Gender Center appointment

I had two appointments scheduled for yesterday. The first of those was an initial consult with a doctor in the Grady Hospital Gender Center. Basically, he’s a specialist in transgender internal medicine.

I’ll admit that I was more than a little concerned about this appointment. As a transgender person, a lot rides on having a good rapport with the person who has the power to take away your HRT. The short version is that we got along well, and I was very comfortable with him.

The details: We discussed my dissatisfaction with the progress I’d made in breast development, as well as my general desire to possibly make some changes to my current regimen. He scheduled me for labs to check my Estrogen and Testosterone levels, as it had been a while. Covid really threw a monkey wrench into my regular care schedule for the last year. He also asked to do a clinical breast exam.

During that clinical exam, he confirmed what I’d already pretty much guessed. I had stalled at Tanner Stage 3. I’ve been in HRT for nearly 10 years now. I should have developed fully by now, if I was ever going to do so. He suggested breast augmentation, which I have no financial means to even consider. We decided to discuss other options (HRT regimen changes) further once the labs came back.

I heard from him later that same afternoon. The labs were back. They showed my E and T were at the WPATH recommended levels for transgender women. He discouraged changing my E dosage and method of administration. We had talked about possibly reducing Spironolactone because of the “peeing a dozen times a day” side effect. Doing so would have the down-side of leading to an increase in T, which I definitely don’t want. So, no changes to those aspects of my regimen.

And yet, still no progression in development of the breasts. We had also discussed progesterone, and he was unaware of any evidence that showed any value to adding that. He’s not opposed to adding it though, should I choose to do so. There’s also no evidence of any major side effects. I’ve since shared this article with him via the patient portal, and am awaiting a response. Article: Progesterone Is Important for Transgender Women’s Therapy

Overall, I’m happy with this doctor. He’s clearly all about the informed consent model, which is important to me, especially in this aspect of my care. I feel I can work with him, and as he’s willing to take a consultative role, with my GP handling day to day care, there’s no significant burden of additional regular appointments to keep up with. What appointments we will have we’ve already agreed to do via telemedicine, and regular labs drawn via nurse visits to my close-by family clinic.

Tags: breast development, HRT, Transgender