Susan's Place Transgender Resources

i have a friend that i recently came out
to. he was ok about the dressing up as
a girl part, but wasn't too comfortable
with srs. he kept saying i was born with
it and shouldn't do it and there would be
complications if i did. my friend is a bit
naive when it comes to this subject.

well, he is in in thailand at the moment,
so told me a story he heard when
he went to some convention. it bothered
me so i decided to post it up here and
get some feedback.

him (12:15:57 PM): also sadly
him (12:15:59 PM): i ask
him (12:16:00 PM): for u
him (12:16:02 PM): a question
him (12:16:04 PM): when i was at the
him (12:16:05 PM): HE SHE
him (12:16:10 PM): CONVENTION SHOW
him (12:16:21 PM): ALOT OF THE GIRLS
him (12:16:24 PM): WHO CHANGED THEIR SEX
him (12:16:28 PM): THEY DONT LIVE THAT LONG
him (12:16:31 PM): according to the
him (12:16:34 PM): tour guide
him (12:16:40 PM): they said most of these he shes
him (12:16:42 PM): they live
him(12:16:54 PM): 50 yeyears
him (12:16:55 PM): or so
me (12:16:59 PM): maybe cause they dont have proper doctor care over there, cant afford it
him (12:17:12 PM): because when a person changed their body
him (12:17:17 PM): automacically
him (12:17:22 PM): they dont live that long
him (12:17:25 PM): and the tour guide
him (12:17:26 PM): said
him (12:17:34 PM): when a girl that does that
him (12:17:36 PM): because and he she
him (12:17:46 PM): she wil love that man she is with
him (12:17:49 PM): foreverver
him (12:17:51 PM): because she knows
him (12:17:56 PM): that she doesnt have much time to live
him (12:18:04 PM): according to the tour giuide
him (12:18:09 PM): and
him (12:18:14 PM): tour guide said
him (12:18:15 PM): a person
him (12:18:22 PM): who usually does this kinda opearation
him (12:18:29 PM): usaually has a bad childhood
him (12:18:36 PM): or always think of herself as being a girl
him (12:18:39 PM): when she was young
him (12:19:10 PM): its a girl trap in a mans body
him (12:19:14 PM): so she wants to be a girl
him (12:19:23 PM): when i was there honestly i saw it

It dose but if you look at the causes of death the discrepancy is largely due to things like prostate cancers and breast cancers which MTF don't like getting checked out for in later life... I mean you can see why they'd not do that.

Of course if you denied these people SRS then the risk of suicide would be much greater than it already is and I think it's already absurdly high amongst the pre-operative group. (some figures somewhere projected it as high as 40%)

KK, I've heard stuff like this before...

There is no conclusive evidence either way... Very few if any comities, pannels, doctors, or orginazations have performed proper research on this and many other TS related topics.

Thailand is well known for its surgeons, but its also well known for poor jobs in surgery...  Do these girls continue on HRT after surgery?  are they on the right dosages?  do they go in for proper medical care?  how well was the surgery performed in the first place...  How old were they when they had it completed....

Also look on our side of the world....  How long would we live if GRS was not available?   Many of us smoke, drink, do drugs and all sorts of horrible life endangering things just because we don't have the guts to properly suicide... Transition in its self is hellish to many which ups the suicide rate... and among teens who don't see the light at the end of the tunnel just end it then and there...

So i cut 20 or 30 years off my life if this tour guide from Thailand is right by getting the op...  But really Ive beaten the odds and ADDED 30 years to my lifespan :D

That is very very depressing... I've already wasted 23 years of my life, living as a male. I'll have to waste 3-4 more until I'm done with my transition. So if that's true, I'll only get to live a bit over 20 years as my true self. Shame there aren't any alternatives to SRS for me.

