"Try HRT and see how you feel?"

[heather3791]

Hi everyone. I've read several post here on Susan's, ->-bleeped-<- and other sites where people suggest to others to "try HRT and see how you feel." Many times the initial post is from someone contemplating transition (MTF) or from someone who is wrestling with the idea that they may or may not be transgender. Now I personally am trans but my decision of if and when to start HRT has not been made yet. If I do start HRT then my relationships with others both personally and professionally will change considerably. For this reason I am taking things very slow and putting a lot of careful thought and consideration into my final decision. My concern is that once HRT is started that the changes with breast development could be permanent and irreversible within a relatively short period of time. Yes, I know YMMV and this breast development takes months to years to reach its maximum but at what point does it become irreversible? I've read from people who report budding breast in just two weeks. Now for trans folks who are 100% cool with transitioning fully and have no intention of turning back then this early breast development will no doubt be a welcomed change. But what about that person who is unsure and who may have second thoughts? An example might be someone who starts HRT (just to try it out) and then just 3 or 4 weeks in starts to bud breast. Then for whatever reason they decide it's not for them. Are those buds then permanent and irreversible and will they have to just live with them? I don't know the exact answers to this question which is why I'm posting to get your feedback. But one thing that is clear to me (IMHO) is that folks who offer the suggestion to "try HRT and see how you feel" need to be very clear about the potential permanent affects that could in fact be irreversible. Thoughts?

[StacyRenee]

From what I've read from various online sources, breast tissue (buds) will reduce in size but not disappear entirely. My son was once very overweight and has developed breast tissue (man boobs) that will never go away completely. He's lost well over 100 lbs. and still has bigger boobs than me. [emoji25] Surgery is about the only way to completely remove it all, much the same as what trans men do when they have top surgery.

I would think two months would be about the point that most would have enough growth that some tissue will remain. After around a year you run the risk of sterility.

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[Devlyn]

Hi everyone. I've read several post here on Susan's, ->-bleeped-<- and other sites where people suggest to others to "try HRT and see how you feel." Many times the initial post is from someone contemplating transition (MTF) or from someone who is wrestling with the idea that they may or may not be transgender. Now I personally am trans but my decision of if and when to start HRT has not been made yet. If I do start HRT then my relationships with others both personally and professionally will change considerably. For this reason I am taking things very slow and putting a lot of careful thought and consideration into my final decision. My concern is that once HRT is started that the changes with breast development could be permanent and irreversible within a relatively short period of time. Yes, I know YMMV and this breast development takes months to years to reach its maximum but at what point does it become irreversible? I've read from people who report budding breast in just two weeks. Now for trans folks who are 100% cool with transitioning fully and have no intention of turning back then this early breast development will no doubt be a welcomed change. But what about that person who is unsure and who may have second thoughts? An example might be someone who starts HRT (just to try it out) and then just 3 or 4 weeks in starts to bud breast. Then for whatever reason they decide it's not for them. Are those buds then permanent and irreversible and will they have to just live with them? I don't know the exact answers to this question which is why I'm posting to get your feedback. But one thing that is clear to me (IMHO) is that folks who offer the suggestion to "try HRT and see how you feel" need to be very clear about the potential permanent affects that could in fact be irreversible. Thoughts?

The person trying HRT is the one who needs to be cautious and know what they want. All of the effects are covered by your provider before you start HRT, and also in the drug information sheet that comes with each and every refill of your prescription.

Hugs, Devlyn

[Angelic]

Well if you don't want to take estrogen, take testosterone and see how you feel. I doubt it will make you feel any better honestly.

[Virginia]

The person trying HRT is the one who needs to be cautious and know what they want.

^THIS

If I do start HRT then my relationships with others both personally and professionally will change considerably.

Not necessarily. HRT may simply relieve your dysphoria so you can be content living your life as a guy.

I know YMMV and this breast development takes months to years to reach its maximum but at what point does it become irreversible?"

Breasts don't sprout over night, but you can't have your cake and eat it too. If breast growth/permanence is a concern, why would you even consider pushing the envelope? Provided a person is not on injectable hormones, HRT can be stopped the minute they feel hormones are not right for them, ...LONG before any breast growth or permanent changes.

