If light were a tangible thing...

8th March - International Women's Day. This year though, I didn't go around wishing all the women in the world I knew; I had other, more exciting, things on my mind! It was after all the day of my appointment with a new endocrinologist, an endocrinologist who, I happened to know, was already administering androgen therapy to at least three other transmen amongst my circle. The possibility of impending testosterone therapy was real. For once.

I had kept ready everything I needed the previous night - bag with medical files, a bottle of water and a book to read while waiting; ample cash in my wallet; a freshly ironed shirt. I had even rolled a bandage & kept it handy for binding. The doctor had called me at 3 pm and I had to go in a little earlier to register. Registration was fairly simple: fill out a form with personal details, sign and pay up at the counter. There was a slight difference though. The form had three columns for 'gender' - male, female & other - a first for me. Although I would have loved to tick 'male', I ticked 'other' - when one is transitioning, one requires all records to be in order, irrespective of what one wishes. Then, I stood in line.

Now comes the fun part. Considering that the form has an 'other' column under 'gender', one would expect that finding it ticked once in a while would be pretty routine for the clerks at the counter, correct? Wrong! The clerk was most confused and asked me about it. I told her it was correctly marked. She asked again, lifting up the form this time and turning it towards me, and the people hovering around me trying to cut in line. People were beginning to notice. I told her again that it was properly marked but she wanted to know what to enter in her records. In other words, I'd have to explain what I meant by 'other'. Fat chance! 

Again, quite audibly, "Par aapne yahaan par 'gender' ke liye 'other' mark kiya hain. Aapne galati toh nahin ki?" ("But you have marked 'other' here, for 'gender'. You haven't made a mistake, have you?")

I am infamous for being tactless, but even I couldn't be that thick.

Scathingly, "I'm literate, aren't I? That means I've read the form and know what I've marked, doesn't it? Don't you think I'm sufficiently literate to know what it means to be ticking 'other' for 'gender'?"

Confused by the rapidity of my speech, "Huh?"

Slower this time, "If I've marked 'other' on that form, don't you think there's a reason I did that?"

Comprehension finally dawning, "Oh, sorry!"

Muttering, "That's fine." Not!

Awkward pause.

"Sir, that'll be Rs. 50/- for registration and Rs. 600/- for consultation." I paid, thanked her and proceeded towards the super-speciality OPD.

I'll admit, I did feel quite guilty about letting my temper fly. Usually, I handle situations like this pretty calmly, and much better. I guess it was nerves, and the fact that it had turned into quite a scene with a good deal of people trying to peek into the form and scanning me head-to-toe.

Super-speciality OPD. I walked up to the counter and handed over the file. It seemed like everything was in order. I was asked to wait for the doctor, who was out for lunch. After about 10 minutes, "Mr. (my last name), the doctor will see you now." Hallelujah!

"Hello Doctor, this is (my name). We've been corresponding."

"Yes, come in and take a seat". I thanked him and did.

Doctor, "So, tell me"

"What would you like to know? I mean, I'm used to having this conversation with therapists so I know what they are interested in knowing. But from the viewpoint of an endocrinologist, what would you like to know?"

Smiling, "Right, so you identify as male but were born female? And now you want to do something about it, including taking HRT or testosterone?"

Smiling also, "Couldn't have put it better myself."

"Ok. But there are certain things we need to get done before we can start you off."

I assured him I understood.

"Alright, first of all I need to know whether you have been seeing a psychiatrist and for how long."

"Yes, I have. For definitely more than two years."

"Good. And has your psychiatrist been giving you any medication?"

"No"

"And are you on any other kind of medication? Regular medication, not like the occasional paracetamol or antibiotic course."

"No"

"Do you have any diseases?"

"Like?"

"Like diabetes, hypertension, thyroid trouble, PCOD?"

"No, not that I know of. But I haven't been tested."

"Any PCOD-like symptoms? Problem with frequency of periods?"

"With frequency, no."
"And what about your weight? Did you put on weight all of a sudden or have you always been heavy?"
"I've put on gradually over the years; as my activity decreased and lifestyle changed. Like for example, I sprained my ankle and put on about 4 kilos during recovery."

"Any family history of diseases like diabetes, hypertension, kidney or liver disease, etc.?"

"Maternal grandmother had diabetes; sister has a thyroid problem - sorry don't know whether hypo- or hyper-."

"That's ok." Walking up behind me, "Stretch your neck backwards and pretend you're swallowing." He placed his fingers on my throat, palpating for about a minute. "Good, let me take your pressure and weight."

He then proceeded to give me information on the various methods of administering testosterone and explained his reasons for picking the injectable form he uses. He also prepared me with what changes to expect. We discussed dosing and my intentions for surgical options. 

Then, he asked me to get a few things in order and report back to him. The first of them was a battery of tests, standard ones being a complete blood count, lipid profile, liver profile & serum testosterone level, and TSH and blood sugar (fasting and post-lunch) due to my family history of thyroid issues and diabetes. He also required psychiatric evaluations and a letter from my psychiatrist stating that I have GID and certifying me mentally fit to undergo medical transition. He was very careful to let me know that the psychiatric requirements were merely for legal purposes and was most careful to not offend. This experience was SO different from my earlier endocrinologist's appointment. I asked him what the next step would be after taking him all the reports (if they were all in order). "Writing out your prescription! The nurse on duty can administer the shot."

I know there was further discussion but I can't remember much of what happened and whether or not I thanked him before leaving - I sure hope I did!

If light were a tangible thing, I would have run forward and bear-hugged the solid block of it I could see at the end of my 10-year-long tunnel.