This hits me particularly hard, so here is a personal story of mine… Light CW for medical malpractice.
When I started HRT, I saw a doctor in a clinic that was supposedly “good” with trans health care and generally was known to treat a lot of trans people where I live. The doctor I was assigned to was an old white guy (yes, it mattered). He did prescribe me HRT as I wanted, but refused to adjust the dosage beyond anything that he usually prescribed. He prescribed me what he prescribed for everybody else for many years. Which may have been fine for lots of people, but it was a disaster for me.
Due to a particular metabolic quirk I seem to possess, my body can’t absorb hormones as well as others. Routine blood tests showed that my hormone levels were critically low with the dosage the doctor prescribed me. Neither the test results, nor my own pleading did anything to change his mind. He always dismissed it as “trans people always want more” and refused to adjust the dosage. Meanwhile the side effects were so severe that other health care professionals were worried for my well-being. [If you want to know what happened to me, look up what having a combination of critically low levels or testosterone and estrogen do. I was a text book example of most of those symptoms.]
I probably don’t need it to say it around here, but nonetheless: Telling a trans person that they only want a higher dosage because “trans people always want more” is transphobic prejudice, particularly when somebody refuses to acknowledge the individual’s problems and even the facts on hand, such as blood tests that done by his own clinic.
It took me 1,5 years before I finally found another doctor who was willing to actually deal with my case.
So, no. A transphobic doctor will not give good care to a trans patient, not even if they are have a reputation for treating trans people and are providing trans specific health care, like HRT.
oh my God I’m sorry that happened to you :( HRT management is so fucking simple, I’m honestly shocked at how many doctors just wing it based on their own conceptions instead of doing the very easy very standardized processes most everyone follows.
had kind of the opposite situation happen to me, my primary care prescribing my hormones was an older dude with trans folk on his staff, everything seemed like it checked out, all I really needed was prescribing the same regimen I’d been taking with some occasional hormone panels.
for a while it was “too early” to get hormone panels, though he was taking blood draws for liver/kidney panels every time I saw him (oftentimes without even making clear that’s what he was doing) 6 months later I was not feeling great and asked if we could do a hormone panel to rule out some things, he explained that he felt like “the online trans community” focuses too much on the numbers and his plan was to increase dosage until it showed up on my liver/kidney panels. I wasn’t really sure but giving me enough estrogen for my liver/kidneys to start filtering it out of my blood seemed wrong and so I insisted on one anyway.
a week later he sent me an email basically saying “so because you were complaining about it so much last time, I went ahead and did it anyway and LOOK it’s fine!” Attached were lab results that were not at all fine - it was waaaaay high out of range and it wasn’t even a trough reading! (somewhere around 2000 pg/mL IIRC) I was confused at how this happened, given I didn’t even think we changed my dose?
So then I looked through my records and it turned out he’s been silently increasing the vial concentration without changing the amount drawn - pretty much the ideal way to increase my dose 8x without me noticing. I shoulda paid attention to the listed concentration on the vials I was getting, but we didn’t discuss a dose increase at all so I didn’t really have any reason to suspect a change.
So I bring all this to him alongside the physical symptoms I’d been feeling and ask for an explanation. Once again he started into the “you’re just too focused on the number” stuff. He also said my physical symptoms sounded like anxiety and that he could prescribe an anti-anxiety med. Immediately stopped seeing him and just did DIY for a while instead.
That is horrible and I am sorry you had to go through this. That level of negligence is certainly on par with the doctor I had to deal with, though hiding the increase from you is certainly borderline malicious (if not outright so). I am glad that you got away from him, because that was definitely the only way to go. . Internet hugs if wanted.
The statement that “all trans people want more” is also crazy to me cause it makes me wonder how he’d react to a case like my sister who in fact wants less (in a way). My sister used to be prescribed it via pill, but her doctor swapped her to the patch (saying it had lower stroke risk), but she seems to be really sensitive to the patch. This is causing her hormone levels to be way to high and I guess giving her symptoms similar to being on her period 24/7. She wants to go back onto the pill but the doctor wont answer the phone or her emails.
I empathize with your sister and I will keep my fingers crossed that she finds support, though my own experience taught me that she may not get it from a doctor who disregards her wishes so blatantly. I hope finding somebody else is an option for her.
i think the fact that he thought that all trans people want a higher dose suggests he was also fucking over all his other patients providing them with the bare minimum dose and being a huge cunt about it to all of them.
Dear god you spent a year and a half with basically zero sex hormone??? That is horrifying I hope you managed to avoid any long term negative outcomes once you got a better doc? My biggest, biggest hugs to you
Thank you. It was for about a year. Something I definitely do not recommend.
After that time I finally wised up and sought outside advise. Afterwards I scraped some donated medication together and basically did DIY for half a year. My test results were still way too low, but - at least - closer to the recommended minimum.
This makes my blood boil. I am glad you found someone better. I had lots of problems with my provider as well and eventually just went DIY which ironically is also MUCH cheaper where I am than the official prescription.
This hits me particularly hard, so here is a personal story of mine…
Light CW for medical malpractice.
