Good news and bad news.

The bad news

My doctor is gatekeeping me. When I last saw him in late November I told him that I’d like to take the next step and send in my applications for the juridical change of gender. I needed him to sign the papers and held a short but well prepared speech about why now is a good time. But he promptly disagreed for no good reason and wants me to wait another 3-6 months. I’ve learnt from experience that it is wise to always add at the least 2 months on every time frame given to me by him, just to keep expectations realistic. As everything in Swedish healthcare freezes over summer, he was actually saying something like “Maybe in September, when I’m back from my vacation”. Almost 10 months from the day I asked him.

He claimed that “It is protocol to wait for a full year after you started on hormones before signing any papers” That is not a valid argument. Firstly, I have been in the loop long enough according to the standards this hospital normally apply. Secondly, there are no specific requirements about a certain amount of time having to pass before an adult diagnosed with GID can apply for or be granted a change of juridical gender. No details regarding time is mentioned in the national recommendations for transgender healthcare or in Swedish law.

In the material about the application it says that you should have “lived as your self- identified gender for a considerable time”. The reason why it is so vague is because time shouldn’t matter. Every applicant is judged individually on the basis of their own story and the material they choose to enclose to their case. But my doctor was stubbornly unyielding, refusing even discuss the matter and nothing I said could make him change his mind.

I very much doubt that any more information supporting or threatening my case is likely to come of further waiting. I have cooperated and done everything they asked from me. There are no more tests, no parts of my body that hasn’t been subject for careful examination, no more specialists I need to see. The most likely outcome I could see following his “Just a little longer but I won’t say how long”– strategy was that my depression might get worse. I’ve been away from school and work due to depression for a full year now. The experience of not being in control over ones life is generally a serious trigger.

Sadly I was right in my suspicions and shortly after that meeting I got a lot worse. Friends and loved ones comment on how I’m so far from my normal self, they worry about me. This last month has been a struggle, I’m not well and I realise that I might not be recovering at the rate I was hoping for.

That was the bad news.

Now here is a challenge for you: Everything you just read is either objectively or subjectively true. I feel a lot worse. The healthcare system is unfair and not working as it is supposed to. Still there are plenty of good news in this post. They just doesn’t make the bad ones go away for me. Try keeping that in mind while you read –

The good news

Luckily I have more good than bad news, so here is a list:

  • Dessert more often I’ve met a dietitian. Surprisingly she approved fully to my approach on food and eating. Instead of scolding me for eating to much, to little or to unhealthy, she helped me with exactly the things I asked for. Then she sent me home with the advice to have dessert a bit more often! She also asked me if I’d like to come back for follow-ups and to learn how I could do even better, which I gladly agreed to.
  • Back at the gym My biceps tendon seem to have healed after an injury that kept me away from my normal routine for a long time. I have been seeing a physiotherapist and done some rehab exercises. Now I’m finally back on track and it feels great!
  • Mastectomy soon The rules state that I only should have to wait 3 months from when I was first put on the waiting list for surgery. That time is due by my birthday 28/2, but in reality surgery happening sometime before summer would be great. My surgeon was not nearly as socially awkward or insensitive as I had feared. Considering my already almost flat chest and the amount of muscle tissue he has to work with, he judged me an ideal candidate for the periareolar-surgery I wanted, just as I had expected. (Advice: Don’t google it if you think you might be more squeamish than curious.)
  • Massive voice improvement I’m much more comfortable with my new voice now. I use it with confidence most of the time, except this last week when I have been down with a cold and can’t speak at all. My voice therapist is impressed by the level of voice technique I can master so far. (One could almost think I had the same university degree as she has on voice and stuff, just waiting for me around the corner.)
  • Testosterone I’ve had my forth injection and been on the treatment for 8 months exactly today. The fresh results from testing my hormone levels reveal that I’m still a bit lower on testosterone than I should be. From now on I’ll be getting my injections with only 10 weeks in between, not 12. I really like what the hormones are doing already, so that is good news.
  • Flexibility Just before it was time for my injection I needed to leave town with short notice. I had to ask if I could get it a few days earlier and it was a relief to discover that it was no trouble at all re-scheduling it! Timing is very important when it comes to hormone treatment. If I miss one injection or if I get it to late, I might get my period back. Suddenly being fertile again when you thought you were not could mess things up a lot.
  • A major revelation Lastly but perhaps most importantly, I’ve recently had a major revelation about the nature of the gender dysforia I’ve been experiencing my entire life. I see so much clearly now how it has been affecting me. Given some time and work, I think this will be a breakthrough unlocking experiences and enabling positive emotions I’ve never had access to before. It could change everything. I know I’m cryptic, but be sure that I’ll get back to this later.

