Androgynity and HRT

[930310]

This is just a theoretical post since I'm not on HRT and haven't consulted any specialists either (Mainly because Sweden sucks in diagnosing anything but transsexuality).

The thing is this. I am not comfortable in my body as of now, I do wish to feminize it, but I'm not interested in growing breasts. I have read around a bit and I know that if you are on MTF-HRT you will grow breasts among other things. I've also read that you can remove your breast glands surgically and this will prevent any breast growth.

So here's the scenario: If I did get a prescription for HRT, would it be best to have the removal surgery before starting HRT, during or after the feminization starts slowing down(About 2+ years in)?

Are there any other alternatives, except training/dressing more androgne you know of?

And again, this is just a theoretical question.

[ErinWDK]

I am working with a specialist to get HRT.  I am looking at the whole package.  This will grow breasts and I am OK with it.  This works as I am saying I am MtA as I am not at all sure I could pass as MtF starting from where I am starting (but that would be a nice place to go).

For you not wanting breasts but some feminization you will need to fine tune HRT.  A milder form of anti-androgen that won't cause some of the T to be aromatized into E and maybe a VERY low dose of E.  This will take working with a specialist with a real sub-specialty in Androgyne.  The specialist I can get to does not have that extra touch, but does work directly with my primary care physician.

This is not at all cut and dried.  But it can be done.

Personally I would not care to grow something I don't want only to have it cut off.  That suggests subjecting your body to all sorts of needless excess hormones.  Just my opinion.


Erin

[Madison (kiara jamie)]

i have grown mammary glands but i also have a significant amount of fat tissue development in my breasts, you can remove the mammary glands but you will still have an increase in fat located in the pectoral area,

also if you are not wanting to grow large breasts, make sure you don't take progesterone, and ask for spironolactone as your anti-androgen since it causes fusing of your breast buds, thus reducing mammary development

[930310]

Hi, thanks for your replies. As I stated earlier I live in Sweden and here it isn't possible to be put on hormones unless you are MTF/FTM, which I don't believe I am. I will see where this leads, but I'm hopeful for more replies and hearing more opinions.

[KayXo]

ask for spironolactone as your anti-androgen since it causes fusing of your breast buds, thus reducing mammary development

This is a theory, not proven at all! A theory advanced by a doctor in the UK but with no real scientific basis behind it. I read the entire study, several times. It lacks scientific rigor and details. Many girls on Spiro have significant breast growth. And it's a common side-effect of Spiro, taken alone. I think the fusing was also blamed on by the exposure to too high levels of estrogen vs. gradually increasing, something of that sort.

[helen2010]

930310

Good question and it is one which  I have had to deal with.  I need HRT to deal with my intense GD.  HRT quitened the demons but there is always a physical consequence - the extent depends on your age, the hormones involved, the dosages, your diet, exercise regime, starting weight and genetics.   It is therefore very true that YMMV.

Dealing with unwanted physical change therefore requires you to look at the factors and determine which can be best adjusted in consultation with your endo.

In my case I reverted to low dose HRT to minimise/delay physical change.  Like you I was most uncomfortable with breast growth.  I therefore elected to have a breast reduction which took me from a C cup to quite a flat chest.  My surgeon advised that I had two options - fat and breast capsule removal or just fat removal and re sculpting.

Because I didn't know where I would eventually head I chose the second option.  I was warned that the breasts may return but I accepted this knowing that I would have time to progress in my understanding and confidence in whatever self expression or presentation that I might choose.   Only downside was some short term loss of nipple sensitivity.

You should certainly discuss your options with your endo and with your surgeon if you choose to take this path.  Note that it may take your breasts up to 5 years on normal levels of HRT to reach their final size but again YMMV.

Safe travels

Aisla

[KayXo]

I think, if I recall correctly, that there are selective estrogen receptor agonists that trigger estrogen receptors in some tissues but don't in others like breast tissue. Tamoxifen, perhaps? You should check it out. This could be exactly what you're looking for. Anti-androgens reduce/inhibit androgen strongly and the less active androgen there is, the less breast tissue is inhibited. Good luck in finding what you need for you.

