Lenovo Yoga 2 11 review

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On Friday, May 23, I got an early birthday present. I got a Lenovo Yoga 2 11 – which I affectionately named Trent. I’ve always wanted to see how its like to use and own a Yoga, and I finally got a chance to get a feel for that back on that day.

Specs
This is what my Yoga 2 11 came with:

Intel Pentium N3520 2.17GHz CPU
4 GB RAM (DDR3L-1600MHz)
Intel Baytrail M GPU
11.6″ HD LED TS LCD
500GB HDD
4 cell battery w/ a 20V, 45W AC adapter
Windows 8.1 64 bit
2 USB ports (one of them 2.0, the other 3.0)
A Micro HDMI 1.4 port
1 PCI Express Mini Card slot
1 Combo audio jack (1/8″)
A 2 in 1 card reader (SD/MMC)
An integrated camera
2 integrated speaker
2 integrated microphones

Feel/built quality
The Yoga 2 11 feels quite solid. It has this very nice feel to it. It does not feel cheap at all. It looks quite elegant and the orange cover is very pleasant to look at. The screen and hinges (which are metal) feel very solid as well.

Keyboard
The Yoga 2 11 is my first laptop with an island-style, 6-row keyboard. When I first looked at the keyboard, I thought the keys were too short to be funstional. I actually questioned its usability, especially since I’m primarily a ThinkPad user – which I have been for almost 10 years – and have gotten accustomed to its keyboard. That all changed when I used it. I found out how responsive and comfortable the keyboard was to type on. Although, I think that if I put it side-by-side with the ThinkPad Yoga, the ThinkPad’s keyboard would (obviously) be more superior, but (at least in my opinion) the Yoga’s keyboard would come very close though. Even though an IdeaPad/Essential notebook can’t beat a ThinkPad’s keyboard, its still pleasant to type on and comes close. Their keyboards are obviously better than the other consumer notebook brands out there.

On the Yoga, the the Ctrl key is placed on the left side while the Fn key is placed on the right side. This is something I’ll have to get used to since I’m more used to the Fn key being on the left and the Ctrl key being on the right (being a long-time ThinkPad user and all). But even with that in mind, I’m actually adjusting pretty well.

Pointing device
This isn’t my first time using a clickpad-style touchpad (I used one before when I demoed a MacBook Pro a long time ago), but this is my first time using one on a daily basis. The Yoga 2 11 is my first notebook with a clickpad. I initially thought it would take me a while to get used to a touchpad with integrated buttons, but I ended up getting used it after just several minutes of use. It has a very nice feel to it and is very responsive – it doesn’t feel clunky at all. The multi-touch function of the clickpad works like a charm – although, it sometimes gets in the way. Touchpads on Lenovo laptops are very easy to use – they aren’t a pain to use as in other brands, which is great for me since my pointing device of choice is the TrackPoint (I rarely use the touchpad on my ThinkPads) and with the Yoga, I have no other choice but to use a touchpad or an external mouse.

Display
My Yoga has an 11.6″ HD LED TS display. Its very crisp and has a nice resolution that’s very suitable for an 11.6″. Using its multitouch functions is a breeze and is comfortable to use.

There are times when I wish I had a larger screen. When I’m doing design (and music) work, I prefer to work on a larger screen, so I wish my Yoga had a bigger screen for that purpose. But I’m doing quite well working on a smaller screen (before this, I was doing my design work on a 14” T60). I think the decent screen resolution, plus the crisp screen compensate for that small drawback.

Performance
The Yoga does what it was made for pretty well. Web browsing, reading, word processing, and social media on the Yoga are a breeze. Watching videos and listening to music are . It can handle light gaming with really no issues, and the integrate graphics card is quite decent – games are really fun to play on the Yoga. Apps run great on it as well.

Since I’m going to be using the Yoga for graphic design for a while, I installed Adobe Photoshop, Illustrator, InDesign, and Dreamweaver (all CS6). As expected, it can run all of these programs quite well. However, since the Yoga 2 11 has integrated graphics, it won’t be able to take advantage of Photoshop CS6′s 3D feature (it will be disabled by default). In order to take advantage of the 3D feature, you will need to get a computer with a dedicated graphics card – which needs to have at least 512MB of VRAM (which I myself am going to do somewhere in the near future).

Battery Life
I can get up to 5 hours of battery life on my Yoga. I’ve been able to watch about 2 hours of video, plus web browsing, Photoshop, word processing, reading, and other stuff in about 5 hours. Of course, how much battery life you get – and the stuff you can do with that time – really depend on what settings you have on your Yoga, as well as the kinds of tasks you do, so you might end up getting more or less than what I got.

