Transgender Update

Michelle sent in an update on the recent announcement by the Veterans Administration (VA) approving gender realignment surgeries:

” Here’s un update on the VA. I talked to several friends that work for the VA and help run clinics for trans people. One stated that it is in the rules and regulations that full trans care has been approved but will take time to get it written into the operating procedures. Apparently, several of the clinics here in Florida already have the personnel that specialize in trans care but the problem is that no formal trans exclusive clinics are set up. My friends say that it may take up to a year to get everything fully established. Here’s hoping it won’t take that long, but then again it’s the government.”

Thanks for the update!

As I have written before, a few of my dealings with the VA in the past have resulted in me being referred to an outside provider.  Which leads me to this point, where you are will probably dictate how fast the VA can react to this new ruling. 

For example, I know of two experienced hospitals here in Ohio which do SRS. Perhaps it would be easier for the VA to refer cases to them. 

We shall see. As you said Michelle, it’s the government. Personally,  as far as I am concerned, I am fortunate in that I don’t desire any radical surgeries to reaffirm my femininity.

Clutter

 I attended a rather lengthy webinar yesterday designed to help care givers deal with elderly parents or patients. Predictably, no mention was made concerning LGBTQ+ individuals. I did have a question in to be answered by email at a later date. We will see if the moderator ever answers me.  I doubt it but at the least I got my point across. At any rate, the whole adventure used all my battery power on my laptop along with the usual allotted time I use  to write a blog post.

Then today, I filled out a LGBTQ+ survey and filled out the on line vehicle license tags registration for our car. As always it took Ohio time to catch up and offer an on line service to residents of the state.

Speaking of Ohio, the Repugs in our legislature tried to pull a quick one and reintroduce a ban on transgender athletes in the state which was previously defeated. Fortunately it was defeated again and so far trans athletes in Ohio can compete.  As always, our transgender rights seem to be so fragile. 

The idea of fragile rights continues in this post as readers discuss the recent VA policy shift supporting gender realignment surgeries. First, Lisa P:

” It is good news, but we will see joy know that we have real progress when the next Republican Administration doesn’t dismantle the program. My advice to anyone who needs the help is to get it NOW, while the getting is good. Hopefully, this policy will remain in place, but one never knows.”

So true Lisa, thanks for the comment.

Then Michelle commented: 

“Remember that the article did state that the VA needs to find medical staff the can perform the procedures. Unfortunately, as with all government programs it will take some time to get it established. I’m with Lisa about if the republican party has anything to do with it, we will see that taken away. I’m also fully aware of the transphobe medical staff that the VA has down here in Florida.
As you said Cyrsti about having a hint of paranoia, I will be waiting to see what will happen. I hope to find out more this weekend when I meet with several members of the LGBTQ group that works in the VA.”

Hopefully this means if the VA can’t do the procedure themselves, they have to find someone to do it!

Please keep us posted! Also the person in the photo is Carla Lewis. I wore a similar shirt to a Columbus, Ohio Pride event several years ago. 

Big Changes?

 I recently received a comment from a fellow transgender veteran Michelle concerning the Veterans Administrations recent announcement they (the VA) would start supporting gender realignment surgeries.

I am a bit slow in sharing this as referenced in this post from the “Orlando Weekly”:

” During a Pride event in Orlando over the weekend, the head of the US Department of Veterans Affairs announced that VA hospitals would begin working on a program to provide gender-affirming surgeries to veterans.
Secretary Denis McDonough said he was starting a two-year-long process that would equip VA hospitals with the training to provide surgery to transgender veterans, calling the move “the right thing to do.”


Needless to say, this is exciting news for trans vets everywhere!


Thanks Michelle. 

Memorial Day

 Once again here in the United States, Memorial Day rolls around . Memorial Day is meant to honor those who paid the ultimate sacrifice for their country.

