Thursday, January 22, 2009

Transition w/o estrogen?

Once I detected the lump in my breast and it was diagnosed as breast cancer I quit taking or using all forms of estrogen; as my hormone receptors were estrogen positive. There are a large number of manufactured products that use phytoestrogen or create these altered forms of estrogen which we use every day and are exposed to during our daily activities.

So after spending a few years testing the waters of transition and being able to find a doctor who would prescribe and monitor HRT, it only took 14 months for my cancerous lump to show up. I spent 3 or 4 months discussing my options while my testosterone raged back throughout my body reversing some of the changes that had been developing.

After getting recommendation to use Lupron injections from all of my doctors that were involved with my medical care; I was given the hormone blockers for about 32 months. My body did very well while I was using Lupron, I lost almost all of my body hair and my shape really shifted to the feminine side. Extreme hot flashes rages throughout my system, I could actually feel the edge of heat rushing up through my chest. Sweat would sit and collect on my skin enough that it seemed as if I had just stepped out of the shower. On our cold Georgia nights, my wife loved to snuggle up against me to warm up. At least I was providing something useful.

As the changes happened to my body, I was achieving my desired feminine results except for breast development. Since I knew that I would never achieve breast size that I have always dreamed about since I even thought I could be a girl, I settled with using a set of breast prosthesis for two years; which was a good alternative; but they weren’t me.

Having to undergo a mastectomy as the treatment for breast cancer with my health care’s authorization, they couldn’t deny breast reconstruction because that would have been medical discrimination based on gender. I am just completing the 10 month reconstruction process. But I was still receiving the Lupron hormone blockers as authorized by my heath care; and I would have to take Lupron for the rest of my life at a cost of $1700 for each injection. An alternate treatment for my male breast cancer with estrogen positive receptors would require the removal of the testes; a procedure characterized as ‘feminizing’ and gender changing surgery prohibited by my HMO. My urologist’s recommendation and request for the Orchiectomy was quickly denied at the first level. We quickly sent documents to appeal the first decision and after 3 weeks we received the recommendation that they would uphold the original denial; we were also given a period to appeal a second time to higher channels. So again we sent documents and letters for an appeal; after 4 weeks I received the letter from my HMO overturning the original denial and authorizated the procedure:

“Dear First Sergeant Riggle:

Thank you for providing us the opportunity to review the denial of “*” preauthorization for the above referenced care.
We are pleased to inform you that “*” preauthorization has been approved. The appeal decision accomplishing this, including the rationale for the reversal of the previous determination, is enclosed……..”

* my military HMO

So, I have been very “fortunate”, if you characterize getting breast cancer a good thing, to have so many procedures paid for that other HMO refuse to perform for trans women. Having my HMO finally characterize the removal of the testes as a viable treatment for male breast cancer over the 'feminizing affects' with receptors that are estrogen positive was vindication enough. When one compares the cost of receiving Lupon for the next 18 years at $367,200, as opposed to the charges of one procedure at $10,586, one would immediately see the savings of $356,614.

I will have to continue to take Tamoxifen for control of the breast cancer which also helps to block the natural occurring estrogen to which everyone is exposed to some levels. Since the last procedure, I have noticed a dramatic reduction of the number of 'hot flashes' and their intensity; which is a good thing.

1 comment:

JCF said...

Congrats! Have you scheduled your orch?

JCF, who'll have to get my own 'nads (ovaries) cut out one day, undoubtedly. I just hope I have health insurance by then (AND that they'll approve it :-/)