It's been a few days now but I'm still thinking about the appointment at the gender clinic.
I'd already been off estrogen 2 Days by that point, and was not having a great time of it. Since the prescription ran out so close to the appointment they wouldn't fill it. Still, I was there, and at least at the time I thought by the end of the day I would have estrogen again, so my mood was improving. The nurse took my weight, the same 240 lbs it's been for a decade, give or take, even HRT didn't shift it. It's like a groove in a knob, it wants to go back to that number every time and I haven't really been in a place to fight with it anyway. No, let's do the blood draw at the end, and could I have a snack to get my blood sugar up? I didn't eat much today.
I made a snap judgment, a poor one, when the two clinicians come in. One sits down, introduces herself, and introduces the younger lady standing by the door, indicating that she's observing today. I assume the younger one by the door is a student, and the older one, sitting at the desk with my chart, is the teacher. I left my heavy work hoodie on the second chair in the room, and I offered to move it so she could sit down instead of standing by the door. She declines, saying she's been doing enough sitting today and she wants to stand. Fair.
There's a little bit of banter, I have some minor questions, but overall there's not really much new to discuss. May will mark 6 years of estrogen and 4 years of progesterone, and if anything exciting was going to happen, really, it's happened already. Towards the end, they're running through the usual questions that they ask, and when they get to a question about headaches, I say that there has been a minor change there, that I feel like I'm getting more migraines than I used to.
There's a shift in the room, some change in demeanor and perhaps body language in both of them. The one sitting down asks me follow up questions. Yeah, the vision in my left eye will go blurry and my brain will get kind of foggy when the migraines are about to hit, I guess they call that auras? And I get really sensitive to light, and most of the time I lay down, and—
The one by the door cuts in, and fast. It's just short of a verbal dressing down. The migraines in combination with my diabetes and perhaps one or two other things she sees that I don't mean that I am definitely at higher risk for blood clots, and they are switching me to Patches immediately, unless I have an issue with that, but if I have an issue with that, I've literally have to sign a waiver that says we went over this. She is quick, professional, and that right kind of mildly forceful most doctors have to be to make sure patient Gets the Goddamn Point. Despite where my mental health is lately and my reckless impulsivity, I do in fact very much like being alive, so I immediately tell her I'm 100% for this and I'm not going to put up any resistance whatsoever.
And this is where I realize I made my mistake an observation. The woman standing by the door is not observing as a student, she's observing as a teacher, and the second she saw the signs she needed to, she cut in like a bostonite changing lanes. The older woman seated closer to me might have more experience in General Medical stuff, but she's probably new to working at a gender clinic, and the woman standing by the door is an old hand. She's very clear about what I need to do, she instructs her Protégé to schedule me for a follow-up in 3 months instead of 6, leads the remaining conversation, and sends me on my way. The only reason I still don't have any estrogen is because my insurance is raising a stink about the prescription changing forms. I can't borrow off either of my partners, because one takes pills and the other takes shots, and both are in that "not safe because higher risk of blod clot" category.
I'm still feeling very much the fool for misjudging both of them, and it's clear to me that I've still got biases to unlearn, which is a constant process and something that never stops for any of us. It also made clear to me very quickly that this is an actual medical concern, one I'm likely going to be dealing with the rest of my life. I'm a week out from when I started rationing my estrogen, realizing that I was going to come up short within a matter of days, and if I get to tuesday without getting it refilled, it'll be a week of no estrogen whatsoever. I had an orchiectomy, so I have to have the estrogen, it's the matter of health and safety at this point. Hopefully this will all settle soon, but it's a clear turning point in my life, a notable event that I'm going to be thinking about for years even after I've forgotten about how shitty I feel without the estrogen.