I’m not really sure what to really do in this situation, so I’m trying to reframe it in my mind. So the butterfly shirt will now become my motivation:
Panel 1:
Sam: (A person wearing a beige, collared shirt, and a bright blue vest, who is facing the viewer, but looking to the side. Eyebrows are raised and pushed together, eyes overflowing with tears, and mouth is open, with slightly downturned edges. One arm is bent up at the elbow, holding a phone to Sam’s ear.) The endo said I can’t go on T because my BMI is too high. I need to lose 9 kgs.
Panel 2:
Joe: (A small floating head with lowered eyebrows, which are pushed together. Mouth is open, with slightly downturned edges.) Darling! The BMI is a horrible, arbitrary weight indicator that is sustained by insurance companies to hike up their rates. It doesn’t take into account the diversity of body types, bone structures, muscle masses, or healthy lifestyles. It’s a completely flawed nonsensical way of looking at your health.
(At the bottom of the panel, are the words:) rant-sized panel
Panel 3:
Joe: (A small, floating head, with raised eyebrows, which are pushed together slightly, and an open mouth.) You’re awesome and beautiful, and I think it’s damaging that he would use your weight to control your wellbeing- surely triggering body issues is a really damaging practice? It just seems like it’s horrible gatekeeping. I mean they don’t tell cis men that they’ll give them testosterone blockers if they’re overweight. I’m sure you can just switch endos if you need.
(Below the panel are the words:) rant-sized panel
Panel 4:
Sam: (A person who is facing the viewer, but looking down. Eyebrows are raised and pushed together slightly, and mouth is open, with slightly downturned edges. One arm is bent up at the elbow, holding a phone to Sam’s ear.) I know, I know. But I DO miss wearing my favourite butterfly shirt. Maybe I could just lose enough to fit into that again. That’s almost as empowering as being on T, right?
Yay the rant-sized panels are back!
Hah, yes the situation called for it.
Joe always seems to be full of excrutiatingly specific and helpful knowledge. How does he do it. Weightloss can be fun? The way I think of it is, “I lack control over any and every aspect of my life, so I’m gonna’ try and ruthlessly administer this one portion of my being all I can even though I really don’t need to and it’d be best if I didn’t”. It’s actually a very unhealthy mindset to have but uhh.. From a 3rd person British comedy perspective it’s pretty funny? I guess? Well that’s the way I see it in my situation.
Haha, oh dear – funny and also a little heartbreaking. I will make sure to buy you some sort of yummy treat when I’m next in Wellington
Dr Rick? It seems to be his pet peeve, although I really do need to lose weight I just like eating my feelings and stuff…
Yep, Dr. Rick indeed. Are you seeing an endo at the moment?
Whatever way you look at it for the sake of your self-esteem. You’ll look great and feel great once you’re back in your fave shirt again! ‘Nuff said. 😉
It’s true, it’s a LOVELY shirt
ugh I hate this shit I had a similar thing when I went on Estrogen, suprisingly i lost HEAPS of weight after HRT cause i was no longer drowning my sorrows in gravy and cake… I wanna give that adorable comic guy a hug and you too!
Aww thanks! Yes, I do think there is definitely a level of feeling yuck about my body and so feeling yuck about looking after it…. so maybe I can begin now, and pretend I’m on T anyway.
that might help… I know Ryan already suggested it, but eating low GI is amazingly helpful I’ve lost 20kg in the past year and I wasn’t even trying… I was just trying to be healthier! If you ever need to talk about Trans-body issues I’m hear and I’ve done more than a few workshops
err I meant I’ve ran more than a few workshops, not that I’m qualified cause I’ve gone to workshops
Coool, sounds like a winner then – I’ll looking into this whole GI business. I’d definitely be keen to have a chat about it some time thanks!
That’s so horrible, and unprofessional, and a million other shitty things, and I’m so sorry to hear that you have to deal with this. Joe is awesome, and so are you; don’t forget that! I will definitely be thinking of you, and hoping that you find a good resolution for this very soon. I know that there will be endos out there who will not have such body-policing requirements – if they exist in Perth, Western Australia (my partner’s BMI was above the “healthy” range when he started transitioning, and quite possibly still is), then I’m certain they can exist anywhere.
Yes, I think it’s just about finding where they are… and how much they cost.
