Hi all,
For most of my adult life, I have flagged myself as 'merely a [MtF] crossdresser' and was happy with that lie to myself (and to others — I came out to my wife as 'merely a crossdresser' a dozen years ago). I've enjoyed it tremendously. After coming out to my wife, I was able to dress as a woman as much as I wanted (well, within limits) and even go out a few times, so all seemed to be really fantastic.
In 2013, everything changed — my mother died, leaving my demented father behind; and all of a sudden I stopped being able to work on my PhD and became easily angry, which was rather the opposite of my usual behaviour. I was diagnosed with severe atypical depression and anxiety; and that, of course, not to mention gender dysphoria.
For the past three years, I have considered myself a 'non-transitioning (confused) transgender person'. Transition is out of the question, for several reasons, the first being my wife, and the second the impossibility to work as a trans woman in my country. I should add that my fellow citizens around here are pretty tolerant towards the trans community in general, and I have had wonderful experiences interacting with all sorts of people, of all kinds, and only got politeness as a result. In fact, I started to get addicted to being so much better treated as a trans woman (one that does not pass but still looks great, or so my vanity tells me ;) ) than as a male, a gender role I have always hated, but had to endure it for the sake of survival.
So, yes, for the past two years or so, I have been on therapy with experts in clinical sexology, and learned a lot about myself. Contrary to what I would consider common sense, all doctors, without exception, have encouraged me to dress and present myself more and more as a woman — they all believe this will be a way to 'trick' my mind into abandoning the depression and focus on my work again, while presenting myself (even if just at home) as a woman, which gives me pleasure. My wife totally disagrees with that 'therapy' and severely limits my crossdressing time, so we have constantly to negotiate complex schedules; she has a very strong conviction that my 'crossdressing urges' comes from a midlife crisis and that once the depression/anxiety are 'cured', I will be able to suppress those urges again, as I have done for several decades. My doctors have a different opinion (and I'm being followed by half a dozen!). I keep an open mind: the little therapy I have done to fight depression encouraged me to keep an open mind and mistrust my opinions, because it was by mindlessly following my own opinions and ideas that put me in this mess in the first place :P Echoing my doctors, I now try to avoid labeling myself; but it's undeniable that I still prefer the female gender role much more, in spite of all the disadvantages that it carries. That feeling doesn't lessen, even though it seems that I'm slowly recovering from depression, but it just gets more intense. In fact, I'm actually surprised that I naturally do so many things as a woman which several of my friends in transition are still 'afraid' to do; I have met several transexuals around here who have been months on HRT but haven't still got the courage to shop for food on their own (just to give an example).
All right, this is the background: my story seems to be pretty similar to many late onset transexuals, especially among those who aren't able to transition for several reasons. But just yesterday I received a small shock when looking at some blood exams, even though a clinical sexologist has warned me that I 'probably would have a surprise'. Even though I was happy to see that, thanks to several months on statins, my cholesterol levels are back within reasonable limits, and everything else seems to be fine... I have very high estradiol levels. Well, at least for someone who has been born a male.
Males, of course, also produce estradiol, even though most of it is supposed to be converted into testosterone; my T levels are normal for my age. Nevertheless, there is still way too much estradiol circulating in my bloodstream. It can be explained for several reasons: estradiol, in males, is mostly produced in fatty tissues, and yes, I'm some 8 kg overweight, all of it fat accumulated in the belly. Males also need some estradiol for some functions to keep, for instance, the bones in good condition. The 'normal'/average value of estradiol in males is about 20; I have 43, which, according to some tables, is either close to the maximum level, or even out of the scale; as a comparison, cisgender women in good health should have a minimum of 50, even though, of course, that value will change tremendously during the menstrual cycle, peaking twice, at around 1400 and 650; and recommended values for trans women are to aim for ca. 200.
So while it's quite obvious that I don't have 'female' levels of estradiol, I'm off the scale for a male. This has several ugly side effects. I can live with 'moobs' (in fact, I love my moobs and wish they were much bigger!), I can even survive with the 'beer belly' (even though I don't drink beer and I'm just a social drinker anyway...), I can live with the loss of some muscle tone (now I start to understand why I seem so much weaker than before — even though I was never strong in the first place — which I merely attributed to being almost 50 and not really working out), and, yes, I'm so used to having zero libido since my 20s that the loss of libido due to high estradiol levels does not bother me at all. Both my wife and I are almost asexual, in fact. I'm quite aware that many transgender people have very low libidos (especially because they feel that they are in the wrong body to have pleasure from sex) and so I really never worried about it, it was just one problem less to worry about :) and I'm the kind of person who would have no regrets from never having an orgasm again if I went through gender confirmation surgery — sex is something I haven't desired for most of my life (even though I pined for it in my late teens!). So... I can take all that.
But unfortunately there is much worse. High levels of estradiol in males can produce breast cancer (yes, indeed), and there are a lot of breast cancer cases in my family; at least half the females among my closest familiars have had breast cancer, even though all survived except one aunt (who died in 1970, mostly because radiation levels those days were far too high and dangerous). But high levels of estradiol can also create other types of cancer, and, perhaps even worse than that, it can lead to severe complications in the cardiovascular system. I have already high blood pressure (kept in check thanks to some medicine) and something tiny in my heart which is not working perfectly as it should — but I shouldn't worry about it, because it's a genetic defect, my father has exactly the same issue (diagnosed when he was 11), and he's almost 88 years old and incredibly healthy (well, just demented...).
