Beam me up, Scotty.

I haven't written anything, online or offline, in several days.  In a hilarious freak accident while cooking dinner on Sunday night, I gave myself a nasty corneal abrasion and spent the next couple days blind.  I'm okay now, but reading is still tough.

( about T )

In other news, I have very little to report indeed.  I went to therapy yesterday and didn't have much to discuss, most of it about me trying to reinvent my image when transferring (eep) in a couple weeks because things with my mother actually went fine.  Passing as a teenage boy isn't going to be enough if I want colleagues I'll be meeting for the first time who know I'm in my mid-twenties to perceive me as male, plus I've been kind of wanting to dress my age for a while now.  Academics (in my field especially) dress incredibly informally, but I'm pretty much at the extreme end of that, and I think it would do me good to have more confidence in my appearance.  It's not really going anywhere, but I feel like it should.

I had an endo appointment today.  I finally spoke up about this cyclic mood swings nonsense.  I'm ashamed that I can't just rely on stoicism to get through it, and I wish there were another way to solve the problem because I otherwise like the pace of changes on my current dose.  My endo thinks switching to shots with an equivalent dose won't make a difference.  She said that with compounded cream, the minimum dose necessary to stop periods is twice what I'm currently getting from gel.  She wanted to just have me double my current dose of 12.5 mg, which is what she prescribed when we met for the first time, but I talked her into switching me to AndroGel 1.62%, whose smallest metered dose is 20.25 mg, a tad lower.  The fact that I can negotiate my prescriptions with my endo is really cool, BTW.  She questioned my info about the effective dose being different for the new concentration, so we simultaneously looked it up on our phones.  It was pretty funny.

In any case, I hope this is worth it.  My insurance covers any AndroGel, so at least it'll be worth it in terms of cost.  I don't feel like I really need any more changes, but I'm not willing to add female hormones to my body if they come with a risk of breast growth.  I can deal with more masculinization (wouldn't complain about it in most regards), just don't want to get changes fast enough that I feel dissociated from my body.  I wonder if I should have advocated more strongly for shots, because then I'd have more of an ability to fine tune my dose instead of taking whatever Abbvie offers me.  Gel is pretty fantastically easy though, and this is still lower than what my endo calls a "low dose" for trans guys, so maybe I'm making a big deal out of nothing.  I think I have enough AndroGel 1% to last until I move, so I'm going to wait a bit to start on the new stuff, at least until I figure out what I'm doing about top surgery.  I think my endo would be okay switching me to shots if I called and asked, but then I'd have to learn how to do it on my own when things are pretty crazy anyway.

This appointment had some other notable moments.  My blood pressure was totally normal.  It was a relief because at Dr. Johnson's office, my blood pressure was actually high.  The only other time I've ever had high blood pressure was when I was having an asthma attack in a hospital.  So now I know for sure that the culprit was indeed car sickness and I am not in earnest developing high blood pressure.

My endo was really concerned about my lungs though.  It was an early morning appointment, and I had a productive cough from when I woke up until a couple hours after the appointment.  It's been like that for over a week.  I told her I thought it was from binding too much at PTHC, since I've otherwise been cutting down substantially by working from home whenever possible and obviously not being very social outside the house otherwise.  She took a listen and kept coming back to the lower part of my right lung.  She asked if I was binding and tried putting the stethoscope under my binder in the back because it sounded "muffled."  I wasn't even binding very hard, just wearing a sportster.  Anyway, after asking me to breathe ten different ways, she concluded that my chest is not truly congested, but she can hear my asthma.  It wasn't really on my mind because I use my inhaler once or twice a year just for emergencies, usually triggered by cigarette smoke.  She expressed approval over the news that I'm in the process of making top surgery happen but didn't tell me I absolutely needed to do it, something that would have been preferable because it would take the decision out of my hands.

To lighten the mood, I'll end with the fact that my endo said my voice was definitely deeper than it was the last time we met (in February?).  alifjiim also said my voice was deeper than he expected when he visited last week.  (I have a couple half-written posts about PTHC and meeting super-cool internet people a couple weeks ago, swear I'll finish those up sometime soon.)  I also met a few people at PTHC who said my voice was deeper than they would have thought given my low dose.  I don't remember if theirearlystuff said anything about it though.  Did I ever mention that my father is a contra-alto?  My voice might be the deepest of all living males in my family, and it's a bit lower than my cis male partner's voice.  I'm pretty satisfied with that.  (-:

I kinda fell off the internet again.  I was really burnt out and barely made it to Spring Break.  I restarted T the week before break because I was a nervous wreck.  By then, I'd been having negative effects from stopping for about two weeks, and I couldn't cope anymore.  I'm going to make a T update kind of post about the whole thing, but the short version was that it was not pretty.  I basically got to the same point I was at when I started, unable to function without it.  I'll admit though, the first ten days or so were a valuable and hardly excruciating experience (that I have no plans to repeat any time soon).

