Alright so stick with me here and I'll try to run through this, the way I see it...
Why is HRT required for SRS? Psychologically, we already identify as female or we would not be seeking SRS. This being the case, I don't feel that we need to be changed psychologically. Physically, our bodies can be altered with facial feminization surgery, breast augmentation, and butt augmentation. As such, HRT seems like it should be optional.
Now let's get to the real meat of the issue: The reason, it seems to me, that it is required is because SRS currently removes the testes and the body then needs to be on replacement hormones once they're lost to remain healthy.
But, allow me to counter: I don't think the replacement hormones need to be female hormones. I think that if one were not on HRT prior to SRS and then given hormones matching their original levels after SRS then they would remain perfectly healthy.
Let's go a step further: After SRS one becomes dependent on an external source of hormones to remain healthy, yes? So why then is this the obvious route that we've chosen to take? Allow me to speculate that if the testes were not removed and rather moved internal analogous to the position of the ovaries that our bodies would continue producing hormones on its own and a dependence on an external source would not be required - required being the key word.
I'll continue: Now, if this were standard practice... one could opt to be on HRT prior to SRS and even afterwords with testosterone blockers if that is what someone wants but what it would do is remove that necessity. As it stands, if someone were to lose their job, their insurance, become homeless, or otherwise become unable to afford hormones, it would be rather bad for their health. So it seems to me that such a procedure that preserves the testes would be preferable.
We can take it further still: As you may or may not know, the testes and ovaries are effectively the same structure in males and in females (https://en.wikipedia.org/wiki/Development_of_the_gonads) which are differentiated as our bodies are developing in the womb and either become one or the other. There is currently research (https://www.susans.org/forums/index.php?topic=156303.0) to transform one into the other: ovaries into testes, or testes into ovaries. This has been done in mice. If this research were to come to fruition it stands to reason that still having testes intact, even if one prefers female hormones, would be beneficial as the testes could be transformed into ovaries and not only could one produce their own estrogen but it is not out of the realm of possibility that we could even produce our own eggs and potentially even produce viable offspring via the traditional methods, eventually. Of course, a uterus would also need to be created for this and potentially other technical aspects that I'm not qualified to talk about, but it does seem as if it would be reasonable to consider.
So why, I ask, is this not the standard practice? Does it not seem superior? Obviously I cannot answer that, but perhaps someone else can... so, I leave that with the rest of you.
Well, I take hormones to help align my body with my mind, and to suppress testosterone to avoid any further effects from it. Plus I've had decent breast growth and fat redistribution from hormones, and it's cost far less money (and pain) than surgery. I have my surgery in 6 weeks, and I'll feel so much better when I know that my body is no longer capable of creating testosterone.
I'm guessing that everything else you talk about isn't the standard now because it's only at the research stage. These things take a long time to become an actual medical option, if they ever do at all. For instance my brother has Type 1 diabetes, and every couple of years we hear about some new research that could herald a cure. We've learned not to get our hopes up anymore.
You raise some interesting points, especially about the reproductive thing -- there really is some amazing science happening at the moment!
As someone though for whom HRT has had profound psychological benefit, not to mention all the physical changes, I guess I do question why one would deny themselves even low-dose HRT if they planned a full physical transition? I mean the money might be a factor, but if one can't afford hormones, how are they going to afford SRS? Maybe if one were trans but planning to continue presenting as male even after SRS, and didn't want to feminise in other ways, I suppose; or maybe HRT is out of the equation for medical reasons...
In short, I think you are probably right that HRT shouldn't be mandatory for SRS. But even ignoring the psychological aspects of hormones, estrogen changes the body in numerous ways that no surgery ever can -- skin texture (drastically!), fat distribution, metabolism, hair growth, smell, etc. etc. Maybe I'm naive, but short of being in denial as to the effects of sex hormones on the human body, it just seems irrational to me to want SRS yet not at least desire female HRT if becoming female is actually ones desired outcome.
I think that some of you may have gotten caught up in my final paragraph and missed the point I was trying to get across... Allow me to break it down without the complexity:
Quote"it seems to me, that it is required is because SRS currently removes the testes and the body then needs to be on replacement hormones once they're lost to remain healthy."
"I don't think the replacement hormones need to be female hormones. I think that if one were not on HRT prior to SRS and then given hormones matching their original levels after SRS then they would remain perfectly healthy."