[KathyLauren]

Breast development is permanent.  Someone on HRT who decides to stop needs to make that decision before the breasts exceed the plausible range of gynecomastia ("man boobs"). 

If the person decides that the breasts are already too big to be acceptable, the only option is a double mastectomy.  And that, too, is permanent.  Once a mastectomy has been performed, there is no breast tissue left to try again.

As has been mentioned above, before starting HRT, your physician or therapist will do an "informed consent" exercise, explaining to you about these and other effects of HRT, and will get you to sign an informed consent document.  If you have any doubts at that point, don't sign!

[Lucca]

My son was once very overweight and has developed breast tissue (man boobs) that will never go away completely. He's lost well over 100 lbs. and still has bigger boobs than me. [emoji25]

Is that how it works? I didn't think that if your breasts grew due to weight gain, it sticks there even after you lose the weight.

[ds1987]

I started the process of coming out to myself and some family and close friends months before starting hormones.  I wanted to see if that would feel genuine, and it did.  I came out publicly as transitioning on my birthday last year, three months before I started hormones.  I had actually gone to the doc that month but ended up holding off because I was still too nervous to start.

I went in last April and intended to only start spiro - the most common default anti-androgen med - and talked with the doc about any and all side effects that would come about with that or if I started with that and Estradiol all at once.  He told me that I would feel some changes with the Spiro, but only recommended I be on that alone for a few months, since we should have one of the two hormones present in our bodies.  He then told me that I should feel mental changes within two weeks and that none of his patients - he practices out of an LGBT clinic in Boston and specializes in trans care - had developed physical changes until a couple of months in.

Essentially, he said that I would know that transitioning, at least to an extent, was right for me once the mental changes occurred.  He said that most people who intended to transition before starting HRT confirmed their decisions when their brain began to shift into a more female (if AMAB) or male (if AFAB) range of thought patterns, emotions, etc.  This occurred in enough time before physical changes that those who did not receive the hormones well - their mental state worsened, sometimes making them even less at home to themselves - that they could stop in time.

Yes, of course, YMMV, but it seems rare for people to develop irreversible changes of any sort before they sense that HRT is the right decision.  I found that it was my fear of the unknown and second guessing myself that was holding me back.  I ended up starting the Estradiol at the same time as Spiro, and I did feel the mental relief and euphoria within a couple of weeks, while physical changes didn't really start until a couple of months in.

[pamelatransuk]

Essentially, he said that I would know that transitioning, at least to an extent, was right for me once the mental changes occurred.  He said that most people who intended to transition before starting HRT confirmed their decisions when their brain began to shift into a more female (if AMAB) or male (if AFAB) range of thought patterns, emotions, etc.  This occurred in enough time before physical changes that those who did not receive the hormones well - their mental state worsened, sometimes making them even less at home to themselves - that they could stop in time.

Yes, of course, YMMV, but it seems rare for people to develop irreversible changes of any sort before they sense that HRT is the right decision.  I found that it was my fear of the unknown and second guessing myself that was holding me back.  I ended up starting the Estradiol at the same time as Spiro, and I did feel the mental relief and euphoria within a couple of weeks, while physical changes didn't really start until a couple of months in.

Hello Heather and DS

I agree with your comments DS in that I certainly felt the mental benefit early. I have been on HRT 7 months and obviously most of us get the immediate "placebo" effect but even allowing for that and waiting 2 months, the fog had cleared and I felt a sense of peace. Shortly thereafter I knew I was on the "right fuel" and for life. At the start I was exploring - reasonably confident I needed HRT but not absolutely sure.

Just to be precise there was one physical benefit I noticed early which was softer and smoother skin.

I intend to publicly transition in 2019 as now I feel I am on the right road.

I wish you both happiness.

Hugs

Pamela

[Dani]

But what about that person who is unsure and who may have second thoughts?

This is what therapists do. Today, they really have a good understanding of our condition and other conditions that may be similar. It is their expertise to help us discover what it is that is really causing us so much grief.

