Why don't trans women over a certain age progress beyond Tanner 3?

[ShadowCharms]

Hi everyone,

I've been on hormone therapy for 2 years now. I have pretty noticeable breast development, but it really stopped for me at Tanner stage 3. I started transitioning at 28, and it's my understanding that it's typical for trans women my age to not progress beyond about Tanner 3. It's my understanding that if you want to go all the way through Tanner 5, you really have to start as a teenager or in your very early 20's. I keep coming back to the question of why that would be, and if there's any way around it. It seems like if my body could have gone through tanner 5 at some point in my life, there ought to be a medical or scientific way to jump start that process again, or simulate the conditions that would have allowed that growth when I was younger.

Does the medical community know what the difference is between age 18 and age 30 that causes development to stop part way through?

[Girl Beyond Doubt]

I am 45 years old, started HRT two years ago, Tanner stage 4 (34 D) and counting.

They grow in spurts.
Adding micronized bioidentical progesterone to my HRT half a year after my SRS started another growth spurt.
I keep my BMI between 19 and 23, eat mostly vegetarian, don't drink, don't smoke, don't exercise much.

[Jenna Marie]

I'm honestly not sure this is true; my endo, who is the go-to person for trans people in the area, says most trans women she sees do get full development eventually. I wonder if it's partly that people underestimate how long development can take (cis girls can take 5-10 years to finish puberty) and/or the Tanner stages really aren't the only way of measuring whether breasts have fully matured. It's an easy way for the layperson to understand, but not every breast will conform perfectly with a chart.

I know I am fully mature/Tanner V according to every doctor who's examined me in the last year or so; it took almost six years on HRT but they might finally be done. Or not, since I've thought this before and then had a bit more fat/padding show up!

[Laura_7]

Hi everyone,

I've been on hormone therapy for 2 years now. I have pretty noticeable breast development, but it really stopped for me at Tanner stage 3. I started transitioning at 28, and it's my understanding that it's typical for trans women my age to not progress beyond about Tanner 3. It's my understanding that if you want to go all the way through Tanner 5, you really have to start as a teenager or in your very early 20's. I keep coming back to the question of why that would be, and if there's any way around it. It seems like if my body could have gone through tanner 5 at some point in my life, there ought to be a medical or scientific way to jump start that process again, or simulate the conditions that would have allowed that growth when I was younger.

Does the medical community know what the difference is between age 18 and age 30 that causes development to stop part way through?

Talk to your endo.
There is a well known effect that breasts grow during pregnancy.
A higher level of estrogen and bioidentical progesterone might help.
Usually safe are considered implants and injections.

Oral/sublingual intake in high doses might cause some clotting factors and liver strain.

Most unfavorable studies for higher levels are with non bio identical estrogen and oral intake.

For internal application of bioidentical estrogen there are no unfavorable studies I'd know of.

After all women have naturaly high levels during pregnancy.


hugs

[KayXo]

Adding progesterone may help and waiting...it takes time...2 yrs is nothing. 5-7 yrs, up to 10 yrs.

[Ms Grace]

If a genetic girl starts puberty at 12 it is unlikely the breasts she has developed by age 14 are the most growth she can expect, the same applies to trans women after two years of HRT as the belief that the breasts stop after two years is a myth. That said, the main difference between the puberty and breast growth of a cis teen girl and an adult (20+) trans woman is that cis puberty is full of a lot of hormones, not just estrogen or testosterone... their bodies are growing in many ways and I suspect the biology is extremely complex. Taking HRT is a "neat" and artificial replication of a bonkers process so the results are bound to be different and restrained.

[Lady_Oracle]

adding on to what everyone else has said, trans women (who have undergone T exposure) in general usually have larger chests so even if the breasts are mostly developed they can still look under developed much like a flat chested/small breasted cis women who have full development, despite that because of the smallness they can look under developed. Hence why so many opt for larger implants which looks great on a broad chest.

Another factor that can really change their look is the loss of muscle mass. My breast shape changed dramatically once I lost what lil muscle mass I had in my back and around my chest. That took a few years and then about 4 months into my 2nd year I hit stage 4. It happened coincidentally around the time I was switched over to injections but it was just my right breast. The left finally hit four not long after.

[Debra]

I transitioned at 28 as well....wondered the same....I waited 3 years and finally just got BA. Went from 34B (small B) to 34DD which is just right for my frame.

[KayXo]

That said, the main difference between the puberty and breast growth of a cis teen girl and an adult (20+) trans woman is that cis puberty is full of a lot of hormones

The key hormone being GROWTH hormones. Progesterone, I think, also plays an important role and this can be seen in pregnancy where levels are VERY high, up to 200 ng/ml.

