Topic: Question about HRT

[Sarah-Red]

I totally get that Rachel, unfortunately. I decided to take the risk of hormones because I couldn't stand it any longer and had to do something. In truth I'm not ready to face the world with any of this. I just know that I either try to find a way through, or die inside.

It's not true that reality is one end or the other, at least for trans people especially, and hormones take time, and someone can wear a binder, so there are ways to make it, but that doesn't mean someone will pass. It's hard for me to accept that, but I don't have a choice do I. I don't want to go back, so I have to see what I can make work by moving forward. If I can't deal with something, I'll try something else or take some steps back, but I had to at least start and be on my way. I want to see where things go and what I can do.

I care too much about what other people think too. And I frequently struggle with how I can possibly be socially expressive while not caring what they think, it seems like a contradiction, but in the end it does matter more to me what I think and feel of myself, so I may be able to find a way.

I know I spoke from my own perspective, but that's all I can do. I relate to a lot of the feelings you brought up, it wasn't easy to process some of them, and I wish it didn't come down to what it does, I wish it were easier, and that we could just jump to the other end, but until there's a way to do that, I just gotta do what I think is more important to me.

Those who matter will accept us. Those who don't ... don't matter as much. I know it's not that easy, we can care about someone who wouldn't like us as trans, but I think that ultimately, I'd rather find people I connect with that do have that openness and acceptance. Again, not saying it's easy, to look past those that judge, it's certainly one of the things I have the most trouble with, but that's how some people do it.

I think it's perfectly valid not to transition, for quite a few reasons, this society... well you know. Sometimes something forces your hand. Whether it's pressure from outside, or pressure from inside, you just do your best, and try to find happiness however you can.

[Pammie]

I think it's perfectly valid not to transition, for quite a few reasons, this society... well you know. Sometimes something forces your hand. Whether it's pressure from outside, or pressure from inside, you just do your best, and try to find happiness however you can.

I think Sarah, that is beautifully put and as good and accurate a summary as one could hope to find xx


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[Allie Jayne]

Honestly, I could probably grow some breast tissue if I just stopped taking the Anastrozol.  My body seems to be very good at converting T to E.

But, I am trying to live presenting as a man.  I am trying to be a good "husband" and "step father" and "brother" and "son".  I want other people to respect me and trust me.  Growing breast (as much as I might like having them) would be embarrassing, because it would make passing as "a normal guy" that much harder.   I try to look as masculine as I can, because I don't want people to see me as feminine when I am presenting as male.  If I were to transition, I would want to look as feminine as I could.

I think I accept the fact that I am a transwoman, but that is something very few people know.  If I were to live openly as a woman, I would want to pass as a "normal woman" too.  I don't have a problem with the idea of a gender binary.  Whether fortunately or unfortunately, reality is more complicated.  Reality is analogue, and, I am not at either end of the spectrum.  I'd like to be at the female end.

Most people would say I care too much what other people think.  Maybe.  But, that doesn't change the fact that I do care what they think.  Telling me I am wrong for feeling as I do doesn't change the way I feel.  I am a social creature.  I cannot thrive on my own, separated from everyone else.  I might survive, but I would not thrive.  I have spent several years being extremely lonely.  I don't think I could do that again.  I don't think I WOULD do that again.  I was suicidal then, and would almost certainly be that way again. 

When I feel rejected, I withdraw.  And, when I withdraw I feel lonely.  And, loneliness leads to worse depression, which causes me to withdraw.  It could easily become a death spiral.  So, I need to avoid that.  Having people figure out that I am transgender would be like a nuclear bomb to my life.

Yep, that is where I was at this time last year! I had a great life as a man, wife, great job, children, grand children, active scuba club member and involved in community activities. I knew I was trans, but take a chance at risking my great life, no way. Along came dysphoria, and next thing I know I am seriously sick, and I have no option but to start HRT. It cures my illness, but I am faced with losing everyone. When I told them one by one of my predicament, every one of them supported me.

If you are trans, you will have dysphoria, though it may not have manifested as much more than a rising frustration. But you can expect that at some stage in your life it will increase, and you may have to do something about it. I was in your position for most of my life, and now being forced to start HRT and come out to everyone at 65, I feel like I've had to pay the price anyway, but have been robbed of decades of being my true self. I'm not saying you need to transition now, but likely at some stage it will become a significant issue in your life.

I really hope you can find your path to happiness,

Allie

[Sarah-Red]

I think that's one more good reminder, Allie, especially that sometimes people do get much more support than we'd think. Not only that but don't leave out that a lot of things did work out for you beyond that as well, including at work and how now you've passed and gave speeches regarding being trans, and even touched people enough to make them cry

And Pammie I do think it's unfortunate that life can force our hand, but yeah it's come to that for quite a few people on this site for transitioning. Of course, there are always some people that don't need that to transition, but I haven't seen as many those around. And then there's those that feel better not risking it, feeling other pressures and wanting to try to be stealth. Bold people probably have an easier time.

