(EDIT: I AM STILL ACTIVE & ABLE TO ANSWER QUESTIONS. I know a shit-ton more than I did 5 months ago and if I don't know something I can ask on the Gender Bridge or Trans and Intersex NZ FB groups for you. idk if this post is archived but you can DM me and I'll respond & then add it to this post)
(Update 25 July 2020: Lena's HRT got through customs - only two people incl. me have ordered so far and both got through today - took 2 months. Payment is via sendmoney24.com)
(Update 26 July 2020: I got progesterone, scroll down for details)
so this is my experience, with as many details I can remember. i am a binary(ish?) trans woman, so obviously my experience will be different but they're apparently really good with gender diverse & non-binary folks too. I was also over 18 when I realised I was trans so if you're younger it's probably going to be very different.
- I told my GP mid-April that I was trans and wanted to start HRT, she asked me for my preferred name (but actually updating my name in their system seems to be a different process that might be harder, I will ask her about it next time), and then sent in a referral to Auckland Sexual Health Services. if you're at uni, GP appointments there cost something like $20-25. something I didn't do at this point was reach out to local LGBT orgs & add myself to FB groups in retrospect I should have done this because throughout the whole process I felt really alone. either that or finding a therapist / counsellor to confide in. also ask your GP for a blood test form for your hormone levels so you have a baseline (ASHS will test them later on but you can't see it)
- getting an appointment with ASHS took about 3-4 months. they will send a text to your phone 1-2 months and give you a list of possible appointment dates, then a confirmation text 1 month before the appointment asking whether you still want the appointment. spaces are really, really limited.
- my appointment was in Greenlane, & with Dr Jeanie Oliphant. if you can't get a lift there look up multiple bus routes in advance, I very nearly fucked this up & missed my first appo.
- in the first appointment - which like everything else is free - they will probably 1. give you a blood test form 2. ask if you want to freeze sperm 3. ask you some general questions about your sexual history, mental health background, how you experience being trans, etc., 4. discuss some possible hrt options 5. give you some forms to complete relating to fertility preservation
- then they will schedule an appointment with a counsellor,. mine was in mangere which was a significantly long drive. they will make you do two appointments with the counsellor, the first 1 month after the 1st appo, and then the second a month after that. if your appointment is in the morning they might open 15-20 mins late, but maybe that was just the one time.
- honestly i kind of did the 'cis baby talk' thing where i described my experience as a trans woman in the most unambiguous & stereotypical way possible to maximise the chance i'd get hrt, but in retrospect that was probably unnecessary. they're working on an informed consent model so don't worry about it i guess
- you shouldn't be worried about how the counselling session will go, the office is kind of cramped & weird but it was very non-judgemental & the guy made it clear to me that the point of the sessions was evaluating mental health & managing expectations around hrt - not "decide whether or not she can have hrt". just be prepared to talk about yourself
- the actual date I got the prescription for HRT was late December, so if you haven't processed your thoughts about your gender yet & you can't afford to go private then get a referral from your GP ASAP, do the processing in the meantime, & if you decide against it you can always cancel the appointment. this wait-time is shorter than other countries but it felt like a stupidly long time, especially because I hadn't found an antidepressant regimen that worked for me yet.
- T-blockers: they offer you Lucrin injections, Zoladex implants, or cyproterone tablets. I went with the cyproterone (12.5mg a day), but I want to switch to Lucrin since it's apparently the gold standard.
- estrogen: they offer you progynova tablets and estradot patches. they will start you on 50ug/day for patches and 2mg/day for tablets. push for higher amounts one month in, prescription guidelines say to start you on the lowest amount. with progynova tablets you can suck the coating off and dissolve it under your tongue which has 6x higher availability, but Dr. Powers' presentation said to start by taking it orally (swallowing it) to mimic the higher estrone (E1) levels (not E2, estradiol which is the pills & the patches) that girls have when they start puberty. I'm trying this
- you can see the max amount subsidised here: https://www.pharmac.govt.nz/2020/02/01/Schedule.pdf. for estradot this is 100mcg day, two patches a week. for more of that, all I know is that the Greenlane Hospital pharmacy charges $55.10 for 24 (3 months supply = max they can give you) but other pharmacies charge more or less. You can google "pharmac estradot" for the pharmac cost, all the pharmacies mark up from that. for progynova you can get theoretically as much as you want, but the 2018 Guidelines for trans healthcare only go up to 6mg, but you can argue for 8mg by just saying you want to try it out - if you're young ask about the risks of deep vein thrombosis, that will kind of force your practitioner to do a mental risk/reward calculation that comes out favourably for you.
- if they schedule another appointment in 3 months, your prescription probably won't last until then. Dr. Oliphant told me to text Jove the fax details of my local pharmacy or clinic to get a new prescription.
- install a pill tracker alarm app to your phone to keep track of when to swap patches/take pills.
- a month in ask your GP to give you a blood test. my e levels were super low & I wasn't absorbing anything from my patches (one 50ug/day patch, rotated every 3.5 days) when I placed them on my stomach, so I used micropore surgical tape I'd ordered from Aliexpress to tape down the edges securely (otherwise you get a lining of lint and hair and shit idk) & placed it on my bum instead of my stomach, which lead to less wrinkling. judging by my better mood this seems to have worked but I'm getting another test to see whether this made a difference or whether I'm just a non-responder to transdermal patches (???)
anyway this is where I'm at right now. I'm planning on switching to progynova, taking 4mg divided up through the day to start off with, and switching to a private provider. list here: https://genderminorities.com/database/medical-surgical/transgender-healthcare-providers/
on the off chance someone else living in nz looks up what the process for hrt is like in new zealand i hope this helped & i can answer any other questions
edit: 15 june update with info I've collected together Progynova dose:
I've been on progynova for like...4 months now. Got my dose increased to 6mg instead of 4 with absolutely no issue, didn't have to pay anything.
