When you come to that fork in the road, take it

January 8, 2010 dstevens11

Enlisted my friend to conduct all of the morning drills with Drew and Aly getting them off to school. As I stated in my last post, today was Jamie’s status update with her endocrinologist as well her yearly thorough exam. We had a 7:15 AM appointment, but it’s close to an all day affair, because of the exam, the blood work, the x-rays, the tests….etc We just got home, she is he the other room playing with her sister who just got home from school. As I said her doctor is real good with her, has a real good bed side manner, which is comforting since some of the procedures are pretty evasive. Measuring testicular volume as an example doesn’t sound like a picnic to me.

As Jamie and I got into the car this morning, I said “Are you ok?” she said, “yeah, I’m fine. Is this the day I find out if I can start female hormones?” I said “No honey, but the information collected today is really the enabler to the conversation with (her psychiatrist) on the 18th.”  “Then can I know?” she said, I followed, “we’ll see. I know it’s the purpose of the conversation.” So I am sensing a sense of urgency with her now. She said “AWESOME” very excitedly.

Results:

We still need to get some of the bloodwork back and test results, but all in all things are looking good.

She is a little over 5’2.

Weighs 101 lbs.

Foot size 5.5 boys, 7 womens.

Sitting height is normal, no  limb or bone structure abnormalities.

We will know bone density next week.

She has had testicular volume shrinkage since last checked in September (discussion below.)

No measurable Testosterone levels

She is puberty tanner stage 1 – which essentially means pre-adolescent.

There are  5 Tanner stages of puberty. Stage 1 being pre-adolescent, stage 2 is the start of puberty when things begin to start changing and so on. Jamie  started her medication therapy to delay puberty when she was Tanner stage 2, but essentially regressed to stage 1 as a result of the therapy. Any testosterone impact that came forward then, did not stick. Which is normal from what our doctor said from this type of therapy. We knew that last year obviously.

A couple of concerns for us and for Jamie:

–          Infertility: A positive approach with this type of therapy is if you stop it, then the born gender puberty starts and proceeds as normal. The issue becomes from the prolonged exposure to the medication (as my dr said the long term effects are still being established) infertility is a real possibility now, and definitely if estrogen therapy started soon. We have discussed this with Jamie, and she has said repeatedly, “I definitely want to be a mom, but will just adopt. I don’t care about “it” (that’s what she calls her penis.)” The issue is even in the lack of testosterone there is a process where they can collect and “freeze” sperm for future considerations. SHE HAS NO INTEREST IN THAT WHATSOEVER!! When we started that conversation several years ago, I do not think she was old enough to understand it, but she has been consistent in her stance. I want to be a parent, but not that way. So her being infertile with the prolonged exposure to the medication is now a probability.

–           SENSITIVE TOPIC: From the lack of testosterone, there is a concern that her genital zone (use your imagination) will not have enough equipment to create a vagina in surgery when that happens in the future. Which she is clear that is absolutely what she wants. Our Dr. has recommended we seek out a gender surgeon to evaluate that area before she starts any estrogen therapy, because the area will just decrease even more then it has already. So that was another concern from the doctor.

After hearing the test results, the Dr sat with me, not with Jamie to understand next steps. He was wondering if estrogen therapy was near in the future, and I stated we are discussing that topic with her psychiatrist in the next couple of weeks with Jamie. He stated that the protocol is to initially start with a low dose of estrogen, not only to initiate the cross gender transition, but also to inhibit any height growth so she lands in a normal female range. Once the Jamie’s body experiences estrogen, then her growth plates adjust to the hormone, and essentially develop a typical female growth spurt. He stated if that was to start in the next month or so, and then adding higher dosages later on, she will most likely finish in the 5’4 or 5’5 range. Which is essentially my height. This is amazing since she was destined to be around the 6ft+ range. Science is incredible.

Also, since she is essentially starting puberty with the female hormone; she will develop physically as if she was born female. Typical hip to waist ratio, female facial bone structure and all of that, female hands and feet etc…..similar to her paternal genetics (me). Not to sound vain, but I am a c-cup and proud of my curves 🙂 I’m 5’4 128 lbs, so Jamie should develop nicely without the needs of augmentation or anything. So our doctor wanted to make sure we were educated on the benefits and timing of the low dosage estrogen introduction.

Scary stuff! It will be a bridge we need to cross, depends on immediate timing. My girl may be developing soon. We will determine next steps with her doctor on the 18th.

I have to talk to ex about all of this stuff Sunday night, wish me luck. More to come in the next few days. The kids are with their father this weekend, so I am Mcawley Culkin and “Home alone” for a few days.

We are at the fork in the road, the direction we’re going next is pretty clear. Love, Dana

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Entry Filed under: transgender

6 Comments Add your own

  • 1. Sherry Ann  |  January 8, 2010 at 5:27 pm

    Great news! Everything looks wonderful for the next step. Enjoy your weekend. I’ll be thinking about you Sunday.

    Sherry

  • 2. F. Lloyd  |  January 9, 2010 at 5:39 am

    Sounds like things are progressing as planed. Enjoy your weekend, I hope things go well Sun. evening. I think of Jamie & you often. Take care, F.LLoyd

    • 3. dstevens11  |  January 10, 2010 at 8:12 am

      Thanks F.LLoyd, appreciate your support and comments. It means a lot. Love, Dana

  • 4. Zoe Brain  |  January 10, 2010 at 6:43 am

    I’m glad you has “the talk” about storing gametes.

    I encourage girls in your daughter’s situation to seriously consider it as an option. A *little* masculinisaton can actually add to a woman’s attractiveness.

    It sounds though that she’s considered it in an adult way, and decided on adoption instead.

    If she hadn’t got brothers and sisters, I’d be more forceful in my argument. As it is – her life, her body, her choice and she’s adult in this area.

    They grow up so soon, don’t they?

    Ok, as to surgery… I’ve seen one gal from Boston in a similar situation: had been on gonadotrophins since age 13, estrogen since 15 (IIRC). No masculinisation at all, and little raw material. She had her surgery on her 18th Birthday.

    Dr Suporn in Thailand uses a technique that is able to deal with this. I’ve seen his results, and if you do your own research, you’ll see that his reputation is very high. He may not be the best surgeon on the planet, but then again, he may be. I know of none better.

    Brassard (in Montreal) is comparable, more convenient, but not so experienced in situations like your daughter’s.

    Other surgeons may have equally good results – it’s just that these two are in the top half-dozen, and I’ve personally seen many examples of the work of both of them.

    All other things being equal, I recommend women in North America go to Brassard, but if transitioning young, or Intersexed, definitely to Suporn.

    I may be biased here – he’s my surgeon, and such matters are often ones of religion.

    • 5. dstevens11  |  January 10, 2010 at 8:26 am

      Thanks Zoe for the information. It is extremely helpful, it’s actually good to hear of an example and technique out there that is available. It’s honestly scary at this point in time to be talking about surgery with her, but it is something we will be talking about next week when we meet with her therapist. I want what’s best for Jamie, and we will consider all of the risks and opportunities that exist. I know she wants to get rid of “it” as she says, but I am sure that is not an easy procedure by any means. It’s a few years off in the future, but want to make sure we do the right things to get there, if that is what she wants. Thanks again for all your advice, it is EXTREMELY helpful. Love, Dana

  • 6. Jamie  |  January 10, 2010 at 4:56 pm

    yeah i heard of him i think too, it was on the bbc radio in the uk… and it was really good.. and that surgeon was as she said (Nikki- fake name for protection) was second to none… that’s which one i want for when im old enough… pity he wont share his technique or something… cus its that good…


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