[Julielynn]

Rachel, you and I share a very similar story.   I grew up in the bible belt so there is no possible way my family would accept anything of the sort.  Very conservative, very high class, and quick to make fun of anyone in the position.

I also had a high profile career that wouldn't tolerate it as well.  Family in the medical field so there was no going there either.  Yeah, I know HIPA exists, but people talk despite it.  Good luck suing anyone over it.  I'm sure you know what I mean. 

I didn't plan to transition either as I was married too.  Eventually, it just came to a head.  I still held off, but it was killing me.  The depression was terrible.  I went to bed a lot of nights completely drunk out of my mind spiraling out of control worse and worse.  I had a headache each morning when I woke up with or without booze. The low T did that.  I wanted live as a woman, but there was just no way I was going to deal with all that rejection, hate, and social problems that came with doing something so extreme.

Ok, this is what I did and maybe you can apply some to your situation.  I ended up slowly figuring out who would be ok with it and who wouldn't.   Unfortunately for me, it was most, if not all of them.  I slowly separated my financial interests from everyone and started setting up my own separate rental incomes and lowering my expenses at the same time.  I didn't want to admit I was really considering it, but I kept doing things as if I was.  I didn't want anyone having any control over my income.  I realized I should probably just go ahead and make sure I was financially secure and could live off it if need be.   Now keep in mind I was doing this because I was self-imploding and wanted to keep things running if I lost my job from all of my troubles. 

My marriage ended up in divorce as most do when my libido started dropping too far down.  She cheated and that was it.   I got lucky in the divorce and she just wanted to start over and took virtually nothing.  By that time, I had separated so much of my finances anyway that it didn't matter much.

I went into rentals full time, but kept the job.   I set myself up dates to try and be able to quit working, but work as long as I could.  This year, I quit working.  Rental incomes are enough.  I lowered the bills enough that I could work as a dishwasher and still have enough to eat at 5 star restaurants in NYC if I wanted to.   

After the wife left, it hit me hard.  The loneliness was terrible. I drank much more.  I dove into work even more.  Amusingly enough, it was a bald spot that started the chain.  I didn't want to go bald and it was getting big.  I decided I'd get a transplant and see what I could do to stop it.  The clinic checked my my blood pressure and it was 210/145  lmao.   Really, really bad.  They weren't going to do the transplant with that high of a BP.  My current doctor was out of the office on Thursday and Fridays and that transplant was coming up on Monday.  I had no time.  I found a Doctor willing to see me that Thursday, 4 hours away in Detroit.  It was Dr William Powers who actually specializes in Trans people.  He called me out on being trans very indirectly.  I denied it, then slowly admitted I wouldn't mind, but wouldn't actually do that.  He noticed I had a ton of the signs.  I told him I was only there because of the blood pressure and he was the only one I could find in Detroit since I was out of town there and couldn't see my own.  He just smiled, we talked more, and by the time I walked out of there I had a prescription in hand for heavy duty BP stuff, a T blocker to stop the baldness, and a little extra one for E to debate on.   Probably my own subconscious at work there.

Of course, I broke and filled them all.  It worked wonders.   The depression lifted, I feel more content with myself than I ever have.   The loneliness lightened up immensely.  So this year I quit working once things get too "cough" noticeable.   Best move I ever did.   

So yeah, I have a doctor 4 hours away.  Solved that family problem with that.   Turns out there's not a lot to it so he doesn't need to see me often.   My finances are separated from everyone.  I might miss old career, but I don't feel so bad when I sit in the Caribbean sun.  My emotions being in order was the best of all though.  I'd just consider a similar path "just in case".  You might find yourself slipping down my road eventually and you may not.  Best to be prepared either way. 

[Rachel Montgomery]

Rachel, you and I share a very similar story.   I grew up in the bible belt so there is no possible way my family would accept anything of the sort.  Very conservative, very high class, and quick to make fun of anyone in the position.

I also had a high profile career that wouldn't tolerate it as well.  Family in the medical field so there was no going there either.  Yeah, I know HIPA exists, but people talk despite it.  Good luck suing anyone over it.  I'm sure you know what I mean. 

Yeah, HIPPA doesn't help when a high percentage of the people you don't want to see the notes are on the other side of the HIPPA firewall. 

I am sorry that things got so bad for you.  They may at some point for me too.  They have been quite bad at times in the past, but I survived.  And, there have been long stretches where surviving is the best I can say for those times.  But, right now isn't too bad.  I still have dysphoria, but I can get out of bed, leave the house, do my work.  I don't think about killing myself every day, and don't seriously consider it as an option anymore.  I still have the thoughts run through my mind a few times a month. 

[Julielynn]

Had that issue as well.  The low level HRT got rid of all my depression.  Amazingly effective for that.

[Rachel Montgomery]

Had that issue as well.  The low level HRT got rid of all my depression.  Amazingly effective for that.

I understand you had a similar issue with HIPPA and health care workers.  Did you also have similar symptoms with migraines, cramps, irritability, depression, etc.?

[Julielynn]

Migraines and depression, yes.   All gone though.   Honestly, I can't say if it had something to do with HRT or a new BP medicine I started at the same time, but not complaining either way.

