Denied by Dr.

[Losethem (imported)]

Thank you all for the comments and advice, it is all very good. It was my general practice Dr. that I spoke with, he seemed to be taken totally off guard, it was like this was the fist he had ever had this conversation. At first he did seem to think I was wanting to get TRT and not chemical castration. He clearly did not understand why I would want to rid myself of libido all together. The bottom line is my wife has had her ovaries removed and an hysterectomy, even before this, she had no libido and I had very little. I think all the other medications like finasteride and metformin have killed my ability to get an erection and lowered my libido. At this point, I have A cup breast, my left testicle is the size of a peanut, the right is the size of a pecan and my penis has struck to about 3 inches. I just want to rid myself of the occasional urge. Hopefully this make sense.

Given this new information, you might have already achieved your goal given your testicles have shrunk and you have little interest. It seems like that's the outcome. I think even guys who have had their testicles removed get interested once in a while, just not all the time like they were before, or when they were 18.

I think the therapist route would be good if you're pursuing this for libido reduction. The SOC 8 actually now speaks about such a scenario. That's the good news. The bad is the SOC 8 was released relatively recently (last fall), so it may not have made it's way down to the local therapist population for implementation. In your situation, I'd read the chapters about

eunuchs and non-binary people,

and you'll find the relevant information for your case. Then take this information to a therapist who deals with gender non-conforming folks. If that label gives you pause, just keep in mind it's best to just roll with it. Let them call you a purple rhino with green spots, if it will get you to your goal. Once you've achieved it, you'll not have to see those folks again unless you wish to.

The roadmap for treating you in a legitimate setting is contained in the SOC8. You might have to help educate those helping you so they know this has a guideline to help, because that guideline has been recently introduced/adopted.

Good luck. I hope to hear you've made some progress, soon.

[erikboy (imported)]

I understand your frustration. Where I live there, it is hard to find any willing doctors. Most are doubtful or trying to speak out of it. On another hand, trying to find a right doctor requires time which unfortunately you are never going to get back. In order not to loose more time and money I took the risk choose and bought drugs myself. But I did only after I felt confident enough to take the risks, to reduce unknowns. I learned how the drug works, how endocrine systems works etc. What other doctors think about this or that drug.

If doctor is wrong, then he or she must answer, if you are wrong you can not blame noone else but you.

A lot of thinking here.

[Nikki85di (imported)]

I believe that is kinda how it goes, I had to speak with a gender specific therapist for a year before I got green lite.

GP's and hospital specialist are not trained in topics like these

[rdfwtexas (imported)]

I have never really gotten anywhere with my Dr. and basically have given up. However, I did finally get him to check my hormone levels after complaining of fatigue. My testosterone was 405 and estradiol was 54 which he said is normal for a 60 year old male. What I have found online, 54 seems high which I am OK with. It seems like my desire for lower testosterone and not liking the fatigue don't go together and I can't have it both ways. Dr. said I if lose weight that will help. I think the finasteride and diabetes may also cause the fatigue, he didn't think so, but he did say the finasteride is why I have large boobs. My wife measured me and I am a B-cup, she thinks I should be wearing a sports bra. I basically look like a 60 year old pregnant man. I also have to go see a cardiologist because of a high calcium score, after I get through this I am going to find another Dr.

[WheelyFixed]

I have never really gotten anywhere with my Dr. and basically have given up. However, I did finally get him to check my hormone levels after complaining of fatigue. My testosterone was 405 and estradiol was 54 which he said is normal for a 60 year old male. What I have found online, 54 seems high which I am OK with. It seems like my desire for lower testosterone and not liking the fatigue don't go together and I can't have it both ways. Dr. said I if lose weight that will help. I think the finasteride and diabetes may also cause the fatigue, he didn't think so, but he did say the finasteride is why I have large boobs. My wife measured me and I am a B-cup, she thinks I should be wearing a sports bra. I basically look like a 60 year old pregnant man. I also have to go see a cardiologist because of a high calcium score, after I get through this I am going to find another Dr.

No need to give up, though finding another doctor might be a good step depending on how your current doc is otherwise... You got a LOT of good advice earlier in the thread, and following it is a good place to start....

I'd also point out that pretty much any doctor is going to want the other medical issues cleared up, or at least managed well, before considering surgery (which is the case for ANY sort of non-emergency operation) so getting started on that is definitely a good idea. However you can 'multi-task' and especially given the wait times and need for therapist letters etc. there is no reason not to at least get things started on getting the WPATH requirements handled while also working on the other issues....

WheelyFixed

[rdfwtexas (imported)]

Thank you for the response, I have been dragging my feet on this because its hard to get the courage to discuss these desires and be very open, even with the Dr. I beat around the bush a little trying to get him to understand, hopefully I will find a Dr. that is easier to talk to, maybe a female Dr.

[WheelyFixed]

I have heard some say female docs are more sympathetic to deal with, so you may be right. I'd also repeat my earlier suggestion of finding one that is associated with a TG center as they have heard it before, so are more likely to be understanding about what you want....

FWIW my TG doc is female, but the urologist that did my surgery is male, and so is my PCP, I haven't had problems with any of them.

WheelyFixed

[Lenkusov (imported)]

IMO the easiest way to bring these things up is in Patient Portal messages, if you're in a modern-enough practice for them to have a portal. Lets you write out your actual, full argument without getting interrupted or running into your 15 minute time limit, and I find it a lot easier to speak my mind over text-based means than face-to-face or video calls. If it's possible, I'd just type up a message saying what you actually wanted to say and a buncha possible ways to go about things, even include some links, and see what happens. The worst they can say is "sorry, we don't provide those services at this practice" in which case you ask for a referral. Puts the ball in THEIR court and doesn't cost a visit copay.

[WheelyFixed]

Excellent suggestion Lenkusov! The only thing that might be a problem is if the portal has message length limits, I know that the portal my hospital uses does, and it's running on "Epic" which is a very common platform for hospitals, etc... It is also likely that your message will be read by one or more of the doctor's staff before he sees it, as it is often the case that the staff screens the messages and handles what can be taken care of w/o needing the doc's attention... (IMHO this is generally a good thing)

The best way to get around length limits can be to make the message in a different program and save it in a format the portal will allow (.pdf usually works, .txt probably won't) then attach it to a shorter summary message... However keep it as short as possible, as the doc probably won't be willing to read a novel... I've had docs say they flat weren't going to look at linked references for instance...

WheelyFixed

[sftineun (imported)]

Thank you for the response, I have been dragging my feet on this because its hard to get the courage to discuss these desires and be very open, even with the Dr. I beat around the bush a little trying to get him to understand, hopefully I will find a Dr. that is easier to talk to, maybe a female Dr.

Not knowing where in Texas you live, it may be best to find doctors / therapists with direct experience with transgender / non-binary issues, most probably in large cities such as Houston. Opening up to other doctors, even female doctors or chatting over portals may be just talking to people who not only have no experience with our issues, but also have biases and prejudices against people like us.

Best of luck to you.