Part 2: Androgel day two

Today is day two of AndroGel and boy is it somewhat anti-climactic!

I put it on in the morning yesterday for the first time and that was fun, but because nothing is "happening" it is kind of boring.  I know it is working its way into my system and will build up and stuff will start to happen eventually, but right now it is sort of the equivalent of putting on lotion when your skin is dry.

I'm hoping I start to see changes before my next doctor's visit which is in six weeks.  I get labs drawn in five weeks and have a meeting with the doctor in six, because it takes a week to get the lab results back.  But I'm guessing nothing will change.  I also think she may up the dose when I see her, but I'm sure that's dependent upon labs.  She does up most people's dosages after six weeks so...we shall see. Two pumps isn't even listed on the prescribing sheet as a dose for men; that starts at four pumps.

It is super easy to put on, though, and dries much faster than I anticipated.  I just hope it is working its magic on me!!!!

I did a voice note today so that I have a recording of what I sound like "before" "T" and I'll do a voice note every week just to see what happens.  I also did a little short video so I can watch my face change, as well as my voice. I'm not posting those anywhere for now, or even potentially ever, but I'm excited to see the changes as they progress.

I can't believe that this is actually happening. I can't wait to see what things are like in a few weeks.

In disappointing news, I found out that my surgeon has yet to sign her notes from our visit two weeks ago so the administrative assistant hasn't been able to submit the paperwork for prior authorization yet.  The assistant told me that she asked Dr. Buckley's nurse to ensure that the notes were signed on Tuesday when Dr. Buckley is in the clinic next so that she can submit the prior authorization on Wednesday when she's back in the office. Let's hope that happens!

Part 2: Transitioning

Today is "T" Day!

Actually, tomorrow will be, but my partner picked up the prescription today from the pharmacy.

Here it is:

I'm both incredibly excited and incredibly anxious about this.

This is something I've wanted for more than two decades.  That's a long time to wait for something.
But how do I know that I've really wanted it. Maybe I just think I want it because I'm unhappy with myself.  The thing is, though, that I know that's not true. I AM happy with myself.
I have an amazing partner, a great place to live, a fantastic job, and stellar friends. My life couldn't be any better right now, unless I finally got to realize my dreams.  And that's what this picture represents. My dreams coming true.  How cool is that?

I knew talking this out would help.  Yay AndroGel!!!

Part 1: Testosterone prescription day

Well, "T"-Day is here. It has practically come and gone, actually.

Things are really real now. I have in my hands a prescription for testosterone gel (Androgel). Oddly enough, Costco was the only pharmacy near me with the right concentration of the gel (1%).  As soon as the prior authorization for the gel goes through, I can start hormone replacement therapy and will start developing male secondary sex characteristics.

Here's the 'script!!!!

Part 1: Coming out some more

I had lunch yesterday with a wonderful woman who was once a city council member and transitioned way back in the mid-80s as a very high-profile person in my city.  As a former deputy mayor and former head of my now department, I reached out to her, fairly randomly, to see if she had any advice to me.

She was FANTASTIC.  She allayed a lot of my fears, which was wonderful.  Boy do I look up to her.  What a pioneer!  And to do something in such a public manner - she's the Christine Jorgensen (or Renee Richards) of Minnesota!

We talked about how to approach coming out at work.  She said that there were many allies that I'd have in my department if I wanted them. And she said it would definitely be safe to come out to my boss w/o having HR involved directly, but she did recommend that I should contact HR right after coming out to my boss so that I have my bases covered.  She did not feel that I would find much difficulty.

So, to that end, I'm going to come out to one of my friends here at work on Monday. He's someone she suggested would be a good ally, and someone I really like and trust.  And then, once there's a plan in place, as far as surgery times, I'll come out to my boss and HR and then they can figure out a protocol, if there isn't one already. I'll take off for surgery as "old name" and return from surgery as "me" and all will be well in the world.  By the time I come back (I'm taking two weeks off) they'll be able to change my email and my business cards etc....