A quick chat with a therapist is not going to be beneficial to most people. We need to understand and accept ourselves as we are before we make any changes to our bodies.

"try HRT and see how you feel"

This sounds like an experimenting with drugs. You never know what undesirable side effects may occur. Yes, we do have some idea with medical drugs, but side effects are not 100%. Sometimes they cause problems and sometimes not.

I do not recommend experimenting with drugs. Know yourself and accept yourself first. Then use hormone therapy to help do what you need to do.

[heather3791]

Thanks y'all for all of your great insightful feedback on this subject. As always I know I can always count on you to provide intelligent and well articulated answers. You are all very smart cookies!

[StacyRenee]

Is that how it works? I didn't think that if your breasts grew due to weight gain, it sticks there even after you lose the weight.

Breast tissue is not fat. There are glands and ducts that are developed. You could drop down to 10% body fat and still have that breast tissue.

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[Autrement]

I started HRT 3 years ago and I still have to live as a man (for family reasons). HRT is helping my dysphoria and makes me feel good. I have some breast but wide shoulders and man clothes nothing is really noticed and I never get any question.

[ds1987]

This sounds like an experimenting with drugs. You never know what undesirable side effects may occur. Yes, we do have some idea with medical drugs, but side effects are not 100%. Sometimes they cause problems and sometimes not.

I do not recommend experimenting with drugs. Know yourself and accept yourself first. Then use hormone therapy to help do what you need to do.

I totally agree that we shouldn't be experimenting, though I have somewhat seen my entire medical transition as an experiment.  With first my doctor in MA, and now my Endocrinologist in WI, I have been doing what I see as "doctor-assisted self-medication."

The doctor in MA had more knowledge and a lot more experience with transgender medicine, but he told me that he often has people who think they might be suffering from gender dysphoria start with HRT to see if that alleviates it.  This is where his basis of understanding for people who knew they needed to transition vs discovered they were not supposed to.

So the first person who told me the "try it and see" method was a medical professional.

[Dani]

Breast tissue is not fat. There are glands and ducts that are developed. You could drop down to 10% body fat and still have that breast tissue.

I must challenge the statement of 10 % body fat for women.

This is typical:

Typical body fat amounts
Description Women   Men
Athletes   14–20%   6–13%
Fitness   21–24%   14–17%
Average   25–31%   18–24%
Obese   32%+   25%+

With less than 18% body fat some women stop having periods, as many athletic women can attest.

[Lisa]

I effectively took a 'try HRT and see how you feel' approach myself, but it sounds like I was in a very different situation from you.  I'd known I had gender identity issues for over 20 years, and I'd been debating transitioning for over a decade, but I was afraid of how I would be accepted, and whether I would ever pass, and whether I would ever feel safe again knowing some of the hate out there in the world.  My dysphoria reached a point though where I was so miserable with my body and with my life as a guy that I was thinking about suicide on a daily basis, and years of therapy and multiple anti-depressants had done little to help.  I started my 'trial approach' with the outlook that I was completely open to immediately starting on a full transition path if that's what felt right for me, and regardless of what else happened, I didn't see how I could possibly feel any worse than I did already, so what did I have to lose?  Even if I decided later that transition wasn't for me, I was ok with the idea of living as a guy with small breasts, or being permanently sterile - given the state I was in, these were small things compared to the risk of leaving my dysphoria untreated.

One thing that might be helpful for you as it's a little lower risk (though not free of risk) is to try blockers alone or lower doses:  I was on testosterone blockers alone for a few weeks before starting estradiol, and the blockers alone made a noticeable improvement in my mental state, and I got further improvement from my initial low dose of estradiol.

Given my own life situation, I felt like 'try and see what happens' was my only option, and thankfully it's made a massive improvement in my life.  The only way I would ever recommend that approach to others though, is if you are fully aware of the potential consequences, and fully prepared to accept them.  If that's not where you are in your journey right now, then I'd suggest trying other things to see if they help - talk to support groups, talk with a therapist, try experimenting with clothing or voice or mannerisms in a safe space, try interacting anonymously with people online as yourself (text, and if you feel comfortable with it, voice), whatever you think would be helpful for you.

