Analysis (Services and Self)

Koan Bremner's view on life as a database and data warehouse professional / addict and non-genetic woman

Friday, November 12, 2004

A note of caution

I don't think I take the medical aspects of my transition lightly; I want to live a long and happy life once the process is complete, so I'm not prepared to take any risks with my health which might prevent that. Even so, if I needed a wake-up call or timely reminder that this is not a trivial process, I had it yesterday.

I had my third appointment at the Gender Identity Clinic at Charing Cross Hospital yesterday (the first was in March, and the second in June). At the second appointment, I was prescribed hormones (specifically, ethinyloestradiol) at an initial dosage of 50 micrograms daily for eight weeks, which would rise to 100 micrograms daily and finally to 150 micrograms daily (both rises subject to the results of comprehensive blood tests to be taken every eight weeks). After the initial eight weeks, I duly moved up to 100 micrograms daily, and the second eight-week cycle finished on Tuesday; I had the corresponding blood tests last Friday.

So yesterday's appointment was fine; I suspect I fall into the category of a relatively easy case for them, since I've been holding down a challenging full-time job in the year since beginning my transition, and don't view Gender Reassignment Surgery as some kind of "magic bullet" that will lead to instant social recognition and acceptance of me as a woman. (Think about it; Gender Reassignment Surgery is essentially genital reconstruction; very few of the people I know have ever seen my existing genitalia, and even fewer are going to see the upgraded version, so the act of changing them alone is not enough; Joe Punter in the street forms an impression of my gender from everything *other* than my genitalia.) My biggest daily challenge is my voice (mentioned elsewhere) and I have as yet had no permanent facial hair removal; as of yesterday, I'm in the position to start voice therapy and laser / electrolysis.

Anyway... at the end of the appointment, the consultant said that he was happy for me to increase my hormone dosage to the maximum level (subject to my latest blood tests having proved satisfactory). So I phoned my GP to check; but he is concerned that one of my liver function test results is raised, and wants me to remain on the current dose for the next two month cycle, to see what the next round of blood tests show.

Now, physically I'm in pretty good shape. I don't smoke (never have), don't drink alcohol (and haven't for some years), don't use non-prescription drugs (and never have) and eat a reasonably healthy diet. Yet even with that near-ideal playing field, my body is obviously having to work quite hard to absorb the hormonal changes which are being imposed on it. As a result, the pace of change (which, understandably I hope, I would like to be as complete and timely as possible) has to be pegged back, at least for a couple of months. This is frustrating, but also reassuring. Frustrating, because part of me feels that my progress is being held back somewhat; and reassuring for precisely the same reason. I'm not prepared to risk my health by being reckless. Until the blood tests show that it's safe to increase the dosage, I'll stay at the current level. I won't risk damaging my body (possibly permanently, possibly fatally).

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  • At 11:39 pm, Blogger James Snape said…

    Interesting post... But not one I want to dwell on too much :) All I want to say though is that I do think the hormones are working - I can see changes.

  • At 6:46 am, Blogger Koan said…

    Thanks, James. Yes, they are working, and there are changes. I was looking yesterday at some photos that were taken a couple of weeks before I started taking hormones, and even facially the change is quite striking. I need to get some proper photographs done soon, for my new passport and driving license, so I'll probably post one of them on here at that point; but I have an appointment with the hairdresser first! ;-)


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