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Angry survivor – five months on testosterone

Five months on testosterone now and my hormone should have reached levels within the normal range for cisgenderd men. I’ve had my first 3 injections. If I live to be 90 years old and treatment continues the same way, I’ll have another 350 intramuscular injections or so to look forward to.

The treatment is working and I can’t even begin to express the difference it has done. I’m feeling so, so much better now. Very simplified it feels like I’m becoming a super hero version of myself; stronger, happier and healthier than ever. But considering how low I was before treatment I suppose that I’m actually more like getting closer to some sort of decent level of existing, a reasonable quality of life-baseline.

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Climbing the walls.

I had to wait forever to get access to treatment. When I think of how close it was, I get so angry for all that pointless waiting and suffering. Nothing provokes me as much as when people (mostly doctors or nurses) out of pure ignorance says something like “Oh, you have decided to start hormone treatment now?” Yeah. I decided. I know hormones are not for everyone and not all transgenderd people want to have them. But it’s not like I just decided and then got a prescription paper in my hand the same day. I almost died while I was waiting for medical treatment.

But one morning a few weeks back I woke up and realised that I was not in fact going to die out of depression, not this time. I have survived the worst part of my journey, just barely and there is a long way still to go. But I’m getting better. Some days I’m mostly so full of energy that I’m basicly climbing the walls. Soon I’ll have to do something about that, find a direction in life again, take up my studies or some sort of employment. I’m not there yet, but that day is steadily getting closer.

T-day is here – I got my first dose of testosterone today!

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The day I’ve been waiting for so long turned out to be today.

This morning I got a call from my endocrinologist. He said that I was all clear for starting my medical treatment. I just had to pick up my prescripted first dose of Nebido (a synthetic testosterone) on the pharmacy and get an appointment with a nurse for the first injection. So I did and I had my first shot this afternoon. The next one will be in 6 weeks and after that every 12 weeks, for the rest of my life…

How I feel?

I feel a bit numb, honestly, probably due to my depression. It does feel good to have started finally and I don’t have a shadow of a doubt about this being the right thing to do. I think the joy and sense of relief will come later. No wonder I’m not all jumpy about this since I’ve been fighting so hard, waiting for years and been very ill lately.

Regardless of how I’m feeling right now, I know I’m facing an interesting time. The first effects of testosterone has been reported to occur within 24 hours or a couple of days after the first dose, but those first signs will probably only be noted by me and those closest to me. Then other changes will come. The more notable ones will happen in 1 – 6 months from now and then go on and continuously stabilise over a period of 1 – 2 years.

In short, my body will go through a speedy second puberty of sorts, but a male puberty this time. I might get acne. My voice will crack because of the increase of volume of the vocal cords and after a whil it will land in significantly deeper mode. I will put on muscles more easily and fat will be distributed differently on my body, giving a more lean and masculine impression, only to mention a few things. I hope that body and facial hair takes a bit longer, so II will have time to get used to the idea, but the time-line for all these things are very individual. I’ll just have to wait and see.

No matter what comes next this is a point of no return. Testosterone treatment is very potent, meant to be life-long and is in many ways irreversible.

Wish me luck on this new adventure, I think I’ll need it.