Whoa, guys, easy with the accusations of body policing. I wasn’t there, and for all I know this endo is a total body policing jerk, but that doesn’t mean that all medical decisions made based on a person’s BMI are bogus. Yeah, BMI is a flawed metric, but I’m assuming the doctor has examined you and would have noticed if you were a body builder or were unusually tall or any of the other things that throw off BMI.
I’m sure you know androgen therapy has several cardiovascular risks (higher LDL, abdominal obesity, insulin resistance, etc.)-trans men have to be really careful to not increase their chances of a heart attack or stroke! Doctors have good reasons for wanting their patients to not be overweight, they don’t just say these things to be mean to people who don’t look like movie stars.
Ha yes, I’m not a body builder by any means, but I don’t think I’m incredibly overweight either. I guess it just seems like being on T would help with depression, bad eating and lack of exercise. Not being on T makes it worse. But maybe that’s his logic – that if I want it bad enough I’ll lose the weight. I’m not really sure.
maureen, i think most of us have done the homework and are aware of risks relating to heart attacks and strokes – but i agree, it’s good to be aware of these things, and good to find a doctor who is able to communicate these concerns without bullying us. in this case, i can assure you that the doctor in question does not communicate well and is unreasonably attached to the BMI as a gatekeeping method for transguys.
i have a wonderful GP and i think it’s important for us to find medical professionals who are supportive and supply us with useful information communicated in a body-positive, trans-friendly, gender-affirming way.
we live in a fatphobic, transphobic world. those two factors combine to cause me a lot of pain (i don’t want to speak for anyone else) and when an experience with a medical person (or any person really) triggers that stuff, i have huge reactions. but i don’t disregard the advice of medical professionals who i trust.
i don’t personally believe the BMI is useful, but i agree that considering all the factors relating to someone’s health is a good idea. however, some of the factors that i think are important are frequently neglected. for example, testosterone for transguys may counteract depression or dysphoria or other weird-sad body-feelings, which often leads to an overall healthier body/lifestyle/person. so preventing access to testosterone often seems to me to be more damaging than helpful when it’s clear that someone will benefit in this way.
okay, rant over. i know i’m coming from a very personal-pain-place, both from supporting sam in this process and from my own experience, and i don’t mean to attack you, maureen. this stuff brings up a lot, for me.
sam: i love you.
No attacked feelings 🙂 This endo clearly brought this stuff up in an insensitive way that made our hero feel awful so another care provider is prob a good idea.
I guess what I meant is that if a piece of health advice is based on a person’s BMI, it’s not necessarily invalid.
Simple advice.. go to another specialist. If you are seeing Rick, remember he’s not even an Endocrinologist, he is not a specialist in this field and on top of that he is the only person who has this BMI bee in his bonnet. All other specialists appear to have the same opinion as awesome Joey!
Yep , just working on who to see instead, and how much it’ll be. Got a few leads so far…
I had a similar deal going on Estrogen, with me though it was getting blood pressure under control. Its what we have to do to be who we want to be sometimes.
Yes, indeed. It is helpful to know that you got there. Lovely to see you again last night too!
It’s so random what they say. I was at least 98kg when I started T. They never mentioned weight at all. You could try the low GI diet, I lost 5kg in a couple of months, and am still on it keeping the weight off. It’s a really easy lifestyle change, just learn which foods are low GI and stick to those. I reckon I eat about half as much as I used to.
Hmm yeh – I’m 89kgs but only 1.65m tall, so I think the height thing is making things more difficult. What’s GI (ignorant about food stuff)?
as others have said BMI is his tool for deciding you are healthy& will not suffer any detrimental health impacts.
Best way with him is to comeback to him with a rational (non emotional) fact based argument on why he is wrong – he will listen to this .
Ok cool, I will see if I can find some resources
I would definately go for a second opinion with someone who is going to weigh up both the risks and benefits, and empower you to be an active part of that decision making. Ultimately when you start T under an endo you should be closely monitored so that you would be well aware of how it is affecting you. There’s nothing more motivating in life than being comfortable with who you are in your body and wanting to make the most of it. Prolonging a already challenging wait is hardly going to inspire wellbeing. I don’t think they realise how long it takes some of us to get into their office and how overdue and overprepared we sometimes arrive. Don’t be discouraged, but on T you’re unlikely to get to wear the butterfly shirt for long, even if you do lose weight first. It could make a great piece of wall art, inspiring other things from a different perspective.
