My Transition Diary

Thursday was my T anniversary. I've now been on T for 11 years (and three days). I don't feel like I have a ton to say about it but I don't feel right about letting it pass without noting it and reflecting at least a bit. I'd say something about how it feels like only yesterday that I started, but it doesn't really, especially when I think about everything that's happened in my life over the last 11 years. It feels like about 11 years' worth of life experience even though I still remember stuff from that long (and longer) ago very clearly. I'd say something about how it makes me feel old, but it doesn't really feel like that either. I don't feel exactly the same as I did 11 years ago, but nor do I feel terribly different. It feels like it's been a very natural progression of time and I don't feel like I just woke up one morning and I'd been on T for over a decade. I feel like I lived every day of it, but not like that makes me an old man now or anything. I feel young but not inexperienced. It's nice for the most part.

For some reason I never got my hormone levels from my lab results last fall when I had blood work done, but I'm going to ask my doctor for them when I see her this fall, and I'll make them available on my site along with this year's levels. It's important to me to keep putting that information out there since there are so few guys who've been on T long-term and are out, and I want someone to start collecting this kind of data so we can eventually understand more about what sorts of effects are associated with long-term T use in Trans guys.

<surgery tangent> My hysto scars have already mostly faded. The big one, which is about 8mm long (not a typo), is discolored but not raised. The smaller one, 5mm long (about the width of a pen), has just the tiniest bit of discoloration and isn't raised either so it's almost invisible. The third one is in my belly button and even I can't find it. Every time I think about my hysto it makes me smile rather a lot. It feels amazing knowing I don't have to worry about those organs, or the associated bleeding, ever again. As for my top surgery scars, there are photos of those on my website so I won't go on about them. They're still entirely visible, but they're slowly fading as the years go by. I love that I have scars and have no real desire for them to be invisible, so that's fine by me. As amazing as it's been to watch my hysto scars disappear so quickly, part of me does wish they'd stick around at least a little. Those are my battle scars. A whole lot of blood, sweat, and tears (especially blood) went into getting those. But this is not a surgery anniversary I'm posting about, it's my T anniversary, so enough about scars for now. </surgery tangent>

One thing I did find myself thinking about was the night I started T. I started T in the best possible way. I was on patches initially, not injections, so I didn't have to start T in a doctor's office and there was no needle trepidation involved. I took my T home and brought my first patch to my friend Steve's house, because it was Friday and a bunch of us always got together at his house on Friday evenings to hang out. I had told my friends that I would be starting at his house because I wanted them to be there for it; it felt important to me that these people, who had been so supportive and amazing all along, be there for this milestone. They were all excited for me and decided to throw me a T(ea) party, which meant that we had exactly the same get-together as always but we made a point of all drinking tea. I remember a load of different kinds of tea on the island in his kitchen for us to choose from, and lots of joking and laughter and fun, just like always. I didn't feel like they were making a huge fuss about it or like I was the centre of attention; for the most part it was just another Friday night at Steve's house, and for that I was very grateful. But I was also so grateful that they could all be there when I put my first patch on.

I started T at 8 pm. I was in the kitchen, I remember, and I took the backing off the patch and put it on my upper right arm, if memory serves. Everyone went "Yay!!" and carried on drinking their tea. My best-friend-since-we-were-six, who's also called Michael, immediately asked me if I felt any different. I made my voice as deep as I could and said I wasn't sure yet but I thought maybe it was starting to work, which made everyone laugh. Then we just carried on as usual for a Friday night. It was exactly the right amount of celebration without making me feel fussed over or uncomfortable. My friends were really good at just getting that about me, I think. And it was the absolute best way for me to start T: surrounded by supportive and loving friends, in an environment that felt completely friendly and safe.

Thank you, Steve (and your family), Sarah, and all of my other wonderful friends who made that a reality for me. It set the stage for a lot of growing, some of it painful and some of it exciting and some of it just weird, but I'll always come back to that memory of where it all began, and how, and with whom. I felt blessed then and I feel blessed now.

Today I got up at 6:15 and was out the door just after 7:30 to ride the T into Boston for a 9 am doctor's appointment. I was due for my annual blood work and I might have been due for a physical, I'm not sure, but I wound up having one anyway. I also had my tetanus booster, which I'd been frankly terrified about but which turned out to be completely painless! My shoulder is a little sore now but it's not bad at all. My doctor said she thought the needle they used was 23 gauge so I was surprised that it didn't hurt.

My doctor told me what labs she wanted to do, which is a lot fewer than she's done in the past. I asked if she'd had a chance to confer with Dr. Spack at Children's Hospital Boston about what labs are appropriate at this stage in transition. She said she hadn't talked to him but she did read up on it - presumably on Nick Gorton's site which I linked her to a while ago - and she's going to just treat me like a cis guy as far as my cholesterol goes. I do need to keep having that monitored along with my T levels as I have a family history of high cholesterol, but she's not going to keep monitoring all the extra stuff she's been testing for years. It'll just be a lipid panel and my T levels, which is what I've been wanting her to do so I'm pleased about that. I asked her if she'd measure my estrogen levels too, just to see what they look like a year after my hysto, which she was happy to do. So I said goodbye, got dressed, and trotted down the hall to the lab.

