I've always been a really paranoid person when it comes to my health. I know that being trans doesn't have the greatest outlook for health, but I'm just wondering exactly how much damage I'm inflicting on my body, and how fast it can potentially come to bite me.
Before I go on, I realize this is a YMMV thing based on many factors.
I get my blood tested bimonthly, checking clotting values, liver and kidney function, among other things. I've never gotten any news back from those tests so I'm going to assume that's fine.
My primary question is how BAD is HRT compared to.. let's say... alcoholism? Or cigarette addiction? Or diabetes? Is the outlook for a trans person's health really as bad as I hear?
Unless you suffer from liver or kidney damage then I wouldn't worry about it. It sounds like you are following a doctors care and that your lab values are in range.
HRT shouldn't cause the same visible damage as say smoking or drinking because it won't do the same vascular damage as smoking and you aren't dehydrating the fool out of yourself every day with booze.
Diabeties also affects vascular structure. Untreated it can literally kill the blood supply to extremities.
HRT as far as I know does not do that. The worst would be that an unmonitored user would damage their kidneys or liver resulting in End Stage Renal Disease or Jaudice/Cirosis. And you already know the risks for blood clots so just take care of yourself and don't add to your risk factors.
If 30-60yr old women start their own HRT to treat menopause for 40+ years of their life and don't suffer horrible health effects I think we all will be fine as well. So relax and trust your body. It will let you know when something is wrong and you do have a doctor :)
Also factor in that you shouldn't need a high "feminizing" dose of hormones your entire life.. only until you are done with second puberty :)
Removal of the T makers through orchi or SRS should also allow a lower dose- or in general... less medication.
I dunno how your endo likes to operate, but mine has mentioned both of these points multiple times during our visits.
If you don't want to worry about health problems besides that of a cisfemale, pellet implants really are the way to go. During my initial consult, my endo actually told me I would avoid many if not all of the T related health problems as well as oral hormone side effects and likely live 5-10 years longer (similar to a cisfemale) as long as I stick with the implants or creams. I'm hoping the creams become available soon because then we will just be able to order them online... It will be much less $$ and hopefully accessible to everyone regardless of location.
Quote from: Jennygirl on August 05, 2013, 07:00:56 AM
Also factor in that you shouldn't need a high "feminizing" dose of hormones your entire life.. only until you are done with second puberty :)
This is not true. My E dosage has remained the same postop. Removing your testes will not impact your body's need for the same needed dosage of external estrogen. If you need X mgs of E before SRS/Orchiectomy, you'll still need X mgs of E after. The whole reduced E dosage after testes removal is a huge myth. You won't need T blockers anymore.
If you think about it, after several years on HRT, most cis-males will have experienced chemical castration by that point anyway... And their dosage remains the same... Why would it change with testes removal? Mine didn't, and neither did it for several other postop MTFs I know.
As for what long term HRT usage may or may not cause, there really haven't been enough long term studies. But from the few I've read, there is little to worry about as long as your liver function is closely monitored, and you are a non-smoker in good health.
As somebody who aims to begin transition within this next year, what are the health concerns for transgenders? We talking anything serious? Shorter life expectancy etc?
I am also very curious about this, are you saying that the health consequences of HRT could shave decades off of life expectancy?
Personally, I'm fine with whatever tradeoffs that may occur with taking hrt versus not taking it. And really there isn't enough real information on what long term effects there might be for trans people. Just try not to abuse yourself too much and enjoy your life, you could always get hit by a truck tomorrow...
Certainly, but as someone who is currently in therapy and strongly considering HRT / transition, health consequences are an important factor to weigh. If there are any studies / statistics available, I'd like to review this information before making a decision so that I can be as informed as possible regarding the benefits and drawbacks. A five year reduction in average life expectancy I could probably live with. A decade or two, I'm not so sure.