I really hope it isn't true. =/

Quote from: Mikaela on May 16, 2008, 05:04:20 PM
That is very very depressing... I've already wasted 23 years of my life, living as a male. I'll have to waste 3-4 more until I'm done with my transition. So if that's true, I'll only get to live a bit over 20 years as my true self. Shame there aren't any alternatives to SRS for me.

I really hope it isn't true. =/

I'm positive it isn't... there is no proof, and this information was 3rd hand from a tour guide no less... I'm sure if a study is done, they could well find the reverse to be true LoL.  TS's at least in the western world tend to lead healthier lives than our Asian counterparts.

It is not uncommon for people who are ignorant of transsexuality, or of anything, to use stereotypes and blanket statements because that is all they know.

I would not get very worried over this as they are probably using data thats maybe 10+ years or older for their stats, alot has changed in health in 10 + years. Also like all of these warnings they give probably will change in another 5 years when some Einstein links transgenders with longevity only to be shot down by another...blah...blah...blah...

I say try your best to stay healthy proper diet and exercise....stay away from any bad habits, smoking, drinking and drug use and the rest is up to nature and destiny... :icon_chick: :)

gina

Quotelife span shortens after srs?

Rats! I've got to call Dr. Bowers straight away & have my GRS cancelled ::)

Yup ....

Prolonged HRT meds are not good for us ....

Breast cancer risk is way overstated (always way less than natal female), & prostrate cancer risk much reduced .....

But thromboembolic / stroke risks way way elevate ....

So does the incidence of hypertension (another killer) and hyperprolactinaemia ....

Cholestertol-wise its beneficial (HDL up / LDL down / total down) ....

But Triglycerides are elevated (arthosclerosis more likely even if arteriosclerosis is not !) ....

Blood glucose and insulin are reduced (less risk of type 2 diabetes) ....

Liver & kidney function could be seriously impaired by the meds ....

Propensity towards HRT related weight gain and fluid retention are not good news for general health ....

So its more minuses than pluses ?

As older "transgendered" women we retain the risks inherited thru our "male history" and take on some more because of the HRT.

Younger transitioners look at decades more HRT and its risk !

And then there is that whole "rat bag" of drug / alcohol / substance abuse and suicide risk which remains elevated despite transition and SRS ....

I'm personally seeing many of the known medical pros & cons, and retain my addictive dependencies, so on balance I'm unlikely to have a higher life expectancy than if I'd not transitioned, statistically less than a woman at my age.

But then statistics are just that .... I could live to be a 100 ?

Laura x

Why on earth would SRS shorten lifespan?

There are plenty of way more traumatic operations which do not shorten life span!

If its done correctly, the only diff is in the how much T you get in your body.

With less T, less prostate cancer.

With higher E, in theory, higher breast cancer chances, but since
most of us have a lower lifetime exposure, the risk is minimal.

With higher E, there is less risk of heart disease .

Trying to see what kind of other disease could be linked to this, don't see it!

so does smoking, pollution, obesity! 

As I said, its a myth with no studies or proof in its favor...

Quote from: Keira on May 17, 2008, 09:21:15 PM
Why on earth would SRS shorten lifespan?

With higher E, there is less risk of heart disease .

Trying to see what kind of other disease could be linked to this, don't see it!

Keira, risk of heart disease, DVT, pulmonary embolism, stroke, are all increased with HRT ....

My "list" comes from the leading UK TS endo who sees / treats 70% of all UK NHS patients (2500+ TS patients in his career).

His approach is to do his best to limit morbitity in his patient group ....

My cholesterol, triglyceride, blood sugar trends all fit with his theory ...

ALT & T4 look good right now, but I retain water (without low Spiro) which makes me wonder about my heart / kidney function ?

Bottom line SRS / HRT messes most of your endocrine function up, and either meds or a no meds approach could lead to an early grave .....

Laura x

Well, for some of those, you can avoid by taking diffrent forms of HRT rather than orals...

Bio identical E used for HRT doesn't increase DVT or pulmunary embolism.

