fem[dot]nz

CW: Transgender healthcare, unhelpful doctor :(, depression, hot flashes

Went to the doctor yesterday because I've been experiencing hot flashes, chills, worsened depression, and early waking (losing up to a couple hours of sleep each night and not able to get back to sleep). These have been developing since just a couple weeks after I went on GAHT - note mention of depression in previous entry. The increase in mood variability has become more of an i-can-tank-and-be-horribly-sad-for-no-discernable-reason. I was meaning to bring this all up before the planned 3 month checkup but it hasn't been getting better and in fact my ability to deal with it (or the severity) has been getting worse. It's interfering with my work and making life quite difficult. Anyway, so my girlfriend (Eliza) has been suggesting I just go to a doctor for some time, and this was also the advice of some trans people I talked to.

Now that we're at the start: I went to the doctor yesterday. They were entirely unhelpful. Their opinion was that this cluster of symptoms I told them about are reactions to the medication. They are a documented response to low hormone levels - this happens to people experiencing menopause, and it happens to cis men on anti androgens when they're not supplementing estrogen. I tried to articulate this, but apparently menopause like symptoms 'only happen to women who stop getting their periods', and because I am supplementing E through 50mcg patches I shouldn't be experiencing any symptoms. It is true that one of the on label use for the patches I'm on is as HRT for menopausal women, so I can understand the confusion, but this is a doctor. And a nontrivial amount of menopausal women don't experience symptom improvement from such a dose. The doctor, then, because of my 'reaction' wanted me to stop taking any GAHT related medicine (in my case 12.5mg cpa/day and 2 50mcg ev patches/week) for a month and see if my symptoms improve to make sure it's the GAHT.

I made sure to articulate that these symptoms all occured after my initiating GAHT and they aren't unsurprising. Doctor disagreed, and would not consider increasing my E dose to help alleviate symptoms or to give me a blood test (none since going on GAHT - I can only infer my levels are low). I am having a really hard time dealing with these symptoms because they are making my life difficult, but ceasing GAHT for a month for reasons I disagree with isn't something I'm open to. So I'm scrambling to find a different doctor that'll be more supportive and informed. Planning to never see this doctor again.

Update (2024-11-1):

I found a new GP, they're definitely more professional and aware than my old one. They won't raise my dosage immediately though because this is technically outside the guidelines (not sure that it is, but they don't feel comfortable increasing my dosage until they've talked to some other GPs/specialist[s]). They had no trouble suggesting I halve my dosage of CPA though - I agree but also why is this different to upping my E before the three month mark? Anyway, so I'm pending more time waiting. I'm feeling a bit better because I think some things could change, but it's tempered by the fact that I'm still on the same dosage of E which I believe is the main operative here.

I could be wrong though - CPA has some nasty side effects too (e.g. I'm contraindicated because of severe depression), but my understanding is that the ones listed by medsafe like 'hot flashes' are more likely responses to low hormone levels which can be induced without adequate E supplementation.