These were my great concerns. I have been increadibly healthy and don't drink or smoke. So I studied, spoke to doctors and therapists before I chose to begin HRT. Yes, there slight % increases with certain problems but you seems to have control with blood tests. It does have a possible benefit - the female hormone reduces and could delay the chance of Alzheimers/Dementia. Also, you will have significantly much less chance of prostate cancer and skip all the other male related sex cancers. Plus u wont get and reproductive cancers which cis women face. All in all GO FOR IT.
Quote from: JennX on August 05, 2013, 08:24:40 AM
This is not true. My E dosage has remained the same postop. Removing your testes will not impact your body's need for the same needed dosage of external estrogen. If you need X mgs of E before SRS/Orchiectomy, you'll still need X mgs of E after. The whole reduced E dosage after testes removal is a huge myth. You won't need T blockers anymore.
If you think about it, after several years on HRT, most cis-males will have experienced chemical castration by that point anyway... And their dosage remains the same... Why would it change with testes removal? Mine didn't, and neither did it for several other postop MTFs I know.
As for what long term HRT usage may or may not cause, there really haven't been enough long term studies. But from the few I've read, there is little to worry about as long as your liver function is closely monitored, and you are a non-smoker in good health.
This is kind of what my doctor has said, except she added it still depended on the amount of estrogen that shows in tests since our bodies change as we age (I'm old). But I completely trust her since she's been so right on other stuff.
Not sure when things changed with the aspect of starting HRT but far as i know before one can start they are supposed to be aware of all health risks involved.
I have been on HRT for a long, long time and have yet had any health issues other then the side effects of the meds. HRT drugs mtf and ftm are taken for the side effects we are looking to get ie: libido suppression or incresed, breast developmennt, body fat redistribution or muscle mass incresed, softer skin etc. I have added a list of just the Estrogen, you can do a search for your other drugs. As you will see there are a whole host of possible things that could happen. As i have said to so many others its all about less is more. Always take the least amount of any drug you need. I know so many want things to happen overnight but they do not. It takes time for second Puberty to set in. Also many keep looking at there E and T numbers but that always is not the best was to go about HRT. Let your body tell you how things are progressing. Sometimes being more worried about a number will put things out of balance and will stall or even stop process. To end this up just listen to your body, relax and look towards tomorrow over today. Remember if you get any of the bad side effects you will have to stop HRT and none of us ever want that.
Izzy
Estrogen
Possible Side Effects:
The most common side effects include enlargement or tenderness of the breasts (both sexes), swelling of the ankles and legs, loss of appetite, weight changes, retention of water, nausea, vomiting, abdominal cramps, and feeling of bloatedness. The estrogen patch can cause skin rash, irritation, and redness at the patch site.
Less common side effects are bleeding gums, breakthrough vaginal bleeding, vaginal spotting, changes in menstrual flow, painful menstruation. pre-menstrual syndrome, no menstrual period during and after estrogen use, enlargement of uterine fibroids, vaginal infection with Candida, a cystitis-like syndrome, mild diarrhea, jaundice or yellowing of the skin or whites of the eyes, rash, loss of scalp hair, and development of new hairy areas. Lesions of the eye and contact-lens intolerance have also been associated with estrogen therapy. You may experience migraine headache, mild dizziness, depression, and increased sex drive (women) or decreased sex drive (men).
Rare side effects include stroke, blood-clot formation, dribbling or sudden passage of urine, loss of coordination, chest pains, leg pains, difficulty breathing, slurred speech, and vision changes. Men who receive large estrogen doses as part of the treatment for prostate cancer are at a greater risk for heart attack, phlebitis, and blood clots in the lungs.
From what I have read HRT is safe over time. There are zero incidents of liver disorder in every long-term study I have seen. I imagine some of these people had liver damage to begin with or Hep C as many trans women have drug problems and still no liver deaths in all studies. I haven't seen one. DVT is more of a problem but still not significant. But really it doesn't matter. What are you going to do stop? That opens up a whole other can of worms if you are like me. So really if I am going to die at least I'll die fabulous!