Most of you regulars know , I am a transgender veteran. A fortunate one in that I survived a very ugly, unpopular and destructive conflict known as the Vietnam War. I have friends who didn’t survive  or returned with psychical/mental scars which never healed. 

I always try to mention too, the inordinate amount of transgender veterans  who served in their closets while attempting to reclaim their masculine gender status. When I see the number of graves and crosses spotlighted in media news shows on Memorial Day, I wonder how many of them took their gender secrets with them to the grave. 

What really upsets me too are the number of people who see Memorial Day as just another day off to BBQ and not spend just a minute to remember those who served and lost their lives. 

Without them, we would all be lost.

The Needle or the Patch

Coming up on the nineteenth, I have my appointment with my endocrinologist. As I have written before, I am considering asking her about the possibility of changing my Estradiol delivery method from patches to injections. As with any other change, injections bring with them a whole other possibility of side effects. As a matter of fact, Michelle sent in this comment on the subject:

” You may want to check out this article:https://transcare.ucsf.edu/article/information-estrogen-hormone-therapy
The highlight paragraph is one that you mentioned:

Many trans women are interested in estrogen through injection. Estrogen injections tend to cause very high and fluctuating estrogen levels which can cause mood swings, weight gain, hot flashes, anxiety or migraines. Additionally, little is known about the effects of these high levels over the long term. If injections are used, it should be at a low dose and with an understanding that there may be uncomfortable side effects, and that switching off of injections to other forms may cause mood swings or hot flashes. Some trans women have encountered difficulties obtaining a consistent supply of injected estrogen due to ongoing problems with the supplier. Realistically, there is no evidence that injections lead to more rapid or a greater degree of feminization. In my practice, I generally avoid prescribing injections unless under very specific circumstances.”   

Thanks for the insight. Plus, as a matter of fact I did check out the article. So far, I have been lucky in being able to have a stable supply of patches through the VA and I have never had the problem of the patches not sticking. 

After talking the whole process over with my therapist this morning, the only benefit would be the possibility of quicker feminine development. So as it stands, I will probably just stay with the program I am on.

As soon as my partner Liz and I become fully vaccinated, I will be able to benefit from public feedback again. Which means so much. 

The Battle Continues

A reminder for a former president outside his Mar-a-Lago  home:

And, on the bright side, reversing Trump, the Pentagon has issued new policies for transgender troops. Policies which largely banned transgender people from serving in the military were reversed and new rules were given which will broaden trans troops access to medical care and gender transition. 

I will be interested to see what if any actions the Veteran’s Administration will take now. Currently, the VA mostly covers only hormone replacement therapy and some essentials such as wigs and prosthetic breasts. To my knowledge, still no serious surgery. 

I “Stuck” to It

Well, yesterday was my appointment at the Cincinnati Veterans Hospital to receive my first Covid-19 vaccine. As always, as first experiences go, it was an interesting time.

First of  all, the weather was cold (25 degree’s F. )  so I had to plan ahead to make sure I was warmer outside until I arrived at where  I needed to provide a bare arm for the vaccine injection. What I finally decided on was to wear a loose fitting long sleeved sweater over a T-shirt so I could strip off the sweater for the vaccine. 

For the most part, the plan worked relatively well and I only dropped all my paperwork once. So I was able to slip out of my coat and sweater without too much of a problem. 

Overall, I respected the organization of the whole operation. At the door of the main entrance directing traffic was a person I thought was a transgender man, although it was tough to tell since they were wearing a mask. Then came the walk around the hallways until I finally arrived where the vaccines were actually being given. As I was being directed forward, I actually was only mis-gendered by two people out of approximately fifteen. Which I figured wasn’t too bad considering how much work I didn’t  put into what I was wearing. My sweater coat is not form fitting at all and I just wore jeans and boots. Plus, since I was wearing two masks, the only makeup I wore was on my eyes. 

Knock on wood, the best part so far is the only reaction to the vaccine so far is a slight itching in the arm.  

