Phew, what a scorcher!

We seem to have been well and truly back in heatwave mode here in England. Of course the weekend when we had an outdoor gig was bound to be the one weekend when it went cold and rained. We have another outdoor gig coming up a week on Saturday actually, so I guess that’s the weather forecast sorted for then…

Last week in fact saw the highest July temperature ever recorded in this country. Bring it on. Global warming perhaps? Whatever, I love it. I wonder how much hotter Thailand will be. Don’t suppose they make such a fuss about it over there.

After a small investment last year in a few strawberry plants, and all this lovely sun, I have had a daily supply of fresh strawb’s all this month. Practically coming out of my ears they were, but I can never have too many strawberries. I have blackcurrants too (they do go well together), and have had a great crop of those too, sadly both are coming to an end now, but it won’t be long until my apples are ready and I will be making pies and crumbles and well and truly keeping the doctor away.

Speaking of doctors, I went to see my GP this week, and am now at last on NHS prescription oestrogen. Although Charing Cross had written to him after my last appointment, he hadn’t yet had any specific instructions from their endocrinologist, so wasn’t entirely sure what to give me. I told him what they had told me to expect – Zoladex injections and a low dose of estradiol valerate, and what I have been taking and what I’d like to continue to take. 17-Beta estradiol apparently is not available on the NHS, so he prescribed me 4mg per day of estradiol valerate, which is probably the next best thing. He wasn’t at all keen on the Zoladex idea, and I have my doubts about it. He checked my blood tests and agreed that as my testosterone level was already very low (average female sort of level) it seemed pointless trying to lower it further. He also commented that Zoladex was not licensed for this purpose, it being a cancer drug. Actually I’m not sure if any hormones are licensed for transsexual feminisation purposes, but I do think he has a point and was right to be wary of it. Charing Cross seem to think that by taking Zoladex one can reduce the amount of oestrogen needed. Maybe so, but I think it’s a little crazy; I’m on a fairly low dose of oestrogen anyway, it’s clearly sufficient to keep my testo levels down, development seems to be going ok, and basically estradiol, either 17-Beta or valerate, is far safer than Zoladex. So in my case what would it achieve? A greater risk. Nothing else. Zoladex is a pretty serious drug, it tricks the body into shutting down testosterone production (or oestrogen if you’re female) entirely. It has a list of side-effects as long as your arm (ok most drugs do, I know), but the simple truth is that it is much riskier. Now if you have cancer and your life is in danger that may be a risk worth taking. For a TS patient trying to achieve long-term feminisation with SRS in the not too distant future, it seems absurd. Maybe for a rugby-playing high testosterone count sort of bloke starting out on hormones it could have some benefit, maybe. But that’s not me, and that’s one of the problems I think Charing Cross has. Cookie-cutter, off-the-shelf hormone regimes, same for everybody, no debate, no discussion, you take what we tell you. We don’t think about it, so neither should you….

So actually I’m rather glad that my GP had not yet received specific instructions from their endo, as it gave us a chance to discuss a sensible regime that was right for ME. Hopefully, if or when he does receive his instructions he will still be prepared to discuss them with me, rather than blindly follow their "advice".

It seems to me that the "experts" at Charing Cross are not really using their skills to good effect; their "expertise" is hindered by red-tape and policies and funding issues. Sadly, the patient’s best interests are not their primary concern. I don’t think they’re half as bad as some people make out (that opinion may change over time), but I can see why people become so frustrated with them. I am reassured though by my GP’s sensible, and honest attitude; he said, "We’re not experts…".

When it comes to hormones for feminisation, I don’t think anybody is.

Charing Cross have given me a date for my next appointment, in November, when I hope to speak to someone about having a tracheal shave, or rather, when I hope that someone will speak to me about it, and not just say, "Ask next time…" I await their expert opinion on that with baited breath.

xx