Studies have demonstrated firmly.

Using the same hormones (not derivative synthetics) as in GG's
gives us the same risks as them.

There's nothing special about our bodies (except the absence of female sexual organs,
so our body will react like any of them).

I hope you're right!

Regardless, I think that if I'm able to leap the wall of when technology improves drastically (this wall is one I imagine quite a bit), and stay as youthful and healthy as possible until then, then aging can take less of a toll on me. People have told me that doubling a human lifespan is well within my lifetime, and I'm still relatively young, so who knows?

Even with SRS, it will eventually drastically improve! So... Maybe then the risk (if it can be proven there is one. Probably not GOOD for you, but neither is anything else we do) will go down even further.


Its kind of why I'd rather wait a bit until SRS, cause pretty soon it will be much better I predict.


Regardless... I don't measure life in years, I measure it in what I have done that is either a burden or accomplishment. Most of my aging has been due to me overusing my body. I can tell when I'm going over the line... Unfortunately, I need to accelerate my life a bit (LOL NAVY DERERRRRRR DERRR) in order to get anything tangible accomplished, and that is that sad reality.

Of course... We could get another completely retarded president again, so I don't know the odds...

I don't really know enough about the medical details to add or take from what has been posted here. I spent 25 years drinking alcoholically, smoking, I and lived on the streets for a time.  I believe that if this is not putting one's body through the wringer, I don't know what would qualify as such.

Anyway, I was a very healthy kid from what I remember. I took some beatings at school but I survived. Now for the past 20 years I have been as healthy as anyone aged 30 compared to my 62 years.

I have been on estradiol valerate injectables for the past 8 year and still feel like I am from ten years old to 20 years old, nowhere near 50, much less 63. Never been seriously sick one day in my life.

Now I better stop bragging and go hide under my rock with my pet critter before Zeus takes a notion to use me for thunderbolt target practice.

Cindy

Quote from: Laura Eva B on May 17, 2008, 09:58:24 PM

Keira, risk of heart disease, DVT, pulmonary embolism, stroke, are all increased with HRT ....

And subsequently reduces as many of us quit smoking prior to surgery and most of us reduce HRT levels after surgery.

Quote from: Laura Eva B on May 17, 2008, 09:58:24 PM

My "list" comes from the leading UK TS endo who sees / treats 70% of all UK NHS patients (2500+ TS patients in his career).

His approach is to do his best to limit morbitity in his patient group ....

I only know a limited number of Transexual people in the UK but only one of them has ever had any dealings with an endo and she payed privately for the consultation. The Largest NHS gender clinic precribed me and many others with high doses of EE. How does this equate to an approach of limiting morbidity?

My blood tests both before and after surgery are decribed as exceptionally healthy by my GP and private specialist. My risk factors for heart disease, DVT, pulmonary embolism and stroke are all low. I accept that I may have an increased risk of breast cancer but also have reduced risk of prostate cancer and no chance of testicular cancer.

My risk of death through suicide or reckless endangerment is significantly reduced.

Ann

Quote from: Anonymouse on May 19, 2008, 09:17:29 AM

Quote from: Laura Eva B on May 17, 2008, 09:58:24 PM

Keira, risk of heart disease, DVT, pulmonary embolism, stroke, are all increased with HRT ....

And subsequently reduces as many of us quit smoking prior to surgery and most of us reduce HRT levels after surgery.

Quote from: Laura Eva B on May 17, 2008, 09:58:24 PM

My "list" comes from the leading UK TS endo who sees / treats 70% of all UK NHS patients (2500+ TS patients in his career).

His approach is to do his best to limit morbitity in his patient group ....

I only know a limited number of Transexual people in the UK but only one of them has ever had any dealings with an endo and she payed privately for the consultation. The Largest NHS gender clinic precribed me and many others with high doses of EE. How does this equate to an approach of limiting morbidity?

