I shot myself (and felt no pain)

So … Round Two of my foray into the Fabulous World of Hormones took place a little over three weeks ago, followed last Friday night by Round Three – the first time I’ve ever stuck a needle in my own body.

And now that I’ve had some time to put at least a little distance behind it and get a little perspective on the deal, three things are clear: 1) Things are not clear; 3) I’m sensing some subtle changes to my body; and 3) I’m wondering if I chose the right doctor.

Well, it’s an interesting life, ain’t it?

At least my first self-injection was painless. Like buttah. I swear.

The main reason I started with the hormone replacement therapy wasn’t for the physical changes, though I surely welcome those. The primary reason I chose to go through what will be a radical change of chemistry is because I believe it will bring me some peace of mind at long last.

If this were simply a matter of dressing and looking much better – well, hell, I’ve been doing that for well over a year already, and most of the time I manage to look great. (Ask the friends who’ve seen me.) I didn’t need estrodial for that. But this goes a lot deeper, or so I think.

Gender dysphoria, for the uninitiated, is the sense that the gender you’ve been assigned by society, based on what’s between your legs when the doctor pulls you out of Mommy, doesn’t match the sex with which you’re born.

Why is this so? Physicians and psychiatrists still aren’t totally sure, but they have a pretty good idea by now. Both my therapist and my new doctor, who’s a post-op transsexual, have told me that it most probably takes place during the gestation period, 8-12 weeks after conception, when the sex organs begin to form. In some cases, like mine, the personality traits develop differently from the characteristics common to the sex we’re born with. We get the plumbing of one sex and the wiring of the other.

As a common saying goes, sex is what’s between your legs; gender is what’s between your ears.

(And to confuse things further: Sexual identity is also believed to be formed around this time, and gender identity and sexual identity are two different things – similar but different. The sexual identities of trans people are all over the place. In my case, I’ve always been attracted to the opposite sex, but at this point I’d be open to a girl of my sex as well if the chemistry was right. And I’m not into guys, so my poker crew has absolutely nothing to worry about, except me taking their chips …)

Like many people who identify as transgender, I knew something was different early on, say around 5 or 6 years old; I just didn’t know how to articulate it, and besides, there wasn’t a real vocabulary for my experience until a few years ago. And until the Internet explosion, when we really, truly found out we weren’t alone, there weren’t many examples of trans people we could point to. And even then, they were of the extreme variety: biological boys who had gone the full monty, with a huge sideshow/freak show element to their news coverage – say, Christine Jorgensen or Renee Richards.

I not only felt that my wiring was different in this inarticulable way, but that something was wrong emotionally as well.

I’ve been wrestling with depression since adolescence. Some of it is definitely environmental. Growing up in Prospect, Ct., in the early ‘70s, I might have been the smartest kid in my grade, or at least one of the smartest, but I was also an outcast. After a crying outburst one afternoon midway through fourth grade – followed by Charlie Brown-like hails of derisive laughter from the other kids in the class and the disgusted look of the teacher who let the laughter continue on – I was dead meat. My sensitivity, seen as a weakness – especially in a boy – left me marked for years of taunts and occasional beatings, and no way to really defend myself.

Even though I went to a Catholic high school in Waterbury where I got along fairly well with most of my classmates – and where physical violence was not tolerated at all – I still had to go back to Prospect come 2:30, and the dreaded bus back home was a torture chamber at times. Also consider occasional sucker punches and beatings at various points, and sensitive me with little in the way to defend myself physically or mentally, and the feelings of isolation and unpopularity, and, well, nearly every day my last three years of high school I thought at least once of killing myself.

The three things that saved me then are the ones that still ensure I won’t act upon it: 1) I couldn’t think of a good way to do it; 2) Let’s face it – I’m scared to death of death; and 3) The Force is strong in this young Skywalker. (Also, as a teen, I thought it would splinter my family.)

Still, the darkness has taken many walks with me over the years; sometimes it’s even taken extended vacations with me, the gracious host. But even as I grew up and realized that my friends far outnumber my enemies, I still was a miserable man. I’ve moped, I’ve often eaten myself further into depressions and out of shape, and I’ve had feelings of insecurity and inferiority haunt me, peck at me, take up residency from time to time. Was most of it just so imprinted in childhood and adolescence that I haven’t been able to shake it? Is it hereditary? Or is some of it chemical?

I’ve believed for a long time that the answer is yes to the first two questions. But as I’ve come to grips with the gender thing the past couple years, I’ve come to believe that the answer to the third question is also a yes. Maybe the cross-up of my wiring also includes some sort of chemical imbalance, some sort of incompletion of the circuits.

