Tuesday, March 13, 2007

Doctor! Mr. MD!

just kidding- this is a post I wrote back in middle of Feb, but never finished/posted. now I've got updates, so I guess I'll just tack those on at the end. it'll be like a time capsule with bonus timewarp to the present at the end!
My last shot, nearly a week ago, was in my right thigh again and this time...drumroll, please...there was no excruciating cramping! I can only assume that it was a matter of my quadricep getting used to the every-other-weekly ritual of suddenly trying to accomodate an injection of 1ml of thickly viscous fluid. There was still some lingering soreness, but nothing unusual, and nothing to make me flinch, limp, or wince, as with my three previous right leg shot experiences. This is very good news, because it bodes well for my future of self-injecting, an undertaking that I could begin in April once my 1 year T-versary rolls around. Plenty of folks self inject in the butt, but I think it'll be a little easier for me to do it in my leg, because I'll be able to sit down, and clearly see what I'm doing.

I hope that self-injecting won't be too difficult. I watch the nurse very closely when she injects me, and I've been trying to visualize holding the syringe myself, imagining what it will take to keep myself calm and matter of fact while I puncture my own skin. I'm pretty sure that it'll be a little tricky for the first time or two, and then get much easier. I actually recently started wearing contacts for the first time, and it's been a damn challenge getting those things in and out of my eyes. I'm just not used to touching my own eyeball, y'know? It's getting better, though, since I realized that it's entirely easier if I can calm down, stop flinching, and just...do it. Which I think will be applicable in this shot process. If I can bypass the part of my brain that's going "Putting a NEEDLE into your OWN LEG are you CRIZAZY?" and just try to be methodical about it, I think it'll be much easier.

I've been reading a bit about guys who give themselves subcuetaneous injections as opposed to intramuscular, which are supposedly quite a bit easier/less painful, but as per usual, there's not a lot of research or information about the effectiveness and safety of the method. Likewise for subcutaneous, long-lasting pellets that are implanted under the skin in order to slowly release a constant dose over three months. Sounds super convenient, but does it work? What are the drawbacks? Nobody knows...

Bit of the scary part about physically transitioning. Plenty of this is still fly-by-the-seat-of-our-pants; there's not a lot of reliable, long term medical information out there. Much of the information that gets passed around the community is anecdotal, which is great, but not the same as documented medical fact.
And here we reach the end of my musings from the past. Now, though, I've got updates! My shot after that was in my left leg, which had never given me trouble before but all of a sudden was painful like the right leg used to be. Not sure what that was all about, but I guess it was just an unlucky poke.

I'm due for another shot tonight, and it's a semi-exciting one because I've gotten the go-ahead from the HOTT staff to start self-injecting, despite being a few weeks shy of my official one year mark on April 10th. so tonight's the first of the three step learning process. She's going to give me the blow by blow and explain everything carefully, so that I can come back next week and do it by myself, with some assistance, and then the week after that I have to do it all by myself under supervision to make sure I'm doing it right- my final exam, if you will.

So now's the point where I have to decide whether or not to switch to 100mg/week from the 200mg/2 week schedule that I'm currently on. I'd been wondering if I was having mood swings because of the T, but some of that has ironed itself out lately since I've been trying to be more self aware and patient with myself. I can still hope that it might help my acne to go to a more frequent dosing schedule. so I think I'm going to try it...if only because it'll also get me through my 3 training wheels session at C-L faster, if I'm coming back every week to do my 100mg shot.

I'm glad to be taking more agency in my injection schedule, though it means I'll have to keep track of my own syringes and bottles, etc. I hope I can clear a space somewhere in my room to keep everything together in a neat little spot. The bathroom might make more sense, but the bathroom at my house is such a constant disaster area that I think it'd be better not to keep 'em there. Maybe I can keep it on the shelf where I keep my high quality whiskey and spices. THe top-shelf trio: Bulleit Bourbon, Penzeys Double Strength Vanilla, Depo-Testosterone.
oh, also, speaking of 'medical fact' as I did at the end of my february thoughts....I'm still thinking about that phrase. I think I stopped there because I didn't know quite what to say next, because it's such a strange little phrase. Medical fact is such an authoritative kind of information, but like any other kind of power, medical authority oughtn't be absolute nor unexamined. I had to have doctors and surgeons and social workers and psychiatrists approve me over the past year or so in order to accomplish much of what I've done. Why did I need to submit myself for evaluation? Who are they and who am I that our opinions about my own life and body are given such different weight?

That's the crux of the issue, I think- where is this authority coming from, and what kind of knowledge is underpinning these medical facts?

I do think it's important to have infrastructure and support for physical/medical transition. I do trust doctors...that's why there is such a thing as medical school, right? So that folks can learn and practice and train and earn the authority that they need in order to effectively practice as doctors. I want to be able to trust that doctors know best in medical situations. So what part of transsexuality is medical, and how is it medically understood?

