
Support Roles are Important Too
M asked about my support system. I told her about Nikki there, and my Mom. That we’re out to nearly all of our offline friends. And of course, about all of you. When telling her about my Dad, she said that the parental bond is strong… and sometimes losing that can be hard. Though sometimes people surprise us, too! People we think will be awesome about it aren’t. And people who couldn’t possibly by supportive are right there by our side. So it’s important to have a strong network in case anyone isn’t so great.
I was asked about my work situation. I told her about the past, and current situation in my office. How I’d prefer to just live presenting masculine for as long as I can, and go from there. She brought up what if Nikki and I are on a date somewhere and someone from work catches me in a cute dress? M noted how living a double life like that can be stressful and mentally exhausting. I expressed how I’m pretty much already doing that with offline and online, so I’ve definitely got the experience! But it’s a valid point to consider, for sure. We came up with a plan to eventually work my way through my company’s HR and either figure out or create their policies and go from there.
It was also something to consider with my Dad, as Nikki brought up. That it’d be better to tell them early, on our terms, than for them to find out later. Especially to be the last to know, because that confirms you didn’t trust them with it. Telling my Dad he’s got a daughter is going to be arguably the most daunting thing I’ve ever done in my life, and coming out to my Mom was already something else. I don’t know when nor how I’ll do it. Honestly, I was kind of hoping he’d continue being as oblivious as he is–he failed to notice wreaths on a wall for a year and a half after all. But he’s been coming a long way in his personal growth lately. We’ll see!
Not So Fast
With that, I was handed a pen to sign the informed consent paperwork. I glanced at Nikki and confirmed with her that we’re taking this step. She’s been my rock through and through–and this is her journey as much as it is mine. She gave the OK, and I checked the boxes for estrogen and an anti-androgen and signed my name and date.
After that, M directed us to their lab chair and thanked us for our time. The phlebotomist came by and took my blood… upon which I had confirmed that, no, I didn’t have to fast for twelve hours before the appointment. Alright alright, I was being overcautious. Whoops! Even though I was hoping on baited breath that I’d be in and out with a prescription in hand, they need a week to send off and test my blood sample. That’s fine!
We left, forgot to make our follow-up appointment, went back in and then made it for the earliest date possible: August 20th. A tiny part of me whined why it was so long. But y’know, after 29 years of this? Ten more days isn’t so bad.
Om Nom Nom
Afterward we chose to eat locally at a new place. This was a special day to remember, after all! And we were both extremely hungry. We ate at a place called The Greene Turtle, a little sports bar and grill in an open mall area. I’ll particularly remember this place because they’re using their own recycled paper straws which is super neat. And yes, they withstand being wet from the drink pretty thoroughly. It was still firm and straw-like after a few refills. I think this is a nice answer to the whole “plastic straws are bad!” thing, because straws themselves are primarily for accessibility.
Anyway, I had ordered my burger medium-well but some parts in the very center were medium-rare. This is fine, because I like anywhere within the medium range. It was just something to note as I absorbed it into my soul directly. The fries were good, and Nikki seemed to thoroughly enjoy her meal. Of special note I’d like to mention their pretzel sticks are out of this world. 10/10 would go there just to eat those again. And for neat paper straws.
On Topic: Intake Method
Sorry for my diversion there but I really wanted to mention that place. Especially as hungry as I was. So estradiol has a few methods by which you can take it. There’s the pill form, which some handle by swallowing but then there’s an extra liver bypass which consumes a huge percent of the pill. So most places, including Planned Parenthood, suggest putting it under the tongue and letting it dissolve. Then there’s also patches, creams, and injection. There’s also a time release injection but that’s crazy more expensive.
Any of these methods vary in their effect from person to person. Most girls are alright with just the pills, as they’re cheap, readily available, and are enough for many to get their hormones within female ranges. Others might have reactions to different methods and have to switch, or aren’t getting their levels properly set and need to change things up. As Nikki’s willing to help with injection, depending on the availability and cost I’m hoping to go that route. One less pill to take each day, massively reported superior results, and a bit healthier.
I asked M about bioidentical progesterone as well, but she’s not the medical intake person so there wasn’t a huge amount of information to give. She was able to confirm, however, that their clinic is one that believes it has positive effects with some patients and are willing to prescribe it. At least, starting at the minimum of three months in–as it’s best to wait for some development. I’ve heard a year for most people, so we’ll see what happens.