hormone replacement therapy, transgender

Estrogen Patches vs. Pills: My Experience So Far

Hi friends! How are you? You look great. Have you been working out? Is that a new outfit?

As I alluded to in my previous post, my new doctor recommended that I switch my estrogen medication. His experience w/his patients had shown a far larger success rate with pills, versus transdermal patches.

Well, I took his advice. On a busy afternoon, I stopped by the pharmacy and picked up my new prescription. For safety’s sake, he’s starting me on a low dosage of 1mg a day. For reference, I was previously on a dosage of four 0.1mcg patches, twice a week (the maximum dosage you can have prescribed).

One of the key things I’ve noticed is something my doctor also pointed out: consistency. Patches can often have variances in how the estrogen is absorbed through the skin. This is important when you’re trying do things like stop or reverse male-patterned baldness (and slow down facial hair growth), or keep your emotions in control. I’m finding he is dead-on about at least two of those points. My mood has been much more stable over the past few days. I’ve felt more alert, focused and less prone to mood swings. Even after a pretty lousy Friday evening, I was able to shake it off and say “meh, those days happen.” I’ve also experience a more-consistent slowing of facial hair growth.

Of course, there are pitfalls. It’s been said that your liver has to work extra-hard to break down the hormones in pill-based estrogen. I had a few trans women tell me exactly that before I started HRT. However, that often depends on which doctor you talk to. My doctor has told me has rarely come across a client who had significant liver problems as a result of oral hormone treatment. In my specific case, I should be fairly worry-free since my liver is already in good shape (thanks in large part to a low-carb lifestyle I’ve led for awhile now).

So, all in all, pills have been a welcome change for me. I’ll be reporting back in a few weeks, once my doctor ups my dosage, to report on any new effects.

Ciao!

hormone replacement therapy, transgender

The Change-Up

Hi friends!

It’s been more than a good long month or so since I’ve posted here (and for good reason, I’d like to think). “What has Alexia been up to”, you may be asking. Well, here’s the Cliff Notes version:

– My boyfriend & I became domestic partners, and we moved in together.
– I made another triumphant visit to my hometown, where I caught up with old friends.
– I landed a new job in the city (San Francisco, for those unclear) as a lead iOS engineer.

As part of that first bullet point, my partner put me on his Kaiser Permanent insurance. Since the time had come to give up my former insurance carrier, the time had come to pick a new primary care physician – one experienced in the care of transgender people like myself.

Kaiser’s suite of transgender services in Northern California, as it turns out, is pretty exemplary. They have a medical center based in Oakland that offers a suite of services to the trans community, and the doctor spearheading the effort to bolster those services is based in Santa Clara…just a few miles from my home. So, I made my appointment and paid my new doctor a visit.

I arrived at the Kaiser hospital & medical center in Santa Clara with just enough time to collect my thoughts over the up-to-that-moment crummy day I was having. After a bit, the nurse called me in to weigh up (I have got some weight to lose, but more on that in another post), take my blood pressure and wait for the doctor.

After a few anxious minutes, Dr. Marcos Siqueiros walks through the door and warmly introduces himself. We have a in-depth conversation about my medical history, and eventually we delve into details about my transition. How I’ve been taking hormones, how long, how I feel, etc.

This part of the conversation is an eyeopener for me. I told him that my previous doctor had recommended patches over pills to take my estrogen, citing that it was the easiest on the liver. He tells me that, for the most part, the differences in how hard your liver works in processing estrogen in either form is negligible, and pills are actually a more consistent way to keep your estrogen levels steady. Even more, he told me that other patients of his had made the switch and were amazed by the near-sudden changes they experienced. On hearing that, the first thought in my head was “I need to get him my last lab reports stat!”

Other eye-opening details about our conversation included:
– disclosing that Kaiser insurance offers facial feminization services
– saying they were in the initial planning phases of covering speech therapy under some insurance plans
– strongly recommending that transwomen be on low-carb diets

All of this was music to my ears. So, I told him that I already had a letter from my therapist recommending me for gender reassignment surgery. As long as I have that in hand, he can get me a referral to the clinic in Oakland for an initial consultation. In addition, he ordered a set of labs done so he could get a baseline reading on where I am right now.

My partner and I left hand in hand, with a smile on my face. I walked out of that building with the sense that I was beginning to take another big step in my journey.