I'm diabetic, have nerve damage from diabetes, have high blood pressure, thyroid problems, etc.
Hormones have NOT changed one blood test reading, all hormones did was help me to develop, look more feminine, and be Happy with myself.
As long as your under a doctor's care you should be Fine.
I've been on HRT for 19 years, since my early 20s. I am incredibly healthy and have never had any HRT related illnesses. What would they be? Of course, it could be that only 'survivors' of HRT can speak for themselves. Alcohol, smoking and being overweight present more dangers than HRT alone. Combine these then perhaps the subject title starts to come into play.
Quote from: Sarah Louise on August 05, 2013, 11:38:16 AM
I'm diabetic, have nerve damage from diabetes, have high blood pressure, thyroid problems, etc.
Hormones have NOT changed one blood test reading, all hormones did was help me to develop, look more feminine, and be Happy with myself.
As long as your under a doctor's care you should be Fine.
So having diabetes did not cause you any problems on HRT? This is encouraging as I have been worried that if I am diabetic (not had a test yet) then it may prevent me from transitioning.
Let me be careful on how I state this, Diabetes adds major complications and while it has not prevented me from taking hormones (with quarterly blood tests) it has kept me from having surgery (along with a couple of other issues).
Having surgery will depend on each surgeon and their feelings about how severe your medical issues are. I've had diabetes for almost 50 years, I have had a minor heart attack (if there is such a thing as minor), I have thyroid issues and Do Not Heal from cuts or other injuries, based on that I was turned down for SRS each time I tried.
Sarah Louise, that sounds like type I diabetes. Some SRS surgeons don't like to operate on diabetics. Is the reason because you do not heal as well?
It comes down to everyones body reacts to drugs in a differnt way. Some have no issues and others have issues up to encluding death.
Before i could even start HRT from my doctor i had to know the benifits and risks and sign off that i understood i could have complications up to and encluding death.
Over the years i know of 7 who had issues with there HRT and had to stop, 5 worked on getting there orchiectomy sooner then there GCS and 2 of the sisters passed due to pulmonary embolism.
With that said i know of hundreds who had no or limited bad side effects so by % if you keep sight that HRT are drugs and respect them as such all should be without issues. Work close with your doctor.
Izzy
Quote from: iiii on August 05, 2013, 11:45:53 AM
Well, you increase the risk of being murdered from 0.4% to 10% (doubtful to these statistics but whatever), so you're on average gonna lose quite many years of your life.
But anyway, if you consider not taking HRT because of a possibility of a shortened life span of 5 years, then I really don't think HRT is for you.
Well for one thing, the risk of being murdered stat is definitely wrong. I'm not sure about the 10% but I can tell you the 0.4% is way too high, especially if we're only talking about English speaking countries. I have a strong feeling 1 in 10 people who use hormones do not get murdered.
Quote from: Nicolette on August 05, 2013, 11:51:55 AM
Sarah Louise, that sounds like type I diabetes. Some SRS surgeons don't like to operate on diabetics. Is the reason because you do not heal as well?
Dr Brassard will not if you are on insulin. I think you could be also turned away if just on pills if there are other issues.
Izzy
Quote from: mind is quiet now on August 05, 2013, 12:03:50 PM
Dr Brassard will not if you are on insulin. I think you could be also turned away if just on pills if there are other issues.
I know about Brassard. I wonder what his reasons are. What do you mean "just on pills"?
So really what you're saying is if you're transgender and diabetic, there is no hope?
Quote from: Nicolette on August 05, 2013, 12:07:28 PM
I know about Brassard. I wonder what his reasons are. What do you mean "just on pills"?
Just on pill ie taking pill to control suger over taking Insulin shots.
In his paperwork the reason is someone that is insulin dependent need to have the surgery done in a hospital with advanced life support just in case it is needed. Dr Brassard has his own private hospital but it not set up for advanced life support. Also i bet somewhere is the fact of healing complications and he just does not want that risk?