Conclusion
The Yoga 2 11 is great for basic tasks like typing, reading, web browsing, and social media. It is also great for entertainment like watching videos, listening to music, and light gaming. It is great for using apps from the Windows store as well. Additionally, it can run programs like Adobe Photoshop, Illustrator, InDesign and Dreamweaver with no issues. The only drawback is if you’re using Photoshop CS6, you won’t get to use the 3D feature, since the Yoga 2 11 does not have a dedicated graphics card. The Yoga 2 11 is also great for (basic/low-intensity) music production, DJing, and drawing.

The Yoga 2 11 is really fun to use. I really love the four modes: laptop, tent, stand, and tablet – which allow me to do different tasks in different modes for a more efficient workflow. Overall, it is great for work and play. I love my Yoga!

To Vlog Or Not To Vlog

This was originally posted on my personal Tumblr.

I started a YouTube channel about two years ago. It can be found here. The only problem is that I haven’t posted any videos yet. I’ve only made playlist.

The reason why I haven’t posted any videos yet are because: 1) I didn’t really have the proper equipment, 2) I wasn’t really sure what I wanted to do, I just knew that I wanted to post videos plus I didn’t have a plan, 3) I didn’t really know how to go about it, and 4) I had certain inhibitions about this.

My inhibitions about this have largely to do with my how I sound, as well as the fact that I’ve never really recorded videos of me or been on a camera. Since I didn’t really have a puberty, my voice still sounds like that of either a prepubescent boy or a very early pubescent boy. I’m pretty self-conscious about it. The good thing is that I’m going to be starting Testosterone Replacement Therapy (TRT) very soon, so my voice will finish developing soon. But still, its pretty embarrassing to be a 24 year old man but yet still sound like a 12-15 year old boy. The reason I’m so embarrassed is because it just doesn’t feel like me – I have a strong male gender identity and a strong masculine identity, and so this just doesn’t feel like me.

I grew up with Selective Mutism. Its when a person who is normally capable of speech does not speak in specific situations or to specific people. While I have come a very long way and have almost gotten over it (largely thanks to my transition, as well as finally meeting and being around like-minded people), I still feel like there’s more room for improvement (I guess you can say that I’m still feeling its aftermath – I also think my Low T is contributing to this as well). By posting video blogs, I would be increasing my social confidence.

I have been watching others vlogs for a long time now. I feel like I’ve learned all the necessary things I needed to learn. I feel like I’ve finally gotten a sense of direction on this, as well as structure – I’ve even made a plan. I plan on doing video production and making music videos, among other kinds of videos, a bit later on in the future. I can see how this will help me get started on that.

I can see all the benefits of doing vlogs. It will help me build my audience, which will translate over to the other things I’m either already doing or are planning to do. It will help increase my social confidence even more. I will get to meet new people and make new friends. It will help me get started on video production. I will help out other people, create more visibility for intersex and trans people, as well as be a source of inspiration for current SM sufferers as well as anyone else who is or has ever had social difficulties. There are obviously other reasons, but I’ll just stop here.

I’m thinking of starting somewhere this summer, if I decide to do this. I think that documenting my legal transition to male as well as my TRT treatments – as a way to compliment my written blogs – will be a great way to start. I think documenting them by video would be very beneficial to not just me but to others as well. The topics that would be discussed are going to range from my transition, intersex status, and TRT, to Lenovo, to my general wereabouts, my past, and really, anything else I’m interested in discussing. It would basically be a video blog version of my personal blog, Elipalooza.

I have quite a lot of thinking to do, and a lot of fears to overcome. All I know is that if I decide to do this, I’m going to feel very proud of myself for finally having the guts to do this.

Journey To Manhood

This transition and quest towards getting TRT (which is independent from my transition) is really my “Rite of Passsage”. I’ve never had one before, and this was my perfect opportunity to have one so I decided to make my own (I’ve been doing this for 2 years now). While I may already be exhibing all the characteristics of a man, I still don’t feel completely like one. I still feel like I’m stuck in childhood. I feel like I’ve “unofficially” or “partially” entered manhood. The problem lies with my body and identity documents (but primarily my body).

Mentally, I feel like a man, since I’m exhibiting all the (psychological/mental) characteristics of one. But physically, I still feel like a boy. My body is pretty androgynous and boyish, not manish. I have a strong male gender identity, so I need my body to conform to that. Its pretty frustrating to have to compare yourself to other 24 year old men and see that they basically have entered manhood (physically, at least), while you’re still stuck in boyhood. Even looking at a teenage boy brings frustration – their bodies are developing into that of a man, and therefore entering manhood. Then you look at your body and realize that you’re 24 and didn’t really have a puberty (talk about arrested development!), therefore you haven’t officially entered manhood. It easy to get jealous of your peers (young men), as well as teen boys (I’m not afraid to admit that I get jealous sometimes). And when you’re Low Testosterone (Low T), its easy to get down and ruminate on this since Low T messes with your brain (I’m very convinced that the worst symptoms of Low T are the neurological ones).

