Letters Volume Twenty-Two
This is Volume Twenty-Two of the collected letters.
Wherein can be found the anonymous texts of actual letters written to me,and my answers in return. They are included because it has been suggested that the discussions are of value. The letters are presented as a rather loose, ongoing continuous dialogue between a hypothetical questioner, and myself.
You can write to me, too!
These are the Twenty-Second set of letters
Reference Topic Index
Relative ONLY to this volume:
For the complete list see main letters page.
basic overview of going through transition and surgery.
The second puberty of hormone replacement can't be a real puberty..can it?
Carefully judge your doctors!
Generally, most surgeons will not touch anyone under the age of 18, and usually prefer 21. There have been some exceptions, but for the most part this is true. The reason is that surgeons do not want to be sued if some kid really does not know for sure what they want...surgery is one way only, and cannot be effectively reversed.
It is required
that a surgical candidate have spent at least one full year living
and working in the desired gender role, to prove that they can
survive and be accepted. The certification of two psychiatric
professionals is also required, stating that the person is a good
candidate for surgery. The surgical candidate is also expected to
have been on hormones for more than a year as well.
Where was Your surgery done?
Mine was done...you can read all about it in my transition story on the front page...in Trinidad, Colorado, 17 years ago. My surgeon, who is no longer in the business...he got old... was Dr. Stanley H. Biber.
Do You know of any good therapist that I may contact by e-mail?
No, but if you try contacting the Ingersoll Center (top of my links list) they can help you find a local gender support group to your area.
How much does it cost for hormones. and who may prescribe them???
Any general practice doctor can prescribe hormones. Before getting hormones, one must consult with the doctor, explain the situation, and so forth. The doctor will need some blood tests and urine tests to make sure that you do not have heart problems , and that your liver and kidneys are OK. This is so that the hormones will not kill you or cause a stroke. If you are healthy, and you do not smoke or drink (which would increase the chance of stroke and death on hormones), you can get a prescription.
Occasional the doctor may want to re-check you, at least until you get surgery. After surgery, you can go on a lower dose, and then you suffer the same risk as any person with normal hormones. You have to take hormones for life.
The doctor visit can run a few hundred dollars, unless you have insurance to pay for it. Some doctors charge more, some less. Hormones cost about 30 dollars (American) per month, unless you have insurance, in which there is generally a co-payment of about 10 dollars or so, instead. I have insurance, so I pay only 8 dollars per prescription, myself. My prescriptions are for three months at a time, so I pay 8 dollars every three months. Twice a year or so, I get checked up on by my doctor, just to be safe. I like to be safe.
One more question, PLEASE, how much does reassignment surgery cost, and where is the best place to have the surgery??
That depends on
your pocketbook, and personal tastes. There are many good surgeons
out there, and if you go through transition, you will find about them
from your doctors. The cost can run anywhere from 8,000 to 30,000
dollars. 17 years ago, I paid 11,000 dollars. So, it costs about the
same as a used car. If you can save up to buy a good used car, you
can afford surgery.
You mentioned that
going thru the change would be like a second
puberty. Can you elaborate on that. I am a transexual male seeking to
be a woman. I noticed a lack of attention to female nature like wil I
get periods menstrual cycles does my pituatary gland come out of
dormancy. I'm sure that It wouldn't involve a normal reproductive
system but what about the rest of what normal females experience? It
can't be a real puberty can it?
The answer to your question is yes....to a point. No, you cannot get periods as a Male-to-Female transsexual. You will not have monthly mood swings unless -for some screwy reason- you deliberately have a hormone regime set up to put you through -as my nontranssexual partner Eldenath put it "Hormone Hell". But in all other ways, it is a very real second puberty.
Puberty is sex hormones changing the body, developing and altering it to become a give sex. That is exactly and precisely what taking hormones does, and to a transsexual it serves to literally remake much of the body. Bones do not change. Teeth do not change. Hair that has already grown from the scalp does not change -though the hair follicles on the head can alter how they produce hair sometimes. Facial hair can get thinner...but once it has been 'switched on' by testosterone, cannot be 'switched off' again...it must be removed forcibly by electrolysis. Hair lost from the scalp do to male pattern baldness will not grow back. Those are the limits.