I had hoped that the phlebotomists would be dressed as vampires but alas, no one was in costume at all. I was amazed when the nice phlebotomist took just one vial of blood and said I was done! In the past they've needed four or five vials every time because my doctor had such a long list of things she wanted to test. She gave me a Daffy Duck plaster which made me very happy, not because I'm a particular fan of Daffy Duck but because I feel that if you have to get poked with needles at the doctor's, you deserve a fun plaster and an ice cream cone or similar treat. Giving blood is routine enough for me that I don't need a fun plaster every time, but I'd hoped for one this time because I had to have a shot as well.

On that happy note I wandered out into the sunshine and took the train home. I'll post my lab results when I get them, hopefully in a few days.

There was a mix-up at the lab when I went to the doctor's a month ago and they only tested one thing - my LDL, which was higher than it had ever been: 156 mg/dL. Joy. I figured it was due to the fact that I'd spent the previous few weeks slacking off both in terms of eating responsibly and exercising regularly, so I got back into doing both of those things and planned to have my LDL re-tested after a month or two to see if there had been any change. But I still had to go back and give blood for the rest of the tests to be done, which I finally did yesterday. Today a bunch of my test results were already available.

Standard ranges are all for a male in my age range. LDL is "bad" cholesterol, which is influenced by diet. HDL is "good" cholesterol, which is influenced by exercise. SGOT (AST) and SGPT (ALT) are enzymes found in the liver and are commonly measured as a marker for liver health.

Lipid profile:
Cholesterol: 251 mg/dL. Standard range: ≤199 mg/dL
LDL Direct Measure: 160 mg/dL. Standard range: ≤130 mg/dL
HDL: 61 mg/dL. Standard range: >40 mg/dL
SGOT (AST): 19 U/L. Standard range: 2-50 U/L
SGPT (ALT) 16 U/L. Standard range: 2-60 U/L

Hormone levels:
Albumin: 4.70 g/dL. Standard range: 3.7-5.1 g/dL
Sex Hormone Binding Globulin: 50.6 nmol/L. Standard range: 14.6-94.6 nmol/L
Total Testosterone: 388 ng/dL. Standard range: 123-814 ng/dL
Testosterone, Free: 57 pg/mL. Standard range: 47-244 pg/mL
Testosterone, Free %,: 1.5%. Standard range: 1.6-2.9%
Testosterone, Bioavailable: 146 ng/dL. Standard range: 130-680 ng/dL
Estradiol, Fractionation 14.30 () pg/mL. Standard range: 10-42 pg/mL
Estrone, Fractionation 19.00 () pg/mL. Standard range: 9-36 pg/mL
Estrogens, Total, Fractionation 33.30 () pg/mL. Standard range: 19-69 pg/mL

So basically my LDL got worse even with the improving of my diet and exercise routine, and my total cholesterol is the highest it's ever been. It is very soon after Thanksgiving, during which I ate less healthily than I have been doing otherwise, which I'm hoping is part (or all) of why it's so high at the moment. But my PCP has instructed me to "lay off the cheese" for six weeks, then come back and have my LDL re-tested. Six weeks without cheese sounds horrible to me, but the fact that my LDL is so high has me rather scared. It's got far more to do with my genetics than my lifestyle, I know, but I had hoped to be a little older before I had to go on cholesterol medication. And I certainly don't want to have a heart attack and die. I'm surprised she didn't tell me to cut out dairy entirely - I can still eat ice cream?? - but I am going to make a valiant effort to be cheese-free for the next six weeks. It is absolutely the worst time to do that, of course, with all the delicious things that make themselves available in December. But at least I don't have to cut out sugar or something like that. That would be well-nigh impossible at this time of year.

Six weeks from today is 11 January. I presume that trace amounts of cheese in something like ranch flavor Doritos are fine, so I'm not going to be too hyper-vigilant, but actual cheese, cheese-based pasta sauces, cheese-flavored snacks, etc. are going away for the next month and a half. I will continue to eat as healthily as I can manage, but if cookies make themselves available to me, I will eat them. Just saying. I'm glad my doctor didn't tell me to avoid latkes because I've been looking forward to those for a while! I figure as long as it's all in moderation, I'll be fine. I was also considering dropping my T dose again, from 40mg 30mg weekly, but given that my free testosterone is slightly too low I'm going to keep my dose at 40mg. I'll wind up on cholesterol meds anyway because this is genetic, but at least we can be satisfied that we tried adjusting lifestyle factors first.