[josie76]

Some doctors do sort of the "try and see" approach.

My endocrinologist starts everyone who comes to him on a low dose. Low enough that the patient should experience the mental effects before too much physical change happens. He requires a therapist letter first and then just sits and talks with the patient.
If you have not had gynocamastia breast budding already then a couple of months on a low dose will just barely begin the budding growth. If you stop then, nothing should be very visable. If you already have budding then tissues will start to ache right away and grow.

Is that how it works? I didn't think that if your breasts grew due to weight gain, it sticks there even after you lose the weight.

Basically being overweight increases conversion of testosterone into estradiol so being very heavy tends to induce gynocamastia in men. The enzyme that changes T into E is produced in fat tissues in the body and a few others. Fatty tissues is a big one.

[Shellie Hart]

I started HRT 3 years ago and I still have to live as a man (for family reasons). HRT is helping my dysphoria and makes me feel good. I have some breast but wide shoulders and man clothes nothing is really noticed and I never get any question.

I have also been on HRT for a fairly long time (2 1/2 years). I also live as male outside home. Luckily for me I live alone so I simply live as female at home. It's enough for me. But I am one of the freaks here as I have grown pretty large noticeable breasts and they are permanent, no doubt. You must be careful. With me it has required several changes to my lifestyle. I can no longer wear certain shirts and I can never remove my shirt in a public setting for any occasion. Taking HRT "just to see how it feels" is really not a good idea. I wanted to become as much female as I could, but I had to keep it secret. It's getting tough to do that now. But I have accepted my lot in life.

In short, HRT made me feel great for a few weeks. The euphoria is over now but HRT has given me a nice feminine shape overall. I just have to be careful how I dress when I go out. A dude with (permanent) big boobs "gets the looks." Something to think about...

[StacyRenee]

I must challenge the statement of 10 % body fat for women.

This is typical:

Typical body fat amounts
Description Women   Men
Athletes   14–20%   6–13%
Fitness   21–24%   14–17%
Average   25–31%   18–24%
Obese   32%+   25%+

With less than 18% body fat some women stop having periods, as many athletic women can attest.

What about supermodels? Or fitness models and the like? Or anyone with anorexia or bulimia? I was making my point to the extreme. (Besides, I think your % for women is a bit skewed. Military specs only allowed 3-4% more for women.)

An excerpt from an online article:

AMY SPENCER
May 13, 2013 10:30 AM EDT

Jack Guy From Health magazine

When California-raised Jillian Michaels was 12, she weighed 175 pounds. After engaging in martial arts and working her way into a career as a personal trainer, the 5-foot-2 3/4-inch star got her weight down to around 117 with just 13% body fat.



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[Kirsteneklund7]

I have also been on HRT for a fairly long time (2 1/2 years). I also live as male outside home. Luckily for me I live alone so I simply live as female at home. It's enough for me. But I am one of the freaks here as I have grown pretty large noticeable breasts and they are permanent, no doubt. You must be careful. With me it has required several changes to my lifestyle. I can no longer wear certain shirts and I can never remove my shirt in a public setting for any occasion. Taking HRT "just to see how it feels" is really not a good idea. I wanted to become as much female as I could, but I had to keep it secret. It's getting tough to do that now. But I have accepted my lot in life.

In short, HRT made me feel great for a few weeks. The euphoria is over now but HRT has given me a nice feminine shape overall. I just have to be careful how I dress when I go out. A dude with (permanent) big boobs "gets the looks." Something to think about...

I trialled HRT under medical supervision and a psychologist. I suspected it might help. I was suffering mentally. First I tried testosterone supplement to cure my desire to be a woman along with anxiety, unease and depression. It made my situation even worse .
  In therapy I dug deep and unearthed the drivers behind wanting to be a woman. MTF HRT brought rapid relief to the point of being happy just being me . That trial gave me the answers!

  Kirsten x [emoji126]

PS I love my b-cup boobs even though I hide them for work.