[930310]

Concerning Mileage and results. I'm 20 right now, I turn 21 march 10th. I am about 1.88m/6'2" and weigh 70kg. What concerns me here is that my mother is really big breasted. She hasn't had any surgery and is about a D or so.

[helen2010]

Given your genetics and age you will need a low dosage and then work out when you wish to have surgery.  Even if you remove the breast capsule, HRT will cause continued fat deposition so you will see further change.  Your call but think about where you are heading, whether you wish to retain enough tissue to support a successful BA if you later decide that this is where you wish to head.  Lots to think about and lots of professional advice worth seeking.

One further cautionary note.  For me HRT is addictive which means that I need it and have always found it to be a real struggle to maintain a low dosage as even a small increase significantly improves my emotional well being

Safe travels

Aisla

[Tori]

This is just a theoretical post since I'm not on HRT and haven't consulted any specialists either (Mainly because Sweden sucks in diagnosing anything but transsexuality).

The thing is this. I am not comfortable in my body as of now, I do wish to feminize it, but I'm not interested in growing breasts. I have read around a bit and I know that if you are on MTF-HRT you will grow breasts among other things. I've also read that you can remove your breast glands surgically and this will prevent any breast growth.

So here's the scenario: If I did get a prescription for HRT, would it be best to have the removal surgery before starting HRT, during or after the feminization starts slowing down(About 2+ years in)?

Are there any other alternatives, except training/dressing more androgne you know of?

And again, this is just a theoretical question.

You will experience a puberty. YMMV.

If you start... And continue... You just might like it. Otherwise, stop.

[930310]

Hi, none of your comments are doing anything but stating what's already been mentioned her though. I don't really know what to do here. Since I am not sure about my gender identity I don't think it's the right way to start with going to a psychiatrist and talking about gender issues until I'm sure about myself. The thing here in Sweden is that you can't get a diagnose such as MTA or so. You must be either MTF or FTM according to the gender evaluation clinics you go to to be diagnosed/prescribed hormones. So I'm pretty much screwed whatever I do here...

[Danielle Emmalee]

I would imagine going to a psychiatrist might actually help move finding your gender identity along faster, but then again, if they don't know of anything other than MTF, I'm not so sure.  Perhaps an online therapist from the US would be an option, depending on if there is a doctor in Sweden that will take a letter from an out of country therapist.  I am currently considering this therapist: http://www.brandnewdaycounseling.com/

[Jamie D]

Hi, none of your comments are doing anything but stating what's already been mentioned her though. I don't really know what to do here. Since I am not sure about my gender identity I don't think it's the right way to start with going to a psychiatrist and talking about gender issues until I'm sure about myself. The thing here in Sweden is that you can't get a diagnose such as MTA or so. You must be either MTF or FTM according to the gender evaluation clinics you go to to be diagnosed/prescribed hormones. So I'm pretty much screwed whatever I do here...

Maybe it is time to start to pull down those walls!  Perhaps Sweden needs to move out of the 1960s.  Raise hell.

Every advancement begins with one person who sees beyond the status quo.

I will help you in any way I can.

[930310]

Thanks Jamie and Caysee!
I know that Sweden is a backwards country in this area and I really hope that things are going to change in the future. I'm actually considering to become a psychiatrist myself one day, but that's a long way yet. I hope that I get into Medical school this fall, I'm currently studying engineering but that's not for me.
I'll see what happens if I contact them and hear what they have to say.

[Jamie D]

Thanks Jamie and Caysee!
I know that Sweden is a backwards country in this area and I really hope that things are going to change in the future. I'm actually considering to become a psychiatrist myself one day, but that's a long way yet. I hope that I get into Medical school this fall, I'm currently studying engineering but that's not for me.
I'll see what happens if I contact them and hear what they have to say.

That is a noble calling!  Best of luck to you.   

