, 11 tweets, 2 min read Read on Twitter
I saw my endocrinologist for my taper plan yesterday. We had been speaking about it since I began seeing her, so the conversation opened with her asking if I was still moving forward with it. After I said yes, we just sat and chatted a bit. A few things stuck out at me.
1. When I expressed concern at the lack of data on long-term health risks for T use in females, she confirmed that this was an issue and that providers should be looking into it more closely. What's more, underresearched co-morbid conditions are even less likely to be researched.
We were talking about genetic conditions, but the logic also applies to dissociative disorders. In part because of the FMS controversy, researchers already receive pushback when investigating dissociative disorders. Their relationship to gender identity is barely explored.
2. Even when some health risks are known, providers may not be aware of them. I mentioned that I had an elevated risk of stroke because of other conditions and my last provider didn't know. She didn't, either, despite having more experience. This is a serious issue.
3. I explained why I was hesitant to continue engaging with the system after a retraumatizing experience with my last provider, including disengaging without communication. Instead of lecturing me, she validated the reaction I had & noted it was consistent with trauma responses.
My peers often tell detransitioned people that disengaging from care is on them, that they should have been more proactive about following up or how it was a mistake on their part. But in many cases it's a legitimate response to traumatic situations.
I'm not the only one that was treated poorly by HRT providers. The issue is pervasive and it's honestly understandable that people will remove themselves from the situation. It's an act of self-preservation. We talk about leaving abusers - sometimes those abusers are doctors.
It's possible that my provider was more open to this because she views me as trans. Which says a lot for the double standards that detransitioned people are exposed to. For a trans person, it's seen as a normal response, but for for a detrans person it's seen as their fault.
4. There is still no medical guideline for tapering off T. She gave a suggestion, but other than that, I'm the one that's in control of how fast or slow it's done. WPATH was supposed to address this in their new SOC, only to remove it at the last minute.
My peers caution others on DIY hormones. What we fail to address is how much of the process is still DIY even when under the care of providers. There's more guidance for going on than going off. This is particularly an issue for those of us with complex medical needs.
Overall, the appointment went well, but it still leaves me with skepticism of how our system is constructed. There are so many gaps that have failed to be addressed. It's been decades and advocates still have so much work ahead of them.
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