Medical Transgender Transition
19 June 2020

Hormone Replacement Therapy

By Alexa

I know it’s been quite a while since I last made a post. Since my previous post about Gender dysphoric dreaming things went from bad to worst up to a point where I could not take it anymore.

It was at that point that I knew I had to take action. The next day I sent two emails, one to my psychiatrist (with whom I have an appointment next week) and the other to a UK doctor.

Before getting to those 2 emails, but first let me start at the start of it all…

Waiting list

…what to say about those darn waiting lists..? The name says it all and all over Europe they are there. In The Netherlands they are relatively short with ‘only’ two years before the first intake.

I have been placed on the waiting list almost a year ago now. At that time I was told it would take one and a half to two years before it was my turn. Thanks to COVID-19 at least an other half year has been added to to that, meaning it’ll be at best the second half of 2021 before I can start.

Trying other ways

I have been using soy isoflavones for a bit over a year now. Soy is a source of progesterone (natural oestrogen). The problem with it being a natural product is that for some it works, and some not. I was lucky enough that it works for me, but it works really slow though.

I have been examining other ways to start on HRT January this year. My health insurance gave green light for my doctor to send me to an endocrinologist. 

Abuse of power and monopoly

Here things get real odd and it shows just how many influence an academic hospital has and has no clue on how bad it is for transgenders to suffer from gender dysphoria.

The second half of January my doctor gave me a referral for an endocrinologist. This endocrinologist had worked with the VUmc in the past and my doctor knew he was one of the best in Alkmaar.

It was half February that the endocrinologist called me to tell me he couldn’t treat me. He had the professional courtesy to have called the VUmc gender poli and ask for their approval. VUmc thought differently about my way to start HRT and disallowed the treatment 😠

Phone calls, phone calls and more calls

Of course I was totally pissed off and I started to call the VUmc and endocrinologist. I think I have made a dozen calls between the two for over 5 hours total (it’s a good thing I have an unlimited phone bundle 😉).

At last I spoke with a male nurse who pointed out that my psychiatrist could send his gender dysphoria diagnosis to the VUmc and I could start with the treatment. This was possible because I didn’t need those psychological talks (which are the main reason for the waiting list).

I asked my psychiatrist to do so and as expected he did. The diagnosis was sent to the VUmc and guess what? Denied! I was told that there was no way I could start through this loophole and should wait my turn.

You what?!? I have the phone calls to prove what I was told. Hmmm… perhaps I should make a complaint with the VUmc about the way they treated me and send them the recordings along as well.

The self-medication problem

I was really tempted to get the medication through illegal / shady ways, but I am smarter than that. Not to mention that late February there was a lot of media attention about self-medication (Dutch article – use Google translate please) by transgenders because of those waiting lists. Most transgenders know of the risk they take but think it outweighs the dysphoria and waiting to start treatment.

In an interview in Trouw with Maaike (once again a Dutch article), Dirk Klink from the UZ Gent (Belgium) warns against bad medicines.

My Hormone Replacement Therapy

As you have read above, HRT has to be done by an endocrinologist. But does it? Elderly cis females after their menopause lack oestrogen as well and they can get HRT on a doctor’s prescription.

This is what made me think. Because I can’t get the HRT within The Netherlands there could be an alternative way outside The Netherlands. I ended up in the UK where a doctor was willing to prescribe me estradiol. Because he is not a Dutch doctor I can’t use that recipe in The Netherlands so I also had to find a pharmacy in the UK.

Now that I have both there is one other problem: blood works. To start with HRT I have to be healthy and the blood works should all be within their limits and they are! I get regular checkups for my blood because of the medication I take for my bipolar disorder. Those same checkups I have to take for the HRT to make sure the I do not get side effects from the HRT (mainly thrombosis, kidney and liver problems).

Who is the doctor?

No, I am not telling you that. Not because I am afraid that the VUmc will contact him and stop the HRT, but out of protection of other trans women on the waiting list. 

The waiting list is there for a reason. It is a screening to make sure you really want a (full) transition. To see if there isn’t an other (underlying) problem why you feel gender dysphoric (I realise the latter sounds weird, but I know someone who says to have gender dysphoria but there’s not a shred of femininity in that person). Not to mention the part I wrote above: self-medication. You need to have your regular blood checkups and a doctor who agrees of you to have HRT.

There are some really exciting time ahead of and my loved ones. Aside of a faster feminisation of my body, emotionally there will be a lot of changes as well with which we  have to learn to life with. On the other side I think gender dysphoria will be less of a problem than before making me happier and less depressed than before.

Lets just see what the (near) future will hold.

Thanks for reading. I probably write an update on the HRT late this month or early next month.

With love from a happy Alexa 💋💕

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TagsEstradiol Hormone Hormone Replacement Therapy HRT M2F Male to Female Medical Transition