What worries me about transition...

[Stranger]

...is the possibility that life on HRT might end up being worse than the dysphoria.

I admit this post is indulgent, but it's heart-felt, and I guess I'm hoping somebody can offer me the wisdom I don't yet have.

My situation: I have gender dysphoria. It pops up all over the place and lately I've realised just how powerful it's been through my life, and the kind of subtle effect it's had (often without my recognising the cause, until now.)

But despite it, I'm a happy person. I read that a lot of women here were deeply depressed, often suicidal, prior to transition. I feel for them and understand, I think, how that can be. In these cases, the possible negatives of HRT are vastly outweighed by the fact that the positives make life liveable. But while I'm no stranger to depression or even suicidal tendencies, I've been lucky in other ways. I have a perfect partner. She makes a dysphoric life beautiful. I have supportive family. I don't have much money, but I have enough. What I have right now I cherish immensely and I'm frightened to put it into jeopardy.

Still, I need to do something about the dysphoria. I know what happens when I try to just let this stuff alone. Now, as it happens, my friends and co-workers seem fine with me wearing makeup, female shirts, long hair, dangle earrings, and so on. They just see an androgynous, metrosexual modern man. But androgyny has never been enough, and once people interpret me as a man and treat me accordingly, I might as well have dressed like a lorry driver for all the difference it makes. There still feels like a fundamental disjuncture between me and my body.

I suspect HRT can help this. But I'm frightened that it's another kind of cage: one that will make me dependent on expensive medication, that will put me at risk of DVT, that might significantly reduce my lifespan, that might kill my libido. It seems like extremely heavy stuff. My fears that my hair will fall out (for example) seem superficial in comparison to the probability that I will get less years to live with her.

It's hard. What do other people do? I feel like a bit of a jerk for this post, just because it's so close to saying "oh my life is so great, and HRT is so terrible" when a lot of people here have deep, valid, and life-saving reasons for taking that option. I believe all our situations and solutions are unique. I just feel lost figuring out mine.  Might the dysphoria get crushingly worse (it has been increasing?) Might the side-effects not be as crippling as I'm afraid of? Any words of advice will be deeply appreciated.

[kelly_aus]

I suspect HRT can help this. But I'm frightened that it's another kind of cage: one that will make me dependent on expensive medication, that will put me at risk of DVT, that might significantly reduce my lifespan, that might kill my libido. It seems like extremely heavy stuff. My fears that my hair will fall out (for example) seem superficial in comparison to the probability that I will get less years to live with her.

You are at risk of DVT either way.. HRT can increase the risk, but it's a maybe, not a certainty - being a smoker does increase the risk substantially. Will it shorten your lifespan? That one I don't know - I know it has extended mine, without it I'd likely not be around any more. And as far as libido goes, mine has changed as far as what I'm looking for goes - but I won't say it's really diminished in any way.

[Nero]

Well for a start, estrogen-filled people tend to live longer than testosterone-filled people. And if you get regular checkups, hopefully you can catch anything before it develops.

Though if something ain't broke...

[Rowan Rue]

Hmm, I think I relate as far as falling into the lucky category goes.  I never "hated" being male and I'd gotten pretty good at being a boy so to speak.  What I've come to realize though is that my dysphoria hasn't presented as a rejection of my physical body but rather of reality as a whole.  I've suffered from a sort of existential dread my whole life that I could never find a reason for until I finally realized that I wasn't happy living as a man anymore.
Since accepting that I'm Trans, that dread has gone.  Now that I'm happy (ok, still a work in progress but way better) with myself, I'm strangely at peace with the weirdness of the world around me. 
I don't know if any of that speaks to your experience, but I do know that my personal stress levels are greatly reduced and I'm pretty sure that chronic long term stress is a greater cause of negative health impacts than HRT.

[Isabelle]

I'm pretty sure that chronic long term stress is a greater cause of negative health impacts than HRT.

Quoted for truth.

If you don't need it, don't take it. If you do, you should. No one here can answer that for you. This is possibly why some people see a therapist to help them come to a decision about what is right for them. Being a trans person is f**king hard. But then, being any kind of person is.

[Cindy]

As others have said being on E should increase your life span. But if you are happy as is, why change? If you are content and happy as you are do you want to risk everything we go through? Lost marriages, lost 'friends',  lost work.

I went through it because there was on alternative. I've been exceptionally lucky, but many have lost everything just to be normal.

A big coin toss.

