Dr. Vitale says that HRT can be used to confirm or reject a diagnosis of GID because psychological changes take place before permanent physical changes do.
Does anyone have experience with this, and how long after starting HRT (Estrogen therapy) do psychological changes take place? How long before irreversible physical changes take place?
I've never heard of it used that way, but I find the notion actually pretty cool. Every one of the transsexuals I know (myself included) experienced positive psychological and emotional changes after going on hormones.
There are now some neurobiological studies which can explain why this is so (I can look for a link, but I don't have one at hand). The same studies would seem to suggest that HRT would have the opposite effect on someone who is not transsexual.
Anyway, this sounds leading edge, but quite encouraging. As long as you're being monitored for health impact kudos to Dr. Vitale.
I have heard of it being ussed as a diagnostic tool but I have not heard of a doctor actually doing so.
I ussed HRT as a self diagnostic tool early in my transition via DIY. (Not something I recomend!) The peace I felt within the first week was so definative that I had no doubts whatsoever after that point.
I do know that cis males who are given estrogene for prostate issues tend to get morose and depressed. Add that to how many trans folk who report rapid positive mental change I personaly think HRT as a diagnostic tool is a great idea.
If HRT is good for you it will show, and if it isn't that too will show. The important part however is utter honesty to self.
jmho I am not in anyway qualified to make that call.
There is a bit of anecdotal evidence that HRT does seem to have a positive effect on those who are trans and a negative effect on those who are not.
This has not been given a lot of scientific scrutiny. Much of the psychological effects may be as a reinforcement of the persons gender outlook in the first place.
A non-trans male, for example who is given estrogen a therapeutic response to prostate cancer can become depressed because of some of the physical side effects such as loss of libido, Gynocomastia and muscle mass loss and view it as a loss of masculinity.
Where a trans male who is given estrogen may feel calm and peace at the physiological changes because it may be viewed as a positive step in their journey.
From my own experience on HRT, I did have a feeling of peace also. Additionally, I found that the triggers that would cause me to go into a bleak depression, such as stress or extreme emotion, no longer had any effect. I personally feel that because of the HRT something *did* happen and it was not entirely because of my emotional state.
-Sandy
How long does it take for psychological changes to start taking place after HRT and how long for irreversible physical changes? How long does one have for a "test period"?
I'm especially curious because of my somewhat unique situation where I have spent the majority of my life without T. Since I'm still questioning, perhaps HRT would both help me confirm my true gender as well as help with the severe osteoporosis that I have. I have dealt with depression and very low self-esteem all of my life, and I'm also curious if HRT would have any influence on this. I know it can't be a cure all, but I've started wondering if perhaps some of the depression and self-esteem issues are due to gender incongruity, which has been buried for decades.
I will see my psychiatrist for the first time this month and will ask her about it. I hope, but have doubts, that she has experience with transgender. I see my psychologist this week for my first session post assessment, and though he is willing to explore the transgender issue, he does not have much experience in the area.
Thanks for your feedback girls - you don't know how much it helps! Its kind of a confusing and little bit scary time for me.
https://www.susans.org/Health/Therapists_and_Counselors/USA/ (https://www.susans.org/Health/Therapists_and_Counselors/USA/)
Check your locale for gender counselors we know about. At least provide your therapist with some contacts to call.
I thought Anne Vitale retired.
Robyn
In my experience, the psychological changes are pretty quick, and also kind of subtle. You just feel a little sharper. Less prone to the darker emotions, even as you experience more range of emotion. Maybe you feel a little more attuned to the world around you. This happens within the first couple of weeks. Well before any permanent physical changes.
Some experience more dramatic changes, but it's hard to tell how much of that is psychosomatic. The consistent thread describing it I've seen is mild and subtle. Nothing you couldn't chalk up to coincidence.
What I would expect your doctor to be looking for is for you to react in the opposite direction. You get moody - but in a consistently dark and depressive way. You don't feel better, but rather worse.
Once again, this is pretty cutting edge as diagnostic treatment. They normally don't let you on HRT until after they've diagnosed you as transsexual. Hard to say exactly what the diagnostic criteria in this case will be. I'm guessing.
Quote from: Robertina on July 12, 2010, 09:27:03 PM
How long does it take for psychological changes to start taking place after HRT and how long for irreversible physical changes? How long does one have for a "test period"?
I'm especially curious because of my somewhat unique situation where I have spent the majority of my life without T. Since I'm still questioning, perhaps HRT would both help me confirm my true gender as well as help with the severe osteoporosis that I have. I have dealt with depression and very low self-esteem all of my life, and I'm also curious if HRT would have any influence on this. I know it can't be a cure all, but I've started wondering if perhaps some of the depression and self-esteem issues are due to gender incongruity, which has been buried for decades.
I will see my psychiatrist for the first time this month and will ask her about it. I hope, but have doubts, that she has experience with transgender. I see my psychologist this week for my first session post assessment, and though he is willing to explore the transgender issue, he does not have much experience in the area.
Thanks for your feedback girls - you don't know how much it helps! Its kind of a confusing and little bit scary time for me.
Robertina:
The psychological effects *seem* to happen in the first few weeks. Some of the physiological effects can occur quickly as well. Initially loss of erection, and libido can occur fairly quickly. There can also be some tenderness in the nipples and minor breast growth. Most of the side effects are reversible if HRT is discontinued within 8 - 12 months. Beyond that and chemical castration with permanent gynocomastia can result.
The WPATH guidelines suggest having a letter from your therapist for your endocrinologist to certify that cross hormone therapy will be beneficial. If your therapist is not familiar with WPATH you may be able to explore informed consent from your doctor to pursue HRT.
