Trans healthcare is a nightmare.
Transgender healthcare is still very far behind, even if you are lucky enough
to find a supportive doctor, there is no guarantee they will even be educated
in the field. I have seen two GPs so far and neither is perfect, the first
one decided it would be a good idea to give me menopause by putting me on a
testosterone blocker at a high dose and not give me any oestrogen for the
first 6 weeks. They also were not aware of proper dosages for the specific
blocker I chose, Cyproterone Acetate, for trans women the dose of this drug
should never exceed 12.5mg a day, but this is what she started me on, and she
even called it a "low dose" with the intention of raising it later on.
I switched to a new GP after this as I wasn't confident they would know the
proper dosages for oestrogen either. Lucky me the next GP didn't know either,
she put me on oestrogen gel at 1mg daily, a very low dose that after 3 months
barely seemed to raise my oestrogen at all. Oh and that's another thing,
waiting 3 months for the first blood test is very excessive, levels do not
take that long to stabilise and should be tested every 6 weeks in the early
stages until levels are in a good range, if she had tested me at 6 weeks we
could have changed the dose and at this moment I may have actually had good
levels, but no, lots of time wasted for no reason.
I went back to this GP after the 3 month blood test and seeing my oestrogen
levels were so low I recommended starting me on 200mcg/d patches and to test
again in 6 weeks, she denied both of these requests and put me on 100mcg/d
which of course is a starting dose, except she doesn't see it as a starting
dose she sees it as high which means she is uneducated on the dosages and is
probably underdosing other patients when they start on patches. She also
again refused to test in 6 weeks, and was adamant about testing 3 months, a
complete waste of time especially since she put me on another low dose.
So, getting pretty tired of this I realised that I still had an old pathology
request for my hormone levels from my previous GP I didn't use since I
stopped seeing them, my plan is to use this to test myself in 6 weeks and see
if my dosage needs to be upped, then I will probably try a new GP. It is
really tiring to have to jump through all these hoops and come up with
loopholes just to get the proper care I need, I wish doctors would just
listen to their patients and respond to their needs instead of following
arbitrary and often incorrect guidelines.
A major cause for these issues is that since these oestrogen products were
originally designed to be used by menopausal AFAB people, the information
available for these medications only consider that use case, which is very
different to the needs for transgender HRT. But doctors don't realise this
and use the menopause dosages on trans women, resulting in wasted time, low
levels and slow changes, and instead of educating themselves properly or at
least listening to their patients they assume everything is correct and
follow it to a fault.
Anyway, more of a rant than a blog post but it's something I just needed to
get out of me, being trans is hard enough without having to deal with bad
doctors and I am just over it at this point, I'm hoping the next GP I try is
better but I'm not really getting my hopes up, if they are good I will make
another blog post about them so other people can find them and access HRT.
Posted on 26 February 2025 by auroradynia