And, the sweetest thing that this woman said to me was that I should put her on my list of people to call if some thing, for some reason, goes wrong, and she'll make some phone calls for me and remind people that I have the law on my side.

What a great lunch and what a great person!

Part 1: Surgery consult

So I meant to post last night because I had pre-surgery consult jitters and I really wanted to get them out on paper, but that didn't happen.

It didn't happen because MN just passed marriage equality and we had to celebrate.

It is totally awesome because it means all my wonderful gay and lesbian  friends who have been either legally married somewhere else or had a ceremony, and all those just waiting for the right time, have the opportunity to finally have their relationships recognized as equal to the rest of the world.  Hooray!

But back to me :)

The consult with Dr. Buckley was wonderful. She barely remembered us from our last visit in the fall when I went in for a reduction consultation. We didn't mention transgender issues at all that time, even though she left the door open for the conversation at one point.  So this time we're in it for real.  We brought along the new HealthPartners policy, which was a good thing, because they were still operating from the 2011 policy.

Buckley is so laid back and easygoing, it makes her so easy to talk to.  She's hilarious in that she swears sometimes and is just all around laid back.  She doesn't strike me as a cocky surgeon at all, which I really like. She's super confident, that's for sure, but not cocky or abrasive or pushy.  She's obviously at ease with the procedure and knows exactly what she's doing.

I do have to have a mammogram, which I'm not looking forward to, as well as a full physical examination with my primary care physician.  This means coming out to my PCP, which I'm a little nervous about, but mostly I think it'll be just fine. I'm not asking her to prescribe T, which she probably wouldn't be comfortable with, and I'm not asking her to do anything other than the physical and to keep being my primary care.  I think she'll be okay with it.  We'll see though! I won't go for the H&P until we get the prior authorization from HP on the surgery.

We talked about dog ears and how far back she'll go to minimize them, which is good. She's definitely conscious of the issue and says she'll do the best she can.  We talked about retaining the pedicle for the nipple, but she basically said that since I'm a bit droopy (her word :)) the pedicle will be really long and I'd end up having a bit of a boob-let, which I'm not too excited about. I will be really sad to lose the feeling/sensation I get in my nipples right now, but I'd much rather have a male contoured chest and little sensation than boob-lets and tons of sensation.  She said I could bring in some photos to show how much boob I'm willing to have, but I'm planning to lose the rest of my weight in the next year or so and I just think a boob-let will look bad and make me really unsatisfied.

So it'll be a full double incision mastectomy with nipple grafts.  She recommends working on the pectoral muscles because she's "only putting on the siding," as she said. So I'm all over that.  We have P90X on deck to start working on along with some dumbbells and some resistance bands so I can build up the pecs/chest and back before surgery.

She estimates that even if the prior authorization takes 30 days (that's the maximum amount of time the insurance company has to respond to the request for PA) I could have surgery as early as July, but that after July I could have my pick of days, probably.  She operates Monday, Wednesday and Friday and most of her top surgery patients come in on Monday.  She recommends at least a week of off work if not two, and she's willing to get you even three or up to six if she has to or you feel like you need it.  I anticipate that I will be bored out of my mind if I do more than two weeks, so that's what I'm planning on for right now.

Once I get the prior authorization I'm going to have to talk to work about it.  That's really intense and scary for me.  But I think that overall it will be okay.  We shall see!

I do have lunch with former Saint Paul Deputy Mayor Susan Kimberly on Thursday to discuss coming out in PED.  I hope she's helpful.  It is really, really nice of her to be willing to meet up with me.

I think that's it on the consult!

Part 1: Is Part 1 now over? Am I on to Part 2?

I got my letter!

My therapist and I wrote it "together" last night at our last (hopefully) pre-T session.  He addressed it to both Buckley and Thorp so I'm hoping that will suffice for both of those ladies as well as the insurance moguls.

I am partly scared to death and partly so excited I could wet myself.  This has been such a long time coming.  I wanted to do this 17 years ago but had no role models and no real, honest-to-goodness knowledge that it was possible.  Then I wanted to do it 10 years ago but wasn't able to follow through because keeping my family in my life was so important to me.  Fortunately, however, I don't have to worry about them anymore. I know they love me and will love me no matter what. So nothing can stop me now.

