Here's my situation.
My T-levels are naturally low - both total (307.8 ng/dL) and free (8.52 pg/mL) levels. The latter you may notice is falls completely off the scale of the cis male reference range and approaches that of the female range.
I find this intriguing, as I've always noticed a natural femininity about my body that has had me be fairly at peace with it. I have no dysphoria; I embrace myself as I am.
Thus I think my goals with HRT are different than most. I'm not looking to so much to repress a part of me that I find abhorrent; rather, I'm trying to promote my feminine qualities that are naturally occurring. I want to give my body the chance to go through puberty just as if I were a cisgendered woman, and I want to create a hormonal environment in which it can do so.
My primary care physician (who is a very qualified transgender specialist) works on an informed consent model, and thus a lot of these decisions are entirely in my court. Given what I've described to her - and given my hesitancy towards losing my erections and fertility issues - we have conjectured that it might be a good call to go without antiandrogens for the moment.
For now she has prescribed for me Estradiol. She has told me that as I am still working out with my therapist whether this is worth the potential side effects (namely the small possibility of permanent fertility effects, the possibly negative effects on my libido & other health concerns), she wanted to give me that prescription with the understanding that I can start and / or stop at any time.
So... I have a few questions for the community here at this point:
- Does it make sense to all of you to start without AAs given my baseline chemistry and goals?
- Is it normal to start with such a low dosage of Estradiol daily w/o any other medication?
I don't want to jump the gun, but part of me thinks that even with my low testosterone levels I should be starting with either a higher dosage or with some degree of AAs if I want the medication to have any meaningful - or even noticeable - effect...