- Background: Please refer to:
- Friday May 18, 2007: I've *always* been very fortunate! I recognize (and emphathize) that many trans people struggle enormously with their gender, and often simultaneously suffer from less-than-adequate support from spouses, family, friends, colleagues, acquaintances, and society at large! Accordingly, I realize how fortunate I truly am! This is evidenced by the fact that my wife (our 19th wedding anniversary is in two days) quite cheerfully made initial contact (by phone) with a local endocrinologist's office, with expertise in treating trans patients, for me while I was at work today! Wow! ...
- Wednesday May 30, 2007: Sunshine and I just had our 13th session with Sam Allen, and we asked him to contact / provide a referral letter to an endocrinologist that we had decided upon! :-) :-)
- Thursday June 14, 2007: My family physician's office scheduled a referral with an endocrinologist, today! I was both very pleased, but also slightly disappointed that it was over 4 months from now. However, this will allow additional time to prepare, mentally and physicially (e.g. additional laser / electrolysis treatments ...). :-)
- Saturday October 06, 2007: Well, it's been almost 4 months since Sunshine and I scheduled our appointment with endocrinologist Dr. Elizabeth Holt (Raleigh, N.C.)! The time has passed faster than I expected, and I have given this issue a lot of thought during that time. It's a sobering, life-altering decision that truthfully causes me some level of anxiety, but that is probably fear of the unknown. The simplest analogy is that it's similar to the first time that I gathered my courage to leave our apartment for the first time (on a sunny afternoon), fully dressed en femme. It wasn't so bad, and it became easier over time. Another anology are the Tuesday mornings that I went to work following Monday-evening laser hair removal sessions, with my face red and swollen - you just "do it," focusing on one day at at time - and you end up getting through it with less difficulty than you imagined that there would be! :-) I do believe that a similar mind-set applies here - to have the courage to follow through with your desires and convictions, to remain flexible, and to deal with and adjust to the obstacles and difficulties that you will inevitably encounter!
It's funny, but the recent debate regarding the non-inclusion of the transgendered from the proposed Employment Non-Discrimination Act (ENDA - refer here) has actually increased my resolve, somewhat. This is relevant to me, as I will have to leave my lucrative job of the last 6.5 years in 6 months, as the award that I have is in it's final year (non-renewable). The timing regarding this and my transition has been largely coincidental, but it's funny how things evolve and turn out. I'm confident that the future, whatever it might be, will be wonderful! :-)
A few days ago I received a copy of the letter that out psychotherapist, Sam Allen, had sent to us (with the other copy going to Dr. Holt). It's a referral letter for feminizing hormonal therapy, and it was a fair and balanced assessment, as well as an endorsement of my desires. I had expected as such, but it was very good to actually see the words, on paper!
- Monday October 08, 2007: Our first appointment (consultation) with endocrinologist Dr. Elizabeth Holt (Raleigh, N.C.), of Raleigh Endocrine Associates! Although we had several options for endocrinologists, locally (including one MTF transgendered physician, who is quite popular among the local trans population), once again we went with our gut instinct, choosing a board-certified, practicing endocrinologist. Dr. Holt has over two decades of professional experience, including transgendered patients. Since I am in my mid-forties, we thought that this would be the best / most prudent choice, for us! After meeting Dr. Holt, I think that this instinctual choice will be proven to be the correct decision!
After a short review of the forms that had been mailed to me with Dr. Holt's nurse, Peggy (who was very nice), plus some background information on the operation of the clinic, contact information, etc., Sunshine and I met with Dr. Holt. She proceeded to take nearly 1.5 hours with us, beginning with me stating my purpose for being there, followed by a mini-assessment (a "psychological profile," for lack of a better word), then a discussion of the risks, benefits, etc. of FHT. Dr. Holt was very easy to speak with, and she really took her time with us, not at all rushing us in any way, despite the length of time that we were there! Before leaving the clinic, she arranged for their lab to collect urine and blood samples, for base-line values - hormones, lipid, etc. - before she prescribes transdermal 17β-estradiol (Vivelle-Dot; &larr this information is taken from the manufacturer's (Novartis) information sheet - also saved here). :-) [I'm awaiting (Fri. Oct. 12) these test results, and my prescription - it can take up to 2 weeks for test results to come back.] Overall, this was a very positive first meeting, with Sunshine and I being very relaxed and comfortable, despite the excitement and changes that that this course of action will produce! :-)
Starting Estrogen ...
