Ten things I wish someone told me when I started HRT:

euryale-dreams:

You can get hormone therapy in the United States without undergoing a long evaluation period or undergoing a ‘real life test’ if you seek out an ‘informed consent’ doctor or clinic. I waited over a year before seeking hormones because I did not want to place myself at the mercy of a mental health professional and I did not want a doctor ‘diagnosing’ my gender. Which brings me to…

They’re going to diagnose you anyway because they need an ICD code to bill your insurance company. I was furious when I found the diagnosis on my medical chart. It would have helped a lot if the doctor had asked my permission or explained that it was for insurance billing purposes only but he didn’t.

Hormone therapy drugs bought from overseas pharmacies are safe and will not cause ‘legitimate’ clinics to refuse treatment should you later decide to switch to a prescription. At the time the information I was able to find talked a lot about how trans women who use ‘black market’ hormones are not to be trusted and that a trans woman who uses such medications should be denied care until they can prove themselves ‘trustworthy,’ somehow. It is a lie.

There is absolutely zero evidence that injectable estrogens are more effective than oral estrogens. The fact is that the ‘advantage’ attributed to injectable estrogens is almost certainly placebo (and injectable placebo is known to be much more powerful than one administered orally). I could have saved myself a lot of discomfort and a serious leg injury caused by an improperly prepared injection.

Properly dosed, there is no reason that sublingual estradiol should be more effective than oral estradiol. The only thing that matters is that enough estradiol enters into your bloodstream and that is something that will be reflected in your labs.

Transdermal estradiol patches are itchy, smelly affairs that cost quite a lot of money and refuse to stay on. Knowing what I know now I would have avoided them entirely.

When I started hormone therapy my endocrinologist gave me conjugated equine estrogen because it came in smaller doses than 17β-estradiol. I was kept on conjugated estrogen for some time under the pretense that he was making sure I didn’t have any bad reactions to being on estrogen. Knowing what I know now I would have been able to argue that conjugated equine estrogen has a much worse side-effect profile than 17β-estradiol and that placing me on this drug unnecessarily endangered my body and my transition. Furthermore, the smallest doses available were far below a healthy dose needed to maintain bone and emotional well-being. Done again I would have insisted that I be started on a reasonable dose of 17β-estradiol.

Low progesterone is implicated in poor emotional health in women. Micronized progesterone is valuable to trans women for maintaining a healthy level of progesterone. I’ve personally benefited a lot, emotionally, from having it and I just wish I started using it sooner.

I wish someone had encouraged me to seek out other trans people as friends. At the time I first came out I didn’t really know there were other people out there that could really help me. The only thing I knew about being trans was what I was able to read online and in books and most of that firmly emphasized the idea that you should transition until you’ve had surgery and ‘pass’ and then disappear and that the people who ‘hung around’ the community were somehow failures. I know that’s not the truth, now, but it really messed me up early in my transition.

I wish someone told me to be cautious. I wish I was told that doctors and mental health professionals aren’t the last word and that if one decides that you’re a ‘failure’ or ‘actually a man’ it’s them that is wrong and not my own instincts regarding who I am. I also wish someone had given me a gentle nudge that some of the people I would meet in the trans community are not to be trusted and do not have my well being at heart. I feel that knowing those two things coming into that experience would have saved me a lot of grief.

Denmark becomes first country in the world to declassify being trans as a mental illness

gaywrites:

Officials in Denmark have announced that the nation will no longer classify being transgender as a mental illness, the first country in the world to do so.

Trans issues are more visible than ever before, and yet the World Health Organization still classifies being trans as a disorder (though the WHO is reportedly working to revise that definition). Denmark, on the other hand, will formally separate itself from that classification, effective January 1, 2017. 

“At the moment, transgender is listed as a mental illness or behavioural problem,” Social Democrat health spokesman Flemming Moller Mortensen told Danish news agency Ritzau. “That is incredibly stigmatising and in no way reflects how we see transgender people in Denmark. It should be a neutral diagnosis.”

He added: “The WHO is currently working on a new system for registering diagnoses. It has been working on it for a very, very long time. Now we’ve run out of patience, and want to send out a signal saying that if the system is not changed by October, then we in Denmark will go it alone.”

HELL YES, Denmark. Set a precedent and demand that the rest of the world follows your lead. Yes yes yes. 

GROSS THINGS U SHOULD KNOW ABOUT CHEST BINDING IN SUMMER

transbutts:

elijahelegia:

you can find fashion advice on how to make things more visually manageable and more comfortable, but for bigger guys some of those tips don’t apply and some issues will come up anyway. here’s some stuff I could’ve stood to know last year.