I do have testosterone, true – I have the deepish voice and the loss of hair up top to show for it – but my testosterone count in recent years, when I started being tested for it, has been mighty low. Maybe the lack of testosterone was supposed to be countered with a higher amount of estrogen that my body never received. I’ve felt a lot better emotionally on some levels since I started really letting the girl out to play a year and a half ago; will the estrodial complete the job? (Well, as complete as can be for someone who doesn’t want to redo the plumbing …)

So, she who would never resort to taking antidepressants is taking the hormone route in the hopes that they’ll complete me somehow.

As mentioned in a previous post, I felt this incredible sense of calm the night of my first shot in late April, interspersed with dozens of tiny tingles whizzing around like electrons orbiting the surface of my brain. But as the shot wore off, three weeks later, I started to feel anxious, cranky – not depressed, but an extended blah. I wasn’t terribly alarmed, but the blah was a cause for concern.

Four weeks after the initial shot – three weeks ago – I returned to the doctor for round two. And, well, she really made me wonder whether all this bullshit is worth it, even as I’ve been plowing straight ahead.

Rewind: The day I received my first shot, she was to have given me a thorough physical. However, her people couldn’t find the results of the bloodwork I had done up the previous Thursday at the hospital next door. So I sat with my pals SpongeBob, Squidward and Patrick in the exam room for at least 40 minutes, stripped down, before the doc came in to see me.

The first time I went to her, in March, I was struck by how unpersonable she was. No hello, looking at the chart with her back to me much of the time. She at least warmed up a little the longer we talked, and we talked for over an hour as she collected my history. But she was a total crank this April visit.

She was put off that the test results weren’t there. She told me I should have said something to the nurse so they would have had the results ready for her. Hello? Do I look like I’m on your staff? I’m just the patient! Does she want me to run the clinic for her, too, while I’m at it? Maybe run out and pick up lunch?

So out she goes, and another 15 minutes or so pass by, me biding time again with the boys from Bikini Bottom. And after all this, she comes in and tells me that she’s run out of time to examine me. But she was satisfied that my cholesterol level had gone down considerably – one of her main concerns about me, along with my weight. The Pravastatin was working its wonders on my cholesterol levels, and I had cut back on a lot of my bad food, to boot.

So she had the nurse give me my virgin estradiol shot and departed – no congratulations, no goodbye, none of the hugs she gave me the first time, the hugs she told me she gave all her trans patients. I would have expected her to say at least something, since this was a huge milestone for me and since she had been there herself.

I was rescheduled for my exam May 25, at the ungodly hour of 9 a.m. At least I wouldn’t have to worry about the doc running out of time. And maybe she wouldn’t be a crank with me this time.

Riiiiiiiiiiiiight.

The nurse weighed me; I had gained six pounds in the last month. Not good. My bad – I had done some anxiety eating, especially as the hormone shot wore off, as I was also anticipating the results of the job phone interview I had early in the month with a company back home. Also, I’m assuming, since it was a baaaaaaad spring for allergies in the Central Valley with all the unexpected rain we got, that my body was retaining water as it fought the respiratory problems.

She took my blood pressure, then said, “The doctor wants you to strip all the way down.” So I took off everything but my underwear and donned the cheap, wretched paper gown and waited about 20 more minutes. I was looking at the implements of destruction the nurse had laid out – needles, various spatulas and flat-end probes, I think a turkey baster – and thought, “Oh shit.”

After the usual requisite waiting, the doc walked in. I was cordial. She was just as charmless and miserable at 9 a.m. as she was at 5 p.m.

“You put on six pounds since your last visit. You’re supposed to be losing the weight” was the first thing she said to me. Well, good morning to you, too. But hey, I deserved that one. I told her it was a little depression eating; she understood that and let it go, except to tell me I really need to lose the weight, especially since so much of my weight was going to deposit itself in my abdomen.

“I’m going to give you a thorough exam. The wig will have to go, too.”

“Really?”

“Yes, I’m sorry. And take off your shoes, too.”

As I stood up, she said, “And your underwear, too. When I said strip all the way down, I meant all the way down.”

OK, that bitchy, snide tone was just about all I was going to take from her. I didn’t recall wearing a name tag that said “Hello! My name is Dogshit.” And I did nothing to deserve being treated like it.

“Forgive me!” I snapped at her. “I’ve never had anyone have me take everything off before!”

She gave me a startled look – I’m not sure whether it was because of the tone of my voice or my revelation.

“No one?”

“No.”

She got down to business. And she was, indeed, thorough. The wig came off so she could check my scalp, presumably for skin cancer. “You’ve had considerable hair loss.” No shit; thanks for reminding me.