I slept through most of the break and basically got nothing done but felt somewhat refreshed at the end.  I'm pretty much abandoning the project I've been working on for the past six months, which puts me at risk of not being able to take my comprehensive exam at the end of the summer, but I don't feel like I have much of an option.  Right before break, I made an appointment to talk to the head of the grad program and explained the problem.  It's not that I don't have time for research.  It's that I have only a few hours each day of peak mental productivity, and I can hardly get anything done like that, at lest not on something so abstract.  At our meeting, he told me that my advisor had just contacted him asking if I was alright, and he'd told her to go easy on me.  It's not what I want, but it may be what I need.  I don't know if this is awkward or expected given how I came out to him, but we have not said a word about it IRL and barely a reference has been made in e-mails.  Related: I need to write a coming out letter to my advisor and have been putting it off for almost two weeks. . . another thing I need but don't want, apparently.

( words about my chest )

Anyway, I don't want to go into this unless I'm confident I won't regret it, even if my regular doctor, endo, and therapist are falling over themselves to write me a letter.  I don't know what I'm going to say to the surgeon when we meet, but I have six weeks to figure it out.  Maybe the surgeon will turn out to be a really good salesperson and totally win me over.  In the meantime, I should do that work I was doing before it occurred to me that I'd think better after getting this out.  I'm hoping I'll have enough spoons to catch up with folks here a bit this weekend.

I just wrapped up a session with my health coach, and since we talked about gender things a lot, I wanted to write something here before I forgot everything (though I did take notes, as always).  Obviously things are a lot more complicated than what I said in our brief phone conversation, but it was more than I'd gotten to say with my therapist over the last month, and I feel like it was a good start in the sense that I can now tell my therapist, "Hey, I got help from a health coach in these ways, and here's how it was useful, can we talk like that, too?"

Therapy has been going really slowly, and I find that immensely frustrating.  I initially said that what I wanted to get out of gender therapy was a decision about what aspects of transition were right for me, but upon taking that apart a bit, I think what I really want is more certainty about what parts I've pretty much already decided to pursue in the nebulous, distant future.  I think I already know what I want, but I want to be confident that I'm doing what I need to, not just indulging something optional or something that I could regret.  And I feel like I really need to decide soon, so that it's easier to just be Ilan, not Ilan who used to be [birth name] when ey registered here, when I head off to grad school in June.

We talked about what changes I want from T.  I really, really want my voice to be lower and for my face to look more masculine.  I'd also like the changes to face, body, and head hair (though I worry I might regret those later on).  Ease of gaining muscle and body fat redistribution would be fantastic, but I'm not sure if I'm even thinking about being on T long enough for that.  And we talked about changes I'm less enthusiastic about, too.  I don't know if I want downstairs growth.  What if I can't ignore things as well then and spend more time being dysphoric about my crotch?  I'm also concerned about my hormonal acne worsening. 

I got to talk a little about why I've waited so long to get started on medical transition.  I felt so comfortable at school where everyone important knew I was genderqueer that the issue wasn't really forced.  Dysphoria regarding my crotch was mostly isolated to one week a month, and as long as I didn't have to wear a bra, my chest didn't bother me because I rarely left campus.  I talked about wanting facial hair and a deeper voice, but I didn't feel like I couldn't live without it. . . now that I'm not surrounded by supportive people who will take my word for it regarding my gender, I feel like I can't be perceived the way I should be without changes from T.  The health coach asked if I wanted to pass, and I said I wasn't sure, because it just seems so impossible and far away.  If I really wanted to pass, I should have already done a bunch of things like cutting my hair, right?  It was another one of those things that just wasn't an issue when I was in college and has been painful on a daily basis since I graduated and moved away, but I haven't done anything to fix it yet.

I also opened up about questioning my motives for transition -- am I just a misogynist? am I doing this for me or for other people? -- and its effect on my health given my other problems.  I'm concerned about being on T for the rest of my life.  I don't like being on medications, and I'm on several that will probably be life-long commitments due to chronic illnesses.  It seems counterproductive to sign up for more of that if less is an option.  But I can't see myself continuing to let my body be dominated by regularly fluctuating female hormones for much longer, and there doesn't seem to be an option to not have sex hormones.  I really don't know if starting T soon will help me resolve this.

I got some useful medical-type information, too.  Though genes control a lot of the hair distribution type stuff (face, head, and body), apparently voice isn't quite like that, because I won't be getting voice changes like a cisguy would during puberty, which makse sense because I know my voice has "matured" in some ways since I hit puberty the first time around.  This means that while I can probably count on not being able to grow a beard, my voice is not doomed to be the same as my father's bizzarely high voice.  It's also possible that my hormonal acne could improve on T, that I might have problems because my hormone levels are currently between the femle and male ranges, and my skin might stop rebelling if given the correct dose for either sex.  Obviously some testing is in order, but it's an option I wasn't really aware of before.

