After My Howard Brown Appointment

Last week was my doctor’s appointment with the folks at Howard Brown.  The doctor was great, he answered all my questions and was really friendly.  In fact, the whole staff there was very knowledgable and approachable.  All around, if you are in the Chicagoland area, and are looking for gender-related care, Howard Brown is the place to go.

In total, K and I spent about an hour there, while the doctor and I reviewed my health history and talked through all my questions.

I was told that yes, cholesterol and blood pressure and red blood cell count are all negatively affected by testosterone, but the degree to which they are affected varies person to person.  I was told that there are no long-term studies on the affects of HRT for trans folks, and that we just manage the levels and monitor our health as close as we can, and that there doesn’t seem to be any serious complications for most folks in good health.

It was also made clear my energy level and sex drive will go through the roof. 😉

I was reassured that if I went the injectable testosterone route, I would circumvent most of the problems testosterone can cause with my liver, as it goes directly into the blood stream in that case, and is not metabolized through the liver.

On an insurance note: I learned that (at least in IL) if your legal gender is male, insurance companies have to pay for your HRT.  So the lesson here, boys, is to get your gender marker changed before starting HRT (if you can) to save quite a bit of money.

All in all, I was looking to be a good candidate for HRT: a healthy, well-informed adult.

And then, we had to talk about the cancer.

Seems testosterone can put one at an elevated risk for uterine, cervical, and ovarian cancer, if you happen to be the kind of dude that has those organs.  So when I told him I already had uterine cancer, he was concerned.  He would prefer I talk to my oncologist and get her opinion about the risks associated with me in particular and testosterone.

It was deflating, for sure, and I am bracing myself for the seemingly inevitable conversation with my oncologist that will end something like this: “Well, Eli, since I can’t say for certain that testosterone won’t give you ovarian cancer, I can’t tell you to go ahead and start HRT.”

Ugh.

The thing is, with this informed consent model that Howard Brown works under, I don’t think I need anyone’s consent except my own, after I have gone through the steps HB requires in their program.

The problem: I am not going to risk cancer, again, for testosterone.  I choose life of any kind over the most fully realized kind.  I may not ever get to be the man on the outside I feel like on the inside, but I would rather be a dude on the inside and a girl on the outside than a dead dude.  This choice makes me profoundly sad.

I think my brush with cancer was environmentally based, meaning, cancer doesn’t run in my family, and I was taking horrible care of myself at the time.  I think I ran my immune system into the ground with the drinking and smoking and bad eating habits and gave myself cancer.  Now I don’t drink or smoke, I eat very well, and I am at the gym regularly.  I think any cancer testosterone could drum up now, my immune system could readily handle in the early stages.  I think that, but I don’t know it for sure.

And so, pending my oncologist’s approval, I swing between looking forward to starting testosterone, and mourning the lost opportunity to start testosterone.  I was hesitant before, nervous about what changing my gender could do to my body and my brain, and so I thought now was not the right time for me to go on it, if ever.  But now that I know I might not be able to go on it at all not because of my choice, but because of a previous illness, I am deeply saddened by the idea of not going on testosterone.  That sadness speaks to me, it has shown me how right testosterone feels to me, or how right the direction of HRT feels to me.

I am going to make an appointment tomorrow for part two of Howard Brown’s program, where I will meet with a gender specialist and outline my transition plans.  I will also make an appointment with my oncologist.  I am going to see this process through, to whatever end it arrives.

To close on a good note: the doctor also gave me the forms I need to change my name legally, and the number to trans legal aid to help me fill out and file the forms, and to get it done for free. Sweet.

Be nice to yourselves,
Your Pal Eli

13 thoughts on “After My Howard Brown Appointment

  1. Sounds like a great appointment and a great program. I feel for you having to make this decision, and think its great that you are still putting one foot in front of the other so you can see where you end up.

  2. The decision you’re facing is a difficult one, but I think I’d make the same choice if I were in your position. I hope all goes well for you.

    -Connie

  3. It’s a tough call. Even if you’ve have a complete Hysto with removal of cervix tubes and ovaries there can always be a few rogue cells left behind. We all have different risk profiles and tolerance. Good luck with your decision. And as always you can call to chat any time. I’m now on month 9 of injectable and have experienced more noticeable changes since moving from gel.

  4. I think getting your oncologists view is a great idea. It doesn’t sound like a clear “no” — more like “let’s get more information.” There also may be other options, not just yes/no to T (e.g. removing your ovaries after some amount of time on T, assuming you like how you feel, — which some people recommend for everyone on T, not just those with cancer history, though I think that view may be changing some. Or possibly a shorter time on T to get some permanent changes and then going back off). All that to say, I think you’ll have some options, and one foot in front of the other is a really good plan.

  5. Pingback: Inching up to the Starting Line: Howard Brown, Part Two | My Life Without Tits

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