My blood tests both before and after surgery are decribed as exceptionally healthy by my GP and private specialist. My risk factors for heart disease, DVT, pulmonary embolism and stroke are all low. I accept that I may have an increased risk of breast cancer but also have reduced risk of prostate cancer and no chance of testicular cancer.

My risk of death through suicide or reckless endangerment is significantly reduced.

Ann

Ethinyl estradiol DOES increase the risks that Laura Eva mentioned. But, that could be reduced by using estradiol valerate or estradiol cyprionate.

If NHS doesn't allow those then I would think all of the risks with EE become very much a factor for Brit TSes.

EV and EC lower those risks considerably.

There are no longitudinal studies for life-span that have ever been done that I could find through Medline, ACCESSMedicine, Biomedical Reference Collection, & PUBMed search engines and reference sections.

I suspect no studies have ever been done in that regard.

The knowledge of a Bangkok tour guide seems less-than authoritative to me.

Nichole 

Ann's post seems absolutely spot-on to me.

Quote from: Nichole on May 19, 2008, 09:55:31 AM

Ethinyl estradiol DOES increase the risks that Laura Eva mentioned. But, that could be reduced by using estradiol valerate or estradiol cyprionate.

If NHS doesn't allow those then I would think all of the risks with EE become very much a factor for Brit TSes.

EV and EC lower those risks considerably.

High dose EE without antiandrogen was the regime of choice even though the risks were known. I understand (and hope) that this has now changed and that EV or EH with antiandrogen is now used although I don't know anyone currently going through the NHS system.

I only discovered the risks assotiated with EE by doing my own research and got it changed to EV with the help of a private consultant.

Ann

Quote from: Nichole on May 19, 2008, 09:55:31 AM
Ethinyl estradiol DOES increase the risks that Laura Eva mentioned. But, that could be reduced by using estradiol valerate or estradiol cyprionate.

If NHS doesn't allow those then I would think all of the risks with EE become very much a factor for Brit TSes.

EV and EC lower those risks considerably.

NHS London Gender Clinic (Charing Cross) tend to prescribe Estradiol Valerate these days and a variety of anti-androgens, but have their argued reasons for not prescribing progesterone (remember having a social drink with their Dr Leighton Seal and him half changing my mind about progesterone !).

Over 50 and they will try to persuade you to do "patches".

My endo was a student / classmate with Dr Seal and I see her outwith of any gender clinic set up, through direct GP referal as she works in my local hospital and has a dozen TS women in her books .... I funded my transition privately so never encountered the CHX clinic.

Sure my risk levels are low being 135 pounds, slim, fit, non smoker, OK cardiovascular hepatic renal health, but my endo is still concerned and I get a full six monthly screen.

Even E valerate or hemihydrate increase coagulation and stroke risk as surveys of HRT taking post-menopausal women have shown.  Increased breast cancer risk hardly figures for TS women.  But "natal" women are still advised to limit their use of HRT to just a few years !

So my philosophy is caution .... long term meds are not good news ....

Laura x

Quote from: Laura Eva B on May 19, 2008, 03:27:52 PM

Even E valerate or hemihydrate increase coagulation and stroke risk as surveys of HRT taking post-menopausal women have shown.  Increased breast cancer risk hardly figures for TS women.  But "natal" women are still advised to limit their use of HRT to just a few years !

So my philosophy is caution .... long term meds are not good news ....

Laura x

Sure DVT and stroke risk does increase loads, but you have to remember that the risks of DVT/stroke etc are small until you get to 40s/50s.  The research on long term usage is from post-menopausal women who are at increased risk prior to HRT anyway.

I'm starting HRT in my early 20s and i'm not too worried about the long term risks.  They're a hell of a lot less than if I didn't take them at all!  If we stay at a sensible weight, don't smoke, have regular blood tests, don't wait too long for srs etc then there isn't real evidence of big dangers, while young.

