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Dr. William J. Powers - Biological factors of gender dysphoria and transitioning

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OzGirl

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I very much disagree with Allie that Powers id the most knowledgeable authority in transgender care! The UCSF worked with transgender subjects already prior to powers becoming a physician. If you want to have some scientifically based information, you can find it in their research papers.
I am in no way connected with the UCSF, and were never involved in any of her research. But as a medical researcher, I hold their work up very high, and would always fall back on it for information.


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Linde

Linde, I didn't say Powers was the most knowledgeable or experienced, just that he is both knowledgeable and very experienced. I still haven't heard of a doctor with more experience, but I don't think it is a competition either. It was about recommending a source of information.

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Allie
 

Linde

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Linde, I didn't say Powers was the most knowledgeable or experienced, just that he is both knowledgeable and very experienced. I still haven't heard of a doctor with more experience, but I don't think it is a competition either. It was about recommending a source of information.

Hugs,

Allie
Allie, and if it is for a HR department to build policy on, recommend a scientific based approach to the transgender situation in a company.
We have heard a lot about Powers, because he is very much out in the face of the public, while other physicians may not want to do that much self marketing.
I don't say that everything he does and promotes is bad, but some of it seems not to be scientifically tested and found to be good and reliable.
I am a medical scientist, and I'd rather go the science route to solve certain medical problems.


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LInde
 

Lexxi

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Remember Linde...being an endocrinologist isn't the end all-be all for trans healthcare. They don't know everything. In fact I believe you call your first endocrinologist "the quack." There's a reason for that...he/she didn't have the first clue how to treat a trans person. So whether or not Dr. Powers is an endocrinologist or not, he has tons of experience working with trans patients and is VERY respected among us. Heck you were the first person that told me about him and how effective his "method" is.

That's just my two cents.
 
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Monica

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Who else is out there educating about trans people the way his power point does? I find it highly respectful of trans people and their care. Is he a bit off beat? Yeah, but sometimes it takes trying something off the beaten path to acquire a better way to do things. I agree Lexxi, so many endo's are by the book, unwilling to be flexible.
 

Michelle_P

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Powers may be a bit unusual, and parts of his approach seem to be more anecdotal than based off large scale research, but there hasn't been that much large scale research.

My first endocrinologist, when I was starting Hormone Replacement Therapy, tiptoed into it, starting me on spironolactone to suppress testosterone (which was already low) and no estradiol until a few months later. Even then, she targeted 50 pg/ml, which she thought was perfectly reasonable, the level she would expect to see in any 62 year old woman. *SIGH* She was considered to be "experienced" with transgender patients, too.

About 8 months in, I had my care transferred to the HMO's gender clinic and my dosage was adjusted, targeting 100-200 pg/ml. That worked better. I felt better, more energy and happier.

There's overlap between good endocrinologists, endocrinologists with transgender patients, and doctors or endocrinologists who can provide good, effective transition care, but they are not a single set of people.
 

Katie

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I applaud Dr. Powers' willingness to color outside the lines. I realize it's risky, but I assume that his patients consent to trying new and untested treatments. Medical history is full of high risk experimentation that resulted in positive things. Look at Edward Jenner, injecting an otherwise healthy boy with cowpox and then infected him with smallpox. The boy did not develop smallpox. The result was proof that a vaccine for smallpox could be easily obtained and administered to eradicate smallpox.

Powers may be a maverick in his field, but he is willing to try new things and bring progress in a field that has lacked any major development for years. Trans healthcare hasn't changed much in a long time. The things being done ar the clinic I go to are essentially the same things that were done for trans patients 20 years ago. And they are considered to be one of the top clinics in the nation for LGBTQ care.
 

OzGirl

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The bottom line is that there simply is no formal transgender qualification, and I see so many reports of endocrinologists, including mine, who have very little real understanding of trans needs. From my own experience I know that this lack of knowledge can be life threatening for trans patients, so with the void of formal trans qualifications, experience is the next best thing we can hope for. I fired my endocrinologist, who claimed to have trans experience, and have put my transition care in the hands of a gynaecologist who is trying to specialise in trans care. For the first time since I started HRT, my levels are at the target area for transitioning. My dysphoria is under control, and I am feeling great.

