GenderLife Forum: The Information Exchange

'ello,
Recently joined and I'd like to share my journey with those wanting to hear it.
Forgive the 'bullet point' style, it helps me sort out things ^_^

Oct. 7th, 1983; I'm born, I have an older sister (and have a younger sister as well 4 years later)
I've always felt different than the other kids, guys call me names because of my weight (I've always been very thin), girls are more kind; they want to play and do dress up (something the guys use as ammo later).
Summer-time, 1992; I play dress up alone for the first time, using my older sisters clothes and model for my younger sister.
Parents break up in 1996, I go with my mother.
I tell a friend I think I'm supposed to be a female and wish there was a way to make it happen, he stops talking to me (as does the next friend I tell)
I retreat inward, saying "there must be something wrong with me" if everyone I talk to stops speaking with me.
Halloween 1999 my confidence grows a bit after talking with a female friend who's brother is a CD. I dress in drag as a costume during my high school's 'Halloween event', a few jocks corner me and pull me out to a truck where they each raped me and beat me. I'm on crutches the rest of the school year. In my mind I tell myself that "this is what happens to freaks like me" As a defense I start to act like a dick to everyone, not letting myself get close to anyone beyond Friend and go through a long list of girlfriends (many of whom I ask to marry me, because 'that is what a guy is suppose to do')
2002, I see a 'I was once a guy' TG themed episode of some day-time show (Springer, Maury, etc. I can't remember which one it was) and I cry for hours afterward, I wasn't alone.
2005, after breaking up with my girlfriend of 3 years, I date a guy for the first time. Had a good time but he was too focused on getting to the sex (proud of myself that I held out.)
Couple of months later I date another guy and he was amazing. Serious head swoosh moments, had sex for the first time and aye, it was amazing.
Guy has to leave (military, and was afraid if his squad found out he'd be bunk-beat). An old friend comes back into town and I hang out with her.
We hit it off pretty well and start to date. A month or so later she proposes to me, I'm shocked speechless and accept.
I love her, but I still feel... wrong... in my mind I tell myself it is because I was with a guy before her, that this is what is natural and before was un-natural.
We find out she is pregnant, freak out over not being prepared and she miscarries.
Fast-forwarding through 3 years of moving every 4 months to a different state or city, another miscarry and a successful birth (my 2 year old son) and the feeling of wrong-ness is still there, more intense even.
I go inward to find answers and the 'I used to be a guy' episode plays in my memory, I can remember the episode completely from intro to credits. I cry again and drop into a deep depression. I can't find the words to tell my wife, knowing she does not want to be with a woman and fearing she would leave with our son. I start the process of regesturing here to ask for help from folks that have gone through something similar.
Yesterday (Jan 24th, 2012) I get up the courage and speak to her. Things go about how I feared, she states I am insulting her choice to be with a man, how she wishes I didn't hate myself so much as to want to mutilate myself and she does not want to state to our kids how their dad 'hated men so much he had surgery to become a girl'.
I agree to spend a year going over the various things I don't like about myself when I think of myself as a man, to see if maybe it is just those things and not my gender that is the issue.

Welcome to the forum. I would suggest you find a experienced gender therapist. One that has worked with numerous clients, and also has list of medical people as far as HRT, Doctors for different surgeries.

You might want to consider having your wife attend sessions with you. I did that with mine, so she could get her questions answered, also.

I'm planning on seeking one out (anyone know of a good one in Charlotte, NC?) though I've already spoke to my wife about going with and she is against the idea. She does, however, want to go to marriage counseling, so that's a start

Beware that some marriage counselors have a religious agenda. I would still suggest you find your own therapist, that specializes in gender issues. Another ting to think about is the money angle. Transition is expensive. But more insurance companies are covering more. You can check with your local PFLAG groups for recommendations of a decent therapist.

that is something I've been wondering about, I've noticed that talking about your treatment doseages is a bit taboo (mainly because ye don't want self-med'ers to take it as guidelines) but is talking price taboo as well? I'll be doing this, in the beginning, on a budget so I'd love info on the averages prices of HRT without having to pay a doctor just to get that very info ^_^

Get your estrogen from Wal-Mart pharmacy.Cheapest place to buy them. My doctor started me on .05mg, reevalulated every 6 mos, and made small increases in dosages.
Electroylsis will cost almost as much as SRS, by time you are done(unless you have SRS in Thailand). Don't know about cost of laser. If you are considering facial plastic surgery, can cost quite a bit , also.
When I started transition, we sold our house. Used that money for transition. But we also moved to a larger city, and rented a house.

HRT basics:

Some HRT medications are available on the Walmart $4.00 / 30 days, $10.00 / 90days formulary.

There are many, many, pharmacies that match Walmart pricing, so using Walmart directly isn't actually necessary, but can be helpful if alternatives aren't available.

To start out:

2mg estradiol would cost about $10.00 / 90 days at Walmart

25mg Spironolactone is $10.00 / 90days at Walmart

10g Medroxyprogesterone $10.00 / 90days at Walmart


The medications and amounts are directly from the Walmart list, and shouldn't be construed as any sort of specific dosage recommendation (ask a physician for medical advise), but rather as a buying strategy that minimizes expense. Based on these prices, it is theoretically possible to begin a basic HRT regimen for about $10.00 per month, which seems like something anyone can afford.

Many physicians willing to prescribe HRT for pre-op ts-womens' purposes are actually pretty clueless. Consequently they may not be aware of, or knowledgeable enough, to prescribe the set of medications above at the right doses to achieve the sort of budget described above. So, be prepared to educate whoever does your prescribing.

