September 18th, 2014 marked my 1st-year anniversary of starting HRT (celebrated with my mom with cake and a candle!). As with everything else gained or discovered along the way it was a long time coming. It is a place I've never even been able to imagine because you can't know what it's like until you get there. Some changes were subtle of course, but when added up into the bigger picture represent a polar-opposite turnaround from where I stood back when I made the decision to transition. All the sadness and discomfort I shed are now a vague and distant memory thankfully, but I certainly haven't forgotten where I started. I continue to relay my experiences to early-stage transitioners and the questioning on Susan's so they can have hope in the scary early days just as others did for me back in 2012 and forward to today. For those interested in some of the back story for context, continue reading the paragraphs in the alternate font - otherwise you can skip past that to the bottom for the rest of my update.
Discovering my identity and making the decision to transition certainly helped lift me from a pit of despair and depression in Spring 2012, but there were other physical manifestations of my ills that would have to wait for HRT to address. Depression played some role in how I was feeling but the baseline ills had existed before that and had progressively worsened since puberty. From as long ago as I can remember I had chronic sensations of anxiousness - constant high nerves. When I was a child I described it as never being able to feel calm at any time. No one took it seriously or knew what to do about it. Over the years I had many different medical tests done but everything seemed pretty much normal except that I always had an extremely high metabolism and was physically smaller proportionally to most children my age.
Once I hit puberty my growth in height took off like a rocket and I was finally not being teased about my height but remained very thin despite a monstrous appetite. Basically I just got really stretched out. My symptoms of anxiety worsened and I began to struggle with morning nausea, a condition that would stick with me almost every day for the next 20 or so years. The nausea would often prevent me from eating breakfast which is a bad way to start a day. I also started to feel more tired when waking than when I went to bed. A sleep test was eventually performed but came up with nothing including no evidence of the night-time tooth grinding my dentist swore I was doing. I did, however, end up developing excessive tension in my jaw muscles and would spend whole months at a time with soreness, especially when chewing food. My doctor mentioned a not-so-clinical term he had heard which described my situation well - "wired and tired". Unfortunately he was of no other use in sorting it out. In the last couple years of my suffering I would often feel like my brain was in the grip of some barely describable tension. Try to imagine a ringing in your ears as a ringing in the brain. There were times when I felt like smashing my head against a wall as if dazing myself might help. (Thankfully I didn't actually try.)
Eventually I became abysmally depressed and felt completely hopeless about my situation. Other things going on in my life combined with this to take me down to a rock-bottom of depression and fatigue. Basically I had totally given up and didn't care if I woke up dead. My nerves felt like they were constantly buzzing and pulsing like an idling bus engine and I was dragging myself around in a state of chronic fatigue. It was at this point that a pure fluke of events got me started in diagnosing my transgender identity.
I went into my personal discovery purely from a gender identity standpoint without any idea that my other problems could be related. I started doing a lot of research and reading old posts on Susan's and was shocked to be finding hints that my system being so horribly out of whack could be related to hormonal effects, effects that might be countered by hormone replacement therapy. Most of the talk on Susan's centers around gender identity, sexuality and body dysphoria, all issues I needed to tackle anyway. The conditions caused by incompatibility with the body's own hormone production are not often detailed. I have no idea how common my past physical problems are and the specialists I'm now dealing with had very little background to go on despite having extensive experience with LGBT healthcare. I went deep into the process of approvals for transition and coming out to people about my identity while having to go on hope and faith that trying HRT could correct my other ills. This was really scary and added another layer of stress upon how bad I was already feeling. Was I going to make a fool out of myself by coming out to everyone only to still be sick in the end?
When I eventually got my first prescription for Spiro on September 18th, 2013, I finally had my proof that everything I was doing was right. For the first day in my entire life I felt washed over by calmness. It was the most glorious sensation I have ever experienced. Until my dose increased and Estrace was added the daily pills created a bit of an up and down. Now the effect is pretty much blended out and constant. The medication has had a strong anti-depressant effect and has tamed my nerves to a point that feels almost numb by comparison. I'm alert and energetic, cheerful and calm. My racing metabolism has finally slowed enough that I've gained some weight I desperately needed. I'm full of hope for the future but savor every day on its own.
On the physical changes side, my face has softened and thinned. My body hair is very slowly changing and slowing. My skin is less oily, particularly my face and scalp. Most notably I've developed what I'd estimate to be 34A breasts and I'm ecstatic about them with no need for more, although they continue to hurt every day so I don't think they are stopping yet. Spontaneous erections are down drastically although the ability has not been lost. It's enough that I can finally ignore 'down there' most of the time. My testicles have also shrunk somewhat. I have learned or gained, not sure which, the ability to have all-out female orgasms. In a shocking discovery this year they have now occurred spontaneously sometimes without physical stimulation or focused intention.
I am just starting to get "ma'amed" occasionally while in guy-mode and strangers seem to be more and more uncertain of my gender when I'm not clearly presenting female. I've also been taking voice lessons and have been ma'amed on the phone simply because my baseline voice character has shifted. Once I get further with electrolysis I think I'll seriously consider going full-time prior to surgery even though I'll still be a work in progress.
What I've gone through in my life has been a terrible, torturous marathon that I would never wish on anybody. When I tell my story it is with the sole intention of helping others learn they can get better before wasting so much of their life in anguish and distraction as I did. Maybe the physical manifestations of my condition were rare, I can't be sure, but if I could even reach just one young person and turn their life around early I would be ecstatic. No one should ever have had to live this way and the medical community needs to very seriously inform themselves. I never really received any direct or proper guidance on this. My body was crying out for decades that something was terribly wrong and the information should have been available even to just test a hypothesis. Thankfully my suspicions were proven correct as I am now in near-perfect health.
Obviously everyone is different and HRT should not be considered a magical solution to all ills, so please be careful and find the right doctor to assess your unique situation. In my case HRT brought me far more invisible changes than the visible ones most desire, but these were the most critical to me. If you share any of the ills I had then I can say at least from my personal experience that there could be hope for you. Be prepared for nothing but cherish any successes. As I told my mother, HRT has turned out to be the single most important thing that has ever happened for me. There was no other possible path for me and I am at peace now.