Plus, the best part is, my second vaccine is already scheduled for thirty days out in March. I was fortunate too it was just cold today as we are expecting close to or over a foot of snow during the the next several days. 

Hurry Up and Wait

 It’s very frustrating when a trip to visit the vampires to have my blood work done becomes such a big deal.

After all though, it was one of the very rare times I have been able to get out of the house these days. I was able to talk Liz into going with me as we had to head north to Dayton to let the vampires do their quick work.

It’s my own fault in that essentially I am stuck between two Veteran’s Administration hospitals. The first one in Dayton is about an hour and a half away but it is definitely more user friendly than the hospital here in Cincinnati. Plus, it might be my imagination but the Dayton VA seems to be more transgender friendly. 

Be that as it may, as we entered the hospital, we had to be checked in and asked the magical question, “What brings you here today.” I so badly wanted to say just to look around or we came just to enjoy the wonderful cafeteria food. Needless to say, I didn’t say that and we were allowed to continue our masked journey to where the blood laboratories were taken. 

Very quickly, we were done and making the trip back to Cincinnati.  Since I had fasted for the blood letting, we stated to look for a place to eat on the way back.

Along the way we found one of those infamous fast food strips along the interstate so we left the highway and began our search. Amidst the sprawl was a Popeyes Chicken restaurant. In the past I have eaten at a Popeyes several times but since there isn’t one close to our home, I had never tried one of their chicken sandwiches.  I loved my first spicy chicken sandwich and wondered why anyone would ever eat at the hate chicken place, Chick-fil-A.

All too soon after a couple more errands the big day out was over and it was back to covid seclusion to me.   Perhaps a light is coming at the end of the tunnel for me. Sunday in typical VA style I received a robo call from the Cincinnati asking me if I wanted a vaccine. When I pushed the proper number saying I did, the voice came on and told me no one was available to answer my request.

I just laughed and thought some things never change in the military…hurry up and wait. 

Update. Close to an hour later I received another call with a real person on the other end I am now scheduled for my first and second Covid shots at the Cincinnati VA.

Yay!

Reversal!

 President Joe Biden will soon reverse the ban on transgender people serving openly in the military, White House press secretary Jen Psaki said in a statement Wednesday.

While the reversal was not one of the 15 actions the new administration announced it would take Wednesday, Day One of the Biden presidency, Psaki said it would be among the “additional executive actions” that will be taken “in the coming days and weeks.”

I’m sure you all know I am a transgender veteran and how good I feel about this

Just My Imagination

To my surprise she told me my estradiol level had risen from the last time she prescribed me new patches from a low of “40” to “80” currently. 

Since I am very poor in asking relevant questions such as what should my levels be, I went to Google and received this answer:

“For transgender women, the Endocrine Society guidelines define the target range of estradiol as 100–200 pg/mL (367–734 pmol/L)1; as many providers in our practice do not titrate therapy when estradiol levels are above 90 pg/mL (330 pmol/L), the range of 90–200 pg/mL (330–734 pmol/L) was used to define effective”

So, I guess because of those levels, she prescribed me adding one more patch I add to my body twice a week. I am prescribed (by the VA) Alora 1 mg patches. Each of the patches contains 3.1 mg of estradiol which is released over a 3 to 4 day period. I am fortunate I guess in that I haven’t had any problems with the patches staying on. Because the next step would be me giving myself injections. I definitely have a problem with needles. 

Actually all these facts and figures are a way for me to understand the advanced gender transition I am going through. If the last time I received permission to increase my dosage is any indication, I can expect more changes again.

Of course the first time I added the extra patch, I imagined I felt an added fullness in my breasts and hip area. Realistically I know changes do occur over a period of time and not the first days. 

Plus I do know the risks of Hormone Replacement Therapy at my age. So does my Endo Doc I guess since wants to check my blood hormone levels in a month.

In the meantime, I will have to try to keep my imagination in check.