[Kaelin]

I'm pursuing an ~androgyne path.  A "low" dose of E (estradiol), even with nothing else, was enough to start genuine breast development in less than two months.  YMMV, but any dose of E without surgery may not work if you want to avoid development.  On the other hand, if you are okay with some development, you can try riding using a low dose and either stop or seek a breast reduction later on as needed.  Depending on the sort of feminization you are interested, are open to, and would rather avoid, you may have more success with other options.

That said, I can't speak to the efficacy of progesterone and anti-androgens.  We don't know a whole lot about the effects of each of these separately due to the very issue of MTF and to a lesser extent FTM being the faces of TG in the research community -- there hasn't been much attention paid to more-limited treatment goals.  However, I do believe there have been some MAAB TGs around these parts who have not used E but have used progesterone and/or AA, and they may be able to offer their own testimony.

I think you are going to have to at least *try* talking to a psychiatrist and laying out your situation.  It's possible you're going to be refused.  It's also possible you'll be accepted.  It's also possible you can receive treatment with some amount of negotiation: you're certain you're not right in your current body, and that while you don't think that the full-on female transition is right for you, you are nevertheless remaining open to the possibility -- however, you would like to take a conservative approach and begin with a hormone regimen more-consistent with your presumed identity.  Whatever changes you undergo should not interfere with your ability to undergo a MTF transition later on, and you can shift to a full MTF transition if you decide that makes more sense.  If the psychiatrist expresses concern regarding whether this approach is consistent with best practices, the WPATH Standards of Care offers supporting research.  If the psychiatrist seems open to considering what you are laying out, then you may be able to make things happen.  If the psychiatrist does not appear receptive, you may try finding a different psychiatrist if another one is available.  It may sound overly-optimistic to think this approach can work, but not every medical professional applies a literal interpretation of what conventional policy calls for -- some of them recognize that medicine changes over time, and they have to be willing to consider new cases such as yours if evidence suggests a different approach is needed.

If that fails, the "raise hell" option is still open.  You'll also have your own personal testimony that the system failed to respond to your health care needs, so it'll give your "raising hell" move a little more punch than if you just assume the system won't treat you.

[helen2010]

930310

From Kaelin's comments she seems to be on a similar path to that which I have followed.  Thankfully my path in Australia is supported and it appears that it would also be supported in North America.  I am not sure about the situation in the UK but from a distance  it usually appears to be similar to that in North America in most areas.

While it may not be true in Sweden, in Australia some endos are often more current in their practice and philosophy than others so it may be worth seeking advice and insight from the Swedish TG community before selecting an endo and booking an appointment

Safe travels

Aisla

[930310]

I'm pursuing an ~androgyne path.  A "low" dose of E (estradiol), even with nothing else, was enough to start genuine breast development in less than two months.  YMMV, but any dose of E without surgery may not work if you want to avoid development.  On the other hand, if you are okay with some development, you can try riding using a low dose and either stop or seek a breast reduction later on as needed.  Depending on the sort of feminization you are interested, are open to, and would rather avoid, you may have more success with other options.

That said, I can't speak to the efficacy of progesterone and anti-androgens.  We don't know a whole lot about the effects of each of these separately due to the very issue of MTF and to a lesser extent FTM being the faces of TG in the research community -- there hasn't been much attention paid to more-limited treatment goals.  However, I do believe there have been some MAAB TGs around these parts who have not used E but have used progesterone and/or AA, and they may be able to offer their own testimony.

I think you are going to have to at least *try* talking to a psychiatrist and laying out your situation.  It's possible you're going to be refused.  It's also possible you'll be accepted.  It's also possible you can receive treatment with some amount of negotiation: you're certain you're not right in your current body, and that while you don't think that the full-on female transition is right for you, you are nevertheless remaining open to the possibility -- however, you would like to take a conservative approach and begin with a hormone regimen more-consistent with your presumed identity.  Whatever changes you undergo should not interfere with your ability to undergo a MTF transition later on, and you can shift to a full MTF transition if you decide that makes more sense.  If the psychiatrist expresses concern regarding whether this approach is consistent with best practices, the WPATH Standards of Care offers supporting research.  If the psychiatrist seems open to considering what you are laying out, then you may be able to make things happen.  If the psychiatrist does not appear receptive, you may try finding a different psychiatrist if another one is available.  It may sound overly-optimistic to think this approach can work, but not every medical professional applies a literal interpretation of what conventional policy calls for -- some of them recognize that medicine changes over time, and they have to be willing to consider new cases such as yours if evidence suggests a different approach is needed.