- Friday October 19, 2007: It's finally "E-Day!" At 6:26 pm, I applied my first estrogen patch, to my lower abdomen! I actually had the prescription for two days, but I decided that I'll apply the patches on Friday mornings and Monday evenings. I'll be applying Vivelle-Dot patches (that release ~0.05 mg/day), twice weekly - Mondays mornings and Friday evenings. These translucent, rectangular patches (2.0 cm x 2.5 cm = 5.0 cm2) actually contain a total of 0.78 mg 17β-estradiol USP (as indicated on the label), and are designed to deliver 0.05 mg estrogen/day. Here is Novartis' Vivelle-Dot product information sheet.
Coincidentally today, I received a copy of my lab test results from Dr. Holt's nurse, Peggy: Except for the Vitamin D being below the normal range (Dr. Holt had also prescribed 12 - Vitamin D 1.25 mg SoftGel caplets - 3/week for 4 weeks, then 1/month) - all of my test results were excellent (within range), except that my HDL (good) cholesterol was above the range (even better?), and my LDL was very low - as expected, I am in *excellent* health, overall ! :-)
- Monday October 22, 2007: "Day +3." I feel completely normal. I changed the patch (overall count: "patch #2, " the first one was removed & discarded) at ~10 pm.
I decided to change patches on Monday evenings and Friday mornings, thus spacing out the applications twice weekly, for nearly identical intervals.
Also, I just had my legs "lasered" for the first time, this evening! :-)
- Friday October 26, 2007: I changed the patch #2 for patch #3, this morning after my shower. Since my last patch (applied Monday evening) was becoming loose around the edges (and possibly the center portion), yesterday I applied some surgical tape over it, to hold it down. The likely cause is the location (lower abdomen, at the crotch), humidity (especially following vigorous daily aerobic exercise), and skin streching / motion issues, due to physical activity.
This time, I applied the patch to the upper buttocks, just off-center of my side center line (i.e. standing, vertically it's at about my mid-buttocks level, just slightly toward the rear, from the side), near the relatively "flat" portion of the buttocks. *So far* [it's Saturday evening - October 27 - as I type these notes], it appears to be adhering very well ! :-)
Following another recommendation that I saw online, last evening I gently rubbed a bit of baby powder (talc) over the patch, to help prevent stray adhesive from picking up lint. I did a web search on this topic (patch adhesion, non-sticking) and summarized the findings, here. :-)
- Monday October 29, 2007: "Day +10." At ~11:30 pm, I applied my 4th (overall count) patch, on the side of my right hip - still no overt effects, noticeable. The other patch (#3, on my left buttock) adhered very well; I actually decided to leave it in place until the following morning (Tuesday) morning. This time, I placed the new patch more toward the front, where it is easier to see, actually on the hip. After applying it, I gently rubbed some baby powder over it, to bind the strat adhesive, thus preventing it from accumulating lint, and also to reduce the chances that the edges will fray (loosen) from sticking to t-shirts, etc.
- Friday November 02, 2007: "Day +14." Now two weeks (no overt effects, but I do "feel different" around the breasts - more cognizant of their presence). I finally took some pictures, this afternoon, as a "starting reference." I also applied a new patch (#5) this morning, on my left hip (above the previous location from last Friday - slight skin irritation remaining). I decided to leave the one (#4) on my right hip, in place for a few more days, to see how wekk it adheres (so far so good - 4 days), and to get a bit "extra" estrogen! ;-)
- Saturday November 03, 2007: After having my shower this morning, and drying off, I noticed that the older patch (#4; in place for 5 days) was lifting up - it had that "milky, opaque" look like Scotch (clear) adhesive tape gets when it's soaked through, not the normal translucent (clear) appearance. As I was patting it dry, it rubbed off &rarr I immediately reapplied it, then (once it dried a bit), dusted it with baby powder, as there was adhesive showing (I hadn't quite reapplied it in the same spot). After it dried, it remained in place remarkably well, until late Monday evening (approaching midnight), when I finally removed it, after it had been in place for 7 days.