[Stranger]

You are at risk of DVT either way.. HRT can increase the risk, but it's a maybe, not a certainty - being a smoker does increase the risk substantially. Will it shorten your lifespan? That one I don't know - I know it has extended mine, without it I'd likely not be around any more. And as far as libido goes, mine has changed as far as what I'm looking for goes - but I won't say it's really diminished in any way.

That's true. I'm probably caught up in the idea of leading a "safe" life to take account of the fact that risks always exist.

Well for a start, estrogen-filled people tend to live longer than testosterone-filled people. And if you get regular checkups, hopefully you can catch anything before it develops.

Though if something ain't broke...

That estrogen, is there anything it can't do! I ought to get checkups more often anyway, so perhaps it'd be good to have an actual imperative to seek more medical advice.

I've suffered from a sort of existential dread my whole life that I could never find a reason for until I finally realized that I wasn't happy living as a man anymore.
Since accepting that I'm Trans, that dread has gone.  Now that I'm happy (ok, still a work in progress but way better) with myself, I'm strangely at peace with the weirdness of the world around me. 
I don't know if any of that speaks to your experience, but I do know that my personal stress levels are greatly reduced and I'm pretty sure that chronic long term stress is a greater cause of negative health impacts than HRT.

The existential dread... I know exactly what you mean. And the continual, gnawing stress. Sometimes I just have to go back to bed and wait until it passe, and it's been like this for as long as I can remember.

Thinking about it, you're so right that lifelong stress is one of the worst possible things for good health. I don't know why I'd never looked at it that way. I was okay with being put on anti-depressants (though I've been, with GP's approval, off them for many years now), maybe I should think of estrogen as something similar?

As others have said being on E should increase your life span. But if you are happy as is, why change? If you are content and happy as you are do you want to risk everything we go through? Lost marriages, lost 'friends',  lost work.

I went through it because there was on alternative. I've been exceptionally lucky, but many have lost everything just to be normal.

A big coin toss.

I worry about things getting worse, basically. When I get into one of my dysphoric "moods", it's distressing for those close to me, because I essentially shut down and hide myself until the feelings pass. As a result I try not to make too many close friends (it's tough managing friendships when, every now and then, you just don't want to leave the house.) As implied above I went through several years of clinical depression, where it was like that every day. This is different somehow, though I wonder if they're not related.

Yet when I'm happy, I'm happy, and the anxiety is at the threshold of tolerance. I have coping mechanisms, like meditation or relaxation, and right now I'm managing it. Of course sometimes the dysphoria hits me unexpectedly, even comically (being called "dude" is devastating, for some inexplicable reason.)

Quoted for truth.

If you don't need it, don't take it. If you do, you should. No one here can answer that for you. This is possibly why some people see a therapist to help them come to a decision about what is right for them. Being a trans person is f**king hard. But then, being any kind of person is.

Nobody can answer for me, for sure, but after reading these replies, I'm very glad I asked

[V M]

The main thing that bothers me are the ridiculous assumptions that people make and the stupid rumors that haters try to spread about trans people

[Cindy]

Ah. If you are struggling to cope and having depression there are very good reasons to seek advice from professionals.

The old comment; talk to a gender therapist (GT). Why?

GTs don't put you on hormones or make decisions about your life. They guide your thoughts with questions and prodding you to think about yourself. Many, if not all TG people, carry a lot of baggage and dealing with that is a major problem. GTs help with that.

'I'm OK but I get miserable' TG doesn't get cured by age, it gets worse. As you (if you are MtF BTW) get older your T levels decline and that also drives dysmorphia.  One cure is taking T but it seems to fail badly for 'true' TG people. There is no suggestion in that comment about greater or lesser TG people BTW. It's a medical treatment.

I would suggest very strongly that you seek medical help. This isn't an easy problem to deal with as many of us know.

Cindy

[Stranger]

MtF, yes, and approaching my thirties (much faster than I'd planned!)

I hope to seek professional help when I get back home to Australia. Unfortunately, as I'm living abroad right now for the next two months as part of my ongoing work, I'm in a kind of grey in-between period. I do take the mental health issues very seriously (I've learned this through experience), and figure the best approach is to endure this period while staving off insecurity. I've become good at recognising and responding to the warning signs of the return of clinical depression, though of course personal judgement is hazardous. I'm not nearly so capable at dealing with dysphoria.

This discussion has helped me a lot. It's reassuring to hear from others who have gone through similar things.

[suzifrommd]

Stranger, you're not alone. I feel the same way (though I'm moving to the position that the benefits of hrt outweigh the downsides).