[Rachel Montgomery]

Migraines and depression, yes.   All gone though.   Honestly, I can't say if it had something to do with HRT or a new BP medicine I started at the same time, but not complaining either way.

I understand that your experience is anecdotal, and my millage may vary, but I am encouraged to hear that your migraines were relieved.  You know, some of it may be less stress because you stopped fighting transition, but the migraines have been a major concern because low T definitely made them more frequent.  I get one a few times a year, but with low T it was daily.  It was miserable.

[DebbySoufflage]

E will not help with migraines. The opposite. E is generally associated with more frequently occurring migraines.

That said, YMMV.
I have always had migraines as long as I can remember. They used to start in my right eye.
Since going on HRT my migraines are less frequent.
My migraine has changed to a less chronic headache type that comes with short electric stings in the head.

Cholesterol is kept in check by a dominant sex hormone.
Menopausal women tend to have out of control levels of testosterone because they lack a sex hormone to keep it in check.

That said, replacing T with E will not heighten your risks if you do not have any kind of genetics that predispose you to a certain estrogen dependent cancer.

T carries the risk for liver damage.
E carries the risk for blood clots, although those risks are low.

One advantage you have is that if you are hypogonadal already, they will only have to administer E and not an AA.

Make an appointment with an endocrinologist in your area and explain your concerns and your medical history. Together you could work out a regimen for you that is tailored to your needs.
Please be advised that most endocrinologists will want certification from a psychiatrist that you suffer gender dysphoria and that hormone replacement therapy is recommended.

Luv,
Debby

[Julielynn]

E will not help with migraines. The opposite. E is generally associated with more frequently occurring migraines.

It's interesting that you say that.   I wasn't one of the ones who "fought" the decision.   I made up my mind back in my 20's.   I just held out because I have a massive fear of being out of work, homeless, and starving.  I did that once.   So I waited until I had the power and money to do it without any fear.  Stress isn't really a concern in my life.

The headaches were a constant thing.  Mine were every single morning.   I had a habit of just waking up and taking advil, waiting for them to hit me.  It dulled it, but they always hit me.  Sometimes bad enough I had to stay home from work and just crumple in bed squishing a pillow to my head all day.   It may not have been E that got rid of them, but the timing sure was perfect.  Hard to say of course what did it, but I can't think of another thing I changed at the time they disappeared.

[Rachel Montgomery]

Make an appointment with an endocrinologist in your area and explain your concerns and your medical history. Together you could work out a regimen for you that is tailored to your needs.
Please be advised that most endocrinologists will want certification from a psychiatrist that you suffer gender dysphoria and that hormone replacement therapy is recommended.

Well, I did travel to another state to see an Endo who does almost exclusively work on transitioning, and I was honest with him about being transgender (but told him he was not authorized to share that information with anyone).  I asked him about the migraines and he said he had no idea.  He could prescribe me E and we could see how it went.

I was hoping someone here had experience with it in their transition.  I understand that it might be different for me, but I still find it encouraging that at least a couple of people have had migraines be reduced when starting E. 

[Pammie]

Well, I did travel to another state to see an Endo who does almost exclusively work on transitioning, and I was honest with him about being transgender (but told him he was not authorized to share that information with anyone).  I asked him about the migraines and he said he had no idea.  He could prescribe me E and we could see how it went.

I was hoping someone here had experience with it in their transition.  I understand that it might be different for me, but I still find it encouraging that at least a couple of people have had migraines be reduced when starting E.

Did he offer to prescribe E without any therapist letters?? Is that allowed in the US? I wouldn’t expect that in the UK x


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[Rachel Montgomery]

Did he offer to prescribe E without any therapist letters?? Is that allowed in the US? I wouldn’t expect that in the UK

It is allowed.  He did offer.  I declined.

But, if I wanted to transition and he wanted a letter, my psychologist would be willing to write such a letter.  She has told me that, as did my last psychologist.   

[Pammie]

It is allowed.  He did offer.  I declined.

But, if I wanted to transition and he wanted a letter, my psychologist would be willing to write such a letter.  She has told me that, as did my last psychologist.   

Gosh. I’d always assumed prescribing E is such a big thing that they would want / need a psychologist letter. - Live and learn!



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[KathyLauren]

Gosh. I’d always assumed prescribing E is such a big thing that they would want / need a psychologist letter. - Live and learn!



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Compliance with WPATH SOC is voluntary.  Insurance companies may insist on it if you want to get your claim paid.  But a medical doctor doesn't need anyone's permission to prescribe medication if they are confident that it is the right treatment.

[Sarah-Red]

It's also possible without a letter in Canada too, though it depends on the doc and I've been told it's better practice to have one.

[GordonG]

Did he offer to prescribe E without any therapist letters?? Is that allowed in the US? I wouldn’t expect that in the UK x

I have not had a "letter" for anything. I've not even been to a therapist for anything trans related.

[Allie Jayne]

I needed a referral from my psychologist before I could make an Endo appointment here in Australia, but that may be because our Medicare system pays for my Endo appointments.

Allie