[stephaniec]

2 years , 38 DDD   64

[Cindy Stephens]

 I was 50 when I started and have been on HRT for about 13 years.  I got to tanner 3 after 8 years then added a progestin after growth had stopped.  I am now at least a 4 and probably closer to a 5.  It is possible.   

[iKate]

Do the tanner stages have to do only with size or other stuff? I'm a little over a year and while I have good size (41 bust, 31 under and I wear 34C comfortably) my nipples aren't as developed as I'd hoped they would be. They are slightly bigger than pencil erasers and not that big. I'm hoping progesterone will help though.

[Jenna Marie]

Tanner stages have nothing to do with size; there are small-breasted women who are Tanner V and large-breasted women who aren't. It's possible to Google for the chart with pictures... I'm not going to link to it, just in case. But yeah, it's mostly about nipple presentation/development [not size] and breast tissue.

[Lady_Oracle]

^ Yeah that, its like I said in my post, you can have tiny breasts and be fully developed. My nipples and areola despite the breast itself not gaining much in size, have changed dramatically in the past year alone (my third year of hrt). The areola enlarged again and nipples are a lot bigger too. I was afraid I was going to have tiny areolas unless I got a breast aug done but nope, I'm pretty happy with them.

I feel like a lot of myths surrounding our breast development are cause of the old hrt regimens/protocols.

[Debra]

I've also taken bio-identical progesterone and prometrium in both oral and cream form off and on over the last 6 years and have never really noticed any breast growth from it......it's just always pointed to genetics for me.

My mom and sister have pretty small boobs.

[ShadowCharms]

It's encouraging to hear that I may be able to continue to see some growth. In my case, it's not so much size that I'm concerned with as getting all the way through development. My doctor says I'm at Tanner 3, and I have been for about a year now. I seem to have stopped developing after about a year on hormones. I haven't had the secondary mound form, or the rest of the development after that. My boobs exist, but they don't stick out all that much. I look more like I have gynecomastia than like a cisgender woman. I definitely have boobs. If I don't wear a bra all day, they hurt, and you can see them from the side. They just don't look fully developed.

So far, I've been on spironolactone, depo provera, finestride, and estrodial. We've been having a pretty hard time keeping my estrogen levels high. They'll get up to around 120 every time we raise my dose, and then the next time we test, they'll be back down to around 50. I take some other medications that can interfere with the estrodial. I'm taking estrodial in pill form. We haven't tried the patches or injections yet. I think I might try those after I get SRS. I can't take two forms of progesterone, so unless I go off of the depo provera, I'll have to wait until after SRS to see if some other form of progesterone could help with breast development.

I've been curious about fat transfer breast augmentation. It sounds like increasingly, surgeons are using techniques to try and improve the chances of stem cells in the fat preventing the fat from calcifying. I'm curious about whether those techniques might also promote additional breast development in trans women.

[michelle666]

I started HRT in April of 2014 and went on injections in August 2014. I'm now a 36-C, Tanner 5 and the Tanner stage is confirmed by my doctor. Of, I started HRT at 43(a few months shy of 44) and I'm 45 now.

[Debra]

Just curious, when are you taking your estradiol vs when you are getting your blood drawn? It makes a difference.

I've tested it and if I take my estradiol an hr (or less) before the draws, my E is high but if I wait 8-12 hours, it's pretty low. It was discussed on another thread as well that E may possibly have a half life of about 6 hrs (depending on the dosage?) so it's best to take it multiple times per day instead of one big dose daily.

But always a good thing to keep in mind about when you take it vs whenyou get your blood drawn.

As for fat transfer to boobs, I have a natal gf that did it last year and she loves it. I'm not real familiar with it and didn't end up going that route for mine because it wasn't quite as 'tried and true' as just using implants. But it seems to be working for some!

[michelle666]

Just curious, when are you taking your estradiol vs when you are getting your blood drawn? It makes a difference.

I've tested it and if I take my estradiol an hr (or less) before the draws, my E is high but if I wait 8-12 hours, it's pretty low. It was discussed on another thread as well that E may possibly have a half life of about 6 hrs (depending on the dosage?) so it's best to take it multiple times per day instead of one big dose daily.

But always a good thing to keep in mind about when you take it vs whenyou get your blood drawn.

As for fat transfer to boobs, I have a natal gf that did it last year and she loves it. I'm not real familiar with it and didn't end up going that route for mine because it wasn't quite as 'tried and true' as just using implants. But it seems to be working for some!

I'm on injections and am supposed to get my blood drawn in between shots. Well this past Friday I forgot that and went in for my labs the morning after my shot and now I have to go back and get it done again. My E level was 2086 and it's usually around 300. My doc called me and knew exactly what happened.

[KayXo]

So what is the point of measuring levels if they go from 300 to 2000?! Doesn't make sense.