I have low muscle mass (even though I’m fit), building muscle is very hard when you’re Low T. Stamina is down, so I can’t do physically demanding activities for very long. Weight management is difficult, so I’m underweight. Facial and other body hair is scanty, so I can’t grow a noticeable beard and I look too young. My voice still sounds boyish, not manly. Lets not forget about the neurological effects of Low T, it makes you feel like total crap! (Again, these would have to be the worst symptoms of low T.) Overall, low T makes you less of a man. It basically turns you into a “girly man”, or (if you’ve had Low T since puberty) turns you into a “man child”. You really don’t feel like a man at all. Testosterone is everything to us guys. It profoundly affects our brains, and differentiates us from the opposite sex/gender. I think you can all see how important T is for manhood (its basically its foundation, which in return defines it).

Lets not forget that I had a gender misassignment at birth. It can be hard to believe sometimes that one little marker can affect your whole life – how people perceive and treat you. It can either validate or invalidate you. It can make your life great or hell. It’s just really frustrating when you have to deal with situations that require you to show identity docuements, and find out about your illegitimate identity. Its sometimes frustrating to have to tell and correct people about your true identity and how you’re working on fixing your identity documents. It is frustrating to have to deal with places and people who basically treat you like someone you’re not, or see you as someone you’re not. Its just so frustrating when your own government doesn’t recognize who you really are. You feel invalidated. When you identify as a man, your manhood is basically straight-out denied and invalidated.

Let’s face it, if we were still hunter-gatherers, I would be totally screwed. Sure, my intersex and transition would be respected, but my manhood would either be denied, or only partially approved (since manhood is an earned status). My body would not be producing enough T, so I would be unable to do a lot of the manly activities expected of me – I would get tired too quickly, be unable to concentrate, be unable to recover quickly, be anxous and on edge all the time, be tired and fatigued all the time, and basically still be a boy (or at least still be seen as one). Since there’s no advanced medicine in those societies, I would have no way of treating my T deficiency, so I would be doomed to be a “man child” forever and a life of mediocrity, where I don’t get to fulfill my manly responsibilities and my potential. With all of that in mind, I feel very lucky that we don’t live in that type of environment anymore. I feel very lucky to live in a more advanced society, with advances in science, technology, and yes, medicine.

After everything I’ve been through, I’m not taking my manhood for granted. I think that unlike a lot of my peers, I’m taking great advantage of it. I, after all, have more to prove, more to gain, and nothing to lose than most of them. When you’ve lived the first 21 years of your life in the wrong gender role and were forced to be someone you’re not, you obviously have more to prove, more to gain, and nothing to lose. I think that a lot of people these days take things like manhood, identity documents, gender roles, and that sort of stuff, for granted. If you’re trans and/or intersex, then you’ll know what I mean.

I’m 24. I’m supposed to be out there conquering the world like all my other peers, not at home resting and depending on others for resources (due to illness). My mind is ready (and wants) to conquer the world, but my body isn’t. It just really sucks when you sometimes feel like you’re the only one going through this. I just really, really, REALLY can’t wait to get over this stupid low T. I can’t wait to get my identity documents fixed. I can’t wait to finally and officially enter manhood.

Forget puberty. Forget adolescense. 24 is my REAL coming of age! (Better late than never, right?)

Journey Towards Legal Authenticity

I was originally going to write and post this on Monday or Tuesday, but unfortunately, I got caught up with some stuff. In addition, I had a very hard time getting started on this because Low T makes it hard for me to concentrate and get started on stuff – because of low energy, fatigue, and overall cognitive dysfunction – so you’re much more prone to procrastinating. Its even like this with my work, which is why I’m so slow with putting out new music, designs, and other stuff. Low T also makes you more prone to getting writer’s block, and getting rid of it can be very difficult (to nearly impossible). Testosterone profoundly affects the male brain, and my struggles show that.

Anyways…

I went to see my PCP (Primary Care Physician) on Monday. I did exactly what I set out to do, which is ask him to write my letter so I can update my gender with the Social Security Administration (SSA). I explained to him why I needed to do that, and he was more than happy to do that for me (I just love my PCP!). It cost me $25 to make the note but I was more than happy to pay it, because I knew it would be worth it and plus I really needed that note. At first I thought that $25 for a note was pretty excessive. But after I got the note written, I found out that it was worth it. The note was very well-written and looked very professional. They even put it in an envelope! It really surpassed my expectations.

Now the next thing I need to do is go to my local SSA office and update my gender. Unfortunately, it will have to wait a little while because I need some form of identification. For me, that would be my state ID. I just renewed my ID last Monday and I’m currently waiting for it to come in the mail. They told me it would take 2 weeks to get it. I really hope this is the case because I really need to do this already – I should’ve had done this a very long time ago. Hopefully after I get this over with, I’ll be able to get my insurance to cover my TRT while keeping my Hypogonadism diagnosis, and without submitting proof that I had therapy to treat Gender Dysphoria (GD). I really don’t want to deal with Low T anymore.