(And all those implements of destruction the nurse laid out? They were for a genetic female patient – the PAP smear and other invasive things doctors do that I wouldn’t have to worry about.)

She poked and prodded in places where I usually wasn’t poked or prodded, and her telling me to relax wasn’t making me feel very relaxed. For the most part, she found nothing wrong. The one thing I found concerning, though not unexpected, was that I have osteoarthritis in my knees. My knees have been creaky on and off for a while, especially the right one. I notice it when I ride the bike at least a couple days in a row. I kind of expect occasional aches and pains and creaks, especially being less than a year from 50. I feel the slight pain when I pedal from a stop or when I crouch down to pick up something, but it’s nothing to complain about. And hopefully I’ll feel even less pain the more weight I lose and the less weight I put on the knees.

But at this point, I was so pissed off at her treatment of me that I just wanted to get it over with. Hell, at this point, I was truly regretting ever having chosen her as my doctor. My responses to her questions became civil but clipped one-or-two-word answers, culminating with:

“Do you have any questions for me at all?”

“No.”

She told me I was ready for the next phase of the hormone treatment. I was to get another shot of estradiol, as well as a shot of depo provera; the latter I’d receive in the office every three months. It was to shut down my testosterone production. It’s the stuff they use, in huge doses, to chemically castrate criminals. For someone with a sex drive and testosterone level as low as mine, it wasn’t really going to radically change anything, anyway. At least I hoped.

She explained I was going to start giving myself the estradiol injections, 1cc every two weeks. She gave me a sheet with the name of the hormone manufacturer to call in Las Vegas; they would send me a three-month supply. If they’re not at cost, they’re certainly not much above it. For a girl on unemployment, that’s pretty damn good.

She also gave me a couple of copies of a prescription for needles I could pick up from a nurse at the hospital down the street from me, as well as a diagram of the safest places to inject myself, along with the locations of blood vessels and nerves that should be avoided. She also gave me a list of supplements I should be taking – a calcium pill twice a day (since my bone density is about to take a hit and I don’t want to end up with osteoporosis), an aspirin (to prevent clotting), a multivitamin (been taking them for years), magnesium. There was also a letter for me to carry in case I’m traveling and need to take my syringes on the plane with me.

Anyway, she finished with me, told me she wanted to see me again in three months, reminded me about the weight, and then left. No goodbye or anything. And certainly no hug.

I started to get dressed, and the nurse came in and gave me my two shots. She then showed me how to give myself the estradiol injections, a process involving a detachable syringe and two different needles. I finished getting dressed, stopped in the bathroom to fix my wig, gave my follow-up appointment card to one of the girls out front and got the hell out of there.

As I drove the 25 minutes or so back home, I was much more upset than anything. I certainly didn’t feel that sense of calm this time. It was another sense of “What the fuck am I doing?” and an accompanying dread. Just as I should have with my previous visit to the doctor, I should have left happy. Beginning the hormone treatment is a heavy-duty, A1, milestone event in my life. And she robbed me of the joy I should have felt.

I don’t expect my doctor to be my drinking buddy, my BFF, my shopping partner or theater companion. But I expect certain things. Decency. Courtesy. Respect. None of which I’ve received except in the stingiest of doses. Both her verbal language and body language tell me I’m not worthy of her time.

I chose her primarily, as mentioned, because she’s a post-op transsexual, and if anyone should have an empathy for what I’m going through, it should be her. Also, I trust that she knows what she’s doing with the hormones, and she came highly recommended. As she stressed to me on my initial visit, she has a master’s in biochemistry, and she was her own guinea pig when it came to formulating the hormone protocol she uses on her patients.

Besides, I can get the hormones at cost through her and get the guidance to go with them. Many trans girls go to clinics and get the hormones for dirt cheap and inject themselves without any guidance whatsoever, without knowing what they’re doing, and somewhere down the road it will all come back at them with a vengeance.

And goddammit all, she’s been there! She’s made the transition! She knows the experience better than just about anyone. I should at least feel I have a bit of support and understanding from someone who knows my situation.

Who knows? Maybe she’s like this with everyone. Maybe it’s just fundamental differences of personality – the dog sniffs your butt and decides it doesn’t like you and lets you know it. Maybe this is her twisted version of a hazing ritual. Perhaps she thinks, because of my generally pleasant nature, that I’m too lighthearted about this or that I haven’t suffered enough, and that I need to be brought down a peg or two. I just don’t know.

I still do believe she knows what she’s doing from a chemical standpoint, and she’s been straightforward about what will or should happen in the process and what I need to do to help the process along. And maybe that’s all that matters.