However, there was a lot that I didn't talk about that I would want to discuss further with a counselor.  One of the changes I'd really like from T is an end to the monthly reminder that I have female reproductive organs.  I feel bad about this because there are other ways to stop it that are perceived as "less drastic,"  and I've never pursued any of those for what seem like weak reasons, plus I might want to be on a low dose that only makes things wonkier.  I'd also be overjoyed to see my chest shrink further, so maybe I could get surgery by a method that's less likely to result in loss of sensation.  (EDIT: I just spent the afternoon looking at Transbucket, and I think I've got a real shot at peri if I ended up going for surgery at all, moreso if I get just a bit more shrinkage.)  One of my unsaid fears about starting T is that the changes will make my long-term partner stop being attracted to me.  He's not making any promises, but knowing that he's trying not to have to break a promise that our feelings will never change doesn't make me feel any more confident in possibly putting our relationship at risk. 

I also didn't go into my non-binary identity at all, which is a bigger deal than I generally let on.  I want people close to me to see me as Ilan, who isn't a woman or a man, but I want those not close to me to just see another guy, because if I have to choose, and I very much feel that I do, I need to be perceived as not-female, which means transitioning to male, at least on the surface.  I guess I didn't mention it explicitly to the health coach because I see him as being part of the not-close category, and I guess that makes sense since we've only met once and talked on the phone three times, but I feel like this is something I should be able to talk about more in counseling.  And because we didn't go into my non-binary identity, we didn't talk about my alternatives to T, namely more exercise, voice coaching, and other things I can do to be read as male and feel more comfortable with my body.

Anyway, we talked a bit about what I can do about getting T if therapy moves too slowly and I end up having to move before starting T.  I think that was really important to consider and not something that would have come up with my therapist.  I'm going to be making an appointment for shortly before I move with one of the sliding-scale informed consent clinics here in the Bay Area. If I get a "T letter" (probably just a referral to an endocrinologist?) before the appointment, I'll cancel and someone with an emergency will get my slot.  But if therapy never gets off the ground and I feel like I need to get going before introducing myself to my new department, I can still make it happen. (EDIT: I called the Lyon-Martin Clinic but got lost in a maze of automated voicemail subroutines.  I'll try again tomorrow with a script for what my message will say and a stimulant to back me up when it comes to following the instructions.) 

Yesterday was the first meeting (over the phone) with the health coach.  I think this is something I'm going to go through with.  He got me to promise to feed myself a sensible dinner and e-mail my doctor (who dismissed my concerns as usual, thanks Kaiser).  I'm willing to spend the money and think I (and my partner) will get a lot out of it, even if the program is very focused on eating and less on exercise.  I wish I had a better sense of whether the health coach would be okay talking about trans-related things, because they're a big part of my mental health, but I don't know if that's a sensitive topic for him, being FTM himself.  I also wish fewer of the meetings would be over the phone, because my ADD makes it very hard to pay attention to someone talking if I can't see them.  I'm going to bring this up before paying for the first month, but I'm not sure what the solution could be.

I also had a minor meltdown about my hormonal situation. 
( "What situation?" you might ask. . . )

I haven't been on-line much since I went to New York, first because I was traveling and had intermittent Internet access, and then because I was focusing on my grad. school applications.  But I got a lot done yesterday and today and can take a few minutes to update and read my friends page (and post a few things that got lost in transit using the nifty "Date Out of Order" option).  Anyway, I was really in the dumps before my trip back east, and I've had a lot of energy basically since I got there, minus a few days when I had a cold since getting back.  I'm surprised that that positive energy carried over upon my return to the Bay Area, but I actually want to do things and advance my life now.  Crazy, huh?

I'll be buying a gym membership (rock climbing and yoga) later today and am so psyched about it, in part because my health insurance will cover half the cost.  And I've scheduled counseling at the local LGBTQ space for the New Year, and I'll be going to a local FTM support group to boot.  Plus I'm finally on the last attempt to cure my acne before I can try Accutane and maybe stop worrying that T will make my skin even worse than it already is.  Oh, and I found out that my current insurance covers voluntary sterilization, which I may try to wrangle into a hysto.  Progress, fuck yeah!

Oy, I haven't been around much due to injuring my hand (not bad, just hard to type for a couple weeks) and then having a lot of schoolwork.  But I wanted to share pictures of some cool stuff I bought during Spring Break.

( Coloring books are way cheaper than road trips. )

I got them from Genderific Coloring Books Inc. in case anyone is interested.  (-: