the state of me: embodiment edition
Aug. 14th, 2019 01:44 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
kindkitBack in June I finally got a check-up for the first time in, oh, about 25 years. (I was doctor-avoidant long before I went through 10 years without health insurance.)
I was dismayed, but not surprised, to find out that I am indeed diabetic. I'm on metformin now, and following the goddamn meal plan and exercising, and having very good results. It's definitely an incentive that my various doctors don't want me to start on T until my diabetes is under control. The meal plan is . . . both more and less tolerable than I had thought it would be. I'm glad that I can still have sweets (in small, small portions) so long as I fit them into the carb count. But the overall carb restriction can be hard. There are days when I would give my right arm for a big bowl of pasta. (Technically I can have pasta. I can have a whole 2 ounces--about 60 grams--of pasta per meal! It hardly seems worth it.)
Try not to become diabetic, folks. It sucks.
My cholesterol is also too high, which is also a factor in starting T. So it's lowfat milk and less cheese and butter and sausage, and more skinless chicken breast. And fish oil supplements, and fish (canned mackerel = really quite tasty). And a statin. There seems to be some controversy about the extent to which dietary cholesterol and fat intake actually affect blood cholesterol levels, heart disease, etc., but it's hard to tell if it's genuine scientific uncertainty or if it's people trying to promote their low-carb, high-fat diet books. Anyway, I admit I am prioritizing the diabetes--if I can't have many carbs I'm going to have some damn meat and cheese. I like broccoli and spinach just fine, but I don't want them to be all I'm allowed to eat.
In other personal, health-adjacent news: transitioning. My primary care provider has been very supportive, but although she's done hormone replacement therapy for menopausal cis women, she's never done hormones for trans people. So today I saw the one of two local doctors who do it (the other doesn't take my insurance). He too said some stuff about needing to get my general health better managed, but he also seemed willing to go ahead with T, slowly and carefully monitored. He and my pcp will consult about me--alas he won't be able to manage the transition stuff himself, because he's moving away to a new practice somewhere. But pcp has said she's willing to learn.
I have to see a counselor to help me cope with transitioning, which . . . ugh, don't wanna. I have had an aversion to therapy ever since I was forced into it as a kid, twice, with two differently incompetent therapists. But hopefully this will be better, and actually useful. And at least it's the only piece of gatekeeping I've encountered--overall everyone medical has been astonishingly supportive, especially considering the horror stories I've heard. It's like they actually believe me and trust my knowledge of myself!
Top surgery has been discussed too, but apparently surgeons are more gatekeep-y, and I will absolutely have to have had counseling and have "lived as the desired gender" before it will be possible. So I guess I had better finish coming out at work without further delay.
Doc asked if I was interested in bottom surgery, but I said probably not unless the techniques get much better soon. If bottom surgery would get me a proper working example of the correct anatomy, I'd do it without hesitation. But I don't want to go through so much pain and risk for a result that's not functional and frankly not that decorative either. (In this one way, trans women have it better than trans men. In every other way, they don't.)
I've been talking about obstacles, but really, this is all much easier than I expected it to be. Much of it should even be covered by my health insurance, since my state has a law prohibiting anti-trans discrimination in insurance coverage. (Basically, if an insurer covers a procedure for any reason--HRT for menopause, or mastectomy for breast cancer--they have to cover it for trans people. It's a good law. Also I have pretty damn good insurance now, luckily.)
Today I signed the 5-page long consent form to start taking T. One hilarious moment during office visit:
Doc: So, I see in your records that you don't have periods anymore.
Me: Nope.
Doc: Well, let me tell you about the possible fertility effects of testosterone. (Proceeds to tell me about them.)
Me: Okay, I assume you were required to tell me that. But I'm 49 and I never wanted kids anyway.
Doc: Yeah, but I had to tell you.
All in all, and despite the less-than-ideal health stuff mentioned above, my life is going better than it has in a long, long time. I will probably be able to be my real self, when for years there didn't seem any hope of that. It's good.
I was dismayed, but not surprised, to find out that I am indeed diabetic. I'm on metformin now, and following the goddamn meal plan and exercising, and having very good results. It's definitely an incentive that my various doctors don't want me to start on T until my diabetes is under control. The meal plan is . . . both more and less tolerable than I had thought it would be. I'm glad that I can still have sweets (in small, small portions) so long as I fit them into the carb count. But the overall carb restriction can be hard. There are days when I would give my right arm for a big bowl of pasta. (Technically I can have pasta. I can have a whole 2 ounces--about 60 grams--of pasta per meal! It hardly seems worth it.)
Try not to become diabetic, folks. It sucks.
My cholesterol is also too high, which is also a factor in starting T. So it's lowfat milk and less cheese and butter and sausage, and more skinless chicken breast. And fish oil supplements, and fish (canned mackerel = really quite tasty). And a statin. There seems to be some controversy about the extent to which dietary cholesterol and fat intake actually affect blood cholesterol levels, heart disease, etc., but it's hard to tell if it's genuine scientific uncertainty or if it's people trying to promote their low-carb, high-fat diet books. Anyway, I admit I am prioritizing the diabetes--if I can't have many carbs I'm going to have some damn meat and cheese. I like broccoli and spinach just fine, but I don't want them to be all I'm allowed to eat.
