When I decided to finally begin medical transition, I agonized over where to even begin. I had a post here about finding medical professionals, and I did finally find somewhere that seemed like a good fit for me! Opened somewhat recently; a local university and teaching hospital started a "pride clinic" that was supposed to be a safe space for people who needed care that may have needs outside of the realm hetero-normative and cis-gendered people. The staff is (as far as I can tell) all part of the LGBTQIA+ community, or at least allies. I like going to this clinic because I don't just feel tolerated; I feel welcome!
I started HRT a few months ago. I was excited for estradiol no matter what form it came in, but they went with their organization's "standard of care" that was spironolactone and estradiol oral tablets, and some finasteride thrown in because, well, I'm old enough for hair loss to be a thing. I asked them if we could discuss injection monotherapy, and got a reply of "Sure, after your 3 month blood work". Two months in, I had to have a second set of labs done because the anti-androgens were wreaking havoc. Dizziness, fainting, high heart rate, low blood pressure, and several other issues. While I was generally happier and able to actually feel and express all the emotions that I couldn't before, the mood swings were so strong and so spikey that even my spouse was commenting on them. I was also frustrated with the lack of any physical changes to speak of, out side of maybe my scent changing for the better.
I started to pester the clinic to change my mode of therapy. After seeing a cardiologist who actually agreed with my concerns, I finally had my teaching appointment for estradiol valerate recently. I am in such a better place now! I have no mood swings, though I still get to keep my range of emotions. There is less random dizziness and no fainting. The best part is that there are physical changes coming along with the rest within a week of starting the injections. The litany of medications I took every day are gone, and the only thing that remains is a small shot once a week.
I'm celebrating a bit here, but I'm also recalling all of this to tell you that if you need something from a doctor, remind them that it's your healthcare you're looking after. Take an active role in it, including reading up on the benefits and drawbacks of what you're after and why. Sometimes you need to be your own advocate. I also want to point out that I'm still going to the same clinic. They're wonderful people providing great care in an environment that I have yet to find anywhere else! But, they're doing the job for so many patients that they sometimes just have to follow the guide book. Your care is for you, so make it personal
I don't know if I have a problem seeing myself. My problem is that who I see is ever so slightly different over time. I also know that the self-image I have is incongruent with many things. Gender. Age. Some basic physical features, like hair and eye color. It's not just the visual, either. There's a gap between how I carry myself today vs. how I feel I should be physically moving. How I sound is wrong. My scent isn't correct, either. So while I don't need to force myself to mentally conjure my self-image, it's a struggle to keep it nailed down to a single me sometimes.