I saw that contradiction, Kristelle. I guess it could be explained by the low dosage administered after the initial phase of striking down the testosterone. So, with the dosage given these patients - 2x0.05 - the breast development may not be a "problem". My problem is... those 2x0.05 is all I will get from my psychiatrist.
I probably would not have been thinking about ethinyl or any other medication at this point if I could raise my number of patches to reach the dosages you're mentioning. And maybe add some progesterone. But as things are here I can do neither.

But at least my psychiatrist's denial have provoked me into doing something. Today I went to my GP and had her refer me to our only "tranny doctor" - him/herself transgendered and member of the board of our organization.


Linda

Ok I want to ask,

How much breast development you got and how long did it take? Oh and what did you take to get it?

Personally I'm on:
150mg of androcur
12mg of progynova
10mg of provera

and thats all daily. I think I have had a moderate growth. I think I'm somewhere between an A and a B cup, they are filling out at the moment rather than getting bigger.

I was told by my Endo that i should have all i will get size wise at about the two year mark. Now the thought thats going through my head is that I may not have the size I really want if they dont do some real growing in the next few months, and I will be in Thailand for GRS by the time I will be at 1 yr 9months of hormones. Thailand is about 1/3rd of the price it would cost to have my breasts done here in Oz.

So does anyone have an opinion on whether it would be wise to wait or to go ahead and have my breasts done while i'm there?

Oh those patches, a favourite among lilylivered doctors... Seems we're having some sideeffect on their poor lives.

I want to thank you too, Kristelle, for this information. I copied it this morning and brought it with me to my psychiatrist. Six weeks ago he gave me a prescription for 50mg patches, but saying that this was to check if there were any serious sideeffects, and that we'll see in a month or so. And now we were well past that. And it turns out he will not give me more than a 100mg - and only "possibly in a couple of weeks". I showed him several papers making it pretty clear that 200mg is minimum. And then he asked me to find someone with a better knowledge of transsexualism than him. I hope my female GP will help me, or else I shall have to look for some third doctor.

Linda


Reminds me of a statement by Graham Chapman, late member of Monty Python, who was also a physician: Don't trust doctors; after all, they're simply ex-medical students.
But then I should have known, I come from a family of doctors..

Hi fiona, ive been taking ethinyl estradiol & cyproterone acetate for 10 months now. take a look at my photos in my profile to see how things are developing for me.
angel xx

ethinyl estradiol...

Three days ago I met my psychiatrist. The same morning I received the bimonthly newsletter from our National Organization for Transsexuals.
In the newsletter there were attached a "Handbook for the Transgendered". The only estrogen medication mentioned was Ethinyl Estradiol - from three different producers. And below that info it said "there are several other varieties of estrogen medication that you may consider while talking to the endochrinologists at the GID clinic".

It seems that what they're saying is Ethinyl Estradiol should be our first choice if we can choose at all, and don't have some special health problem. They just can't say it openly because of the doctors at the GID clinic, and their government funding. (The GID clinic prescribes patches for anyone past forty regardless of their health, and the doctors there are the only ones that can prescribe free medication.)

If things turn out the way I suspect I will not get the medication I'm asking for from my psychiatrist. I will have to get it elsewhere or wait for the diagnosis. And then I will have to fight for the right kind and a sufficient dosage. And might not get it.


Linda

J Urol. 2003 May;169(5):1735-7.

...and other morbidity (gynecomastia) was negligible. Transdermal estradiol therapy prevented andropause symptoms...

Seems to me that the paper actually confirms that there will not be much growth of breast tissue from the use of these patches - as opposed to Ethinyl Estradiol. And the fact that the patches are "preventing andropause symptoms" seems to be saying the same ? Isn't what we want in fact a "definite pause" to all andro effects ?

I can of course see the point of avoiding thrombosis, but how great are the risk, really, if we are of good health ? And if we have to take significantly higher doses to achieve the same effect with patches, couldn't this mean that the risks turns out much the same ?

I looked for some info on DVT and found this site:

What can you do to decrease your risk ?

If you stop smoking and lose some weight, you will greatly reduce your overall risk of developing DVT

But there are also other factors - like avoiding muscle injuries or fractures, and not staying too long in static positions - especially when travelling by air. From my own experience I know of two relatives who most probably had their thrombosis because of staying too long with one particular muscle in a contracting position. This accords well with what I found on another site:

emedicine

Pathophysiology: The Virchow triad, as first formulated - ie, venous stasis, vessel wall injury, hypercoagulable state - is still the primary mechanism for the development of venous thrombosis. The relative importance of each factor is still debated. (...)
In practical terms, the development of venous thrombosis is best understood as the activation of coagulation in areas of reduced blood flow. This explains why the most successful prophylactic regimens are anticoagulation and minimizing venous stasis.