When I started HRT, I saw a doctor in a clinic that was supposedly “good” with trans health care and generally was known to treat a lot of trans people where I live. The doctor I was assigned to was an old white guy (yes, it mattered). He did prescribe me HRT as I wanted, but refused to adjust the dosage beyond anything that he usually prescribed. He prescribed me what he prescribed for everybody else for many years. Which may have been fine for lots of people, but it was a disaster for me.
Due to a particular metabolic quirk I seem to possess, my body can’t absorb hormones as well as others. Routine blood tests showed that my hormone levels were critically low with the dosage the doctor prescribed me. Neither the test results, nor my own pleading did anything to change his mind. He always dismissed it as “trans people always want more” and refused to adjust the dosage. Meanwhile the side effects were so severe that other health care professionals were worried for my well-being. [If you want to know what happened to me, look up what having a combination of critically low levels or testosterone and estrogen do. I was a text book example of most of those symptoms.]
I probably don’t need it to say it around here, but nonetheless: Telling a trans person that they only want a higher dosage because “trans people always want more” is transphobic prejudice, particularly when somebody refuses to acknowledge the individual’s problems and even the facts on hand, such as blood tests that done by his own clinic.
It took me 1,5 years before I finally found another doctor who was willing to actually deal with my case.
So, no. A transphobic doctor will not give good care to a trans patient, not even if they are have a reputation for treating trans people and are providing trans specific health care, like HRT.
oh my God I’m sorry that happened to you :( HRT management is so fucking simple, I’m honestly shocked at how many doctors just wing it based on their own conceptions instead of doing the very easy very standardized processes most everyone follows.
had kind of the opposite situation happen to me, my primary care prescribing my hormones was an older dude with trans folk on his staff, everything seemed like it checked out, all I really needed was prescribing the same regimen I’d been taking with some occasional hormone panels.
for a while it was “too early” to get hormone panels, though he was taking blood draws for liver/kidney panels every time I saw him (oftentimes without even making clear that’s what he was doing) 6 months later I was not feeling great and asked if we could do a hormone panel to rule out some things, he explained that he felt like “the online trans community” focuses too much on the numbers and his plan was to increase dosage until it showed up on my liver/kidney panels. I wasn’t really sure but giving me enough estrogen for my liver/kidneys to start filtering it out of my blood seemed wrong and so I insisted on one anyway.
a week later he sent me an email basically saying “so because you were complaining about it so much last time, I went ahead and did it anyway and LOOK it’s fine!” Attached were lab results that were not at all fine - it was waaaaay high out of range and it wasn’t even a trough reading! (somewhere around 2000 pg/mL IIRC) I was confused at how this happened, given I didn’t even think we changed my dose?
So then I looked through my records and it turned out he’s been silently increasing the vial concentration without changing the amount drawn - pretty much the ideal way to increase my dose 8x without me noticing. I shoulda paid attention to the listed concentration on the vials I was getting, but we didn’t discuss a dose increase at all so I didn’t really have any reason to suspect a change.
So I bring all this to him alongside the physical symptoms I’d been feeling and ask for an explanation. Once again he started into the “you’re just too focused on the number” stuff. He also said my physical symptoms sounded like anxiety and that he could prescribe an anti-anxiety med. Immediately stopped seeing him and just did DIY for a while instead.
That is horrible and I am sorry you had to go through this. That level of negligence is certainly on par with the doctor I had to deal with, though hiding the increase from you is certainly borderline malicious (if not outright so). I am glad that you got away from him, because that was definitely the only way to go. . Internet hugs if wanted.
The statement that “all trans people want more” is also crazy to me cause it makes me wonder how he’d react to a case like my sister who in fact wants less (in a way). My sister used to be prescribed it via pill, but her doctor swapped her to the patch (saying it had lower stroke risk), but she seems to be really sensitive to the patch. This is causing her hormone levels to be way to high and I guess giving her symptoms similar to being on her period 24/7. She wants to go back onto the pill but the doctor wont answer the phone or her emails.
I empathize with your sister and I will keep my fingers crossed that she finds support, though my own experience taught me that she may not get it from a doctor who disregards her wishes so blatantly. I hope finding somebody else is an option for her.
i think the fact that he thought that all trans people want a higher dose suggests he was also fucking over all his other patients providing them with the bare minimum dose and being a huge cunt about it to all of them.
Unfortunately very likely yeah…
Dear god you spent a year and a half with basically zero sex hormone??? That is horrifying I hope you managed to avoid any long term negative outcomes once you got a better doc? My biggest, biggest hugs to you
Thank you. It was for about a year. Something I definitely do not recommend.
After that time I finally wised up and sought outside advise. Afterwards I scraped some donated medication together and basically did DIY for half a year. My test results were still way too low, but - at least - closer to the recommended minimum.
Criminal negligence imo, I’d report him to anyone that will listen.
This makes my blood boil. I am glad you found someone better. I had lots of problems with my provider as well and eventually just went DIY which ironically is also MUCH cheaper where I am than the official prescription.