This is a rant about doctors and the medical system. Immediate note: This is unfortunately not easily accessible for all for either availability or financial reasons, but if it is, it's worth it whatever your gender goals are.
Literally I am getting so old, I'm pushing 40, been going to docs about "this" since I was about 10 years old. My main symptoms have always been hyperadrogenism in clinical symptoms such as hirsutism, etc, and blood levels. This was figured out early on. I was put on androgen blockers in my tweens, got off them cuz I felt crappy. I had regular checkups would push for trying to dig deeper if I have PMOS (or anything else like NCAH I learned about some years ago) and endometriosis and every single time they would dismiss me. I didn't fit the phenotype because I was leanish and menstruated regularly enough. For years I removed my body and facial hair so that was dismissed from my self report as well and noone wanted to check my blood levels and the way they treated me just made me want to stop having any sort of contact with them. My mom had PCOS (but less hyperandrogenism than me) and mutliple gynos would literally tell me it's impossible she had PCOS and had me.
Then some years ago I grew it all out. Suddenly its so obvious how high my androgens are the gyno I see even refuses to check my levels because it's "obvious" they are mega high. Refuses to test me for endometriosis. Prescribes me a medication for pain that barely works and is known to cause liver problems. I stopped taking it because I was feeling a weird gargling feeling where my liver is (right side under ribs).
I decide to implement new very strict rules about what doctors I see.
If I don't have a a direct referral from an organization or a friend/acquaintance and I am blindly figuring out what doctor to see, I ONLY go to middle aged women (30-55) I have had great men (cis and trans) doctors and therapists, but they have all been from friends or orgs, I'm sure there's decent older women out there as well, but my random experience has been very bad.
Somewhere I learned I need to look into NCAH with my history, levels and so on and also I dunno how this is possible, but I realized late I need to see an actual endocrinologist not just gynos, or even gynecologist-endocrinologists double specializations have been ... well I'm not particularly impressed with where we've gotten over the years to put it mildly.
So turned out I do need to look more into NCAH, and for the longest time I've been told I don't qualify for PCOS/PMOS cuz I only have 1 of 3 (according to the Roterdam criteria which are a popular criteria, but they are not epistimically sound, don't rule out NCAH and are too generalized). So I'm on the road to diagnosing that more, going to do genetic testing finally, we'll see what that shows, but I want to get to my actual point of this post.
So for a random other thing I decided to go to an expensive gynecologist that is on a suggested for trans and lgbt+ people list. A bit irrelevant why, I'm too shy to go into details, but I wanted to see someone who would not be awkward about the hyperandrogenic symptoms of my body and would be easier to understand why I'm Ok with how I look, less weird about it and hopefully easier to focus on other wellbeing things, hopefully more up to date with the science etc.
This wasn't even why I went in but I gave her a quick rundown of my general history, she did some basic routine checks and was the first doctor ever for whatever reason to notice I have enlarged ovaries. I don't know if they just weren't enlarged earlier, I find it quite strange they would get enlarged just now. But basically she said that because of that that means I actually DO qualify in the Roterdam criteria for PMOS. Because one criteria is polycistic ovaries, but as that it also counts enlarged ovaries except apparently many doctors forget its polycistic OR enlarged. She did confirm that this is not particularly change much, does not mean much and could also be present in NCAH as an effect of the androgens and I am very right to continue checking for NCAH anyways. She also was the first gyno to say yes I SHOULD get checked for endometriosis.
PMOS needs so much more research and to probably be broken up into several different conditions ultimately anyway, it doesn't mean much to learn I actually do fall into the Roterdam criteria. But I'm just sooooooooooooooooo pisssssssssssssedddddd how bad the doctors have been at having a grasp at even the existing knowledge about these things. I am at the end of my rope as far as my sanity about this goes.
Anyways so yeah, doctor suggested for trans people turned out to be an actual pro finally who knows her shit.
Another thing that is driving me crazy is I am paying triple for healthcare in this case. I pay for public health insurance in taxes (which is almost useless for me here in Poland, but I wanna be able to not pay the hospital bill if I get hit by a car), I also pay for private insurance to see specialists because when I was doing this in public the waiting list was like a year and a half for an allergist and he was pretty bad in the end. But finally, for a lot of things like specialized tests and this doctor I am paying out of pocket, because visits with her aren't covered by my private insurance. Very very frustrated with all this.