Izzy
Quote from: Dreams2014 on August 05, 2013, 12:08:03 PM
So really what you're saying is if you're transgender and diabetic, there is no hope?
I would say that you might have less options with GCS.
Izz
Quote from: mind is quiet now on August 05, 2013, 12:17:09 PM
I would say that you might have less options with GCS.
Izz
And I wouldn't settle for a transition without surgery. I hope my tests come back negative =/
I have been on insulin for a long time. My numbers are "pretty" much under control, but the damage has already been done to my body.
As I said earlier, it depends on each doctor and how bad they feel your complete physical condition is. Type 2 diabetes does not have to rule you out, but it has to be under control.
Ive done fair amount of research on this
and as long as you have normal kidney + liver function, there's one major risk factor in breast cancer. There's more than that, I'm sure. But for the most part I don't think that HRT affects too badly as long as we watch ourselves.
When HRT is done under a doctor's supervision, it is quite safe. Many people have had it for 30 plus years with no ill effects.
As to surgery, sometime diabetes can interfere with proper healing, even when it is controlled.
Quote from: Hideyoshi on August 05, 2013, 06:10:13 AM
I've always been a really paranoid person when it comes to my health. I know that being trans doesn't have the greatest outlook for health, but I'm just wondering exactly how much damage I'm inflicting on my body, and how fast it can potentially come to bite me.
Before I go on, I realize this is a YMMV thing based on many factors.
I get my blood tested bimonthly, checking clotting values, liver and kidney function, among other things. I've never gotten any news back from those tests so I'm going to assume that's fine.
My primary question is how BAD is HRT compared to.. let's say... alcoholism? Or cigarette addiction? Or diabetes? Is the outlook for a trans person's health really as bad as I hear?
No, you should be fine. A lot of those adverse effects come from old reports about people who were not using bio-identical hormones, and instead using the cocktail of things that are found in pregnant mare urine.
I started of on HRT with very high BP (on medication) High cholesterol (on medication) depression (on medication).
Now, BP is excellent (115/55) cholesterol is fine (3). No evidence of depression (medication stopped).
It was suggested that I get screened for BRACA1/2 mutations prior to HRT as breast cancer runs in the family. I told them it would make no difference to my decision, give me HRT.
Under medical supervision there should be no problems. I am under strict instruction not to smoke (I don't anyway), only drink as much alcohol as recommended for females (One standard drink a day with rest days included.)
Quote from: iiii on August 05, 2013, 11:45:53 AM
Well, you increase the risk of being murdered from 0.4% to 10% (doubtful to these statistics but whatever), so you're on average gonna lose quite many years of your life.
But anyway, if you consider not taking HRT because of a possibility of a shortened life span of 5 years, then I really don't think HRT is for you.
Wrong and wrong. I'm not sure where you live to come up with those numbers. I suspect any increased risk in being killed has more to do with life choices (i.e. becoming a sex worker or playing the stealth dating game) rather than simply being on HRT.
As far as health risks, if you are patient/stay on reasonable doses and don't try to force puberty to happen in 1 year blasting your body with hormones, the risks are minor. Especially using transdermal meds. Stay active and eating healthy will solve most issues someone would develop from HRT.
Well maybe the lower E dose only applies with pellets. My endo told me that after orchi, srs, or a years time on 12 pellets we could drop it down to 2-3 pellets. Way lower E dose.
Quote from: iiii on August 05, 2013, 08:55:01 PM
I don't even know what to say about this... I really like how you put those 2 things as life choices.
OK choice 1, working in the sex trade. I would hope most people know this is a dangerous profession, not only from a violent crime perspective (especially if they combine it with point 2 below) but from getting AIDS or some other deadly STD. Just being in that world with all the drugs, guns etc is a risky place to be. I found a job working as a church secretary after I started living full time. Lack of planning and/or education IS a life choice. A transgendered person with job skills can fine a job outside of the sex industry. IMHO before someone starts living full time they should have some sort of employment plans in place.