In the meantime, I’m going to try to “decode” the special instructions that I have to follow in order to get to my local SSA office. One of the instructions is pretty confusing to me, so I am going to ask one of my relatives to help me out with that. In addition, I am going to try to get some legal help regarding my health care coverage, as a transgender person, with Medi-Cal. Basically what I’m going to ask them is if I will be able to get TRT, without showing proof that I had therapy for GD, if I update my gender with the SSA. Hopefully I’ll get something good out of this.

I’m officially on my way towards getting the government to recognize my authentic self! The next two things I have to do is get my legal name changed and get a new birth certificate, reflecting my real gender and name. I will be starting the name change and birth certificate amendment process in July. Since my transition is purely legal, I will officially complete my transition after I’m done with these two things!

The TRT Diaries – Pre T, Part 2

I had my 2nd appointment with my Endocrinologist on Tuesday (June 3rd). This is where I got the results from the blood draw I had back in mid-May. I had quite a bit of work done (I had to get blood drawn to 8 tubes!), and the results show that:

Comprehensive Metabolic Panel:
Glucose: 93 mg/dL
Urea Nitrogen (BUN): 11 mg/dL
Creatinine: 0.58 mg/dL
eGFR Non-Afr. American: 130 mL/min/1.73m2
eGFR African American: 151 mL/min/1.73m2
BUN/Creatinine Ratio: 18.9
Sodium: 141 mmol/L
Potassium: 3.5 mmol/L
Chloride: 104 mmol/L
Carbon Dioxide: 23 mmol/L
Calcium: 9.7 mg/dL
Protein, Total: 8.0 g/dL
Albumin: 4.9 g/dL
Globulin: 3.1 g/dL
Albumin/Globulin Ratio: 1.6
Bilirubin, Total: 0.3 mg/dL
Alkaline Phosphatase: 63 U/L
AST: 14 U/L
ALT: 10 U/L

Hormone Panel:
Estradiol, Ultrasensitive LC/MS/MS: 251 pg/mL
17 Hydrodyprogesterone, LC/MS/MS: 81 ng/dL
Androstenedione, LC/MS/MS: 215 ng/dL
DHEA, LC/MS/MS: 471 ng/dL
Dihydrotestosterone, LC/MS/MS: 18 ng/dL
DHEA Sulfate: 338 mcg/dL
FSH: 4.0 mIU/mL
LH: 22.9 mIU/mL
Prolactin: 15.2 ng/mL
T4, Free: 1.1 ng/dL
TSH: 1.27 mIU/L
Testosterone, Free: 2.6 pg/mL
Testosterone, Total, LC/MS/MS: 29ng/dL

CBC (Includes DIFF/PLT):
White Blood Cell Count: 8.1 Thousand/uL
Red Blood Cell Count: 4.31 Million/uL
Hemoglobin: 12.9 g/dL
Hematocrit: 39.5%
MCV: 91.7 fL
MCH: 29.9 pg
MCHC: 32.6 g/dL
RDW: 13.5%
Platelet Count: 192 Thousand/uL
MPV: 97 fL
Absolute Neutrophils: 5840 cells/uL
Absolute Band Neutrophils: DNR cells/uL
Absolute Metamyelocytes: DNR cells/uL
Absolute Myelocytes: DNR cells/uL
Absolute Promylocytes: DNR cells/uL
Absolute Lymphocytes: 1110 cells/uL
Absolute Monocytes: 494 cells/uL
Absolute Eosinophils: 616 cells/uL
Absolute Basophils: 41 cells/uL
Absolute Blasts: DNR cells/uL
Absolute Nucleated RBC: DNR cells/uL
Neutrophils: 72.1%
Band Neutrophils: DNR%
Metamyelocytes: DNR%
Myelocytes: DNR%
Promyelocytes: DNR%
Lymphocytes: 13.7%
Reactive Lymphocytes: DNR%
Monocytes: 6.1%
Eosinophils: 7.6%
Basophils: 0.5%
Blasts: DNR%
Nucleated RBC: DNR/100 WBC

So as you can all see from that extensive list, I had a lot of work done, but I think it was well worth it (and is required for successful TRT). Now, lets go over some of the numbers on the list. Be warned that this is going to be a pretty lengthy post, since there’s quite a bit to cover, so get ready to devote quite a bit of time to reading this.

If you look at my (Total) Testosterone levels above and if you remember the results from my last blood test, you’ll see that my T levels have actually gotten worse. My T levels from last time was 36. This time around its 29 (ouch!) (I think that a cold/cough that I had during that time might have contributed to my lower T levels this time around). My Free T levels are low too (obviously). My Estradiol (E2) levels have also gotten worse. My levels from the last blood test was 192. This time around its 251 (yikes!).