"As it stands, if someone were to lose their job, their insurance, become homeless, or otherwise become unable to afford hormones, it would be rather bad for their health. So it seems to me that such a procedure that preserves the testes would be preferable."
"if the testes were not removed and rather moved internal analogous to the position of the ovaries that our bodies would continue producing hormones on its own and a dependence on an external source would not be required"
"if this were standard practice... one could opt to be on HRT prior to SRS and even afterwords with testosterone blockers if that is what someone wants but what it would do is remove that necessity"
"So why, I ask, is this not the standard practice? Does it not seem superior?"
The point I'm making here is that if rather than removing the testes they were moved internal that they could continue producing hormones so that someone could remain healthy where they otherwise might not be able to if circumstances were to arise where they could no longer afford hormones from an external source.
This doesn't mean that someone couldn't be on HRT and have estrogen along with testosterone blockers. What it means is that someone wouldn't be
dependent on hormones from an external source to remain healthy under the worst case scenarios. So, it would effectively be sort of like a safety net to ensure someone could remain healthy even if they could no longer afford hormones, for whatever reason.
I'll address some posts now...
Quote from: Squircle on September 20, 2015, 04:19:01 PMI'm guessing that everything else you talk about isn't the standard now because it's only at the research stage. These things take a long time to become an actual medical option, if they ever do at all.
I think this is probably just a case of getting caught up in that final paragraph which just sort of underlines some of the possible future benefits of what I laid out previously. I don't think that moving the testes internally so that they could continue producing hormones would really require much of any research and would be a great safety measure for those on HRT for the worst case scenarios where they're no longer able to continue with HRT or a great alternative for those that simply don't want to be on HRT to begin with.
Quote from: boheme on September 20, 2015, 04:24:19 PMAs someone though for whom HRT has had profound psychological benefit, not to mention all the physical changes, I guess I do question why one would deny themselves even low-dose HRT if they planned a full physical transition?
For me personally I don't really consider the psychological changes beneficial, and some of the potential psychological changes terrify me. I'll answer in great depth below...
Quote from: Jessica Merriman on September 20, 2015, 05:50:33 PMMy question to you is "Why are you so resistant to being on HRT"?
I mentioned it a little bit in my response to boheme but I'll expand on it for you... Keep in mind that these are my own personal observations:
Observation 1) HRT tends to significantly lower a MtF individual's libido and in some cases eliminate it almost in its entirety.
Observation 2) An unknown percentage of heterosexual and/or bisexual MtF individuals have a tendency to change their sexual preference during HRT, gaining an attraction towards men or strengthening an existing attraction towards men, in some cases losing attraction to women all together in addition.
Observation 3) HRT makes some MtF individuals more emotional and makes cold logical analysis more difficult, especially in stressful and/or emotional situations.
These three observations that I've made relate to a very core part of what makes me who I am, things that I would never ever want to change. Essentially, what makes me
me.
I'll expand now...
1) I do not want to lose my libido. My libido is very high and it is extremely important to me. I do not want to be a prudish girl with a low or non-existent libido. It would destroy the entire experience for me. I want to be a horny perverted girl.
2) I am a heterosexual male. My sexuality is very important to me. I'm infatuated with everything about women and it's not just out of some kind of lust of wanting to be a woman and I would never accept telling myself that. Beyond everything else the idea of changing my sexuality is by far the most terrifying.
I am not at all, not even remotely, attracted to men and I never have been. I like the idea of big penses, I like the idea of anal sex, and I even think fellatio sounds kind of hot. But, men? Zero attraction. Nothing.
If HRT were to make me become bisexual I would be completely open to that possibility. I might even enjoy it, opening up the other half of the population in terms of potential love interests.
But if HRT were to make me unattracted to women and exclusively attracted to men... that, that is something I would not be comfortable with. It's not something that I could accept. I say this now in a clear state of mind. Maybe if I were on seriously mind altering hormones I might feel differently at the time but I can say now that I would be very unhappy with that outcome and it is not something that I want. It's not even an eventuality that I want to risk becoming a possibility. I feel
that strongly about my attraction to women. I would never want to not be attracted to women.
I'm not just being overly paranoid, either. I have read many posts on this site and others where this exact thing has happened to heterosexual MtF individuals on HRT. Some - seemingly nearly all - become bisexual to some extent, and at least a few have become completely disinterested in women and exclusively interested in men. This terrifies me.
