It was a dull grey day at the end of January when I eventually got to fly to the appointment with the endocrinologist in Tenerife. Having a 10 o’clock appointment meant the only flight that was available to me in order to get there on time was the first flight of the morning at 8am. In order to make sure I made the flight I arrived at the airport an hour before, it’s a rare occasion that you are forced to wait for the security checkpoints to open. When they did it was straight through and on to the plane.
Taking off and climbing above the clouds in the early morning light was an experience, it helped immensely to reduce some of the nerves that I had been feeling about this trip, that had only been made worse by a weeks delay. The downside of the flight from La Palma to Tenerife is how brief it is, before you know it we were preparing to land in Tenerife.
Walking from the plane right past the baggage collection belts and winding my way through the throngs of tourists, I headed downstairs to locate the bus to the interchange, because in a great piece of logic, the tram system in Tenerife does not extend to the airport. This means taking a 5 min bus ride before I could change to the tram which delivers me right outside the hospital.
The next challenge was to figure out which of the many buildings that make up the university hospital was the one I needed to be in. When I had located the building, getting to the right place was easy as I knew which floor as that was on the appointment letter. The first thing when I arrived was being sent down to the nurse to be weighed and measured.
Then it was in with the doctor, most of the chat was going over my medical history, good job I had brought my initial report from Dr Reid and the surgical report from Dr Seghers, without these I might have had some issues proving that I had a trans diagnosis in the past. Some of his questions did seem intrusive especially regarding my sex life, however given the nature of the interview, it was understandable.
Then followed something that I hadn’t totally been prepared for, a physical examination, nothing particularly intimate. However I was on edge, when he said my blood pressure was a little high, and maybe it was due to being in hospital, I thought, “I’m sitting here in my knickers being poked and prodded and you don’t expect my blood pressure to be high”.
Once that was over and I was dressed, it was time to get the paperwork. First he wanted a full blood test to check my baseline hormone levels, a bone density scan to see what damage being off hormones has done to my skeleton. He also put me in for a mammogram due to the fact that my mother had breast cancer. He also gave me a copy of the contract I would have to sign to start hormone treatment, I have to sign this to say that I give consent due to the fact that technically the medicines are not licensed for what we are using them for.
With all this done I shall return on the 12th March and hopefully 12 years after arriving in Spain I will be back on HRT
When I first came to Spain back in 2007, I didn’t get a formal introduction to the Doctor as I think I was working at the time. So I didn’t get my current medication that I had from the UK transferred over, and I thought I would be OK. I’d been taking hormones since 1998 and I didn’t think that it was urgent to sort out right away, and I would sort it out later, well one thing lead to another and it never happened, even when I started to be treated for high blood pressure it I never brought it up.
A couple of years ago when I started to realise that I had slipped into a depressive state and started to take action to deal with it, I decided that as well as an antidepressant ( I initially started on st. John’s wort) I would try and take some thing that was as close to a hormone that I could get, I found something that was based on a soja extract. The combination of these two did help to stabilise my mood and make it a little bit easier to get things under control.
A few weeks ago just before I left for New Zealand I decided that I would approach the doctor and ask if she could put me back on hormones properly. At first she said that she would have to send me to the hospital so that they could do a ultrasound to check what was going on with my ovaries, I gave a chuckle at this point and explained that wouldn’t do any good, which got a blank look from the GP, So I took an intake of breath and explained that I was trans, etc, etc. She said she would give me hormones, but required a blood test first, This would have to wait until I returned as I was leaving in a few days and wouldn’t be back for about 3 weeks. So on my return I got the tests done and then went back to speak to the doctor, only this time I get a different doctor, and she said that she can’t do it and refers me to the endocrinologist at the central hospital on the island.
So I wait a few weeks to get a phone call from the hospital with an appointment, So at the required time I arrive at the hospital. When I finally get into the talk to the endocrinologist, she’s a little confused as to why I’m there, so I explain. It turns out that for some reason the original doctor totally screwed up the blood tests and referral it was down on the system as hyperthyroidism which is not right at all, and that there were no hormone levels on the blood test, only the thyroid hormone levels.
Then she drops that bombshell, that she can’t put me on hormones as a trans woman without approval from the specialist gender clinic in Tenerife so she sent them a referral. So once again 20 years later, I’m back on a waiting list for an appointment with a gender clinic.
This a typical thing across the globe with any form of trans healthcare, had I been a cis woman presented at an endocrinologist with these hormone levels, then I would have been on HRT right away, but because I’m trans I have to jump through the hoops like a performing seal once again. There is an expression of the trans broken leg where you go for treatment of a completely unrelated medical condition, but it’s gets complicated or made harder just you are trans.
So hopefully sometime in the new year I’ll get a phone call and then I can take a flight over to Tenerife and continue the next step in the journey. It will be interesting to experience the gender clinic process in a new country.