My FSH levels haven’t changed much from the last time. Although it seems like my FSH has dropped a bit from the last time (from 5.3 to 4.0). This isn’t surprising as my my low T levels and high E2 levels are very likely compromising my fertility (my FSH also seems to be on the low side). Plus, my T levels dropped a bit and my E2 levels went up from the last time, so its only natural that my FSH would drop as result of this. This time around I was able to get my LH levels checked. The result I got was 22.9. This is a high number and is very typical of somebody with 17B-HSD, as well as a male with primary hypogonadism (high LH is an indication of primary hypogonadism). This is something I was expecting – I guessed that it would happen and I was right.

This time around, I also got my Androstenedione (A) checked. The result? 215. This is pretty high and is just above normal (normal is under 151 – although just like every other hormone range, there is no definite range). This, along with low T levels and high E levels, is very typical of somebody with 17B-HSD (characterized by a high A:T ratio, in my case 215:29) – and I’m betting that the number would be higher if I had taken an HCG stimulation test.

I got my Dihydrotestosterone (DHT) checked this time around as well. The result was 18. This is a low number (it needs to be 30-85), but seems normal for someone with my T levels (29). Obviously, the T:DHT ratio (mine is 29:18) isn’t high enough to indicate 5-Alpha Reductase Deficiency. I knew that the result would be something like this, and this indicates that I was right about having 17B-HSD.

My Prolactin fortunately wasn’t ultra high (which I knew), so there’s nothing indicating a possible tumor :D (something my Endo was worried about). However, my Prolactin is on the high-normal side, almost above normal – which isn’t surprising considering the fact that I have Gynecomastia. But the good thing is that it’ll be easy to manage and get it to be lower – more towards the middle of the scale.

My white and red blood cell counts are in range, although it looks like my RBC is on the lower end of normal (does not seem uncommon with Low T). My Hemoglobin and Hematocrit seem to be on lower end of normal (which is normal for Low T guys) – . The rest of the numbers from this blood draw are all in range (except for a couple or so, which are slightly above normal, but not a big deal). My Thyroid is all good (which I suspected). Although, my Creatinine is below normal. Additionally, Glucose seems to be on the high end of normal (which I don’t think is surprising for a guy with Low T). My Liver and Kidneys also appear to be working well.

The only results I didn’t get back was from the Sex Chromosome test – this was due to an error. I really have no problem with that. I don’t need a Chromosome test to tell me I’m 46,XY – my physical characteristics tell me that, as well as the results from my bloodwork (but really, why should it matter? Here’s a very insightful article that deals with this). I don’t plan on re-taking that test, simply because of the fact that the evidence that I have already tells me that I’m biologically male. I don’t need this test to ‘validate’ me (I rather take a semen analysis). I know what I am and I know how my body works – it is after all, my body, and nobody knows my body better than me. Intersex people are already medicalized enough and this just contributes to it, in my opinion.

See, the thing that bothers me about this is that they’re (the medical establishment) are trying to mythologize us and basically are trying to tell us that either we don’t exist or that we are ‘hermaphrodites’ (with two sets of working testes and ovaries). I mean, if the testes are palpable down there, despite the fact that the person (in this case, that would be me) has ‘ambiguous’ genitalia, then that should tell you that there are no ovaries – especially if those “lumps” are adult-sized (i.e. adult-sized testes). I mean, what else could they possibly be? Its humanly impossible to have a working set of testes and a working set of ovaries. I think that right there should tell you something. All in all, I don’t care what my chromosomes are because it doesn’t matter (and chromosomes actually don’t matter).

Now at this point, you may be asking yourself why I’m putting a spotlight on the ‘medical’ side of intersex, if I’m against the medicalization of intersex. The answer is because I want people to see that intersex folks have differing hormonal (and other) profiles, even within their own variations (if that makes any sense). This also helps people to see that overall, intersex people tend to be healthy just like everyone else, and that when it comes to health, we basically face the same challenges like everyone else. I’m simply educating people on this stuff in a way everyone can understand (I’m trying to make everyone understand how diverse intersex and everyone else’s bodies really are). The rest of this series will be focusing more on my treatment of and recovery from Low Testosterone – from the perspective of an intersex person :D. Overall, this shows that we’re no more different from non-intersex people, and that’s the message I’m trying to get across here.

I think you can all see from my blood draw results that I’ve got the green light to go on T. Unfortunately, there’s another hurdle I have to get through before I can get T: I need to update my gender with the Social Security Administration (SSA) before I can get T. The reason for this is because my Endo said that because my gender on my insurance (which is connected to my Social Security number/records) is still female, I need to provide proof that I got therapy for Gender Dysphoria (GD) – this will also require changing the diagnosis from Hypogonadism to GD. I need to provide my Endo the notes from that therapy session I had with my then-psychologist, so he can submit them to my insurance company, so they can approve my TRT. If can’t track them down, then I will need to go to therapy for GD all over again, and I will not have that (I mean, why do I need to do this again? I’ve been living as a man for 2 years now with great results). This has already consumed a lot of my time (I’ve started this journey early last year), and I just want to get this over with so I can go back to living my life.