I'm a generally happy person, and transition will make my life harder, not easier. I don't hate my body.

I do hate, however, not having people see me for who I am and I hate that my body (which I'm grateful to for seeing me through a half-century) doesn't look or feel the way that it should.

Will we be happier in transition? I can't know that. I just feel that, happy or no, I can't stay where I am.

[justmeinoz]

There's only one way to find out I guess, and that is to try.  My mood improved dramatically within a few days of starting HRT, after years of chronic Depression.  If you don't like how it makes you feel you can always stop after a few weeks trial.  The only concern is whether it will affect your fertlitiy if you decide you want children.

There are as many ways to transition as there transitioners, so don't worry about fitting any sort of template.  If it works for you, that is all that matters.

Karen.

[JoanneB]

Hmm, I think I relate as far as falling into the lucky category goes.  I never "hated" being male and I'd gotten pretty good at being a boy so to speak.  What I've come to realize though is that my dysphoria hasn't presented as a rejection of my physical body but rather of reality as a whole.  I've suffered from a sort of existential dread my whole life that I could never find a reason for until I finally realized that I wasn't happy living as a man anymore.
Since accepting that I'm Trans, that dread has gone.  Now that I'm happy (ok, still a work in progress but way better) with myself, I'm strangely at peace with the weirdness of the world around me. 
I don't know if any of that speaks to your experience, but I do know that my personal stress levels are greatly reduced and I'm pretty sure that chronic long term stress is a greater cause of negative health impacts than HRT.

What she said!

About the only thing I can think of adding is how most of the train wrecks in my life I can attribute indirectly to being trans. Finding that root cause is what led me away from a life of distractions, diversions, and denial to one often times filled with joy as I've come to embrace being trans. Like what choice is there? I know after 50 years I cannot stop being trans

[Nathine]

Everyone has their own story and path to follow. If possible see a therapist, to talk about the issues. It sounds more like you fit the "full time cross dresser" aspect of the spectrum. You want to look and be treated as female, but not necessarily be female. Once on HRT things do change. Breast development, to some extent, loss of upper body strength, loss of muscle bulk and abdominal fat, skin thinning and softening, change in pheromones etc. If on HRT long enough, changes can become permanent, so going back to "male" can be a problem and costly. Make sure this is what you want to do.

[Annah]

never met a crossdresser who suffers from bouts of dysphoria as much as the OP describes.

But yes, I would recommend the OP to see a therapist before we hand out labels for her.

[PaigeMtl]

This may be obvious to some but I made the mistake of not differentiating between a regular therapist and a specialized sex-therapist in the beginning... big difference.

They some times cost more but you won't be wasting your time or money in the end.

[JenniL]

Like all the previous ladies have stated,  see a therapist that specializes in gender identity. This will allow you to work out issues and such before you make a decision. Honestly, you should be only one deciding if transitioning is right for you.

As for the DVT and short life span, honestly transitioning and going on HRT caused me to stop smoking, and take better care off myself. I got myself back in shape somewhat lost alot of weight. I go to the doctor regularly, report things that don't seem right and you can live a long and productive life. If anything I think I added a few precious years to my life

Jennifer

[ZoeNicole]

Much like Jennifer, my personal lifestyle has improved since I decided to do something and I am alot healthier than I used to be. Even exercising regularly and taking care of myself as I want to improve my physical self as much as possible

[Stephe]

I was actually fairly happy as a guy and had a pretty decent life pre-transition. I had no decent relationships and one failed marriage but enjoyed my work, had some decent friends and for the most part had fun. I wasn't one of the people who would have slit their wrists if I couldn't transition either. It seems like the older I got the more it wore on me and I realized there wasn't really anything stopping me for living as the gender I always wanted to be, so I did something about it.

All that said I starting living full time 3 years before I started HRT. I know you read "the list": you must have full electrolysis, be on full HRT for a year etc before you consider going full time. It's just not true. Plus you don't have to take massive doses of HRT, I really believe a reasonable dose of a T blocker and E isn't going to shorten your life span to any degree. As far as libido, I lost some of what I call the male sex drive, (morning erections etc) which I am glad is gone but I still have a decent sex drive and things still work fine when there is some stimulation/something worth getting excited about.

I really don't think you have to choose either or and I totally relate to NOT wanted to be treated like a man but to be seen and treated as a woman. That was my goal as well and I am now

[Stranger]

I do hate, however, not having people see me for who I am and I hate that my body (which I'm grateful to for seeing me through a half-century) doesn't look or feel the way that it should.