My worry is that if a formal qualification for trans care was established, it would possibly be developed by the same people who errantly think they know what trans people need, rather than someone like Dr Powers who has made the effort to find out and put trans needs into practice.

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Allie
 

Monica

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My worry is that if a formal qualification for trans care was established, it would possibly be developed by the same people who errantly think they know what trans people need, rather than someone like Dr Powers who has made the effort to find out and put trans needs into practice.
Well put Allie! We don't have a lot of studies done with trans people, and there isn't an extensive track record either. Do we want someone who is ultra conservative making the decisions for us? I look at his presentation and I believe this doctor cares. We don't want reckless of course, but we do want increased knowledge from someone willing to listen to their trans patients. Aside from the medications discussions, I found his teaching of others to respect the validity of trans people very inspiring. On a personal note, had I known about what he says about Spiro, I probably would really questioned the conventional wisdom of taking Spiro. I doubt I would have taken it.
 

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You could argue that we already do in WPATH.

Agreed! Kaiser endocrinologist tend to be apprehensive and follow WPATH timidly. For a person with less than favorable health, suspecting my new endo would be overly apprehensive with me, I armed myself with Dr. Powers work, and other documents suggesting positive effects of HRT. Perhaps it only worked to convince her that I wasn't going to go away. She was, however, agreeable with most of the documentation I presented to her. I got what I wanted, and feel far better, physically and mentally, for it.

I have to say no to ultra conservative. But definitely monitored, and paying more attention to what the patient is saying/feeling.
 

Rachel

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I forwarded the power point from the HR site to the Director of our Gender Clinic.

I gained access and a copy of my genome, 930,000 lines. I have that in excel now and at home.

I have several research studied that link the 17B hydrolalate 1, 2 and 3. They specifically correlate the enzyme to cis and trans and have suppression effects.

The enzymes allows T to DHT (reversabel) and E forms is suppressed. The forms of E and T allow for a stronger form of the hormone and storage of the hormones for later conversion when levels of the strong hormone is low. I will also find the gene polymorphism for D too.

The research papers are on my work computer and I tried to get the info out via e-mail but our security is too high. I will print them.

We are the largest recipient of NIH grants and have the largest privately owned vivarium in the country.

I worked with a geneticist post doc in March and April on the covid wards. I forwarded the info the the Director of the Gender clinic. I will have a chat with her. I will see if she would support research into the area. I will see if the Post Doc is still looking for a project. I have no money for research but I will see if we can make a project. I know the Research institute COO. We were on an advisory board for the artificial placenta project. I worked on the project as well.

I am a PI on a project with Drexel and a Doc. It would be very nice to find out more info on the subject. I am sure HR is completely in the blind with the Powers power point and the Gender Department will be very interested in the document. The Gender Department Director was on vacation last week. We do not support non-evidence based health care. We do not support non-standards of care health care.

R
 

Linde

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Because of the insecurities and not knowing what really is going on with all this trans stuff, left my individual endocrinologists behind (they all were gatekeepers), and went with the gender department of the Mayo Clinic. I was immediately put on injections, got progesterone and testosterone (mine was not detectable). Their people come from the UCSF, in my opinion the most knowledgeable trans people in the US.

As a medical professional, who did a lot of research, I am a little concerned with how non nonchalant Powers is treating his patients. We only hear his praises, but what is wit his failures? I talked with him a few times from doc to doc, he seems to have the right spirit, I just wish he would work a little more controlled.


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Lexxi

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Linde I'm sure you've heard that old saying about how if a person is happy with your service they'll tell a friend or two. If they're unhappy with your service they'll tell 20 or 25 people. You know how much reading and research I do into all things trans right. In all that time I've never heard even ONE person complain about Dr. Powers or the Power's Method.

That's pretty telling in my opinion. You yourself just basically said that you've not heard of any failure stories...that should tell you all you need to know about him. Because trust me...if there were failures, then those people would be screaming it from the rooftops. So maybe it's time to give him a break.
 