Getting those notes has already proven difficult to do. This is obviously already wasting my time. So as a solution to this problem, I made an appointment to see my Primary Care Physician (PCP) on Monday morning. Hopefully, everything goes well and I get my note to take to my local SSA office later that same week. I personally think everything’s going to go well. My PCP is very understanding and laid-back, so I trust him with this (as he was going to do it the first time around but unfortunately ran out of time). But, I’m still going to be a bit cautious – I don’t want to get my hopes up only to have them crushed. Hopefully with this done, my Endo will be able to keep the Hypogonadism diagnosis (he’ll have to or else the insurance company will think I’m a TransWoman and deny my request to cover my TRT) – since I won’t have to go through that ordeal with my insurance – and make my next appointment to finally get my 1st prescription for T very soon.

I’ll keep everyone posted on this situation. Expect an update on this on or after Monday.

My First Day With The Endocrinologist

I had my first appointment with the Endocrinologist on Tuesday. I had to wake up pretty early (before 8am – I woke up at 5am). Normally, I’m not a morning person (however, I think this will change soon for various reasons) but this time around, I was willing to wake up very early since I was very excited about my day. I was eager to see how the endo would treat me, not only for my Low Testosterone, but also as an intersex and transgender person.

I left my house at around 7am and pretty much got there in time. Since it was my first visit to this endo, I had to fill out some paperwork, which didn’t take very long to do. Additionally, I also had to show my insurance cards and ID. It didn’t take very long to go in and see him (since I was one of the very first ones to arrive and it was still pretty early). The nurse had me come in and check my weight and vitals and then had me wait in a room for the endo to arrive.

After probably 5-10 minutes, the endo came into the room. We both introduced ourselves, and of course, I told him about my real name and gender, which he took very well. Then came the big question: What can I do for you today? (Or something like that…I can’t really remember right now.) I right away told him that I had Low T and was seeking treatment for it (he seemed a little puzzled about when I told him this). I then explained to him how I am really a biological male who happens to be intersex and was misassigned female at birth and was diagnosed as Low T in October, and that that explained why I was seeking treatment for Low T. He completely understood this and then had me explain a little more about my background (as an intersex person), which I did.

The endo then had me do a physical, which included checking my upper body and groin. I was a bit hesistant at first. I told him I was a bit self-conscious about showing my chest to other people because of my Gynecomastia, but he completly understood this and tried to make me feel more comfortable. So after feeling more comfortable with the procedure, I went ahead and did it. First, he checked my upper body (which included my face – he even asked me if I shaved and I said yes). Then, it was on to the lower part of my body.

I think he noticed my testes down there (it seemed like he wasn’t very direct about it) because he referred to them as “lumps” (which is a commonly used phrase used to describe testes in the presence of ambiguous genitalia). He also didn’t seem to hesistate in ordering a sex chromosome test when ordering my blood work. Let me say right now that they are clearly testes becuase they look, feel, and function the same way testes in typical men do (the only person who really, truly knows my body is me). With this in mind, they can’t possibly be something else – in particular, ovaries (because ovaries don’t hang down there and neither are they about the size of chicken eggs). But even with this in mind, my endo probably just wants to make sure they truly are testes since, lets face it, its not his body so he doesn’t know how its like or how it works – plus, I have ambiguous genitalia and its not always easy to tell what is what. He also very likely wants to make sure that I’m indeed 46,XY and not something else.

Let me be clear right now that there was no pressure on me to do the part of the physical that included checking my upper body and groin. The endo was completely laid back about it and was okay with me not consenting. He did not pressure me into it whatsoever. My guess is that he’s very well aware that a lot of intersex people are uncomfortable with doctor visits due to past bad experiences with doctors and the fact that a lot of doctors are ignorant about intersex, and how to treat us.

He has not prescribed me Testosterone yet, but he’s clearly very much willing to (with my abysmal T levels, there really isn’t any other choice). Additionally, he also seems willing to prescribe me any type of T (I’m hoping to be on Androgel – hopefully my insurance is willing to cover it). Not only that but, he seems willing to prescribe me Anastroozle (Arimidex) or another Aromatase Inhibitor to bring down my Estrogen levels (again, there’s really no other choice). I asked him the hard questions so this is how I know that he’s very open to doing so. He wants me to re-check my T, E2, and FSH levels, as well as several other markers before prescribing me T. In addition, he also wants to rule out the possiblity of a tumor (which I highly doubt is present) from having high Prolactin levels and such. If there’s anything that indicates the possibility of a tumor (which again, I highly doubt), I will have to get an ultrasound of the testes and possibly get my pitituary checked.