Ha yes – it’s weird that the moment I finally feel ready enough is that when they start saying “no, no, just wait…”. Sad about the butterfly shirt – I didn’t think of that 🙁 Wall art it must be!
Hey roostertails; GI = Glycemic Index (how much sugar is in a food and then the impact that sugar will have on yr body). Anything below 55 on GI indexes are good foods. http://www.the-gi-diet.org/glycemicindexchart/
I’m a diabetic genderqueer who’d love to have the perfect male body but being the diabetic i am there tends to be quite a bit of sugar craving and quite a bit of weight gain…which sucks. But when I have stuck to low GI foods I feel much better (said with a smirk on my face).
Your endo sounds crap dude – go for the new one I say. Maybe pay the new one in comics instead of cash?
…ammendment to be made: ‘perfect male body’ – in terms of my personal idea of perfect male body. ha ha.
WHOA HELLO BODY POLICING FAT HATING DOCTOR. what a fucking shithead is all i have to say about that.
I agree with Evan (there is a first for everything)…but I also think the Dr’s rational is flawed in yet another way that hasn’t already been mentioned…When you go on T yes it increases all the heart risk stuff but it also builds muscle. Muscle burns fat, so in my understanding wouldn’t it help” you to “lose” weight??!! You might not actually weigh much less but it would be muscle mass not fat, and if YOU did feel you wanted to weigh less the fat would be easier to get rid of. T totally changes the way your body uses,distributes and needs fat…I think this DR really is focussed on a non issue if he actually thought it through properly. If your cholesterol was through the roof or something he may have a point, but Im guessing given that you eat a vegetarian diet it’s not, cos thats pretty hard to achieve without animal consumption. But even if it was you would have a valid explaination RE: poor diet, eating, bodyimage all are connected and you could argue that if you feel better about yourself and in control of your life/body you are more likely to take “better” care of yourself.
I don’t think you should lose weight just to jump through this Dr’s flaming hoop, it just reinforces to him that he is right. But I also totally understand the need to just do what you have to, to get what you need for you to be ok with you.
Good Luck, My thoughts are with you.
Any ways I’ll jump off my soap box now, the shirt I am totally in love with and I think it would be wasted as wall art…I think I could find a better use for it if at some stage in your future you are unable to wear it ;-)…AHH that feels much better I didn’t totally agree with Evan after all.
I did read this! And then forgot to comment back!
I definitely think the doctor’s rationale is flawed – but when I think about arguing with him about it I start thinking about how I’ll probably cry. And since he seems to have a weird/stereotypical definition of what a man is (he told me I didn’t shake his hand firmly enough on our first meeting, and that “if I want to be a guy, I’ll have to do better than that”) I’m not sure that he’ll listen anyway. Blerggh.
Yes, vegetarian diet it’ll be from now on I think.
And you will be the first to receive said shirt, for any variety of uses that you want, if the T makes me into a huge muscle man (assuming that I will eventually get on it).
It was awesome seeing you all this weekend! Safe travels back home.
That’s a load of bollocks! On the plus though, that is a very nifty shirt and it should be worn with glorious pride.
My therapist told me I wouldn’t be able to have my chest reconstructed if I didn’t work out muscles in my chest and arms. My surgeon laughed his face off and said that was irrelevant but I’d probably look good at the beach with a six pack. “Professionals” are nuts sometimes.
Oh weird – I think I’ll just have to try and save up for a second opinion and hope that the next dude isn’t as strict
What a load. I mean sure, health risks are something to keep in mind, monitor, and if possible work to reduce – but I know plenty of people with what would be considered a high BMI begin T. Most famously Chaz Bono (not that I know him, he’s just a very public example), and from his documentary both he and his doctors are aware of the risks but must see the value in his starting. I’m sorry this is being used against you as a gate-keeping measure, that’s so very unfair. It makes me angry you need to jump through this hoop, I hope you can reach a solution at some point.
Yeh – it’d be cool to take in the doco of chaz to the endo and tell him ‘look chaz is at least twice the size of me and he’s on T, why can’t I?’ blerrgh. Anyway, we’ll see what happens. I think I’m mostly frustrated bc it took me such a long time to decide I was ready for T, and now I am I can’t get on it. Quite annoying.
I find the BMI has a too-low threshold for overweight, making you “healthy” at lower weights than before, and “overweight” at lower too. I’m a bit on the lumpy side but not in the least bit fat, but apparently I’m quite overweight.