Will we be happier in transition? I can't know that. I just feel that, happy or no, I can't stay where I am.

I feel that sense of necessary momentum as well. I think there's some part of me that's angry, or at least resentful, that it's *me* that needs to change because *they* attach so much significance to my being born a man. But then I do the same thing when I look in the mirror and feel unhappy about having a male body.

There's only one way to find out I guess, and that is to try.  My mood improved dramatically within a few days of starting HRT, after years of chronic Depression.  If you don't like how it makes you feel you can always stop after a few weeks trial.  The only concern is whether it will affect your fertlitiy if you decide you want children.

For various reasons, children aren't an issue, which makes that part of things easier. When it comes to trying, here's something I'm unsure about - when seeking prescriptions for HRT medication, I assumed we had to demonstrate that we were 100% ready and committed to the process. Is it okay to openly confess "I'm not sure I'll want to stick with this, but I'd like to give it a shot?" Though I guess this depends on who I see, and where I go...

About the only thing I can think of adding is how most of the train wrecks in my life I can attribute indirectly to being trans. Finding that root cause is what led me away from a life of distractions, diversions, and denial to one often times filled with joy as I've come to embrace being trans. Like what choice is there? I know after 50 years I cannot stop being trans

Yes, it does seem to have a way of turning things upside down! I'm already feeling better these days by having talked about it, with some close friends and of course my partner. It's given me a way of articulating something that I've experienced kind of vaguely as a life-long dissonance.

Everyone has their own story and path to follow. If possible see a therapist, to talk about the issues. It sounds more like you fit the "full time cross dresser" aspect of the spectrum. You want to look and be treated as female, but not necessarily be female. Once on HRT things do change. Breast development, to some extent, loss of upper body strength, loss of muscle bulk and abdominal fat, skin thinning and softening, change in pheromones etc. If on HRT long enough, changes can become permanent, so going back to "male" can be a problem and costly. Make sure this is what you want to do.

This could be true. Many of the physical changes don't bother me (at least in theory; who knows what they'll feel like?). Quite a few seem welcome: I'm short-ish and slender, and have never had much fat or muscle, which has always been fine by me. As for skin, I've been religiously cleansing, exfoliating, and moisturising for nearly a decade, and while I'm pretty soft for my age, I'm inevitably getting coarser. For the future I can look to my father, who's tough as leather. So softer skin would reassure me. So would reducing the chance of losing my hair, which I've worn long ever since I was old enough to have the choice, and which I have an irrationally-strong attachment to. Of course, my father is bald. I love the guy, but maybe I have father issues

But I certainly have no idea what it would be like to have natural breasts, or to experience pheremone change. One of my big fears initially was that HRT involved personality changes, though further investigation seemed to suggest this was implausible. I'd like to believe that rather than becoming anyone or anything else, I should accept myself as I am, with an imperfect body but with every right to present and act as I prefer. I just don't know how difficult this might be when more physical changes creep in five, ten years down the track.

As for the DVT and short life span, honestly transitioning and going on HRT caused me to stop smoking, and take better care off myself. I got myself back in shape somewhat lost alot of weight. I go to the doctor regularly, report things that don't seem right and you can live a long and productive life. If anything I think I added a few precious years to my life

Sounds motivational! I'm pretty good generally, with a careful nutritional diet, no alcohol or smoking, etc, but my only exercise lately is walking an hour or two each day. And when I'm having an off-day, no exercise at all. But my worst problem is definitely not seeing the GP often enough. Regardless of what happens to me, I should look into changing that.

All that said I starting living full time 3 years before I started HRT. I know you read "the list": you must have full electrolysis, be on full HRT for a year etc before you consider going full time. It's just not true. Plus you don't have to take massive doses of HRT, I really believe a reasonable dose of a T blocker and E isn't going to shorten your life span to any degree. As far as libido, I lost some of what I call the male sex drive, (morning erections etc) which I am glad is gone but I still have a decent sex drive and things still work fine when there is some stimulation/something worth getting excited about.

Yes, I'd read online an equivalent of the List, and it was overwhelming! It's reassuring to think that these are more like guidelines. I've already gone past the point of social stigma in the way I dress in public, so as long as I'm not physically in any danger, I think I can handle some of the stares and double-looks. The main thing that keeps pushing HRT to the forefront of my mind is reading, here and elsewhere, the urgency with which people recommend getting HRT "before it's too late." But hell, what's really to say it's too late so long as I'm both happy and certain?


Thanks to everyone who responded, you are all wonderful and inspiring