I will be getting my blood drawn on Friday morning. Here are all the markers that I will be getting checked:

Androstenedione
17-Hydroxyprogesterone (LC/MS/MS)
DHEA (LC/MS/MS & Sulfate)
DHT
Estradiol (E2) (Ultrasensitive)
FSH
LH
Prolactin
Testosterone (Free & Total)
T4 (Thyroxine), Free (FT4)
TSH
Sex Chromosome Analysis

I’m aware about some of the horror stories of people dealing with endo’s, but my experience so far has been great! He even knew what intersex is! Not only that but, he completely respected my background and referred to me by the right name and pronouns (although there was a slip up at one time, but that’s natural). Overall, he really seems to know what he’s doing and is great to work with. My next appointment with him is on June 3rd and I can’t wait for that day to arrive! I’m very eager about what my blood test results will be and hopefully everything will clear out fine (meaning: no possibility of cancer, thyroid issues, or oher serious complications that might further delay treatment ) and will get my first prescription for T!

So all in all, my first visit with the endocrinologist was great!

P.S. I’m very happy with my new insurance so far. This one’s way better than my old one (which was pretty limited). I’ve had nothing but positive experiences so far. Not only did they approve my referral to see an Endocrinologist (unlike my old one), but they also chose a competent one for me, and I was able to keep my PCP too. I’m very sure they’ll cover my prescriptions as well. I definitely feel like I made the right decision when choosing my new health insurance.

The TRT Diaries – Pre T

Hormone Levels (as of October 2013):
Testosterone (T; Total T): 36 ng/dL (Total Joke!)
Estradiol (E2): 192 pg/mL (Ugh! Don’t even get me started on this one!)
FSH: 5.3 mIU/mL (I’m fertile, yay!…Well, sort of.)

So as you can see, low T levels and high E2 levels are normal for someone who has 17b-HSD [type 3] (17 beta-Hydroxysteroid Dehydrogenase Deficiency [Type 3]). I wouldn’t be surprised if my LH levels were high (but actually doesn’t need to be) and if my Androstenedione levels were also high (again, doesn’t actually need to be – especially since I’m experiencing the other signs of 17b-HSD). I’m considering getting my LH and Androstenedione levels checked out during my next blood draw (as well as other important things for TRT like red blood cell count). If my A:T ratio is high (that is, if I have high Andro levels and low T levels), then I definitely have 17b-HSD. But then again, I probably don’t need to do this as all the signs point toward 17b-HSD. But even with that in mind, I do plan on getting genetic testing a bit later in the future to confirm this and to see what type of mutation I have on that gene (out of mere curiosity). Its also possible that I could have low LH levels because it turns out that excess E production in males shuts down LH production which in return shuts down T production (and so you end up with T levels normal for women and castrated males).

As for the FSH levels: these are typically high in 17b-HSD (as well as in 5-ARD [5-alpha Reductase Deficiency] – which is basically 17b-HSD’s sibling since they’re so similar to each other), mostly because of undescended testes. However, they can be normal (and even low), as in my case. This seems to mostly come from people with descended testes (as in my case). Even with normal FSH levels, its very likely that my fertility is compromosied because of low T levels and high E levels. It also seems like its on the lower side of the normal range, and combined with all these other numbers, its pretty clear fertility is compromised.

One more thing about T and E levels in 17b-HSD: T levels don’t need to be low and E levels don’t need to be high. They can actually be normal (for both T and E) or low (in the case of E), while T levels can be high (less common but possible). All this depends on your genetics. All this is why genetic testing is far more reliable than endocrine testing.

Voice: My voice is kinda low (but not deep yet) – its about the equivalent of a Transsexual male 2 months on T. I sound like a teenage boy who’s just starting puberty (because that’s pretty much where I still am right now, lol). Its been this way since my voice first cracked on New Year’s Day 2002 (I was 11 and a few months away from turning 12).

Facial/body hair: I actually have hair in my upper lip, chin, sides, chest, and abdomen (I already have hair in my legs and arms). However, the hairs are so light and thin (or in other words, scanty) that you can only see them with a magnifying glass (that is, if you have bad eyesight) and in a well-lit room – or outside during the day, if the weather permits (I can actually see my hairs with just a mirror).

Body build: I currently weigh anywhere from 88-91ibs. As you can see, I’m pretty underweight for a 5’4″, 23 year old man, who should be weighing anywhere from 108-140ibs. I’ve been struggling with my weight since I was a teen. I didn’t know why back then but now I do – it turns out low T makes weight management difficult. Additionally, my chest size is 31-31 1/2 inches, bicep size is 8 inches, neck size is 12 1/2-13 1/2 inches, and I have body fat percentage of anywhere from 11-14% (my six pack almost shows!) and a body mass index of 14-16 inches. All of this makes me look and feel like a kid (or even wrose, a girl), and I’m not very happy about it. I’m fit, but my muscles aren’t huge yet (I want to achieve that ripped look).