Since I was also on boron it was more like 9mg? or 10mg? Dr Oliphant wrote a paper on trans healthcare that suggested going above this is unnecessary so I'm imagining I'll get resistance if I try to push the dose higher, but I'm planning on asking since there's no harm. Switching to sublingual:
I switched to sublingual 5 days ago (and I should've done it earlier, my boobs were stuck at tanner 3.5 for a while). 1mg at 8am, 12pm, 4pm, 7pm, then oral at 10pm since I cbf. Someone recommended to crush them into powder but I found that unnecessary. Split them in two and it takes five. Pill cutters from Aliexpress are less than $4, they're a life-saver. Once you suck off the coating, they dissolve completely under your tongue in 14 minutes. The first time I did it, I swallowed a lot but it was a learnable skill and the longer you avoid swallowing the easier it becomes, what I do now is: swill water around in my mouth for 30 seconds to stop saliva production, don't put anything in and try to stop swallowing reflexively for 2-3 mins which means you'll get the reflexive swallowing over and done with, and then put the pill in and start doing ocused in-out deep breathing (I'm sure there are more tips, look up "how to stop reflexive swallow"). Since I got diagnosed with ADHD ritalin has made this 100x easier for some reason, could be partly salivation inhibition as a side effect, could be better focus and self-control. Maybe neurotypical people find this whole thing much easier. Overall changes:
Okay I'm getting Boron:
Obviously this is still experimental blah blah blah etc. etc., I got boron from iHerb like 4 months ago, I compared around 5-6 different sites with different shipping policies and a LOT of different brands and the cheapest per unit was [this](Now Foods, Boron, 3 mg, 250 Capsules) at 7.7c/capsule, realistically 23c a day (9mg was the point at which I got really noticeable breast tenderness w/o changing my e dose at all), currently it's Source Naturals Triple Boron since the other one is out of stock. I considered buying boron from Alibaba (USD$23/kg) which is literally a thousand times cheaper but that requires talking to people and negotiating and shit. Maybe a long-term option. If it goes well I will list the supplier I ordered from. EDIT:
so according to this
post, boron doesn't do much unless you're taking a lot of e already. check out their chart Progesterone:
So I'm on the Genderbridge FB group (really
should've joined ages ago) and there are at least two people who have managed to get utrogestan prescriptions from their GPs. A few more with progesterone creams. My GP said go to the specialists and the clinic said no. So I'm going to find someone else and if that's not possible I'll try get progesterone creams since amazon4health says 90% of unauthorised pills get caught. Not sure about vials. UPDATE ON PROGESTERONE:
Oneroa Accident and medical ctr gives out progesterone. Make sure to speak to Dr Michael karetai or Dr Isla Karetai or Dr Margaret Karetai. They do phone consultations, $70 if you're not registered and you're over 18, details on their site, much lower if you have a community services card. Further update:
Dr Margaret Karetai is the absolute best. If you have done the research, then she will trust you. Be clear about exactly what you want. She is very nice and I got utrogestan 200mg and bicalutamide 50mg!!!!!!!!!!
Note: pharmacy costs vary a lot, ask for your utrogestan prescription to be faxed to your nearest Chemist Warehouse (cheapest option) since it's not subsidised. The cost is here: https://www.chemistwarehouse.co.nz/CWH/media/Documents/CWNZPrescriptionPricelistNov2019.pdf
right now it's $24.99 for a pack of 30 100mg pills. If you're doing Dr Powers' 200mg regimen this comes out to $600 a year. Kind of steep but this is what I'm doing until I've finished negotiating with Alibaba suppliers and getting the powder tested at a harm reduction place (forgot what it's called.)
If I find a good Chinese supplier, I will do a full write-up as another post, with instructions and prices & link it here. DIY options
Regarding SRS and other surgeries
- According to Amazon4Health, 90% of pills don't get through Customs.
- You can get estrogen implants now, imported from Adelaide, there's at least one GP who does them. Ask on one of the trans FB groups. Comment for more details.
- You can get injections legit if you have a letter from your GP. Comment if you're interested, I can give you the whole procedure.
- The two non-prescription EV sources I've interacted with that ship to NZ are Lena and otokonoko. Otokonoko is pricier but their shipping is faster and they do refunds if it doesn't get through customs. However, they seem to only take bitcoin & other crypto at the moment which is tough since NZ's regulations make it difficult to get bitcoin, none of the major markets allow NZ. Might have changed since I last tried 6 months ago, though. DM me your results so I can add them here & expand our pool of collective knowledge
Regarding electrolysis and laser
- Orchiectomy - 100% free, and according to other people the waiting list is around 3-6 months long.
- SRS - probably better to get it done privately in Thailand or something, the current 'waiting list' is 15 years long.
- Breast augmentation is regarded as "cosmetic"
- If you're nearby I recommend Julie Martin for electrolysis. Electrology is kind of expensive, for her it's $90 for a 1 hour session if you can tolerate up to that much and it doesn't go that much lower. Apparently another option is combined electrolysis+laser, you start with laser, wait 6 wks, go to an electrologist and get whatever's left cleared away. Some laser places are doing a 50% discount right now, and they cheapen it if you pay for all your sessions at the same time upfront. Not sure, this might take longer overall, not sure about permanence.
- I'm using a home IPL kit for body hair, brand is Bosidin.
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