What can a and does change, to degrees great and small, are all the soft tissues of the body. Every system is affected to some degree as cells activate certain genes and deactivate other genes all because of the hormonal signal that comes from estrogen or testosterone (in the Female-to-Male transsexual).
Cells will die in certain places, and other cells will be created in others. This causes a shifting of fat and muscle all over the body. Muscle tissue alters, skin becomes soft and delicate, breasts grow (in the Male-to-Female transsexual) and in the Female-to-Male transsexual, beards start, muscles shift to bulk and power, and skin becomes tough and strong. Pimples, too!
The voice will change in the transsexual man, but for us Male-to-Female transexual women, the voice does not change. Once something is constructed, it stays, and the male voice is a mutational construction.
This transformation cannot grow a womb, nor can it replace surgery. But it is so complete that -if a fully transmogrified MTF transsexual were given the proper chemistry, such as the hormone oxytocin, they could express milk from their breasts. Indeed, some rare cases have, in record, due to the action of the pituitary gland. Anything that does not involve the wholesale creation of missing organs will be developed.
If the growth of breasts seems to violate this, understand that all males have breasts fully capable of becoming female breasts. All the necessary cells and wiring is there, it is just dormant. Rarely, a male who is not transsexual will develop breasts do to a hormone imbalance. This causes men much distress, and they will often have reduction or removal surgery to eliminate this condition...called gynocomastia, by the way. Female-to-Male transsexuals, or transsexual men, feel just the same as any man about this issue, and feel just as unhappy about having breasts and transsexual women feel about having incorrect sex organs.
Unfortunately, once developed, a breast will not go away. It is permanent. Just like beard hairs and other secondary sex characteristics.
within the limits of what actually is possible for the body to do
since it came out of the womb, the second puberty of hormone
replacement therapy will change whatever can be changed to fit the
appropriate sex. The transformation can be so impressive that it
often seems miraculous...but it is simple biology in action, and a
testament to the both the closeness of the sexes to each other, and
to the capacity of the body to rebuild itself.
I went and saw a doctor yesterday to discuss my acne. (Darn that venom known as "testosterone"). When I was there, I asked him about gender dysphoria and what can be done about it. I figured that if ANYONE in the world could help me, it would be a medical doctor. However, he told me that the only thing I could ever do was to accept myself for who I am. He said not to tell anyone and that life will go on. When I mentioned going on hormones, he thought that was absolutley absurd and that sort of thing should never be treated. He can't be right, though, correct? Excuse me, but I've known of my condition for about seven years now and it doesn't "just go away". So, who can possibly help me? Should I go see a psychologist or counselor first?
A little destruction of the Great Ivory Tower is needed.
Doctors, in our culture, are often seen as greater than human, and indeed they sometimes even fall into this belief themselves. The fact is that a doctor, that any professional, is just some ordinary human bugger who -be it for the love of money, the need for prestige, strange interests, or even a genuine desire to help others- decided to pursue a vocation. Being human, any given doctor may well be incredibly bigoted, undereducated, sloppy, confused, or utterly unsuited to the profession they have chosen. It is guaranteed that 50% of all the doctors you will ever meet, graduated in the lower 50% of their class. You will, sometime in your life, almost certainly meet a doctor that scored in the lower 20%. Yet they may be utterly convinced that their sheepskin connotes absolute superiority. And many, many people would agree with them, simply because they are that most respected of things, 'A Doctor'.
The doctor you describe is an ignorant, bigoted fool. I have only total contempt for a supposed professional who would, in this day and age, so counsel a patient. The cause and circumstances of transsexuality are remarkably well understood, and transsexuals have been treated successfully by the medical community for longer than 30 years. There is no excuse for such potentially harmful advice. Your doctor is a quack.
AROUND. Doctors are just mechanics for your body. Find a better body
shop, and a much better educated mechanic. Ultimately, always be the
primary force behind your own medical treatment. You pay them...and
you make the decisions. Always remember that. If a doctor is clearly
unhelpful, do not bother wasting your time with them. There are some
brilliant, upper 50% of the class, caring doctors out there. Go find
one, the one you have clearly is not worth your time. Go get what
help you need...what ever that help might be. But always, always
judge THEM. You are buying, they are selling. Remember that.