Physical performance: Yeah, that has gone down drastically. My recovery is a total joke (I take a very long time to recover) and my stamina has declined. My muscles are still pretty fatigued from my previous workout (which was a very long time ago). I have had to really cut down on working out/exercising because of that (plus, I don’t really have the energy to do that stuff anyways). I really miss working out. I really can’t wait to get over this stupid low T and go back to doing that. Before my regular workouts were interrupted, I could do 50-100 pushups, 36-40 pullups and chinups, 45-75 second planks, and 50-100 squats – all in 1 cycle, as well as and 8-15 sec sprints in a few minutes (I’m following the Primal Blueprint Fitness regime). I could also lift up to 50 ibs (I do compounded workouts).

Energy: Don’t even get me started on this one. My energy levels are a joke. I’m constantly fatigued. I can barely get through a whole day. I even have had to reduce the hours I work, and take more days off as a result, since I don’t have much energy to do stuff. Its affecting other parts of my daily life too – I probably don’t need to say anymore, as I’ve pretty much already said it all. Basically, survival is my only goal. Everything else is a chore. I just wish I didn’t have to feel this way. But you know who I really feel bad for? The people around me. I feel like I’m neglecting them.

Mood: I have a case of “Dr. Jekyll/Mr. Hyde Syndrome”. My moods fluctuate pretty often. I get irritable pretty easily. I have no patience for people who get on my nerves. I feel like like a walking zombie (which is a common statement made by men with low T). Additonally, I don’t seem to be really “grasping” life – I feel like like its just going by…I literally just “exist”, I’m not really “living” life (this is also a common statement made by men with low T). Additonally, my anxiety levels seem to have gone up (which has always been this way), but there’s nothing that’s really incapacitating (in other words, I don’t have an anxiety disorder). Apparently, this is common with men who have not just low T but also high E – there’s evidence that high E levels cause anxiety in men.

Cognition: I feel like low T is affecting my cognition quite a bit, especially my concentration and verbal performance (which has always been a weak spot for me because I’m a visual-spatial thinker/learner). I actually seem to have this thing called “anomic aphasia” (or “word selection anomia”, or “dysnomia”), which is apparently a side effect of low T (but particularly very low T levels, such as mine). From what I’ve read, I should see improvement on that in about 2-3 months after starting T, and that includes my overall cognitive dysfunction. My performance at work has taken a huge hit – I can barely concentrate on my work and it takes a long time to get me into the “flow” of things. All this stuff isn’t good, as my career is intellectually demanding – so I gotta have a sharp mind and low T isn’t giving me that. Additionally, my memory is lagging a bit as well. Overall, this stuff is a huge pain in the ass.

Libido/Potency: My libido is inconsistent (or in other words, its a mess). I only think about sex occassionally (its not as frequent as it should be), and I have pretty long refractory periods – during these times, I have a hard time getting an erection (which I heard is common during these periods…more on that here). My morning/nocturnal erections are infrequent as well. Same goes for spontaneous erections. Not only that but, they don’t seem as firm as they should be. In addition, my semen volume is very low and at times I have a sort of watery semen – at least at times (these two things are very common with 17b-HSD and 5-ARD – and of course, Low T).

Appetite: I don’t think my appetite is as big as it should be. This is probably because of my lack of energy, which also means that I’m not moving around very often. All this translates into reduced need for caloric energy, resulting in a lowered appetite. I’ve done research on this, and I’ve also seen it in myself – whenever I more around more, I get more hungry and so forth. Low T seems to be messing up my metabolism (which isn’t surprising). The good news is that I will get higher energy levels, and as a result, a bigger appetite when I go on HRT.

Other: Some other stuff I think I should mention is that my bone structure is that of a male – which means that I have wide shoulders and narrow hips, my fat distribution is that of a male (I have no fat around my hips, buttocks, and tights), and I get hot flushes (common with very low T and high E levels) – which seem to be more noticeable in warmer weather. Not only that, but I also have a severe case of Gynecomastia (which is typical for people with 17b-HSD to have). Additonally, I seem to have a bit of imnsonia, which I’ve been dealing with for a long time.

As you can see, low T is making me pretty miserable. This is not a great way to live life and I definitely do not want to live like this anymore – I’m so freaking tired of it. I shouldn’t have to go through this, especially since I’m in my 20s. I just hope I’m on T soon (and I’ll be taking an Aromatase Inhibitor as well, so I hope to be on that soon too). I’m going to got visit the Endocrinologist for the very first time (I got a new insurance provider) on Tuesday (5/13) and hopefully I walk out of that endo’s office with a prescription in my hand by the end of the visit on that morning. I just want to get this over with so I can go back to living my life. Being sick sucks and you’re just not really alive if you’re low T. I want this out of my life now!