Hey all, 20 year old FtM here and have been for about 5 years now. I've been very reserved about the idea of HRT as it is a big, somewhat irreversible decision, so for a long time I've been telling myself to wait until I'm sure. I'm starting to come to a point in my life where I'm transitioning from school to the workplace (planning on getting an internship this summer and I graduate with a bachelor's next year), and it's made me extremely conscious of my inability to pass. In classes, usually 65 student lectures, there isn't much pressure and I hardly interact with anyone. However, at the workplace, I'm assuming I'm going to have to, y'know, communicate with people, which will result in much more direct misgendering. Ideally, I'd want to begin transitioning before I get a job, because having coworkers see me go through transition...just sounds awkward...and I'd rather them think of me as male from the get-go.

So anyhow, it's come to a point where I feel like I need to do this. The only things that are staying my hand are the limited amount of information on the health risks of taking T (may increase risk of liver/ovarian cancer? maybe not? who knows), how it may interact with PCOS (which I think I may have, though I have not been professionally diagnosed), aaaand...

...my social anxiety is making me freak out about going to see a therapist. And this bit is why I'm posting here. As someone who has only been to a doctor about 3 times (for a broken foot and immunizations), and have always been accompanied by moral support in friends and family, this is extremely unknown territory to me and I have no idea what I'm doing, and I'm going to have to go alone.

Things I'm paranoid about:
-not being written a letter for hormones because I'm not "trans" enough/not being diagnosed with GID
-how to talk to a therapist, what to say - I'm a very socially reclusive person and bad at opening up or expressing emotion
-other small things I'm too embarrassed to write but still inflame my anxiety

TL;DR: Does anyone have advice, tips, or stories about their first time going to a therapist in order to start hormone therapy? I'd just really like to have an idea of what I'm getting into before I jump in headfirst.

(P.S. This turned into a massive essay, oop)

Hi, welcome to Susan's!

I can't answer any specific concerns about potential health effects of T for someone who is F2M. I will say though that the effect of hormones usually takes several months to become apparent and before they are not reversible (body hair, voice, beard, etc). Also, the starting dose is usually low before being increased. As such you have some window of opportunity to see if it is working for you, or not, and whether you want to continue.

As for "not being trans enough", there is no such thing, and any therapist that trots this misconception out should be given their marching orders.

In terms of being open with the therapist, they should hopefully make you feel enough at ease to talk freely. Keep in mind the less you say to them the less they have to go on. The nature of their work means that they should be non-judgemental and they should work with you to find solutions that work for you. I always see the process of talking with a therapist as one of bring honest with myself more than with them. Speaking my truth, with a specific mind to the circumstances and desired outcome of the consult/session means getting what I need faster.

Good luck!

Welcome to Susan's Place. If you are here, you are trans enough for HRT. Being transgender is the only condition where the patient diagnoses their condition and the are only there to help you explore yourself. A therapist is more a partner in your transition and if a therapist fails to work in this manner, you need to continue your search for another therapist. As for tips, I have a couple of links you might want to look at. The first is our WIKI where transgender will be defined in detail. The second is "the transition channel" where you will see some of the topics discussed in a therapy session. Let us know if you have more questions.

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Thank you both for the welcomes and information! I'm no longer concerned about effects such as voice changes or body hair at this point since I'm now very sure in my identity, only concerned by overall health concerns (which, I don't really expect anyone to know much about, since there just isn't enough data to assess to even come to a certain conclusion), though it is nice to know that there are a few months to assess the situation before fully committing.

Also made me realize I've been kind of viewing therapists as an adversary or gatekeeper rather than someone there to help me, your comments and the videos definitely helped me gain a better understanding of the whole thing.

I'm in possibly a different situation than some trans people, in that I am going to the university health clinic (students get a discount and I don't have health insurance), and I first have to schedule an initial visit with counseling and psychiatric services, and then the person I see will assess me (whatever that means /:) and then appropriately assign me a therapist who I'll have to see after that, so who knows who I'm going to get in my journey through transition.

Still open to hearing some personal accounts though!

Under proper medical care, hormones are very safe and only a very small number of people have issues with treatment. If anything, T may be safer than estrogen in the short term however over the long term, men tend to have shorter lives than women so it kind of balances out. I started on estrogen in 1977 and have had no issues. We had a FTM consoler in my therapy group who transitioned before me and not long ago, I found that he is still alive and well. Treatment will include extensive blood work to ensure you are healthy enough to start treatment and additional test to ensure you aren't developing any issues.

My feeling is this.  If you feel that you can't be 100% honest with your therapist, then you need to see another therapist.
It's kind of like going to a doctor and not telling him/her your symptoms. The result will most likely be a misdiagnosis.  If you're concerned about gatekeepers there's always informed consent clinics. That's the route I took. But I was in therapy at the time and could easily have gotten a letter.
And don't worry about not being trans enough.  Just be you.

Describe how you feel about being gendered male, versus how you feel about being gendered female.  The difference should be stark enough to make it perfectly clear exactly who you are.

Huh, that's interesting to hear since from what I've read I feel that testosterone has a more drastic effect on the body than estrogen, which in turn made me feel that drastic = more likely problematic. But gosh, someone starting T from way before I was even alive and not having any problems, a nice assurance there. Actually though, one thing I am worried about is the regular testing that you [should] go through while taking T to make sure all is well - since I have no health insurance, I'm going to have to pay the costs out of pocket. Any idea what the fees average out to be per month or year?

Thanks for the advice all. Yeah I feel like if I just be myself I should be fine, but my anxiety of course is lurking in the background being a wretched downer, always expecting the worst of things. Also, I'm not sure what informed consent clinics are?

Hi,

The studies that have been done on long term health effects on transgender people have included about 2000 people (from memory) and was performed in Europe and included the UK and European TG groups. There were little to no health side effects of T in transmen. There was an increase in thrombotic conditions and an slight increase in breast cancer (compared to cismales of the same age groups) in transwomen from E.

Taking into account the poor mental health of the population prior to transition with depression and self harm issues the transitioning of both male and female transexuals under supervised conditions can only be seen medically as a health bonus.

In my opinion when you are ready, go for it!!!

And welcome to the site.

Cindy

An informed consent clinic provides transgender transition care without a letter from a therapist.  All you have to do is show up with your ID say you want HRT and they give you a form to sign that explains all the advantages and possible harmful side effects of the medicine that they are about to prescribe for you.