So why am I so scared? Well, it comes down to this - I don't know exactly how transition will go and there are so many variables and unknowns that it make it very hard to plan for it.  And I'm a planner, for goodness sakes!

I have what I think of as irrational fears about silly things like the bus, and the coffee shop and the gym and other places where I frequent and am seen as a regular. Fortunately that's pretty much the bus, the gym and the coffee shop :).  My therapist did remind me yesterday that most people are too wrapped up in themselves to think about the others on the bus or at the gym or in the coffee shop.

I still also have to come out at work.  And on Facebook. And figure out the logistics of changing my name and gender on all of my documents.  And coming up with the money to do that, which I'm not actually too worried about.

But, I have my letter. It is up to me to do with it as I see fit, I guess. I do have my surgery consult with Buckley on 5/14 and the "T" consult with Thorp on 5/21 so things are moving along at a fair clip!

Part 1: Therapy 6 and some random thoughts on binding

So I had my last therapy session prior to the letter writing session coming up on May 7th on Tuesday night (April 30).  It was really good. We talked about my worries about coming out at work and my parents' and family's great reactions to my coming out to them.  We really didn't have much to talk about.  He outlined changes that T would cause and stuff, which was nothing new, and he gave me a referral for Dr. Thorp.

I'm a little nervous about the letter-writing process.  I want it to say all the right things so I've printed out the Healthpartners GRS info sheet to bring with me.  I also want him to write a letter not only to Dr. Thorp but also to Dr. Buckley, who I actually see first.  I'm hoping he's willing to do that. Oddly enough there's no letter required for T, according to Healthpartners, but there is for surgery.  Totally makes sense for surgery, but I sort of feel like the letter is necessary for T, too.  What if you're too unstable for T?  I know that I'm not, thanks to the MMPI and my conversations with Dr. Brose and my therapist, but still....just seems unwise to send people out to add hormones to their systems without being sure about them being stable and sane.

Fortunately I'm pretty stable and sane. :)

So back to the letter writing - what happens if he doesn't write a letter addressed to Buckley and I meet with her first and then can't start the prior authorization process? I can't go about on T with these stupid giant boobs.  They get in the way, they make binding and passing virtually impossible and I hate them.  They're the biggest part of my dysphoria.  I love looking at myself from the collarbone up. I hate it when the mirror shows more. I need them to go away, and soon.  So I need this letter from Scott addressed to Buckley.  I'm concerned he wants me to start T and then do top surgery later and that's just not an option. And if that's what he wants, what do I do? Do I find another therapist and start over? Find someone who operates by informed consent and not WPATH?  *sigh*  This is what is stressing me out right now.

So on to binding and packing.  That was the topic of discussion at "group" last night.  It was a really good, lively discussion.  It made me think a lot about binding. I don't do it 99 percent of the time because a) I'm not really trying to pass right now and b) I'm afraid of any damage it might do to my skin, my breast tissue, and my body in general. I don't feel a real need to do it except for sometimes.  Like, I hate my boobs and I want them gone, but it is way more important to me to protect my health than to bind because surgery seems like it is so imminent. BUT there are times I'd really like to bind and I haven't (until last night) found something that works well enough.  The double/triple-front compression shirt from Underworks creates this big uniboob thing that hangs out with my gut and it just looks bad.  Not male, not female, just. bad.  And ties don't look great with it, either. However, one guy last night showed us how he binds - he uses a back supporter turned backwards and moved up and boy does it work great. Granted, he's been using it since he was a teenager, but I bought one last night and it was amazing how much better it worked.  We're going to go to a medical supply store and check out other options this week/weekend and see if we can find a better one than the one I got at Wal-mart.  A) I got it at Wal-mart and would prefer not to support them and b) it is a two person job to get it on.  But it is super comfortable and super effective. So off we go to a medical supply store.

Next week I'll post about the letter!