Perhaps the understanding of the medical components of being trans* needs to shift, such that outdated/limited thinking isn't the basis for this training and knowledge. If folks learn in medical school that being a real transsexual means decrying one's own anatomy since toddlerhood, well, then naturally that's going to be the model through which all of these other opinions interact.

I think I'm going to write my midterm paper on the authority that's vested in medical terminology, and how it interplays with the labels and identifying words that are claimed by the individuals who are delineated by those terms. How did "sex change" become "transition" and where does it need to go from here?

Maybe I'll dedicate it to the last gynecologist I went to, who told me as I was leaving "Good luck with your sex change!"


Anonymous said...

I just told Sam about your "top shelf" T storage solution, and then I had the idea of a T-cozy. Like, a knitted cover. He demanded that I tell you. I would make you one but I can't knit.

(and, this is kb. i forgot my blogger login and so can't anymore, because it's linked to my src email and that's been deleted. the internet is complicated.)

Anonymous said...

some scattered thoughts in response to your comments on transsexuality, medical facts, and authority.

first, are you aware that there is one theory of transsexuality which posits that it is one form of an intersex condition? rather than developing ambiguous genitalia, facial features, or the like, transsexuality happens when certain brain structures develop according to the pattern of one sex, while the rest of the body develops according to the opposite sex pattern, according to the theory. the cause may be a hormonal imbalance in the mother's womb within the first 8 months of pregnancy. I'm sorry, but I haven't got the time to look it up now.. it may or may not be known as "Benjamin's Syndrome". right now, it is nothing more than a theory, but if it were true, it would place transsexuality (only; gender "diversity" would be something different) squarely in the category of medical.

one politically important fact of medical authority is that people consider most medical conditions to be blameless. obviously there are exceptions-- for instance, much of the public still believes that AIDS is some kind of curse from God. but generally, if a human experience can be linked to a medical cause, for better or ill, people no longer "blame the victim", so to speak. (no, I am not recommending that we refer to ourselves as "victims"-- it was just a comparison)

next up. in the current way that the U.S. medical profession and insurance industry function, you usually need a diagnosis to get a treatment-- particularly a treatment with such significant risks and social consequences/indications as hormones and transition-related surgery. Although some plastic surgery is conducted on demand, MOST medical proceduress still involve the diagnosis/treatment model. so, transition-related procedures must remain "medical" in order for surgeons and other doctors to continue providing care under the current system.

a short point. in order for surgical procedures to improve, it is necessary that published medical studies are available. this means that, to a certain extent, transsexuality will need to remain "medical" (or academically medical, in journals) in order for the treatments to improve.

Finally, it is worth a note that the medical profession is responsible for making it possible for you and others to change their bodies according to their needs and identities. Doctors are the experts at hormones and surgeries- they have professional standards to remain accountable to, and their care allows us to live the lives we do. just something to consider.

I speak only in regards to transsexuality. I can't speak for or about genderqueer or gender variance, and don't intend to.

regards, annonymous

Anonymous said...

ah. one more thing. most medical facts have the advantage that they are testable and repeatable, along with most of what is produced as knowledge by the physical sciences. of course there are often biases and oversights at play, but in the main, the advantage of medical facts is that you can count on them. your endocrinologist knew what effect a certain amount of testosterone would likely have on your system; your surgeon knew what sort of activities would promote or retard scar healing. that is one reason medical facts get such authority-- they have a long track record of accurately predicting physical reactions, healing people, and preventing illness.

Eli said...

hey KB- love the idea of a T-cozy! Right now I've got my needles and syringes in a little pencil case with holographic bowling balls on the side that my sister gave me, and my gauze, swabs, bandaids, etc in the medicine cabinet, and my actual vial of T on my bookshelf. It'd be nice to have an actual knitted (or crocheted?) cozy, though.

Eli said...

hey, anonymous! thanks for your thoughtful insights about transsexuality and medicine.

I have heard of Benjamin's syndrome, and I find it very interesting if firmly theoretical...particularly since when I heard it explained, the person was saying that the mother being involved in an adrenalin-pumping accident while pregnant could be the source of the hormonal imbalance...and my mother was in a (mild) car accident while pregnant with me and my sister. hmm. interesting.

That, and other of your points, raise interesting considerations about transsexuality as a medical condition and its overlap (and conflation, accurate or not!) with gender diversity. If the two can be parsed apart, it might solve some of the culture wars (as I've heard them termed) in various FTM communities. On the other hand, I don't think it'd be that easy or even possible for me to separate the two in terms of my own identity and experience.

as far as medical support for ending transphobia (to cease the victim blaming), that's a great point- but it'd be good, too, to work to achieve some of the same results through social justice.

thanks for your comments!