If that fails, the "raise hell" option is still open.  You'll also have your own personal testimony that the system failed to respond to your health care needs, so it'll give your "raising hell" move a little more punch than if you just assume the system won't treat you.

Spot on!
Thank you so much for this. This explains my situation well and you gave some great advice too. I'll try to get an appointment to a psychiatrist and hopefully I'll get somewhere then. As for the possibility that I'll get accepted I believe they're next to none. In Sweden there exists three teams of psychiatrists who specialise in this area and they only diagnose transsexualism. It's really sad that there are about 10 of these psychiatrists and 10 million people in Sweden.

[Mirian]

930310, my two cents if you care...
From your photo you're so PRETTY, really, and that's a luck for you since everything you'll
decide to do with your body will result in a success, believe me !

As for the HRT and your situation... I don't believe you can avoid some degree of breast
growth. When I just started with Spiro at 16, my breast started growing a bit aswell... not
so much, but to the point of being noticed when I was bare. However I'm not and expert
endocrinologist, I think there may be some selective AA drug around without either
estrogenic or progestogen effects. But again, you're so damn pretty that you'll perhaps
need taking just very few of it.

But please read on, before thinking of removing your breast glands !!! One day you
might repent seriously !!!

A bit of my story in short: even if I'm a woman now and I had my SRS about 10 years ago,
even if I always had quite female appearance since I was born and I realized around my
20s I was a woman inside too, that took me really some time to realize !!!
Simply because I was pretty born and grown and treated and also named as a male, and
it takes years before one develops such a maturity inside to understand one is actually
female inside also - when that is the case !!! That said, when I started refusing my body in
my puberty and I was desperately searching a doctor for starting my HRT, I initially wasn't
aware of the fact I wanted to be a girl: paradoxically, this idea almost scared me
initially ! And thus I was asking just them for an AA therapy to feel and look "less male",
I was asking them to be more "androginous", me too !!! (And you're fully so, believe me !)
But they warned me, that I would have developed breasts aswell, they asked me whether I was
sure or not. And I at those times replied NO, that I didn't want a breast ! But actually I
rather felt quite unready, ashamed maybe, to find the bravery to tell, even just to myself,
I wanted it and I wanted to be a woman. So I felt quite as you feel now, at those times !!!

Well, here's how the story went on: finally I had the luck to find an endocrinologist
(female) expert in HRT for TG people, who ACCEPTED this fact, my unreadiness, and also
accepted to follow my desires and my possible future developments without forcing me
in any direction. Well, as soon as I started my AA and Estrogens, however, I really
gained that well being, those certainties I could't find before... and in few years
I felt ready for transitioning and I realized one day (looking at my bare body) that
at the end my aim was not that ambiguity, as I believed, but I wanted to be a girl.
And I started loving this idea, like a developing blossom...
So please consider what happened to me before taking extreme choices

Good luck !
Miriam

[930310]

Hi Mirian and thanks for replying. I can't see myself as pretty and I have never thought of myself as that either.(I was bullied A LOT when I was younger and I have an extremely low self-esteem because of that...
I understand your arguments and I agree with them too. I don't know who I am and I can't remember when I knew myself, if ever. I don't have any stories about dressing up girly or telling my parents so either. I've always just been, I've just walked through my whole life not knowing anything about who I am where I'm heading. I have Aspergers and I'm pretty limited in my ability to speak with other people. I know that this is mainly the reason that I was bullied when I was younger too, and I've always heard from others that I was different and stupid etc. so yeah whatever I don't know. But thanks for replying.