check-up

I went to Callen-Lorde a week or so ago for my one year on T bloodwork- a little late, since I'm actually around the 15 month mark. Still, close enough, given that everything came back fine last time.

As it mostly did again- my doctor went over the lab results line by line, and congratulated me on my great blood pressure, cholesterol, liver function, kidney function, etc. Apparently I'm in rather excellent health...except when we got down to my red blood cell count.

C-L uses red blood cell count as a means of monitoring testosterone levels, since there's a normal male range and a normal female range, and they're pretty much exclusive. My count is at the high end of the normal female range. Pretty high for female, but definitely lower than normal male range.

My doctor told me that this is an instance in which he relies on patient experience to determine how to proceed. If I were feeling like my transition were proceeding too slowly, then he'd feel comfortable, based on my labs, prescribing 250 mg/two weeks rather than the 200 I'm currently at.

The trouble is, I don't really have any way of knowing whether things are proceeding "too slowly." Certainly, all of the changes that I've been expecting have occurred- musculature, facial and body hair, acne, voice dropping. And a few that I haven't expected- more sweating, different appetite patterns, mood issues. But who am I to say how fast things are meant to be going? Certainly I'd prefer to have my beard fill in more quickly, but I'm not sure that more T is the answer to that. I'm thinking back to a workshop I attended at the Trans-Health Conference, in which Nick Gorton explained the cascade of hormone conversion, how T converts into both DHT and estrogen, so more T can lead to more facial hair, etc (DHT) but also more acne and baldness from the same source, and it can also be converted into estrogen.

Anyway, I told him that I feel pretty good about how things are going, and that we could do some bloodwork again in 3 months (rather than waiting another 6) and see what the levels are like.

He also told me that I could probably expect to see my acne clear up by around 18 months from now, which is a relief. He also reminded me that mine is really not that bad- though he was careful, in true Callen-Lorde fashion, to emphasize that he wasn't trying to diminish my experience in any way...that if I feel my acne to be an affliction, then that's valid!

That's one of the things I love about Callen-Lorde, that I've consistently experienced (through the HOTT program, that is, since they're the only ones I've interacted with)- the earnest and concerted effort to make me feel validated and justified in my concerns, as well as an effort to assure me that they're on my side, that they're not looking to make me jump through any hoops, but rather that they just want to offer the best medical care that they can.

I know it can come off as pedantic and condescending to some folks, but I find it really reassuring and warming, and I have to believe that it's one of the only sources of positive feedback that some of their clients have. So hurrah, Callen-Lorde!