This should imply that avoiding risk is also about avoiding prolonged stress/contraction of the veins. And possibly taking anticoagulatory medicine - ie aspirine ? There is also some evidence that omega-3 oil lowers the risk of blood clotting.

I must admit that this information is of little value for me as my not too courageous psychiatrist will not give me anywere near the necessary estrogen dosage. And no antiandrogens, no progesterone.


Linda

The evidence is there...what more do they need??

You're certainly right to ask, Kristelle. I have been wondering myself. The answer may be simple: They feel they need a permit from the GID clinic.
Last year the clinic raised a totally unfounded malpractice case against a transgender doctor (him/herself TG). A couple of days ago I found some new info on that case, and it may explain why I'm having this trouble. When I heard of the case last winter I had the impression that it was all about prescribing antiandrogens to a 14 year old tgirl. But now I have found out that the real reason was also about "several persons meeting at the GID clinic and already being well on their way with HRT - and without proper psychiatric evaluation."

So, my psychiatrists unwillingness probably comes from fear of loosing his licence. The minimum amount of estrogen I'm on now can be considered a "precautionary measure" - made to calm me down, I guess. But I'm not, of course. I just feel swindled as he gave me the impression seven weeks ago that he would consider a higher dose if I had no sideeffects the first month.

Well, now I am referred by my GP to the recalcitrant tranny doctor.

Linda

You're right, Sandra. He doesn't have much experience with medication at all after working mostly as an analyst for thirty years. So, maybe he has been willing to go as far as anyone could fairly expect from him. It's just that he said in spring already that he would help me with this, and he mentioned that he might consider giving me a prescription for patches. But when summer came and when I asked him one final time he would not. And then, when I met him after summer, he admitted that he had put me in real danger. So he may have given me that token of a precription to calm me down.

As for monitoring my health I thought I had a deal with him - my GP takes care of the tests - sends them to a laboratory. When I checked the papers for my last test I found the same endo as used by the GID clinic...
Still, there is an endocrinologist involved. Question is if my GP can know what kind of tests should be requested. Is it really that complicated ?

When reading through the papers from the transgender organization I found no mentioning of endos on their list of "recommended partners", only a few GPs - and first on their list was the sexologist/gender doctor I am now referred to. I guess I will find out more when talking to him/her.

Linda

I'm pretty sure that an endo is THE doctor for this stuff. After all it is the field they specialise in. Yes some may not have much experience in relation to trans people so you may have to have a look about for one who does.

I'm lucky. I went the most notable doctor in the field of Trans in Sydney and then he refed me to the right endo. I am deffinatly not this endo's first transwomyn. He seems to know the questions I am about to ask before I hav asked it and there is always a transwomyn in the waiting room.

Find an endo who knows what they are doing, I'm sure thats the key. If you have trouble finding one, ask your board of health or what ever it is called in your area to help you find one.

Psychiatrists went to medical school and are not the same thing as psychologists...

Yes, that is what I thought too, Kristelle. And this is the reason I think that it's to a large extent a question of empathy, courage and will. Anyone with a medical degree should be able to pick up the necessary knowledge for prescribing the right medication. And if they feel too unsecure the regular procedure in this country is referring the patient to a specialist - in this case an endocrinologist. I know from my father's and grandfathers work how these things are supposed to be done. And my mother, a certified nurse working at the State Hospital for more than twenty years, she says the same: Why aren't they simply referring you to the right specialist ? Well, the only referral I got until now was to the GID clinic. And this does not solve my medication problem as they have their strict procedures. I had to find out by myself however that these procedures are not meant to hinder any kind of private treatment. The psychiatrist at the clinic told me that. And it was only after telling this to my psychiatrist that he gave me that stingy prescription.

I must say this country is starting to feel more and more like one big closet. I remember one swedish minister calling us "the last Soviet state" some years ago. I did not agree with him. But when experiencing how this system really works I'm inclined to say he was right.
Twice have I tried to order the medication myself. But the borders are soo well protected... As a last resort I have been thinking of leaving the country. And that is what I will tell the TG doctor I'm referred to now.

Linda

Hi Fiona I'm not a TS so won't be going through this. But Sandra is right you should wait untill your body has gone through all the changes it's going to. When your body is back in balance to where it's going to be everyday for life.
Then if you want to still go with it then would be the time.