But if I weren’t so far along already – and unemployed and living in an area with so few options for physicians dealing with my disorder, and having to start the drill all over again with another doctor – I would consider ditching her. I need to know my support system is there and on my side, and after my past couple of visits, I sure as hell don’t know that. As it is, I don’t have to see her again until late August; we’ll see if she improves any.

There was no sense of calm after this second shot, as I said, but rather a lingering anxiety, atop the job-hunt anxiety. This is all a big waste, I started to conclude. But a funny thing happened along the way.

Sometimes, changes are so gradual that you don’t recognize them as such until you take a step back. Two weeks ago – a week after the last visit and a couple days before my birthday – I rolled out of bed and I felt an odd sensation of pain – nothing too sharp, but noticeable. It was my nipples. They were sensitive to the touch. My first overt physical manifestation. My boobs haven’t grown any, but the first signs of change could now be felt beneath the cotton of my T-shirt.

Also, I started feeling more bloated at night, whether I ate a lot or a little, late or early. The weight had begun its redistribution to my abdomen. If I ever needed a wakeup call, this was it. I don’t want to start my next life as an out-of-shape, middle-age housewife. I need to be a lot trimmer so that my belly doesn’t battle my boobs for prominence when the time comes.

And I’ve noticed, especially in the last two weeks, that my facial hair growth has slowed down considerably. What was once a day’s growth is now two or three days. Same with the hair on my torso. And my friends tell me my face looks so soft, both in complexion and features. One woman asked me last night if I exfoliate. Yep — it’s called shaving. Which is still a bitch because I always have to be careful not to rip my face apart.

And as a topper, the sense of calm returned very gradually. It took a few days, but once the bad taste of the doctor’s visit subsided, the calm started lapping at me like high tide, before I even noticed it. True, maybe my birthday had something to do with it; I had a much, much better time than my worst. birthday. ever. a year ago. I felt loved and appreciated and all that very good stuff.

But even in the midst of some heavy emotional turmoil and insecurity and uselessness most of last week, where I was trying to justify my existence and not really succeeding, I retained an odd sense of serenity and didn’t let the black mood entirely get the best of me. (That’s my next post.) I believe the lifelong chemical imbalance is finally starting to right itself.

And it was in this frame of mind that I entered the world of self-injection.

The small vial of hormones arrived a week ago Tuesday in a Priority Mail box, wrapped in bubble wrap and surrounded by newspapers – 40 mgml of estradiol valerate. Thursday I rooted through the crap on my desk and found the script for my needles and rode my bike the four blocks to the hospital.

Or so I thought. Turned out Community Regional Medical Center had shut down the hospital and moved all its clinical operations to some new buildings downtown, next to the main hospital.

So downtown I headed and finally found the building. But when I mentioned the nurse’s name and tried to figure out where she was, I got a couple of blank stares, a bit of garden-variety new-building confusion. I finally figured out where I was going, only to find out the nurse I needed to see had left early. Oh well, I got some exercise, anyway. I couldn’t help but laugh it off.

So back on the bike Friday morning, and this time, the nurse was in. I showed the woman at the desk my script – 14 each of 3-cc syringes, 18-gauge needles, 21-gauge needles and alcohol wipes. This time, I left with what I wanted.

I came home from hanging out at Revue, my hangout coffee shop in the middle of the Tower District, a little early Friday night. I was wiped out, and to be home early on a Friday says volumes. But I wanted to stumble my way through the injection process before bed.

The instructions I had received from the doctor didn’t include a recap of the needle assembly process, so I took a minute to remember what the nurse had shown me. OK, take the syringe out of the wrapping; unwrap the larger, thicker needle; screw in the syringe; stick the needle through the top of the vial; draw out 1cc; unscrew syringe; unwrap the thinner needle and screw on the syringe; push down on the syringe oh so slightly to get ride of any air pockets; wipe the area I was going to inject with the alcohol wipe.

Hmmm … easier than I remembered it in my mind’s eye. All done except for that tricky last step.

I found a spot in between the right hip and cheek. (I’m righthanded, so that was a logical place to start; I’ll shoot in alternate sides from here on in.) It’s where the nurse had given me my previous shots, and where I had gotten my testosterone shots from my previous doctor. I applied the alcohol wipe … then I paused.

Was I ready to do this?

I know people who are deathly afraid of needles; I’m not one of them, but I’m not comfortable with the idea. Maybe it’s too many images of junkies in films, on TV and in magazines – they make self-destruction look so easy. I can look at the nurse sticking that big one in the crook of my arm when I’m getting bloodwork done, deal with the pain, but I didn’t think I was ready to do it myself.