• if you feel the need to layer or wear something thick, sleeveless hoodies exist. they can save you a bit of heat.
  
• take off layers when you can. wash carefully in the folds of your skin, dab moisture away occasionally during the day, and wash your binders OFTEN.
  
• fungal infections: for bigger guys, these can happen between and under breasts. if you notice a vinegary smell when you unbind, that’s what that is. afaik there’s no massive health risk from this kind of thing on your skin, but still try to keep those areas dry and clean.
• you might get some pimples on your chest, which is fine.
• you might also get sebaceous cysts. LEAVE THEM ALONE. do not try to pop them yourself, it increases risk of infection. they’ll probably go away on their own; if one becomes inflamed, see a doctor.
• in the heat, your binder will stick to your skin more and the shoulder straps will dig into your skin. don’t wait until you’re bleeding - if it feels raw at all, pad your straps. you can get bra strap pads online, or just make your own with whatever you have handy.
  
• lastly: drink a lot of water. you’re wearing layers, and binders are skintight. you will sweat more.
  

I know everything is gross + miserable but hang in there and take care of yourself.

Summer is around the corner! Please remember all these safe binding tips. Stay hydrated and don’t over exert yourself. Your identity is important, but so is your health/well-being.

*hal

Starting HTR! (Hormone Replacement Therapy) - MTN - Non-Binary Transition - Neutrois Transgender -  

video by Adrian Wu talking about their experience pursuing (and finally receiving!) hormone therapy for a neutrois MTN transition.

Sex And Gender Are Actually The Same Thing (but bear with me...)

alicelovelace:

murbellas-musings:

alicelovelace:

murbellas-musings:

transmensch:

murbellas-musings:

agendermetalbender:

:

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*

crossdreamers:

There is no sharp division between male and female brains, according to researchers who found that we are all a mixture instead. 

Read more about this research over at Crossdreamers.com.

when writing transgender 101 guides directed towards cis people, please consider:

androgyneity:

• NOT including intimate details of physical transition (including surgical and hormonal treatments, presentation techniques and devices used by some trans people to manage the appearance of their physical sex characteristics).

• Cis people are already obsessed with our bodies in a really unhealthy way that often comes out in fetishization, repulsion, tokenization or general inappropriate fascination. It’s not helping trans people’s interests to make one of the first things you tell cis people about us be all the gritty details about our physical bodies, when so much of transgender identity is already medicalized, pathologized and seen as a strictly physical thing.

• Also it’s none of their goddamn business what trans people do with their bodies. It’s not like you’re providing this information as a resource to people who will benefit from it, you’re literally just sating their curiosity and by extension alienating the group you’re attempting to speak for.

• It gives cis people a sense of knowledge of trans bodies, which reinforces their entitlement to demand intimate information from usabout our medical histories. (because they “get it”).
  

• It creates the expectation in cis people’s minds that transness is defined by these physical steps you’re describing, and delegitimizes the identities of trans people who make not take some or any of those steps.

• If you’re going to provide this information (which, to be entirely honest I can’t think of a legitimate reason why you would need to provide in-depth information about trans bodies to cis people who were not serving a health/care-providing roll to trans people) at least Do Not put it in the 101 “basic information” package. Because it is not 101, the information you provide will invariably be oversimplified and misguiding, it is not important to developing a basic understanding of trans people and issues, and if you’ve gotten to the point of describing the ins and outs of trans medical treatment within your first few sections than i guarantee you there’s probably a dozen more important and more relevant topics you haven’t covered.

I’m not saying avoid these topics all together if you want to talk about dysphoria and how some people get surgeries and/or take hormones and/or change their physical presentation to feel more comfortable.

I’m saying you don’t need to provide detailed, in-depth descriptions of trans medical treatment and the ways in which trans people relate to their physical bodies, because it’s not relevant, it’s none of their damn business, and we don’t need to have cis people any more fixated on trans people’s bodies and medical decisions than they already are.

neutrois:

The 2nd part of Non-Binary Transition provides a new framework with which to approach transition using a delicious metaphor involving chocolate chip cookies. So grab a glass of milk, and enjoy!

See all 3 parts of this workshop in video or transcribed slides:
neutrois.me/non-binary-transition

Workshop Description

More and more people are identifying outside the binary, feeling their gender does not fit into a male or female box. For these folks, as well as for the professionals supporting them, questions surrounding transition are often left unanswered.

What does a non-standard transition route look like?
Is this quickly becoming the norm?
Does it even exist?

This workshop will explore the myriad options people have, covering social, medical, and legal transition needs. It includes busting myths and clarifying misconceptions, outlining alternatives and loopholes, and developing strategies for empowering you and your clients in their transgender journey.

MTN Transition