Next week I have my first appointment with the good people at the Howard Brown Health Center. Their transgender health program, THInC, is really great stuff. It is based on informed consent, not lived experience or psychotherapy, and therefore very trans-friendly and empowering.
For those of you who don’t know, the Howard Brown health center has been serving the Chicagoland LGBT community for over three decades (previously it was part of the Center on Halsted) and has a serious track record of doing real good for us queer folks.
Basically, I will go in for an initial consult: in this first encounter they will preform a full physical, review all my medical records, and likely draw some blood for lab work concerning liver function and other “check under the hood” type stuff. They want to make sure I am in good working order before we start messing about with my chemicals. I am glad for their thorough approach.
I am excited, and scared, but mostly excited. I am still pretty dang nervous about the long-term health risks of hormones, but for this first visit I am mostly excited to talk to a real expert, an actual doctor, with experience serving not just endocrine disorders, but the transgendered population specifically. I have lots of questions, questions I am going to outline here for myself and for those of you thinking about testosterone for yourself.
Some myths and internet half-truths I would like dispelled or illuminated:
-Testosterone and cancer: what link (and likelihood, given my uterine cancer history) is there documented between ftm testosterone usage and cancer development? If there is no documented data, what professional and educated inference can you make from your history of treating ftm transgendered patients?
-Testosterone and vital organ health: what link is there documented between ftm testosterone usage and the development of liver or other vital organ disease?
-Testosterone and appetite: it is my understanding that testosterone can increase one’s appetite. Does it also increase one’s metabolism?
-Testosterone and red blood cell count: can you explain to me the damage ftm testosterone usage can cause to the circulatory system? How likely is this damage to occur to someone in my current state of health?
-What long-term health risks have been documented with ftm testosterone usage?
-What special risk does keeping my ovaries pose? How does testosterone affect my ovaries, and would an oophorectomy result in less health complications?
-What are my testosterone levels at pre-HRT*? What are the testosterone levels of cis-gendered boys before puberty? How long do they usually go through puberty, and what are their levels, typically, after the completion of puberty?
-Testosterone and cholesterol: What documented link is there between testosterone in ftm men and cholesterol?
-Does HRT put me at a special risk as a trans man, or are the risks associated with HRT similar to those of cis-gendered men with average levels of testosterone in their systems?
-Please tell me about the different kinds of testosterone delivery systems offered and your professional opinion of the pros and cons of each method.
Additional health-provider specific questions:
-What is your medical background? (Speciality, degree, years of experience treating the transgendered community, etc.)
-How many ftm patients have you treated? Can you talk a little bit about the common health problems (as a result of testosterone usage) you have seen in ftm patients at Howard Brown?
Lastly, I would love to read any suggestions you readers already on T (or partners or loved ones of folks on T) have for me if I left something out. I’m not looking for you guys to answer these questions, of course, I’m just looking for you to add to the list, or augment the wording or perspective. I thank you in advance for any and all input you might have for me. 🙂
I could talk a little bit now about my fear: fear of making the wrong decision, fear of taking T for 2 years or 5 years and wanting to go off it but being stuck with certain undesirable side effects–I fear future indecision I have little inkling of now. I could talk about the fear of entering a social group I have no intimate knowledge of being a member of: I will be shoved out onto stage on opening night with no rehearsal or prior knowledge of the script. I will be asked to play the role of an adult male…a straight adult male, after having played the role of a gay woman my whole life.
That was the cart, here’s the horse: I am just going to a preliminary meeting with someone who can answer all my scary questions to the best of current medical science’s abilities. And that is all the comfort I need for now. This fear of the unknown I am experiencing currently is one like the fear I had before top surgery. I question whether I really feel like a guy, whether I really want to go this far now, because now I can finally do something about it. In the past (growing up) (my whole life) I wanted to be treated as and seen as male because I always thought of myself as male. Now that I can get there, I panic. But we all know action is scary. There is a palisade in front of me–the adventure is hidden on the other side.
I am reminded of Dante: “Heaven wheels above you, displaying to you her eternal glories, and still your eyes are on the ground.” Guess I better look up and get going. Virgil would have never abandoned his traveller in Purgatorio.
Be nice to yourselves,
Your Pal Eli
*HRT: Hormone replacement therapy