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.

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out-and-about, transgender

Truth, Purpose & Letting Go

Hi friends. It’s been a little while since my last post (I feel like I keep saying that).

For what it’s worth, I’ve been struggling to find the right topic to write about. I always have a tendency to write about what’s top of mind for me, but there’s been so much going on lately that it’s hard to pick just one thing. So, to get back on track with regular updates, I’ll share my thoughts on a pretty big moment for me.

This year, I was asked to be part of the entertainment lineup at San Diego Pride. Specifically, I would be one of the DJs at the new Free Rainbow Zone area. This was a big deal for me. To come back to my hometown, do what I love to do, and represent the trans community in a very public way? How could I say no to that?

Word got out quickly, and I was contacted by a journalist from the San Diego Reader. He wanted to do a profile ahead of the festival, on one of the performers, for the print & online edition of their publication. Being trans, a DJ, and originally from San Diego, I seem to fit the bill. However, in my conversations with him, it became clear that I would need to do more than talk about myself in the current sense. I’d have to reveal my past – who I was, where I’m from, my old name, etc. I’d essentially be doxxing myself. People from my past would know where I had gone. My past, my innermost feelings on transitioning, even where I went to high school; it would all be there for public consumption.

Most trans-people that I’ve met choose to live a private life, and for good reason. They struggle so much with just being accepted and getting to a place in life where they can live day to day without harassment and scrutiny, a quiet existence blending into the crowd sounds like bliss. To some degree, I had managed to accomplish that. While my friends all knew about my past, the general public would see me and not assume much beyond my short stature. Why risk that all now? Why put it all out there, and put myself up for open discussion this way? Why give up control of who knew what about me?

I did it for a reason bigger than myself.

If you read most media coverage on transgender people, you’ll often notice a recurring theme. We’re often portrayed as down-on-our-luck outcasts, living in the shadows. I wanted to do my small part in breaking that narrative and show everyone that being who you truly are is not an automatic sentence to a lifelong, personal hell.

Perhaps more so, in coming out, people who know me now have a personal stake in the struggle for full equality for the trans community. It’s often said that people don’t pay much attention to an issue unless it affects them personally. Sharing my story connects everyone who knew me before, and now knows about my transition, to the struggle in some way.

A fellow DJ at San Diego Pride asked me if I would let her share the article on Facebook. She revealed to me that she has a transgender stepchild, and she wanted to show that trans people can be successful, and can live openly…proudly.

Right at that moment, I knew what I had done was worth it.

(If you’d like to read the story, click here and take a look.)

 

out-and-about, transgender

My First Swimsuit

Hi friends!

This past weekend felt like a rite of passage for me, as I attended my first bachelorette party with some of my very best friends, and maybe a little too much fun was had by all (note: is there a thing as too many mimosas? ) Of course, we did the typical things. We all got dressed up and went out for drinks. We got up and drank a restaurant out of all of their champagne. We all wore matching tops. However, one of the planned activities had me nervous from the moment I heard it would happen: we’d be hitting a hot tub during the day. That meant I’d have to wear a swimsuit and not much else (well, maybe sunglasses).

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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!