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.
Elipalooza 