Re: Some German Eunuchs here?
Posted: Sat Jul 20, 2019 6:20 am
Hello again!
No personal offense taken for any terms as long as they are not directed directly towards me. I just wanted to remind readers and contributors that not everybody uses, likes and fits every terminology. Of course it is up to every individual themselves how far one wants to phrase inclusively or explicitly. My learned lesson is that if one is interested in a wide scope of people and responses, they are more likely to achieve that when phrasing cautiosly and inclusively. One can always specify later.
Having said that, some answers to your question.
I had a short talk with my GP before going for the orchiectomy, she knew I would come back without testicles, and she offered any help she could provide. I also had some contact to an urologist some years ago, when I had halfway done the job myself with injections, and I was open to him, too. He also offered an open door and help (although he probably would never have helped with testectomy without a solid indication like cancer). So I knew I could fall back to something.
I had also taken self-provided antiandrogens and estrogen for a while twenty years back, and I checked for a supply before leaving for the testectomy to be sure to have one if I needed or wanted one because of the repercussions of the surgery. After three months, the hot flashes got so extreme that I started medicating. I knew that sooner or later that would have to be looked after by a doctor and that it would be wise to get a proper prescription and maybe also dosage by a specialist.
So in 2018 I went to aforementioned urologist. He did thorough blood (liver, kidneys etc.) tests (everything ok) and also hormone levels, but was relatively uneducated about estrogens and the according risk assessment for things like blood clotting and breast cancer. He said he couldn't prescribe me with estrogens, only testosterone if I wanted. I did not. Next I went to a psychiatrist, who in principle could write prescriptions, but in that case did only a psychological assessment and sent me to an endocrinologist. The endocrinologist again did blood tests finding everything in order (again), but after some discussion and back-forth communications with the psychiatrist refused to prescribe estrogen, because I do not have a diagnosis of "transsexualism" (F64.0 in ICD-10). I do not want that diagnosis, anyway, and, taken literally it would be wrong anyway, since I do not "have the wish to live as member of the opposite sex".
Now I am trying to open a route through the application of a recent German guideline on "gender incongruence, gender dysphoria and trans health: diagnostics, counselling, treatment" (AWMF 138-001), which also covers people under the non-binary label. I think that guideline can be used to make the system provide help to people like me. My GP also knows that I am self-medicating with hormones, and maybe I can convince her to give me a prescription, or I just continue to cause costs to the health system by sitting around in doctor's offices, while hoping to always find a source for self-medication that does not get me (or anybody else) into trouble.
As I stated before in a different post elsewhere, my main advice for you personally would be: Think really hard about what you want. Get clear about your motifs, expectations, be realistic if they can be met, educate yourself about the repercussions of what you want, check if there are other, maybe less radical ways to reach your goal. You needn't take 25 years for that like I did, but take your time. If in the end you come back to the same conclusion all over, go through with it.
No personal offense taken for any terms as long as they are not directed directly towards me. I just wanted to remind readers and contributors that not everybody uses, likes and fits every terminology. Of course it is up to every individual themselves how far one wants to phrase inclusively or explicitly. My learned lesson is that if one is interested in a wide scope of people and responses, they are more likely to achieve that when phrasing cautiosly and inclusively. One can always specify later.
Having said that, some answers to your question.
I had a short talk with my GP before going for the orchiectomy, she knew I would come back without testicles, and she offered any help she could provide. I also had some contact to an urologist some years ago, when I had halfway done the job myself with injections, and I was open to him, too. He also offered an open door and help (although he probably would never have helped with testectomy without a solid indication like cancer). So I knew I could fall back to something.
I had also taken self-provided antiandrogens and estrogen for a while twenty years back, and I checked for a supply before leaving for the testectomy to be sure to have one if I needed or wanted one because of the repercussions of the surgery. After three months, the hot flashes got so extreme that I started medicating. I knew that sooner or later that would have to be looked after by a doctor and that it would be wise to get a proper prescription and maybe also dosage by a specialist.
So in 2018 I went to aforementioned urologist. He did thorough blood (liver, kidneys etc.) tests (everything ok) and also hormone levels, but was relatively uneducated about estrogens and the according risk assessment for things like blood clotting and breast cancer. He said he couldn't prescribe me with estrogens, only testosterone if I wanted. I did not. Next I went to a psychiatrist, who in principle could write prescriptions, but in that case did only a psychological assessment and sent me to an endocrinologist. The endocrinologist again did blood tests finding everything in order (again), but after some discussion and back-forth communications with the psychiatrist refused to prescribe estrogen, because I do not have a diagnosis of "transsexualism" (F64.0 in ICD-10). I do not want that diagnosis, anyway, and, taken literally it would be wrong anyway, since I do not "have the wish to live as member of the opposite sex".
Now I am trying to open a route through the application of a recent German guideline on "gender incongruence, gender dysphoria and trans health: diagnostics, counselling, treatment" (AWMF 138-001), which also covers people under the non-binary label. I think that guideline can be used to make the system provide help to people like me. My GP also knows that I am self-medicating with hormones, and maybe I can convince her to give me a prescription, or I just continue to cause costs to the health system by sitting around in doctor's offices, while hoping to always find a source for self-medication that does not get me (or anybody else) into trouble.
As I stated before in a different post elsewhere, my main advice for you personally would be: Think really hard about what you want. Get clear about your motifs, expectations, be realistic if they can be met, educate yourself about the repercussions of what you want, check if there are other, maybe less radical ways to reach your goal. You needn't take 25 years for that like I did, but take your time. If in the end you come back to the same conclusion all over, go through with it.