Chapter 9: Guess this is the next phase.
I have socially transitioned (told everybody that I am transgender). Now to start acting like it. I've talked-the-talk, now to walk-the-walk. So to speak. I know there isn't a certain way to ACT trans, etc., but it's a figure of speech.
I, almost immediately after coming out, start wearing, exclusively, "women's" clothing 24/7. At home, at work, wherever. It's not a big change as it's still mostly t-shirts and blue jeans (work dress code), but still, and I wear my fake boobahs anytime I'm out of the house.
The bigger changes were that I started to shave more often and, in general, increased my overall grooming and hygiene to a higher standard. To put simply, I now care about my flesh vessel. Most of this actually started before socially transitioning, but it was at a smaller scale then.
One of my first steps to transition, medically, was to call my local Planned Parenthood for an appointment regarding Gender Affirming Hormone Therapy (GAHT), aka Hormone Replacement Therapy (HRT). I chose P.P. for 2 reasons. 1) I was between primary care docs at the moment and had no pref. where I went, and 2) P.P. is immersed in the LGBTQ+ space and would be the last place to make it a hassle for us in the "alphabet mafia" to get the care we need.
Way more than an abortion clinic or the place to get the morning-after pill. They offer :
I called and got an appointment within 2 weeks. Pretty surprised as my last doctor appointment was scheduled 3 months out.
The following is excerpts are from my actual journal on BetterHelp.
A Big Step 🏳🌈 (Feeling excited)
Today was the day. I had my first appointment at Planned Parenthood for HRT/Gender affirming therapy. It was mostly allot of talking and question asking/answering and then a quick blood draw and, if all is ok, I should be able to start HRT! Lab results within a week (usually within a couple of days.) and the prescriptions ready 48 hrs. after (assuming labs are ok).🤞🤞🤞
****
One more big step taken.
Step 1: Understand my feelings and realize who I want to be. Test the waters in private. ✅
Step 2: Announce my decision publicly and start to live my life as my chosen identity. ✅
Step 3: Start HRT to medically transition to my new Identity.
Step 4: Profit.😂
****
On the being open about myself front, I have been out as my true self a couple times now and starting to fully embrace it. I feel better overall and, aside from the lack of self-confidence, I am starting to accept the new normal. I have had a couple nice moments as well. One person, who has been super supportive since I've told them, when I said that I was now unsure which bathrooms to use, said "You're a woman, right?, Then use the women's room." Like duh, everyone (that I care about) here knows and supports me, so of course, if that is who I am, then I need to commit 100% and everything else that I want will follow.
Context for my speed and ease in regards to getting treatment:
I live in New York State
I have a Medicaid Managed insurance plan, offered by Fidelis care, through NY State of health, that's part of, what is commonly referred to as, Obamacare. So, it's free for me cause I'm not wealthy.
I am going through Planned Parenthood for my treatment.
Planned Parenthood Of Northern NY uses the informed consent model. Basically, The doc asks you to sign a paper that says you understand the risks/rewards of a procedure, and then you proceed with said procedure.
The above combo gives me full coverage for my treatment with little to no out of pocket expense and, luckily, relatively short waits (so far). I know there's a ton of variables as to if, how and when you get care, but these are the ones relevant to my journey.
- Local Fertility clinics
- Transitioning Guides
- Speech therapists
- counselling groups
At the appointment, The doc and nurse both asked me a lot of questions;
health history and family health history,
Do you know what you want (just HRT, surgeries, both?)
Are you interested in gender affirming surgeries?
Do you need help with any of the following? legal name/gender marker change, voice lessons, etc.
When did you first realize you were not happy with your assigned gender,
How out are you?/Who all are you out to?
Who all is part of your support system?
What are you doing to live as your preferred gender?
Are you currently seeing any other medical professionals to help you along this journey,?
It was really great and there was so much support along the whole way. They made sure I was fully aware of the implications of HRT and also made sure I was getting enough help with my transition and offering many other services/providers should I need/want. I was kinda blown away by it all. Yes, they went over stuff that I already knew, but in between, there was still some things that I didn't and, If I hadn't known any of it, this would have been an extremely informative introduction to the process.
They also gave me a welcome packet that has a ton of useful info in it. Names and flyers for local organizations, as well as, some guides on things like socially transitioning at work, or what reproductive options trans individuals have. It's kind of an overwhelming amount of info, but they were patient in explaining what each thing was, and of course, I was able go over it all at my own pace once I got home.
Once we went all over the paperwork and decided where I wanted to start (HRT), they took a blood sample and informed me that, as long as nothing looks out of the ordinary, they will send the prescription over to the pharmacy. A week later, I was picking up my prescription of Estradiol (estrogen supplement/replacement) and Spironolactone (to block testosterone). Once again, I was fortunate in that it was only $1 per script.
Back to those questions for a minute. Here's a quick rundown of my answers to those on that day.
Q1: Do you know what you want (just HRT, surgeries, both?) and are you interested in gender affirming surgeries?
Q2: Do you need help with any of the following? legal name/gender marker change, voice lessons, etc.
Q3: When did you first realize you were not happy with your assigned gender?
Q4: How out are you?/Who all are you out to?
Q5: Who all is part of your support system? Family, friends, support groups?
Q6: What are you doing to live as your preferred gender? Any use of prosthetics, grooming, clothing, etc.?
Q7: Are you currently seeing any other medical professionals to help you along this journey,?
Q8: Since you are interesting in hormone therapy, are you interested in having children? HRT can cause infertility in some individuals.
A1: I am pretty confident that I want to start HRT as soon as possible. I do not plan to have any surgeries anytime soon.
A2: Yes, definitely my voice is not where I want it and I am not sure where to start with the other stuff.
A3: Well I guess it has always been in my subconscious but back in June was when I finally realized that I was Transgender.
A4: I am out to everyone publicly, at home, work and on FB.
A5: Huh? Oh, well, I don't really have a support system per se, but I have my parent and a couple people that I can confide in.
A6: I am dressing and grooming myself as my preferred gender including the fake breasts.
A7: Yes, I am seeing a licensed counsellor through Betterhelp.com
A8: I used to be really hung up on the idea of having my own kids, but over the last couple years, I have decided that it is a nice to have and no longer a requirement in my life.
I was started on 0.5 mg of Estradiol and 50 mg of Spiro., twice daily. Some docs do not prescribe both at the start, usually starting without the T-blocker for the first 6 months. Others, like mine, start them both at the same time. Both are valid for different reasons and it's kinda up to the doc and patient as to which way to do it. My doc recommends both at the start and I personally prefer that idea too as it can make perceivable changes show up quicker.
I start that medication and continue about my life for a few months until the first 3-month checkup. (It is recommended to do a checkup every 3 months for the first couple years to get the hormone levels correct, and after that, space it out over the next few years until its just an annual checkup.)