My Week of Abbreviations – LHR & HRT

[Notice: I do not receive any compensation for my opinions or mentions within my blog.]

My Busy Week

I never know if I am doing something correctly, or if I look at it another way, I worry far too much about whether I am doing something correctly. I worry over things because I was always taught to do something right the first time, but it was reinforced by physical punishment. I am over 40 years old and I am still reacting to the things done in my childhood. It’s odd, isn’t it? I had times where I was afraid during the war, I cried with one of my team members one night. It was strangely alright to cry wearing combat gear, it was an unsaid agreement that you console each other when the emotions got too great. I was a woman trying to act as a man, but real men also cry. Sorry, that was a bit of a deviation, as I was saying I was afraid during the war but it never matched the fear I had of my father and the punishments he might exact. So, though I made mistakes (being human) I strived to always do things right the first time. Now, being old and somewhat established, I worry about doing my transition right the first time. The problem is there is no “right” way to do this, only what is right for you alone. I say this because as I actually go through the steps for my transition, I don’t want to imply at any point that what is right for me should be right for you. Choose your own path, do what is right for you. Like love, sometimes transition is a long and winding path and sometimes you never choose to step upon the path. In my life, love and transition is indeed long and winding, but it’s the walk and not the destination.


I went to my second LHR appointment at Harpe Laser & Wellness. The three areas we are starting with are the “beard” which includes upper lip, the neck and hands. I didn’t have much of a “beard” even before I started, as you can see in the photo above (taken several years ago). I could only grow what amounts to a goatee.  After my first appointment, for a week or so afterwards, there was some bumping on my chin, where the hair was thickest and more densely packed. It went away after about a week as the hair worked itself out, coxed by my use of an exfoliating loofah. Now, after the second appointment, I have noticed a drastic decrease in growth. The hair that does grow back on my chin and upper lip is fine and not at all coarse like it was. Now I have some rough(er) patches but they are small and even after two days growth they don’t appear dark and rough. On my neck, there is barely anything which is good, though I still shave it. On my hands, the hairs have grown back very fine and almost invisible. I will proceed with the hands for another treatment, see what Lylla my LHR tech, recommends and then switch to my forearms.

Ok, so the second treatment seemed a bit more painful than the first. I think primarily it’s all in my head because I was bracing for impact, knowing it was coming allowed my head to perceive all kinds of pain and torture. But I know that the chin was not as bad, this time the upper lip and cheeks were painful. I can deal with pain, it is fleeting and I am getting so much out of this treatment. I still opted for nothing on my face beforehand, I know I can dull the pain, but it just doesn’t hurt long enough to justify pain cream.


I went to my first HRT appointment at WNCCHS, I was extremely nervous as I don’t like being in new places without a plan and knowing exactly what I will encounter. But even the security guard at the entrance was sweet and courteous. I told him what I was there for and he instantly modified the pronouns he used and told me where to go. At the check-in desk, the lady was nice and helped me get all my paperwork done, she used correct pronouns and my proper name. I actually didn’t wait long until I was seen by the nurse that takes my information and vitals. She had several questions as she checked blood pressure (normal but a bit elevated due to my excitement), and weight/height. They were standard questions but she also took the time to talk to me and make me feel at ease. I wish I remembered her name, but I was in that haze of “things are happening”. She was very nice and sweet, by the end I was sorry to leave her to go get my blood drawn. She took me back to the initial counter where I waited a few minutes before an older gentleman called my name. I love, love, love hearing “Elizabeth” yelled, across the room. I jumped up like I won a prize, “That’s me!” I was saying in my head. He led me to a bench to take blood, all the while making jokes, mostly about his advanced age. He was a cute old man with a sweet disposition. He never once used the wrong pronoun or name, despite I was there after work and had on male clothes. So, he drew blood and gave me a pink wrap for my cotton ball and led me out to the finance department.

Once at the finance department, the gentleman there also used the correct pronouns and name. He asked about my annual salary and other financial questions so that he could put them into the system. I believe because they use a sliding scale for charges. He went over the services they supply at the facility, I was surprised at the sheer amount of services these people provide to the public at little to no cost. Once this was done, I was alright to leave. This place, though it is a public clinic, put a lot of effort into putting me at ease and not treating me like I was on a conveyor going down the line. I really appreciated their care and commitment. The next day, I got a call to come in on Friday for blood work and my HRT meds.


I went back to WNCCHS about an hour and a half early. Yes, I was excited so I showed up for the appointment about an hour earlier than I usually show up to them. I went to the same check-in desk to find out that this appointment was in the main entrance, so I walked back around to the area I had parked. I went to the desk and they told me to take a seat in the slightly crowded waiting area, about 5 minutes and they were calling my name, “Elizabeth!” I again jumped up like I had won a prize with this big smile on my face. They took me back through a maze of rooms and put me in an exam room. A nurse came in and checked my weight and blood pressure again. She pretty much asked me everything the nurse had asked on Wednesday, but added a lot more information. She asked me about what I am looking to get out of their care, which I really appreciated. I explained that initially I had just wanted to start HRT and then get a referral to an endocrinologist in the area that specializes in transgender care. I told her that this doctor had recently moved out of the area so I was going to have to search around again. She explained that the doctor who oversees the transgender care at this facility was one of the best in the area and was up to date on the newest treatments. I told her that I wanted to include progesterone with my estrogen meds, one of the reasons for the endo that I had initially wanted. She said that they have no problem with that treatment scenario, which made me feel a lot better. She listened to what I wanted and then helped me plan a treatment that made sense for me. These people, they truly are good and kind and want to help those of us who are often marginalized. She told me that we would start off slow, make sure I am responding to the meds and then increase as needed without having to make an appointment. She had me read a few papers that explained the side effects of HRT, and I signed for consent to treatment. Right now, starting out, I will be on Estradiol 0.1mg patch and Spironolactone 50mg tablets. I told her that I wanted the Spiron to be temporary, that if I responded well to the lack of T, I wanted to get an orchiectomy. I like that we are on the same page and that my input matters in my treatment.

After this, she asked if I would be alright to take another blood draw so they could get a baseline Testosterone level. I was all for that, the more information we have the better they are able to help me in my treatment. So, she led me back to the front desk and I waited for about 20 minutes for the blood draw. It had gotten busy in the waiting area, so the wait times had gone up a bit. Still, the wait was not horrible and it wasn’t loud or annoying. They drew my blood and I was soon on my way back to the truck.


I had to run a few errands, then I went to the Walgreens to pick up my meds. I was disappointed to find out that they put my Estradiol on “order delay”, meaning that they have it but they aren’t letting me have it until they talk to my doctor. This sucked because it was a Friday afternoon, which meant I won’t get it until next Monday. I wasn’t happy, but there was little I could do, so I got the Spiron which they did let me have. I have a Walgreens app on my phone, so I keep looking at it like suddenly my Estradiol will suddenly become available.


I will attempt to not post repeated evaluations of my HRT month-by-month. I know this can get monotonous, so what I will do is update in 6-month increments. If I see some definitive changes earlier than this, I will of course include it in my normal posts, but I think that 6 months is a fair timeline for HRT which can be slow to make changes for most people.

[ WNCCHS is a private, non-profit, tax-exempt corporation based in Asheville, Buncombe County, North Carolina. They provide a LOT of services to the public, not the least of all, transgender care. If you would like to donate to Western North Carolina Community Health Services, click HERE ]

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