As far as the "stealth dating game", this is where a LOT if not most of the violent crime against transgendered people occurs. A trans person assumes no one will care they are trans, dates/hits on some unknown to them straight guy and when he finds out, mugs or kills them out of rage. This is totally a life choice that the trans person doesn't disclose this before things go too far. It is a known risk in playing this game with strangers, which you have no idea of how they might react. Yes it's wrong this happens but pretending it doesn't or ignoring the reason why the attack happened doesn't mean this behavior is safe. Again the transgendered person has chosen to do this, no one has forced them to attempt to pull off "stealth".
If you take the two above scenarios out of the equation, the incidence of violent crimes against someone for simply taking hormones isn't going to be any higher than someone who doesn't.
Quote from: iiii on August 05, 2013, 11:45:53 AM
Well, you increase the risk of being murdered from 0.4% to 10% (doubtful to these statistics but whatever), so you're on average gonna lose quite many years of your life.
But anyway, if you consider not taking HRT because of a possibility of a shortened life span of 5 years, then I really don't think HRT is for you.
I figured it out on TDOR last year based on the number of transgender people reported murdered. It turned that the chance of getting murdered as a transgender person, was only about twice the chance for population at large.
Hi friends :)
This topic is not about murder and rape and prostitution and so forth, it is about a young person's health concerns regarding the effects of HRT
Please try to stay on topic
Thank you
V M
HRT has extended my lifespan by about 4 years so far.
There are no significant risks to HRT at all unless you were already in serious trouble before taking anything. Like, if HRT is gonna harm you, probably, any medication past Tylenol would have done the same. There are doctors who assess you for HRT. If they say you'll probably be fine, you'll probably be fine. Honestly, HRT is nothing significantly different from your random medications for another random health problem.
Comparing it to alcoholism or smoking? That's literally a joke. That's like asking if atmospheric pollutants from a small town can kill you faster than street drugs in a syringue shared with shady thugs.
If HRT has any noticeable effect on your health, then it's either because you have the negative equivalent of winning the lottery, either because your doctor (unlikely to be honest - they're usually overly prudent) or you didn't follow the guidelines/safety rules properly.
As far as I know there might even be a slight life lengthening effect from HRT, because for various reasons, statistically, women outlive men slightly.
a high dose of hrt is not good long term. the problem is that estrogen may aggravate your gallbladder and they worry about the risk of a blood clots especially if you smoke as many transwomen do.
a combination of E and progestin increases the risk of breast cancer and uterine cancer.
post op you can take a lower dose of E eventually but you have to take it or else you will get hot flashes and maybe brittle bone disease.
But pre op and non op you can stop HRT if it causes you worry or a problem and have your natural male hormones take over.
Quote from: victoria n on August 10, 2013, 01:19:53 PM
a high dose of hrt is not good long term. the problem is that estrogen may aggravate your gallbladder and they worry about the risk of a blood clots especially if you smoke as many transwomen do.
a combination of E and progestin increases the risk of breast cancer and uterine cancer.
post op you can take a lower dose of E eventually but you have to take it or else you will get hot flashes and maybe brittle bone disease.
But pre op and non op you can stop HRT if it causes you worry or a problem and have your natural male hormones take over.
This post is filled with incorrect info and misinformation.
I'm postop and take the same dosage of E as I did preop... And it is an above average dose. Several other postop MTFs I personally know have done the same thing. You medicate and prescribe dosages based on your physiology and blood tests... not what is read and recommended on the net.
I have not read on long term study of MTF trans people that have shown negative effects due to long term / above average E dosages over time. I also come from a medical background. So if you know of one such study, please post a link.
After a period of time on HRT (again this varies with the person) but from 1-2 years, a male's testes will no longer produce testosterone. This is called chemical castration. Your hormone levels will not return to normal after this period.
Please check your info before posting.