Linde

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Lexxy, it is pretty common in the medical as also the legal field that negative comments are suppressed. Either with money or certain contract language.
Any research center lists negative and positive results, Powers seems to not have any negatives, which is hard to believe!
I mean, i worked in medicine for 36 years, and still do some limited consulting, and I know from experience that not every outcome is desirable.

Where are those of Powers patients?


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Lexxi

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Linde I'm positive that he hasn't threatened any unhappy patients with a lawsuit if they talk bad about him. So maybe it's just like I described...maybe there are no mad or upset patients. No matter what argument you throw out there...apparently no one has been unhappy with him or running him down.

As far as the medical community suppressing bad reviews, I've never even heard of the endo you call the quack but nothing he's done has stopped you from talking bad about him. You've been running him down almost since the day I met you.
 

Linde

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Linde I'm positive that he hasn't threatened any unhappy patients with a lawsuit if they talk bad about him. So maybe it's just like I described...maybe there are no mad or upset patients. No matter what argument you throw out there...apparently no one has been unhappy with him or running him down.

As far as the medical community suppressing bad reviews, I've never even heard of the endo you call the quack but nothing he's done has stopped you from talking bad about him. You've been running him down almost since the day I met you.
Lexxi, he can't forbid a fellow doctor to voice their opinion. But I have hardly any contact with other trans people around here, so any bad mouthing would not affect him.
Concerning Powers, it is unheard of that with his thousands of patients he claims he has, not a single negative outcome is heard of. This is statistically not possible.

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OzGirl

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Lexxi, he can't forbid a fellow doctor to voice their opinion. But I have hardly any contact with other trans people around here, so any bad mouthing would not affect him.
Concerning Powers, it is unheard of that with his thousands of patients he claims he has, not a single negative outcome is heard of. This is statistically not possible.

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Linde

Linde, the internet is not able to be suppressed. I have read bad reports on many doctors, and seen so many good reports for Dr Powers, but like you, I haven't seen a bad report. I believe this is because he gives his patients what they want and need, rather than most doctors and endocrinologists who give their patients what the doctor or endocrinologist believes they need. It is so hard to get medical providers to just listen to what you want and need, because these medical providers think they know what patients need, without listening to them. Because medical providers don't listen to their patients, they never learn, and just keep giving the same incorrect treatment. This causes so much unnecessary pain to the trans population, and I will go as far as to say, even deaths.

The doctor I now go to for my HRT at least wants to learn, so he listens to what I tell him. He admits the knowledge he gained through formal study is simply not adequate for trans patients. He doesn't see the volumes of trans patients that Powers does, but he has already realised he needs to alter the way he treats trans patients. My ex Endo just kept referring back to standards, and my psychologist had to tell him he was killing me. Trans medicine is relatively new, and needs innovation because the research simply hasn't been done to provide adequate care. if I waited until the medical fraternity carried out the research, and published enough papers to change the standards of care, I would simply be dead. I, and millions of trans patients, must have our needs catered for now, and so our only option is to seek treatment from an innovator, or at least, someone who will listen and respond to OUR needs.

Hugs,

Allie
 

Linde

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Allie, I follow Powers recommendations to a point (that's why I take progesterone), but I can't believe that he has not a singele Nay sayer among his current or former patients. This would speak against any statistical science. But where are those outsiders?

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LInde
 

Lexxi

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How many different ways can people say it??? Maybe he has no naysayers. It's been explained, then explained again, then explained yet again on this thread. Plus it was explained numerous times on all those other threads were you've claimed that there must be detractors. Eventually you need to realize that you just might be wrong about that. Because believe me...if he'd harmed a patient in any way that patient would be screaming it from the rooftops on every forum they visited. And yet we've not heard a peep. That tells me that he has no angry patients.



Why would outsiders have any opinion on his practice. His patients are the ones we should be listening to...not someone who isn't transitioning. We also shouldn't be listening to endocrinologists who come across as dumber than a box of hammers. From all the stories I've read there are apparently a lot of them "practicing" medicine nowadays. A lot of them are doing nothing but harming their patients in one way or another. And keeping patients at such low levels that they'll never have any feminizing effects IS harming them in a BIG way.
 

OzGirl

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I think this thread has run it's course, and there are no new contributions, so I'm locking it!

Allie
 
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