Quote from: jenny_ on May 19, 2008, 04:36:07 PM
I'm starting HRT in my early 20s and i'm not too worried about the long term risks.  They're a hell of a lot less than if I didn't take them at all!  If we stay at a sensible weight, don't smoke, have regular blood tests, don't wait too long for srs etc then there isn't real evidence of big dangers, while young.

Jenny, you're lucky to be so young that mortality seems in the distant future ....

But for us at our "decrepit age" the grim reaper seems soo much more real !

I note that one of Zucker's arguments for "aversion / reparative therapy" for TS children is that its in a medic's duty to steer children away from a "program" that means lifelong and life-shortening medication, infertility, possible partner rejection .... one thing its hard to dissagree with !

Sure I expect to be taking HRT into my 60's even if at reduced levels no matter what my endo says ....

And accept the risk !

Laura x

If you use estradiol (same as in GG's), the risk will not be higher than they would have.

You do have to realize that by the time you reach 50, you are more at risk of DVT from
multiple sources. But, DVT in GG's is generally not a conterindication (especially since they
take low doses anyway). If you use injection or patches, the risks are quasi zero
(not zero, but lost in the noise of everything else that can happen to you).

The reason they caution against using HRT in menopausal women is often, they start
using too late after they're E levels went down and damaged their circulatory system
(increasing risks), lifetime E exposure's impact on breast cancer rate (which
most of us don't have to worry about).

If you start E as soon as E levels go down at menopause, the only increased risks
for a GG is increased risk of breast cancer (since this risk is correlated with lifetime
exposure).

Yay for the evil needle I stick in my rump on a weekly basis LoL

Id say transition in general has probably greatly increased my lifespan... the further I go, the more healthy I become... I actually care now. Beats the heck out of booze, smokes, coke, beyond random eating and sleeping patterns... reckless living and working...  Hmmmm I think between the lifestyle changes and the needle in my rump I'm in pretty good shape for the future LoL

Quote from: Keira on May 19, 2008, 05:11:14 PM

If you use estradiol (same as in GG's), the risk will not be higher than they would have.

I'm confused about the risks of HRT cos everybody keeps saying different things (especially doctors!).
Is it the actual oestrogen (i'm british :P) that increases DVT risk, or is it the actual medication that does?
Its always confused me especially since estradiol is meant to be the same as in GGs ???

The type of HRT med AND how it is administered is what modifies the DVT risk.

On the whole, the more time a estrogen like substance has to go through
the liver to get inactivated, the more by-products, some promoting DVT,
are produced (not to mention the liver is working harder).

Ethinil estradiol is very very hard to metabolise by the liver thus very small doses are very potent.
Premarin is not as hard to metabolise, but still much harder than estrogen biologically identical
to what GG's have.

Since going through the liver is what produces the DVT by products, avoiding it reduces the risks
(but much less than switching from EE to estradiol).

The safest, is thus are in order
- Estradiol patch, same thing as GG's directly in the bloodstream then gets metabolised by liver
- Estradiol gels, gets to the bloodstream then gets metabolised by liver
- EV injections, added risk from injection itself. Cleaving valeric acid need a trip to the liver (cleaving doesn't produce any by-product, so benign). Once cleaved, same estradiol as GG. Tendency to produce varying E blood levels with high peaks which is why often its not given to older people.
- Sublingual estradiol
    - Part is directly absorbed, other part goes through digestion (portal vein to liver, which produces a less potent by-product of estradiol, estriol).
- Sublingual estradiol valerate
- Oral Estradiol  (goes through digestion), most estradiol degraded to less powerfull estriol before getting to destination
- Oral Estradiol Valerate (Same as Estradiol), though tends to produce less peaks since the EV -> E transformation slows down distribution in the body.


There's also EC injections (estradiol cypionate), which are probably about as safe as oral estradiol because the EC molecule is harder to process by the body than the EV molecule.

ethinil estradiol, conjugated estrogens and premarin are all riskier than any of these.