oh my God I’m sorry that happened to you :( HRT management is so fucking simple, I’m honestly shocked at how many doctors just wing it based on their own conceptions instead of doing the very easy very standardized processes most everyone follows.
had kind of the opposite situation happen to me, my primary care prescribing my hormones was an older dude with trans folk on his staff, everything seemed like it checked out, all I really needed was prescribing the same regimen I’d been taking with some occasional hormone panels.
for a while it was “too early” to get hormone panels, though he was taking blood draws for liver/kidney panels every time I saw him (oftentimes without even making clear that’s what he was doing) 6 months later I was not feeling great and asked if we could do a hormone panel to rule out some things, he explained that he felt like “the online trans community” focuses too much on the numbers and his plan was to increase dosage until it showed up on my liver/kidney panels. I wasn’t really sure but giving me enough estrogen for my liver/kidneys to start filtering it out of my blood seemed wrong and so I insisted on one anyway.
a week later he sent me an email basically saying “so because you were complaining about it so much last time, I went ahead and did it anyway and LOOK it’s fine!” Attached were lab results that were not at all fine - it was waaaaay high out of range and it wasn’t even a trough reading! (somewhere around 2000 pg/mL IIRC) I was confused at how this happened, given I didn’t even think we changed my dose?
So then I looked through my records and it turned out he’s been silently increasing the vial concentration without changing the amount drawn - pretty much the ideal way to increase my dose 8x without me noticing. I shoulda paid attention to the listed concentration on the vials I was getting, but we didn’t discuss a dose increase at all so I didn’t really have any reason to suspect a change.
So I bring all this to him alongside the physical symptoms I’d been feeling and ask for an explanation. Once again he started into the “you’re just too focused on the number” stuff. He also said my physical symptoms sounded like anxiety and that he could prescribe an anti-anxiety med. Immediately stopped seeing him and just did DIY for a while instead.
Yeah that’s a possibility, I also suspect he believed that trans women would need/want as high a dose as possible and didn’t seem to believe a lower dose would have any effect.
That is horrible and I am sorry you had to go through this. That level of negligence is certainly on par with the doctor I had to deal with, though hiding the increase from you is certainly borderline malicious (if not outright so). I am glad that you got away from him, because that was definitely the only way to go. . Internet hugs if wanted.
oh my God I’m sorry that happened to you :( HRT management is so fucking simple, I’m honestly shocked at how many doctors just wing it based on their own conceptions instead of doing the very easy very standardized processes most everyone follows.
had kind of the opposite situation happen to me, my primary care prescribing my hormones was an older dude with trans folk on his staff, everything seemed like it checked out, all I really needed was prescribing the same regimen I’d been taking with some occasional hormone panels.
for a while it was “too early” to get hormone panels, though he was taking blood draws for liver/kidney panels every time I saw him (oftentimes without even making clear that’s what he was doing) 6 months later I was not feeling great and asked if we could do a hormone panel to rule out some things, he explained that he felt like “the online trans community” focuses too much on the numbers and his plan was to increase dosage until it showed up on my liver/kidney panels. I wasn’t really sure but giving me enough estrogen for my liver/kidneys to start filtering it out of my blood seemed wrong and so I insisted on one anyway.
a week later he sent me an email basically saying “so because you were complaining about it so much last time, I went ahead and did it anyway and LOOK it’s fine!” Attached were lab results that were not at all fine - it was waaaaay high out of range and it wasn’t even a trough reading! (somewhere around 2000 pg/mL IIRC) I was confused at how this happened, given I didn’t even think we changed my dose?
So then I looked through my records and it turned out he’s been silently increasing the vial concentration without changing the amount drawn - pretty much the ideal way to increase my dose 8x without me noticing. I shoulda paid attention to the listed concentration on the vials I was getting, but we didn’t discuss a dose increase at all so I didn’t really have any reason to suspect a change.
So I bring all this to him alongside the physical symptoms I’d been feeling and ask for an explanation. Once again he started into the “you’re just too focused on the number” stuff. He also said my physical symptoms sounded like anxiety and that he could prescribe an anti-anxiety med. Immediately stopped seeing him and just did DIY for a while instead.
I’m… confused why anyone would even do that. Purely the idea that he’s infallible and that you should increase until it shows up in his tests?
Yeah that’s a possibility, I also suspect he believed that trans women would need/want as high a dose as possible and didn’t seem to believe a lower dose would have any effect.
That is horrible and I am sorry you had to go through this. That level of negligence is certainly on par with the doctor I had to deal with, though hiding the increase from you is certainly borderline malicious (if not outright so). I am glad that you got away from him, because that was definitely the only way to go. . Internet hugs if wanted.
hugs back! I’m sorry you had a similar shitty experience, thanks for sharing it here so I could get mine off my chest :)