Generally, after showering, the patches remain "clear" (translucent); if they appear "milky" (opaque), carefully pat it down / "dry' it, let it air-dry, and firmly press it back into place, and lightly dust it with baby powder.
- Monday November 05, 2007: "Day +17." Still no "overt effects." Very late this evening (around midnight), I removed patch #4 (on my right hip for 1 week), cleaned and shaved
- Friday November 16, 2007: "Day +28." Removed old patch #7 (from last Friday), applied new patch #9 (1st patch from a new box, #2, of 8 patches) on my left hip. Left patch #8 in place (right hip). No "overt' signs. yet - *perhaps* a bit of breast swelling?? (I do believe! &rarr My wife even made a similar comment!) - and other male characteristics (sexual) unchanged (perhaps 'better,' even, although this my be due to being very fit, including aerobically fit).
- Friday Nov. 23 (early morning): "Day +35." Removed old patch #9 (left hip; from last Friday), applied new patch #11 on my left hip. Left patch #10 (the one that rubbed off, above) in place (right hip).
Additionally, I decided to move most of the content from this online (public) FHT journal to an offline, private HTML page, so that I can add more detailed notes and observations.
- Tuesday December 25, 2007 - Christmas Day!! Here are some excerpts from my private FHT journal:
"Day +67:" There are no overt psychological effects, i.e. mood swings, depression, elation, just a general 'satisfaction.' One change I do believe is quite evident regards my fingernails and body hair. Interpreting changes in the latter is complicated by the fact that so far I've had one round of whole-body laser, but I definitely find that I'm epilating comparatively very little, mostly for hairs in the wrong growth cycles that escaped being killed by the laser, and overall, there's much less hair! :-)
This is probably related: although my nails are still chipping (but not as bad? - I'm also taking biotin, daily, for this), my fingernail growth *has* slowed significantly, I believe, as I am trimming them much less frequently?! One again, this may be purely wishful thinking, but both Susan and I *have* noticed that my face is 'softer.' This could be due to the laser treatments, as particualry following the last session, and subsequent 'clearing,' my face is indeed smoother and softer!"
Like my previous facial laser sessions, my face did clear wonderfully, particularly from about early December until now! Just over the past week - the last few days or so - I have noticed a few stray hairs growing again on my face, plus (more numerous now than the dark hairs) gray hairs, but my face looks great today - cear and relatively smooth! Also, my body hair growth is *significantly* retarded, as mentioned above, including my armpits, chest, abdomen, arms and legs, torso.
- Friday December 28 (early morning): "Day +70 (10 weeks)." Removed old patch #19 (left hip, from last Friday), applied new patch #21 on my left hip. Left patch #20 in place (right hip).
My breasts *are* very slowly, but perceptibly developing! :-)
- Tuesday February 05, 2008: This morning I had blood drawn (plus a urine sample) for laboratory tests, prior to my first (4-month) checkup with Dr. Holt, next week.
- Tuesday February 12, 2008: Note: I have been on transdermal estrogen for just over 4 months now! Today, Sunshine and I mety with Dr. Holt for my 4-month follow-up (1st follow-up appointment. Everything went very well! Dr. Holt reviewed my lab results with us, which were much more profound than I had anticipated, since the overt effects of my FHT are still rather muted.
My 4-month check-up, my T/E2 ratio went from ~20.5:1 (470 ng/dL : 23 pg / mL) to 1.6:1 (110 ng/dL : 67 pg/mL)! &rarr My testosterone dropped 4.3-fold (to 110 ng/dL; normal male range 241-827), while my estradiol increased 2.9-fold (to 67 pg/mL; normal male range 0-53; mid-cycle female 150-528, cycle range 19-528) :-)
- Friday February 15, 2008 (early morning): "Day +119 (17 weeks)." Applied new patch #35 on my right hip. Left patch #34 in place (left hip).