-Sandy
For me, it was like a high performance engine that was being run on regular. It runs but not at the pike of performance. Now it is running on premium. It runs smooth and can never stumbles.
I noticed drastic, and I mean drastic, psychological improvements within a week of starting HRT, but it still took about 4 months before I started actually smiling. It was like major improvement in my mood, followed by a slow and steady improvement for 5-6 months after.
Physical effects depend on your genetics. They say you should be ready to have to be hiding things within 3-4 months (if you go the part-time route) but for me it was more like 8+ before I would have had anything to worry about. If you mean sterility and stuff, I'm not really sure on that one. I had no interest in becoming a father, so I would have been fine with instantaneous and permanent sterilization.
Quote from: Robyn on July 12, 2010, 10:56:24 PM
https://www.susans.org/Health/Therapists_and_Counselors/USA/ (https://www.susans.org/Health/Therapists_and_Counselors/USA/)
Check your locale for gender counselors we know about. At least provide your therapist with some contacts to call.
I thought Anne Vitale retired.
Robyn
She might be. I got the info from her website (wasn't sure if I was allowed to post the link or not).
I was diagnosed with Gender Identity Disorder (not particularly keen on the disorder part, but I guess that is the DSM). I wouldn't be so concerned about HRT except that I really need some form of hormone for my physical health and I just hate what the T does to me.
Quote from: Robertina on July 13, 2010, 01:40:47 AM
.... I just hate what the T does to me.
That was what I found (a long time ago). Having some natural oestrogen was good in my early teens and some DIY HRT helped but more so by "taking the edge off". They didn't have blockers in those days so I don't know what the effect would have been but definitely getting rid of the T in my early 20's made all the difference for me. For everyone I knew, oestrogen had a positive effect.
As to development time-line, I can only say that my natural oestrogen level at puberty was low, about 1/2 normal female levels, but by 15 there was no hiding the effects. (T was about 1/2 normal male levels so having boobs and facial fuzz was DEFINITELY uncool! LOL!)
Because of medical concern about the long term risks of HRT, I was taken off oestrogen for over a decade and suffered the beginning stages of Osteoporosis. With proper HRT and exercise, I have reversed the bone density loss by age 61. When I asked my endo how long I should remain on HRT she said for as long as I want because Osteoporosis WILL happen if I stop but the other risks are just statistical.
How I wish that I had stopped T before I got more than facial fuzz (I didn't begin male puberty until my early to mid 20's), but pain forced me to keep taking T, but just not on a regular basis, which is why I have osteoporosis now.
I have no idea how much estrogen I have, if any (not sure if the problem that causes me to not produce much T would affect estrogen production too or not). I am a very sensitive person and in touch with my surroundings. I have strong feelings, but sometimes have trouble describing them.
One of my worries is that Estrogen might make me more moody or emotional, but then maybe it would provide more stability - I just don't know much about Estrogen.
I can acknowledge that T does give me a tad bit more feeling of well being, but all the other negative aspects far outweigh that, especially the increased libido, unwanted erections, and hair. Without the T I still have libido, just not as strong and takes more to get going, and maybe it is at a deeper level connected more to emotion.
Have your doctor check your hormone levels, they can then advise you on what they need you to take.
I was also very emotional prior to HRT and once my mood stabilized I would say I'm even more apt to burst into tears over something now =O. But the main difference is happy tears, I get those a lot more and I don't mind them :). I cry out of sadness maybe a bit more, but not much. I used to be a very sad person :(.
About your moodiness, whatever amount of anger I used to have has all but disappeared. I cry more, I smile more, but I'm almost never mad.
YMMV.
Quote from: Jen on July 13, 2010, 10:51:08 AM
I was also very emotional prior to HRT and once my mood stabilized I would say I'm even more apt to burst into tears over something now =O. But the main difference is happy tears, I get those a lot more and I don't mind them :). I cry out of sadness maybe a bit more, but not much. I used to be a very sad person :(.
About your moodiness, whatever amount of anger I used to have has all but disappeared. I cry more, I smile more, but I'm almost never mad.
YMMV.
I am so with you on this one Jen!
Happy tears rock.
My doc says I need T, but he does not know about my GID diagnosis.
I cry easily at movies, or for other people, so they are kind of sad tears. On occasion I have tears of joy, mainly when someone shows great kindness to me. The last time was when my brother hurt my feelings, then came to my room where I was crying and he so sweetly apologized and just cradled me in his arms, stroked my head, and held me while I cried until I felt better. He can be so sweet, until he reminds me that I am not a girl.
Until just recently, I think I experience a fair amount of irritability and anger. Things get to me real easy. I've spent so many years living for other people or according to other people's beliefs. At 46, my biological alarm clock has started to ring pretty loud. I've given up any desire for career or saving the world (phases I went through, but can no longer pursue do to my health) and all I really want now is to have a loving husband and grow old together, even if that means living poor on a simple farm in a tiny town in Mexico.
The question is whether I would be happier living as a man or woman, and I have serious doubts about the former but feeling awful old and tired to attempt the latter.
PS: As an after note I'll add that for many years I had wanted and even planed to be a celibate monk, so gender and sexuality were not quite as important to me; however, I was worried about the temptations of living a celibate life in a male monastic community. I would have been much more comfortable with nuns, I think. Anyway, though I still have some attraction to that way of life, I don't think I have the stamina, dedication, or faith to do it, and perhaps and a bit selfish for just wanting to love and be loved by someone while growing old together - something we all likely deserve.