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.

hormone replacement therapy, transgender

A Letter To My 10-Year Old Self

Exactly one year ago tomorrow, I began my medical journey towards becoming my true self. On August 11th, 2015, I stopped into a Walgreen’s and picked up my first doses of Estradiol & Spironolactone.

This milestone is cause for a great deal of self-reflection, both on the past 12 months and my life as a whole. In the spirit of that, I want to try something new. Inspired by USWNT star (and World Cup champion) Megan Rapinoe, I’m going to pen a letter to my 10 year old self.

Continue reading

hormone replacement therapy, transgender

My 9-Month HRT Follow Up

Hi hi!

Today, I paid my doctor a visit to evaluate my hormone levels after 9 months.

I actually hadn’t seen the lab report from my 6 month follow-up, so I was interested in seeing how I was doing. After a little chit-chat and catching up, my doctor prints out my report and breaks things down for me.

The Good
The report mentions the “reference interval” range of testosterone for average adult males up to 40 years old is between 348-1197. Mine, by comparison, is at 8. So, my testosterone levels are minimal. I joked “doc, I could’ve told you that before I transitioned.” *rimshot*

The So-So
My estrogen level was at 46.5. My doctor tells me that the average range for women needs to be in the hundreds, so I’m being bumped up from 2 patches, twice a week to 3 patches, twice a week. To think I was moody before…

The “Let’s Keep An Eye On It”
The most notable thing my doctor pointed out was that my prolactin level was at 26.3. As a preventative measure (he assured me it’s rare that someone at that level would show anything concerning), I’m being sent to get an MRI. This is to ensure that my pituitary gland looks ok and has no abnormal growths. Am I a little nervous? Sure. However, he assures me that there are plenty of options for treatment should anything arise.

As a bonus, my doctor rewrote my prescriptions with my new name. That was nice.

I’ll be posting another update once I hear the results of my MRI back. Until then, be good to each other and GO SHARKS!

coming-out-to-family, hormone replacement therapy, transgender

I Came Out To My Father And The World Didn’t End. 

Yes, you read that title right. I finally told my old school, Mexican Catholic father about my transition. I’m happy to report the world didn’t end and I still have a loving father. You’re probably thinking…

Pretty much.
 
Apparently, for me, it did work that way. I couldn’t be luckier or happier. 

My amazing little brother (who’s known for a while) and I hatched a plan to give him the news. Having a decent meal first seemed like a logical choice, so we took Pops out for a late lunch at our favorite taco shop. (Sidenote: honestly, if you’re not full of love after street tacos, you should probably see a doctor). After a lunch that consisted of way too many adobada & carne asada tacos, we went to a nearby marina for some privacy. 

After a walk for about 10 minutes down a boardwalk, we found a bench with no one around. We sat down & chit-chatted for a bit. I could feel the weight of the world bearing down on me. For a minute, I sat in nervous silence as I stared off into the setting sun against the horizon. Once I found a break in the conversation, I took a deep breath. With a heavy sigh, summoning as much courage as I could, I told him there was something important I needed to talk about, and it’s the reason for bringing him out for the day.

I choked up at least twice, and the second time came with you don’t have to say it if you don’t want to” from my father. I think he sensed that I was coming out as gay. I had come this far, though, and I had to get it out. I explained, through heartfelt words, about my journey thus far. I paused towards the end and, with the entire world fading into nothing behind me, uttered the words that I’ve been struggling and agonizing with for so long: “Dad, I’m transitioning genders.”

A hush fell over us. After a minute, his initial reaction surfaces. 

“Did you get the surgery?” 

“No, that’s not even on the table yet”

I don’t think he fully understood the extent of what 6 months’ worth of hormones would do, essentially not requiring the surgery. For some reason he pleaded not to have the surgery. I reluctantly agreed. 
In the end, after a couple more questions, we shared a big hug and a few tears. He pulled me in close and said to me “I’ll always love you, and you’ll always be my son to me.”
It’s a start. More than that, though, it’s as best an outcome I could’ve hoped for. The world didn’t end, and I still have an incredible, loving and remarkable man I get to call my father. 

Dad, I love you…no matter what. 

hormone replacement therapy, transgender

HRT: Week 24

Hi folks!

Here we are again. After a few weeks of switching things up on my blog, let’s get back to basics with another weekly update on my hormone replacement therapy.

I seem to have hit a growth spurt of sorts. Things I hadn’t felt since a few weeks after starting hormones, like pain in my hips & sore chest, suddenly came back. More importantly, I seem to have finally reached the point a lot of trans-folk refer to as “second puberty”. Aside from STILL being constantly hungry, I’ve noticed a sudden change.

That change? ACNE!!

Not only did it sneak up on me, it hit me with all the force of a sixteen-wheeler. The breakouts are more than a little embarrassing, and now I have to kick my skin care game up a few notches to ensure my face doesn’t feel like a pizza.

tumblr_lqec7mzjir1qfjrdco1_500
My complexion, right about now.

I’m REALLY hoping this subsides in a few months. Meanwhile, aside from proper skin care, I may need to slow down on my performances just so I don’t abuse my face with heavy makeup.

And I had such a nice complexion too. Ugh. Well, until next time friends!