There are alternative medications to the ones listed above, but for anyone on a budget, the three above will get the job more than well enough to justify the price savings.

Many people have found that at a certain stage of HRT development going to high dose progesterone of some sort can remarkably increase breast development, and especially areola/nipple development. Having as large as possible areolas helps to make breast augmentation with a periareolar incision possible.

Experimentation with higher estradiol doses after an initial trial period can be a useful exercise too. However, excess estrogen can be counter productive, because it can induce endogenous hormone production that counteracts the effects of estrogen! The best plan is to get blood tests to measure blood plasma estrogen levels, to determine exactly how much estrogen is actually making it into the blood, since some may be lost to liver metabolize by some people, and the only way to know is with specific blood measurement. Again, many physicians are pretty clueless about this and won't suggest periodic blood estrogen measurement on their own, so you may need to educate your prescriber. It can also be important to measure blood plasma testosterone levels while still possessing testosterone producing gonads while taking an anti-androgen medication. Also, blood plasma estrogen measurements only work with estradio/estrace, and not with other estrogen analogs like Premarin (Pregnant Mare's Urine) (which is mostly estrone sulfate) or synthetic estrogens like those used in most birth control pills.

(source - Walmart 2012 $4.00 / mo drug list)
http://i.walmartimages.com/i/if/hmp/fusion/customer_list.pdf


p.s. Consider yourself lucky for many reasons. One great reason is because of the invention of anti-androgen medications, even though they were invented for entirely different purposes. Back in the pre-historic early days (1960s - 1970s - even 1980s), people on pre-vaginoplasty HRT took huge amounts of estrogen to suppress their testosterone production because anti-androgen drugs had not been invented. The amounts they took would be considered completely outlandish and outrageous, if not dangerous, these days. Back then people used a synthetic estrogen called ethinyl estradiol, which its maker manufactured in a mega dose of 10mg to be used for treating prostate cancer (because anti-androgens did not exist), which is a dose that is equal to about 100 times a 2mg dose of estradiol/estrace, plus large amounts of injectable estradiol valerate. Amazingly, there aren't any reports of liver failure, stroke, or related potential side effects in the medical literature, or even in folk lore within the ts-population, about the consequence of that HRT strategy. Thankfully, pharmacology has come a long way from those meager, and rather brute force, radical, early days ts-HRT.

Also, a good way to tell if a physician or whomever you are dealing with is serious about and/or experienced with helping ts-patients is to ask them if they are members of HBIGDA/WPATH. People who are not members of WPATH are usually pretty clueless and/or aren't knowledgeable enough to know that becoming a member of WPATH is a minimalistic way of demonstrating to potential patients that they are actually interested in the subject matter they are treating.

http://www.wpath.org/

Thank you all very much! I had fears of it costing like $100+ a month lol
One thing, how much do these blood tests normally cost? I know they're more of a one every six months type thing but for a budget that probably means saving a little each month so it adds up to the right amount every six months ^_^

The cost of blood tests to measure plasma estrogen and testosterone levels can often be more than the entire annual expense of the HRT itself.

Getting any blood test, even a basic complete blood count (CBC), usually involves multiple charges that most people don't notice because they have insurance and don't scrutinize the details of their medical bills.

The costs can include:

physician office visit charge
physician room rental charge
(this is a recent healthcare scam)
blood draw charge
actual blood test charge


A lot of physicians have figured out that they can multiply their revenues by charging patients for the exam room and separately for the physician's services. It is a scam, but insurance companies are letting the system get away with it. Then they also let the nurse/phlebotomist who draws the blood collect a fee just to do that, over and above the separate cost of the actual test performed at the lab. Then each of the lab tests has a charge.

The four parts of the charges can quickly add up to hundreds of dollars. Consequently, it is a good idea to get an entire set of annual blood tests performed all in one visit, since the fee for first three parts stays the same even for multiple blood tests. Also, although HRT is generally safe for 99.9% of the population, before starting HRT, blood tests should include standard liver function tests, since people with liver disease need to be watched carefully while taking any medications, including estrogen and such. An even smaller group of the population has blood clotting abnormalities that can cause blood clots while taking estrogen and/or progesterone, but that is even more rare.

Frankly though, the majority of people doing pre-vaginoplasty HRT do it without any blood tests whatsoever. Consequently, given a cooperative physician, and a healthy patient, it is possible to skip the blood tests.

Also, depending on your insurance, the blood tests might make it under the radar unless the physician raises a red flag by reporting a ts related diagnosis to your medical insurance. You may want to discuss that very frankly with the physician who gets the blood tests performed. If your physician outs you to your insurance company, because of big brother insurance information sharing, you may find yourself outed to the health care system for life, and consequently discriminated against by insurance companies long into the future, as they refuse to pay for all manner of tertiary medical care they believe might be even remotely related to being ts.

Good luck.

ew scary X_X
I've never had any blood issues, so that is a good thing, and thanks for the tip on speaking to the doctor about being gentle in their reports. Now I'm currently not on any insurance though I plan to be somewhat soon, does anyone know if it is possible for them to read any reports from -before- I was under their insurance? Basically what I am saying is should the doctor not mention things even if I'm not on an insurance plan?

If you keep the same doctor. The insurance insurer will look for any pre existing conditions. An that might not get covered.

I have been on HRT for 5 years, never had blood test to check levels.