Well, thanks to a little skewered depth perception, I was more ready than I thought.

I relaxed my leg muscles so the needle would enter easier. I directed the needle on a perpendicular toward the spot, turning my head to the right and downward to look.

And then I realized – oh fuck! – I had misjudged: The needle was already in! Holy shit! And no pain! How did I manage that? I’m guessing beginner’s luck.

I pushed down on the syringe. Done. Pulled it out – no pain and hardly a pinprick of blood at the surface. Grabbed a Band-Aid from the closet and felt a strange sense of accomplishment.

I had injected myself. This is old school to a diabetic, but not to me – yet. And not too many transitioning trans people, either – many take their hormones in pill form, though it’s nowhere near as effective as the injections.

And so I continue to meander along on this crazy trip. I’m still feeling some of the unemployment/uselessness anxiety, but despite all that, the overall calm has stayed with me this week. I’m starting to see and feel progress, which makes the exercise-and-diet routine a lot easier. The last few days, I’ve been eating two meals a day, one of them cereal and fruit for breakfast and the other usually a salad. (There’s iced coffee and water along the way, too.) There’s more of a lightness in my step, and the bike rides are starting to get easier on the knees. I think I’m starting to like this.

If I can just learn to deal with my doctor – and, oh yeah, get a job – maybe I still have a chance to truly enjoy this wild trip of a lifetime.

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4 Responses to “I shot myself (and felt no pain)”

  1. Jackie Says:

    I admire your strength.

    Hopefully Doczilla will come around, if not, maybe you should share with her how you feel about your visits.

    I look forward to following your progress 🙂

  2. Colleen Says:

  3. Jay Says:

    Fran, just read your new blog. I’ve probably said this before, in an earlier comment, but it’s funny how for years I just read your music reviews & articles and just thought you were this guy who wrote for my local newspaper, and obviously had no idea of all the problems you had faced in your life, gender issues, feelings of depression and near-suicidal thoughts. It’s hard to know what the real person behind the Fleshtones and Lyres album reviews is really like, ya know? But now, through your blog, I have found out on a weekly basis the true Fran Fried. Obviously, not having gender issues myself, it’s hard for me to know what you’ve gone through all these years, especially now, but I do see myself a lot in your descriptions of periodic bouts of depression, loneliness and uselessness (as you know I’ve been unemployed awhile). Then, of course, the fact that we are both total music junkies. All this makes me realize that we all have stuff in common more than we think, if you only just look at the surface. People who scorn trans people or gays or other races or religions really don’t realize how they probably have more in common with these people they dislike than not. And their prejudice is based on the fact that they can only see what’s different about the other person, without looking at what common beliefs or traits they share.
    Also, this just makes me realize that behind a singer, actor, writer, or even your own family members & co-workers, you really don’t know what they are truly like when they are alone – what they are thinking, how they feel. This blog has given me a chance to see much more than the “guy” whose album reviews I always liked reading. Since I didn’t know you, it was easy to just think of you in terms of music, and not realize there is a real human being behind those articles, as is true with anybody you watch, read, listen to, etc.
    I know this really has nothing to do with the blog above, but these were some of the things going through my mind as I read it.
    As far as your doctor, she sounds like a real you know what, but at this point, you are probably better off keeping her and not telling her where to go. You’d probably just be spiting yourself.
    Good luck with everything. I truly hope this brings you the peace of mind you have been struggling to find all your life.

  4. leeah Says:

    Hey Fran, honestly, needles and shots scare the hell out of me. I can’t imagine…well, I’m getting an idea by reading your blog, what you are going through. But I wish you luck with the treatment. I hope you can bypass all the bad side effects…and stick with your cycling to get on the good side with your doc.

    Also, I have a show opening here in CT. If you are back in town during the show, call me and we can get lunch at the museum’s cafe…which is quite good. Hey do you have any journalist friends still hanging on to papers in CT? Please pass the info onto any arts/culture writer. Maybe we can get some ink.

    Wishing you best!!!
    love, Leeah

    Where Lies Beauty
    June 26 – Oct 24 2010
    Mattatuck Museum Arts and History Center
    http://www.mattatuckmuseum.org

    Opening reception
    Friday June 25th 5:30 – 7:30
    RSVP 203-753-0381 ext. 10

    Call and RSVP your party with the museum.
    When you come to the reception,
    at the front desk tell them you are
    friends of mine to avoid admission fees.

    Here a little blurp about it:

    http://www.cpbn.org/events/cultureconnect/where-lies-beauty-josephine-lois-livingston-mcmillen-exhibit

    Hope to see you!
    Leeah

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