I don't smoke, I don't drink, and I don't do drugs. My father was psychologically altered by years of prescription drugs and it destroyed who he once was as a person. He wasn't even abusing them and he became aggressive, abusive, and paranoid. I don't do anything that could alter my mind. I love my mind just how it is and I wouldn't change a thing about it... except maybe being a bit better at math, but that's it!
3) I am an extremely logical individual and logic has always ruled my life. I can't even imagine a life where emotion ruled my decisions and I wouldn't want it to. I am not an emotional person and I do not want to be. My ability to think with cold logic regardless of the situation is one of my greatest attributes that few people possess and I do not want to lose that. It truly defines me as a person.
So yes, the psychological changes of HRT terrify me. It could, potentially, obliterate who I am as a person and I'm not okay with that. What's more, I already see myself as a girl mentally, even my inner voice is that of a girl. I do not need nor want psychological changes.
The physical changes that I want I could acquire with surgery. In fact, the physical changes that
I want are
only achievable with surgery. Hormones could never make my breasts or my butt as big as I want them to be. They could never change the profile of my nose, or make my lips as pouty as I'd like. HRT would effectively give me zero benefit and carry insane risks that I can't, in sound mind, take.
I can't get SRS without the hormones but I'm not too optimistic about current SRS procedures in general, from all the results I've seen. I don't want to disenfranchise anyone else with my worries but I haven't seen any that look like what I'd call perfect genitals, or even designer genitals. Most look pretty gross and I realize a lot of cisgender girls have gross looking ones too but let's be real: this is plastic surgery, and it shouldn't be unrealistic to want them to look how we want aesthetically and as a shallow person the aesthetics are extremely important to me. A lot of the results that I've seen don't even look passable to me, and I'm sorry for saying that but it's how I feel. And then there's the scars on the pubic mound, because that's a thing... and since I want to be smooth and hairless down there and scar easily they'd be very visible.
I could wear tight pants, or swimsuits, but... I don't have genital dysphoria at all. I have gender dsyphoria (diagnosed by my therapist even, on every account), but... I like my penis, and I'm okay with my testicles. They don't cause me any emotional distress whatsoever. Maybe having an erection in a tight dress would be a bit scary, but that's about as far as my fear over my genitals goes. Well, I mean... I'd like it to be bigger... but that's pretty normal.
It's not just the appearance, either. The increased difficulty reaching orgasm, the lack of lubrication, and the fact that it's not a true to natal vaginal experience is pretty big too.
I'm so concerned over the psychological changes that even if there was a surgeon that'd do an SRS without HRT, and even if it was a proper real natal vagina, like 3D printed with stem cells and the real deal... with the fear of those psychological changes... I would still be terrified of HRT. I'd just want to replace my natural hormone balance that was lost without changing my hormone balance to cisgender female levels. I don't want the mental changes. In fact... this entire line of thinking is what prompted this thread.
Quote from: Jessica Merriman on September 20, 2015, 05:50:33 PMYou cannot just pick and choose what you want done
Well, you can, actually. Many transgenders opt to never have SRS or HRT.
Quote from: Jessica Merriman on September 20, 2015, 05:50:33 PMPS_ I would love to see this research you talk about where a sperm producer is magically transformed to an egg producer. I am a retired medical professional and to me this sounds like a bad science fiction movie sub plot.
I actually linked it in my original post - see the blue text, which are hyperlinks. Here's a link to the thread that discusses it and you can find links to the studies therein: https://www.susans.org/forums/index.php/topic,156303.0.html
I was careful with my wording however: "it is not out of the realm of possibility that we could even produce our own eggs and potentially even produce viable offspring via the traditional methods,
eventually" The key word here is "eventually."
Here's a small excerpt from that thread:
QuoteAround 2009, the European Molecular Biology Lab isolated a gene that allows ovaries to remain ovaries and in 2011 researchers at the Univ. of Minnesota identified the antagonistic gene that allows testes to stay testes. By manipulating these genes in adult mice they've been able to transform testicular cells into ovarian cells and visa versa. While the switched cells don't produce eggs or sperm, they do produce the estrogen and testosterone that corresponds to their new identities.
I think it's important to understand that the ability to produce viable eggs or sperm is just a "future possibility"
eventually whereas being able to produce estrogen or testosterone could more reasonably be expected, and supports my original point of keeping the testes for their potential or inherent benefits, both current and future.