In other personal, health-adjacent news: transitioning. My primary care provider has been very supportive, but although she's done hormone replacement therapy for menopausal cis women, she's never done hormones for trans people. So today I saw the one of two local doctors who do it (the other doesn't take my insurance). He too said some stuff about needing to get my general health better managed, but he also seemed willing to go ahead with T, slowly and carefully monitored. He and my pcp will consult about me--alas he won't be able to manage the transition stuff himself, because he's moving away to a new practice somewhere. But pcp has said she's willing to learn.
I have to see a counselor to help me cope with transitioning, which . . . ugh, don't wanna. I have had an aversion to therapy ever since I was forced into it as a kid, twice, with two differently incompetent therapists. But hopefully this will be better, and actually useful. And at least it's the only piece of gatekeeping I've encountered--overall everyone medical has been astonishingly supportive, especially considering the horror stories I've heard. It's like they actually believe me and trust my knowledge of myself!
Top surgery has been discussed too, but apparently surgeons are more gatekeep-y, and I will absolutely have to have had counseling and have "lived as the desired gender" before it will be possible. So I guess I had better finish coming out at work without further delay.
Doc asked if I was interested in bottom surgery, but I said probably not unless the techniques get much better soon. If bottom surgery would get me a proper working example of the correct anatomy, I'd do it without hesitation. But I don't want to go through so much pain and risk for a result that's not functional and frankly not that decorative either. (In this one way, trans women have it better than trans men. In every other way, they don't.)
I've been talking about obstacles, but really, this is all much easier than I expected it to be. Much of it should even be covered by my health insurance, since my state has a law prohibiting anti-trans discrimination in insurance coverage. (Basically, if an insurer covers a procedure for any reason--HRT for menopause, or mastectomy for breast cancer--they have to cover it for trans people. It's a good law. Also I have pretty damn good insurance now, luckily.)
Today I signed the 5-page long consent form to start taking T. One hilarious moment during office visit:
Doc: So, I see in your records that you don't have periods anymore.
Me: Nope.
Doc: Well, let me tell you about the possible fertility effects of testosterone. (Proceeds to tell me about them.)
Me: Okay, I assume you were required to tell me that. But I'm 49 and I never wanted kids anyway.
Doc: Yeah, but I had to tell you.
All in all, and despite the less-than-ideal health stuff mentioned above, my life is going better than it has in a long, long time. I will probably be able to be my real self, when for years there didn't seem any hope of that. It's good.
no subject
Date: 2019-08-14 09:33 pm (UTC)no subject
Date: 2019-08-14 11:03 pm (UTC)no subject
Date: 2019-08-14 09:38 pm (UTC)no subject
Date: 2019-08-14 11:04 pm (UTC)no subject
Date: 2019-08-14 10:02 pm (UTC)Awesome! Good luck with the less-than-ideal and enjoy the rest of it.
no subject
Date: 2019-08-14 11:06 pm (UTC)no subject
Date: 2019-08-14 11:51 pm (UTC)yay for self. good to hear things are going well.
no subject
Date: 2019-08-16 02:18 am (UTC)no subject
Date: 2019-08-14 11:58 pm (UTC)Yay for healthcare, and yay for what sounds like supportive medicos. Yay for T!
no subject
Date: 2019-08-16 02:21 am (UTC)no subject
Date: 2019-08-15 11:03 am (UTC)no subject
Date: 2019-08-16 02:22 am (UTC)no subject
Date: 2019-08-15 11:24 am (UTC)Food restrictions not so good (I know the feeling!) but hopefully worth it in the long run.
no subject
Date: 2019-08-16 12:20 am (UTC)Also, WTF about the fertility information. WTF!
no subject
Date: 2019-08-16 03:55 am (UTC)Gah! that fertility stuff is so frustrating. I understand the logic behind the caution, but what part of "no, I am positively, definitely, 100% positive that I'm pregnant and never intended to be" requires follow up questions? *sigh*
Happy to hear the good news! M.
no subject
Date: 2019-08-16 10:07 am (UTC)no subject
Date: 2019-08-16 07:32 pm (UTC)no subject
Date: 2019-08-17 04:44 am (UTC)I agree about the cholesterol, and there's a lot of research going into the genetic side of things at the moment. With known family history, there seems to be a limit to what diet can do (e.g. my mother, her brother and one of my cousins are thin, active and have what should be low cholesterol diets and yet have moderate to high cholesterol; everyone else in the family has ideal cholesterol regardless of age, body type, diet or exercise) and yet for other people there seems to be a limit to what the drugs can manage. It's as if different people react differently!
re: transitioning
Date: 2019-08-22 10:32 pm (UTC)