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Starting testosterone therapy

August 7, 2010

I started T on Monday! It doesn’t feel like it’s really happening because my doctor insisted on prescribing gel –and a low dose, at that– but I’m glad that I’ve been able to start on something. Part of the reason I haven’t been posting is that since February or March I’ve been actively searching for an endocrinologist who would work with me, and it proved to be more patience-draining than I imagined. I could get testosterone without a doctor –it isn’t a controlled substance in Argentina– but I chose the safer path.

(I’m sorry if the following account has a negative tone to it: this whole ordeal has been very emotionally taxing. I’ll try to at least be neutral and point out the bright side, and in a day or two I’ll write about nicer things, like my experience with the gel.)

The doctors covered by my healthcare either declared themselves incompetent or unwilling to supervise such a treatment, so I ended up going to a public hospital that has a trans health program. It’s really impressive that such a program exists in a public (government-run and therefore free) hospital, but it has a huge downside: they still require a gender identity disorder diagnosis, and it has to be done by their own psychiatrist. They wouldn’t even accept a letter by my psychologist of two years. And since the hospital has so many patients, one can only get appointments every two weeks (at best) so the diagnostic process lasts several months.

I’ll write about my experience with the gender psychiatrist later; it got ugly at times. He could tell from the first day that I was ready for T, so we both knew my seeing him was useless, but he was very reluctant to approve me in less than his usual time. I was lucky, though, and he sent me forward after some three months (most people have to put up with him for 6-12 months), not counting the months I had to wait before my first appointment.

As an aside, I’m grateful that I didn’t have to pay for my diagnosis — I know that in other countries where it’s still required, one has to pay for it out of pocket. So far, the only thing I’ve had to pay for is the gel (which is expensive, but not so much because it’s generic).

So a couple of weeks ago I finally went to the hospital’s endocrinologist, who prescribed testosterone gel. I’m not a huge fan of how this doctor works: he acts like a technician, only looking at lab exams and not seeing the person at all. Also, he did not like it when I tried to ask questions — he only half-answered them and said “I know what I’m doing” as if I were questioning his authority (I just wanted to know a few things). But after enduring the psychiatrist for so long, I don’t want to leave the program and take hormones unsupervised.

I have mixed feelings about the gel. It was definitely not my first choice, but I had absolutely no say in the matter. I’d feel okay about it if I knew this was the first step, a way of seeing how my body reacts before switching to injections. However, since this doctor doesn’t like to explain things, I might be on gel forever for all I know (and I met a few patients of his who have been on gel for a really long time). I have to see him again in a month, so I’ll try to talk to him about this. I’ve researched the gel and I’m not as prejudiced against it as I used to be, but these doctors’ lack of patient communication skills are really getting on my nerves.

All in all, though, I’m grateful that (1) I have access to a doctor who will supervise my physical transition; and (2) I was finally referred to that doctor and given the green light for starting T. Yes, I’m frustrated because I don’t know how my doctor plans to treat me, but it doesn’t compare to how tense I was when my fate still lay in the hands of the gender psychiatrist. Hey, I’ve been on T for five days!

8 Comments leave one →
  1. August 8, 2010 12:17 am

    I’m sorry to hear it was such a difficult process! Nevertheless, congrats on getting the T!

  2. August 8, 2010 5:49 am

    I’m glad to see you’re back writing, even just a little bit, and with a semi-frustrated update. I was worried about you! good luck with bending the medical profession to your will. and, I totally know what you mean about doctors who won’t answer questions… infinitely frustrating…

  3. nome permalink
    August 9, 2010 9:37 pm

    I was on the gel and actually really liked it. If it helps, I’ve heard from folks who’ve seen both methods that the gel is a smoother, less emotional transition.

  4. August 13, 2010 1:58 pm

    Why would you want to switch to injections?

    I kind of have the opposite scenario over here in a conservative state in the United States. I take testosterone cypionate injections every 2 weeks, but would prefer gel. The injections come with these “peaks” and “lows”, which have me feeling incredibly lethargic/moody pre-injection, and from what I’ve read can actually be harder on the body to have it all injected at once like that.

    With the transdermal T (patch, gel, or cream) it’s typically applied to the skin in smaller daily doses (is yours?), which is better for mood regulation and not as hard on the body to my knowledge – and more similar to how a cisgender feller has a regular daily dose of T.

  5. genderkid permalink*
    August 13, 2010 7:51 pm

    Thanks for passing by, all of you! I’ve gotten over my frustration at the system and I’m pleased with the gel right now (changes have started surprisingly fast).

    Dexter, I was skeptical that the gel would work because I’d read so many negative things about it — for instance, it seems that it makes most people’s changes go slower (based on people who have used both) and I’ve even heard of people who didn’t react to it at all. It is useful for maintenance after the first 1 or 2 years, though.

    I was afraid that if it didn’t work for me, the doctor wouldn’t let me switch over for months until he was absolutely sure that I wasn’t absorbing it. Now that I know it’s working, it’s a different story. I’m even ok with going at a slower pace — it has its advantages (although I still think that patients should have had some say in the matter).

    Also, the injectable T that my doctor uses is applied every 3 months (it’s Nebido, which hasn’t been approved in the US), and since it has different kinds of T in it, it avoids the fluctuations. Given that this doctor only works with Nebido and gel, it makes sense not to start on injections — if I react badly, I’ll have that stuff in my system for months.

    • August 14, 2010 4:42 am

      Ahhhh ha. That is neat, by the way, about the every-3-month injectable T. I hope it’s approved here in the states!

  6. August 31, 2010 10:32 pm

    Just to let you know, not all forms of injection come with highs and lows. I inject sub-Q with delatestryl every week and, since there is an injection before the 10 day absorption period is up, the moods are pretty stable.

    Anyway, I’m glad the gel is working for you : ) I never heard that it didn’t go fast, only that, for some people with specific kinds of lifestyles, it can be a hassle. If I remember correctly, you have to apply every day and be careful not to touch anyone until it is completely absorbed. Some guys that I know who tried it couldn’t handle those aspects of it. But if it’s working for you right now, that is great news!

  7. genderclown permalink
    September 16, 2010 8:39 pm

    Hey genderkid! This is gunk (I have a blog now, and a new name!)
    It’s awesome that you’ve finally started on T, even if the process has been somewhat frustrating. And from your other post, it sounds like some of the effects have been pretty exciting, even if they are small.
    I hope that things continue to work out ok for you. I’m glad to see you back writing again; I’ve missed your blog.

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