Hormones and Milestones

Went to see my endocrinologist, the "Prof", this morning. I've been going about every six months lately. The "Prof" is a remarkable man, well beyond retirement age but soldiering on. A real old-fashioned doctor, supplementing all the usual gamut of tests with his own rigorous observations and measurements; taking meticulous notes; a thorough gentleman. I believe he could be quite daunting if you weren't being honest...with him or with yourself; or if you weren't being sensible. But if you are those things, he's wonderfully professional, caring and supportive.

He - along with the others in my health care "team" - has saved my life.

Before my surgery he had me on weekly Primogyn depot injections supplemented by Depot Provera progestogen and Androcur anti-androgen. Since my surgery he's put me on twice weekly Menorest patches. We started out with the strongest dose, 100mcg then I tried 50mcg.

I didn't feel right on either - on the stronger I found myself overly emotionally labile and prone to bouts of woolly-headedness and fatigue; on the lower dose I felt irritable and cranky and felt "hard" and "dry" and somehow subtly less feminine. Each time I see him, the "Prof" carries out extensive blood tests; he was concerned that on 50mcg my blood levels of estrogen were too low and carried too greater a risk of both osteoporosis and also a noticeable loss of femininity in my features. As a compromise, we tried the 75mcg patches.

On those I felt well in myself; even-keeled yet "feminine". Don't ask me how, okay - it's sort of a feeling of being soft and round rather than like being a sharp dry stick! And yes I know this long streak of dishwater doesn't LOOK round - I said "FEEL", right?

Well this morning, the "Prof" went over my results. I have estrogen levels equivalent to the high end of normal in post menopausal women not on HRT which is what we were aiming for - not abnormally high but neither too low. PSA levels, which give an indication of the risk of prostate cancer - yep! I've still got one of those! - were extremely negligible. That's the protective quality of estrogen there! However that very same level of estrogen exposes me to the same risk of breast cancer as any other woman of my age. Menorest has the advantage of not being being processed through the liver which makes it safer for a woman of my age. That's good because, having neither ovaries or testes I rely on hormone replacement therapy both for feminisation and lowering the risk of osteoporosis. These little patches and I are in for the long haul.

I am aware that, being a 54 year old baby boomer, I'm part of that pioneering first wave of transsexual people entering middle and old age in significant numbers. We're an unknown quantity when it comes to all the medical, legal, social and political considerations of aging, retirement, superannuation, inheritance and dying.

Transsexualism is not something you take off, or grow out of or give up, it's you; a birth-mark going all way down to your core; the blood flowing in your veins; your being; your growing and your growing old; your living and your dying; your forever and always.

The "Prof" closed his file. "Well, Paula, I think you're doing very well. I don't need to see you again, unless you feel you need to. So we'll leave it at that, 'appointment on request'". I thanked him and walked out into the bright cold sunshine of an early winter morning.

I stood waiting for the lights to change, just as I'd stood there four and half years ago after my first visit to him. Clutching, my heart pounding, my first script for oestradiol. I'd gone into the first chemist I'd seen; got "on the train"; never looked back.

Now I was walking out after my last visit. Somehow, that was it, a milestone had been passed. There's still things I need to do; but I do them as the woman I am, living MY life, its highs and lows, its excitement and humdrum; its bright promise, its dark depths...an ordinary life at last.