That's a pretty good point about the linked papers, also a lotta IT departments block hyperlinks, but you can also just do a quick in-line citation like (John Doe et al, 2019, DOI 42069) or something if you wanna show that you know what you're talking about and give em something to search. Doctors spend 8-10 years in academia so the fact you've got citations at all adds a fair bit of credibility and if you include a DOI number it's just as findable.

As for the length limits, usually it's something manageable like 2000 characters so you can get your initial message across, and then just add a reply to it to elaborate if you need to. If you message after-hours they won't see it until the next day so you can type out a 2 or 3 message RE: thread without getting interrupted. The RTF file workaround is a possibility but often they either don't open your attachments or the portal doesn't allow patients to add attachments, only healthcare workers.

rdfwtexas (imported) wrote: Mon Apr 08, 2024 1:54 pm 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.

Assuming your "testosterone" meant "total testosterone in ng/dl," it is not particularly low. However, your gynecomastia is a good sign. Speaking as a chemical eunuch for over 10 years now, I can say that I do get "horny" once in a long while, the longest period was every 3 - 4 months. In other words, that need never totally goes away.

However, you are experiencing fatigue. I experienced a lot of fatigue as well, along with osteopenia (early stage of osteoporosis), and ended up having had to take low dose testosterone to slow osteopenia development and help reduce fatigue. Unfortunately, my libido increased. Now, I need some release about once a week.

Given your other health issues, I would strongly urge that you do not go experimenting with chemical castration without doctor's supervision.

Best of Luck!

Thank you everyone for all the comments and really good suggestions. I am searching now for a Dr. with non-binary/transgender experience.

I have an appointment with a new female Dr. on May 8. My wife did some searches and made some phone calls, she always handles my appointments. The Dr. she found the receptionist had the nurse call us to discuss the purpose of the visit and my desires, she was extremely understanding and explained the consultation and how the whole process worked including getting appointments with counselors when considering surgery. It did not sound like she requires counseling for chemical castration. The set me up with portal access and questionnaires to complete. I am to fast overnight, at the first appointment they will do labs. Already this seems like it will be a totally different experience than with my current Dr., while she told me to expect this to take some time, she was eager to help, it was almost like they were happy to find another man to hopefully castrate. By the way, she is not a urologist but if I was not mistaken, she does surgeries. Is this common? The discussion left my wife and I very optimistic.

I have noticed that in the medical profession, it is the female members all around the world that tend to be more open to LISTENING to patients and not relying on numbers, labs and other diagnostic testing.

A lot of the time choosing a doctor by speciality will also determine treatment options. I have had that issue a lot in my life, doctors giving meds instead of getting another consultation or upgrading to different treatment options.

Also in my experience, female medical professionals have less connection to testicles and have less hesitation to consider removal.

And in my case that my wife was involved in the process made a HUGE amount of difference.

rdfwtexas (imported) wrote: Mon Apr 15, 2024 12:28 pm I have an appointment with a new female Dr. on May 8. My wife did some searches and made some phone calls, she always handles my appointments. The Dr. she found the receptionist had the nurse call us to discuss the purpose of the visit and my desires, she was extremely understanding and explained the consultation and how the whole process worked including getting appointments with counselors when considering surgery. It did not sound like she requires counseling for chemical castration. The set me up with portal access and questionnaires to complete. I am to fast overnight, at the first appointment they will do labs. Already this seems like it will be a totally different experience than with my current Dr., while she told me to expect this to take some time, she was eager to help, it was almost like they were happy to find another man to hopefully castrate. By the way, she is not a urologist but if I was not mistaken, she does surgeries. Is this common? The discussion left my wife and I very optimistic.

Sounds like great news, hope your appointment goes well!

It does sound like you and your wife have found a good match for getting your needs met... If you haven't already done so, I'd suggest reading at least the Eunuch Chapter in the WPATH SOCv8 (and possibly the whole thing, or at least the more relevant looking chapters) to get an idea of the kinds of things they are looking for... In some ways I see this as being sort of like a job interview, in that you don't want to lie about anything, but HOW you answer questions can make a big difference...

Counseling is not an absolute requirement for chemical castration, but the doc will be wanting to make REALLY sure that you are doing a very 'FULLY INFORMED' consent, so you should expect to be able to demonstrate having done your homework and have a really good understanding of what chemical and surgical castration involves, and all the consequences, side effects, etc. and have considered how it will impact you, especially any of the negatives...

She is right in that the process will take time (among other things the SOC suggests a minimum 6-12 months on chemical castration before surgery) but if your experience is like mine, you may get some initial steps (including a possible CC drug script) after one or two visits...

My TG doc (and the rest of my care) is part of a major hospital, so there are lots of specialists... She is 'officially' a pediatrician when I looked her up in the doctor databases, and when I asked she said she got started providing care for TG kids... But she is not the surgeon. (and had never asked to look at my bits) Basically looks at my hormones and other meds, and managed the CC but had a colleague who is a urologist, with a specialty in gender surgery that did the surgery.... However he is not the urologist that I saw for other care. I was told that since my surgery was 'simple' he did all of it, but for more elaborate things like nullification or a vaginoplasty he would also have brought in folks from the plastic surgery department... I wouldn't be at all surprised if you find that something similar with your doc...

WheelyFixed

Thank you for all the suggestions and help. I have been reading as much as I can, feel like I am studying for a test. I am really excited and hopeful.