So I'm not exactly thrilled by this revelation. My first reaction was, 'yay, there is a biological condition to my gender dysphoria!', but the second reaction was to read what it implies, and it's anything worth celebrating.
I'm wondering if any of you have naturally high estradiol levels and what your doctors have recommended as a treatment.
Now, I know that some people might have artificially enhanced their female hormone levels via self-medication, either with synthetic drugs (like estradiol-based anticonceptive pills...) or natural plants rich in phytohormones. That's not my case. I'm completely against self-medication, and after having read so much about the real problems that can come from self-medication — especially when we're talking about hormones! — I have avoided that like the plague, even though a lot of my trans friends tell me how great it is or how safe it is. I don't care: I have towards self-medication the same attitude as I have against recreational drugs — they might be fine for others, but not for me (I'm a heavy smoker and that's enough of a health risk for me, thank you very much!).
I have therefore to assume that in my case there is something wrong with me which is producing an abnormal amount of estradiol. Because this is the first time in my life that I got blood tests specifically for estradiol, I have no idea for how long they have been so high.
I've looked up some of the available 'treatments'. The first is to raise testosterone levels, because for some reason doctors believe that the excess estradiol is not being converted into testosterone. For obvious reasons, this is most definitely an option I do not want, unless it's really a life-or-death choice — at this stage of my life, even though transition is not an option, I want to look less masculine in all regards, and I most definitely don't want the side-effects of testosterone — namely, increased aggressivity, an increase in sex libido (which would make my life very complicated at this stage!), more muscular development, more hair loss (even though I have lost quite a lot already), and probably a regrowth of all the body and facial hair that I have been lasering out for so long and at a considerable (even though reasonable...) expense. So, no, thanks, no more testosterone for me!
So... what other treatments are available? What will be the side-effects of those treatments? I'm asking the community because many of you might have gone through the same problem, and had to figure out a solution that worked for you. Just take into account that a full transition is impossible for me. On the other hand, I don't mind any 'feminisation' effects at all (it's rather unlikely that they will be perceptible anyway), but I will be seriously against any 'masculinisation' effects at this stage (unless the alternative is a quick death from a heart attack :-P ). In other words, I'm fine with any 'treatment' so long as I can still wear male clothes and go to work (well, assuming that I could work, meaning that the depression would be over).
Any suggestions? Even a suggestion of 'don't worry about it, the harmful effects of high estradiol levels in males are seriously overrated, and yours are not that extreme in the first place' is quite welcome, especially if you can give me a few pointers to research material :)
Thanks to all in advance!
Those levels aren't high enough to do anything in the presence of unblocked male gonads. My baseline was a good three times higher than what you listed... and zilch effect. I'm an aging powerlifter, and Aromatase was my middle name.
Corrolary that will interest you. If you do block your male gonads, your estradiol will drop like rock. My post HRT estradiol levels were LOWER than pre hrt. Though that is no longer the case now that I"m at a full transition dose., but being on sublingual pills makes measuring E2 a pointless exercise.
Thanks, Becky, I was hoping for an answer like yours :)
I've already stopped worrying about it!
My pre HRT estradiol level was also 43 alongside a pretty high testosterone level for my age. My health was great despite several abusing my body in different ways before I started HRT. So the conclusion I draw is that while this may be a risk factor your genetics are far more important to avoiding problems. If your tests indicate that your health is good you probably don't have a lot to worry about.
It is better to be hated for what you are than to be loved for what you are not.
André Gide, Autumn Leaves
If this is just a one off test I wouldn't think too much about it. It could just be a blip and not a clear pattern. Some clinics don't even put a lot of stock in estradiol tests as they can vary quite a bit during the day even among cisgender women. To experience the wonders of estrogen you pretty much need a steady source of exogenous hormone.
Ten years ago at age 57 I was diagnosed as hypogonadic. My T was 150 on a 300-1100 scale. My estradiol was 80 on a 0-50 scale. (both T and E2 levels are midway between normal male and female ranges).
I started testosterone injections. Six months later my nipples were erect all the time and I started growing boobs.
I weighed around 200 lbs back then and evidently had plenty of the enzyme aromatase. A couple of years ago I went off testosterone for a few months and test showed that I had virtually zero testosterone.
I've also been on estradiol, both gels and injection. I found that I need some testosterone to avoid weakness and lethargy. I have to admit I've found no answers. It seems biologically impossible for me to be male. If I take testosterone I feminize, although I do gain some energy and strength. On estradiol I feel better mentally, but without any testosterone, I get weak and want to sleep all the time. It seems the best combination is mostly estradiol, keeping E2 levels in the female range, with just a little testosterone boost from time to time.
So I'm a mostly bald 67 year old with very large boobs and very shapely legs. Maybe I should just get a good wig and learn makeup.
Randi