Hey, would you know much about HRT for AMAB folks and not wanting all of the side effects of estrogen injections? (Namely breast growth) if not someone or somewhere I could ask/find out?
unfortunately there isnt that much information out there about this, at least not that I could find (and I’ve tried to look into it a few times).
from my experiences with AMAB nonbinary people who wish to transition in some way, most of them wind up taking other steps (epilating or getting laser to remove body hair, changing their hair style/way of dress, voice therapy etc.) rather than going on HRT, since HRT I believe has more side-effects for AMAB people and isn’t permanent (i.e. if you go off estrogen the effects revert).
If any of my followers know more about this and would like to share their experiences or resources it would be greatly appreciated!
(I’m an amab nb on estrogen and antiandrogen HRT for 1.5 years)
“Typical” trans woman HRT involves a combination of estrogen with a testosterone inhibitor/blocker (antiandrogen), because testosterone is normally too high and too potent for estrogen alone to have effects.
So, even without estrogen, you could still take antiandrogens like spironolactone and/or finasteride as HRT. They’re reasonably effective at lowering testosterone levels and helping to tone down its effects. Body hair does tend to thin out, sex drive often diminishes, things like that. Definitely worth investigating–look up HRT for trans women and just disregard the estrogens.OOOO, I have knowledge on this as well! Disclaimer: 31 yo AMAB NB on ½ dose HRT for 1 year (2mg E + 200mg spiro per day, basically balanced 1/2way between cis male/female). From my personal findings on the matter, I’ve had all of the effects of HRT, body hair thinning, lowered sex drive, reduced erections, breast growth, body fat redistribution. I’m aiming for all the above, but not full on at cis woman standard ranges. No clue if this is just internalized trans or otherwise misogyny, but I’m happy with how things are going. Everything happens slow no matter what you do and can be slowed or stopped if things are going down an unintended path.
Spiro in and of itself does have mild estrogenic effects and can cause gynecomastia. So spiro alone will reduce T levels, but will result in some feminization. The other concern with an antiandrogen alone is basically bone loss and other mental/emotional effects from low sex hormone levels.
The other option is taking E alone without an AA, this will result in feminization to some extent. Due to the nature of all the feedback systems in the body, taking E alone will reduce T levels in your system so E alone will probably result in more feminization than taking spiro alone.
One option worth considering is adding a Selective estrogen-receptor modulator to an anti-androgen. SERM’s are a class of drug that stimulate estrogen receptors in some tissues, but inhibit them in others. They are traditionally used with post-menopausal women to prevent bone loss, or inhibit estrogen linked cancer in certain tissues. If you find an open minded informed consent endocrinologist, you might suggest this as a possibility as an option. Basically you could take a SERM and an AA and get the T reduction, avoid bone loss due to estrogen receptor stimulation in bone tissue, but avoid breast growth as those tissues will be inhibited. Again I caution, that a person should consult a doctor for this as these drugs are almost completely unstudied for this purpose.
I took spiro without estrogen for like six months plus. And estrogen+spiro (which ive been on it for a year) makes me feel good in a way just spiro didn’t. IMO just get on normal trans lady doses and then experiment with taking less and find what feels right, thats what I wish I just did. (Unless you’re deadset on avoiding breast growth in which case I can’t help you)
yeah, the negative mental effects of hormone imbalances can be huge and are very much important to consider if you plan on trying anything which lowers only T production/action along with the whole bone density issues.
I’ve heard from a lot of people that lowering T without taking E will cause negative mental effects, but I’ve never been really clear on what they are, and I don’t think I’ve noticed anything so far myself. (It also seems strange to me, because my impression is that historically eunuchs had no trouble being functional people?)
I’m very light on the topic of eunuchs so I wouldn’t be able to really get into that without some far better research…
As far as the symptoms of hypoandrogenism are pretty well understood. Basically the mental/emotional effects are understood to be depression, fatigue, anxiety, lack of motivation, and lack of sex drive. I will add a few caveats though. First, there is a great deal of marketing money going into attempting to get cis men to fear their possibly low testosterone levels and drive them to taking T for the profit of pharmaceutical companies. This does not mean the research is faulty, just that if you were to read media summaries of research, conclusions will be mildly weighted towards the negative effects, also since any possible chance at losing masculinity is unthinkable😜. Second, I would assume the data on symptoms of low T is generally coming from cis men and not trans AMAB people. Basically most of the mental and emotional effects of low T are coming from people who’s minds function best on standard cis male testosterone ranges. It would make sense that a trans AMAB person would fair better mentally and emotionally than a cis man in conditions of lower testosterone. I might even be safe to guess that hypogonadism (low sex hormone levels) might be emotionally beneficial for some agender or neutrois trans people.
That all said though, low sex hormone levels does result in several physiological negative effects in terms of muscle support and bone density which cause a person to have low energy and be at risk for injury which generally would not be advisable long term.
Thanks for the detailed response to this!
Given that I’ve been suffering from major depression for several years now, it’s hard to say for sure, but I don’t think that my depression and anxiety have gotten worse since I lowered my T levels most recently. I also don’t _think_ motivation has gone down. It is a bit worrying that it’s hard to tell, though, since I certainly don’t need to be doing things that could make my depression symptoms worse.
That said, I think I’m overall actually happier with the mental consequences of my current hormone levels. Certainly, I’ve gotten a significantly reduced sex drive, and that’s a huge relief, given how unpleasant I find having a male sex drive (and male orgasms/sexual response in general, honestly).
Sadly, yeah, know my current hormone regime (200 mg/day spironolactone, 5 mg/day finasteride, and no estrogen) isn’t a good long term plan for bone-density reasons, as much as I’ve been trying to not think about that fact. I’m a bit more surprised that it causes problems from low muscle support: I know that testosterone promotes more muscle development, but I didn’t realize that estrogen did as well, relative to a hypogonadal baseline?
I am starting to be increasingly convinced that I should start a low-to-moderate dose of estrogen when I have my next hormone appointment in January. I continue to have a bit of a worry about how I’ll react to breasts (and possibly not fitting into my pants), though…for the forseeable future, I seem to be living as male, especially since I’m living around my parents and not out to them. So I want physical changes, but I also want to be able to hide them. *frown*
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