@packetcharmer "Are you a doctor?" Who the hell do they think they are belittling you for advocating for their patients' health? How old are the guidelines they're working from? I don't even know where to begin with someone who treats people like that.

@cute_weeds She’s in rural California, 60 mile drive to Fresno where her doctors are. I’m not sure what guidelines they’re basing their decisions on or if they’re deferring to her cardiologist’s opinions. I’m trying to get her to move up to Seattle with me, but she’s overdue for some heart surgery to fix a valve issue(that you can hear when listening to her heartbeat, it’s pretty freaky). That surgery needs to happen before she leaves California.

@bea @cute_weeds she started with patches before pills. She’s been pushing for injections and then the doctors respond “we don’t know if your insurance covers that”
A. Fucking find out then
B. For a girl with a heart condition I’m sure they can file for an exception
C. I wish I could be there for her at every appointment but she’s 1000 miles away

@packetcharmer "We don't know if that's covered..."

Are THEY doctors? 🤦‍♀️

@cute_weeds I mean to be fair I don’t expect doctors to know all the ins and outs of the insurance system, that’s what the billing department is for. Still though, this reaction and lack of interest in following up really blew my mind. Not sure if they’re discriminating against her for being poor, trans, or Hispanic, but either way fucking wow.

@cute_weeds @packetcharmer

As the girl in question, I'm going to add that the place I go to, does not test my testosterone levels at all.

Thought Planned Parenthood would be better than this. but like everything else, Fresno is the worst place for anything.

@maritroniuity @cute_weeds so they upped you to 200mg/day without even knowing if you need it? Even though that forces you to to take another pill because that much spiro raises your potassium higher than your heart doctor wants?

@cute_weeds @maritroniuity the most fucked up thing is I’m not a doctor but I can do a better job of managing a HRT regimen than they can.

@packetcharmer @maritroniuity Frankly, a lot of doctors are less informed than their patients about HRT :/

@cute_weeds @maritroniuity I did DIY for my first 7 months where I actually got my own blood tests done that I used to determine my dosing too, so I’m a bit better informed than the average trans girl. Did quite a bit of research before I started DIY too.

@cute_weeds @packetcharmer @maritroniuity I'm meeting with my endo in a week or two. She's literally written (part of) the book on this stuff.

I could try to remember to float questions past her? Just let me know specifically what to ask, so I can write it down in my notebook.

≈3% chance I won't have time during my appointment, as I've got my own questions & HRT problems rn; but that leaves a ≈97% I WILL have time. ∑:3

@Qwyrdo @maritroniuity @cute_weeds heck, I’d be interested in reading this book. I’m going to be dealing with HRT for the rest of my life, or at least until I can get a robot body, so I’m always interested in new information on the subject.

@packetcharmer @Qwyrdo @cute_weeds

I'm interested in reading this as well

@maritroniuity @Qwyrdo @cute_weeds I think I know what she needs already, 4mg E or injections, and lower spiro to the minimum dosage that keeps T in female range, even if it means she has to cut pills to do it. If we were paying out of pocket I’d also consider getting Cyproterone from overseas because it shouldn’t interfere as much with her heart stuff(though I’d also need to see a list of those meds to confirm). It’s a goddamn tragedy that Cyproterone isn’t FDA approved.

@packetcharmer @cute_weeds @maritroniuity OK, I finally found the book again: it's "Principles of Transgender Medicine and Surgery":

https://www.amazon.com/Principles-Transgender-Medicine-Sexuality-Hardcover/dp/0789032686

One thing to note is it's 11 years old; IDK if there have been any newer publications that address trans medical care. But, at least it's a start!

@packetcharmer @cute_weeds @maritroniuity Making breks atm but I'll check my clinic email for the title; my PCP got a copy per endo's suggestion.

@packetcharmer @cute_weeds Yeah, it was also what I started with. 50 mg to 200 mg within three weeks.

@maritroniuity @packetcharmer Oh, hi! I didn't know we were talking about you! I'm so sorry to hear all this bullshit is happening, friend.

Obstructing your efforts to switch methods, browbeating you, and they don't even measure T?? Sigh.

I hope you can get things sorted out enough to move out of California soon. 💙

@cute_weeds @packetcharmer

Been talking to a good friend outside of Mastodon (also a trans girl), she says that I have a good case to sue for malpractice.

@packetcharmer @cute_weeds it sucks and it's unjust but i think if you/she want to go this way the leg work will probably be up to you. calling the insurance provider can tell if it's covered. calling pharmacies can (hopefully) tell you how much it will be without insurance, and perhaps more importantly if it's available at all. afaik there's still a shortage of (mainly high concentration?) injectable estradiol valerate in the US

wish i could help more :c

@bea @cute_weeds I mean worst case I can just give her one of my spare bottles of estradiol until she can get up here to some better doctors.