Hello everyone. I am transgender MTF and I have been transitioning for about a year and 3 months. a couple months ago I started to get very bad anxiety and even had several panic attacks. Now I notice that throughout the day I am sometimes short of breath and fatigued and cannot stop worrying. Some of my biggest concerns are having a blood clot or heart attack even though I am probably not at risk currently. I am 23 years old and weigh 170 pounds. My worrying has gotten so bad about this that its making me even want to stop transitioning even though I am not happy as a man and do not identify as one. Does anyone have any suggestions to help with the anxiety? Is it normal to be this anxious about it?

I am transitioning to male but my experience with female hormones in the past is that they are connected to inexplicable attacks of anxiety. Whenever the levels of E fall especially. Also, falling E and T correlated exactly with increased fatigue and joint/muscle pain back before I began male HRT.

Putting the E levels back up to what they should have been fixed the anxiety. (As did replacing it all with T in my case).

Basically I believe drops in sex hormones are bad news and tied to otherwise unexplainable anxiety attacks and pain. If you're on HRT have you maintained a regular routine with it to keep the levels where they should be?

Hey thanks for replying! and I have had a pretty regular routine. I use the patches for the estrogen I had my blood work done recently and my estradiol level was 647 pg which is very high. It could be partly to blame for the anxiety I just hope its only anxiety and nothing worse. My doctor simply lowered my dose I take now and have to have my blood done again in about a week or so. All she said is it could be related to my anxiety and didnt really help ease any of my fears though  . It would probably also help if I started working out again I used to be very active but lately havent done anything but work. I think its anxiety though cause it will come and then go away if it was something serious I feel like it wouldnt go away and something bad would have happened by now.

I had a lot of anxiety when I was in the midst of transition -- just the act of transitioning itself can be a source of anxiety.  Wondering how we're making it out there, waiting for surgery dates, paying for all of it, dealing with physical and psychological changes, adapting to new social expectations, tensions with people from "the old life" -- there's frankly a lot to be anxious about! 

I'm not so sure I'd call your estradiol levels "very high" -- that's well within the normal range, actually, and I worry that lowering your dose will not help to alleviate your anxiety, not to mention it might slow your feminization.  If you're actually worried about possible side-effects of estradiol I suggest you review KayXo's many posts on how there's really nothing to worry about when it comes to bio-identical hormones; the real health risks are with the older drugs like Premarin. 

For me, though, cutting my progesterone is what really did the trick as far as my anxiety went back in the day; that particular hormone exacerbated the other stressors in my life.  Also, if you had been working out, and now just work, that would certainly contribute to elevated stress hormones.  Exercise is proven to reduce stress hormones, so it might behoove you to start working out again -- plus, working out elevates our natural growth hormones, which can help with other "development" of our bodies. 

You don't have much posting history so I need to take a guess. I think you should consider some therapy to help get the stress in your life under control. Transitioning is stressful and the earlier stages are the worst. Some people feel this stress more than others and if it's bad enough, you might be prescribed something mild to help take the edge off. In my case, I was able to accomplish this in a group setting but you may find private sessions more to your liking.

Once you learn the tools to dealing with stress you should have minimal need for additional therapy but life can present new issues so keep your therapist available.

I have VERY bad anxiety (generalized anxiety disorder, PTSD, and depersonalization) and I'm the same way as you.... I always think I have cancer, AIDS, some rare illness, or think I'm just going to fall over and die or have a heart attack. It's the anxiety putting these irrational thoughts in your head!! The first step you need to do is realize it's just the anxiety talking. It's a cycle...... the anxiety causes fear, fear causes the glands to release adrenaline, adrenaline causes physical symptoms such as racing heart, feeling like you can't breathe, legs weak, shaky, etc. and the physical symptoms of course cause more anxiety. It's truly a vicious cycle. But you need to learn to break that cycle, or atleast get it under control. When you feel a panic attack coming on of feel the anxiety coming on, address it. Tell yourself "okay, I'm having an anxiety attack, this is normal, it won't last long, and it's JUST anxiety" that helps a lot. Another thing is to do things that keep your mind off of the anxiety... keep your mind occupied. I know how scary and depressing it is to live with anxiety, but once you train yourself, you'll eventually overcome it or atleast make it manageable.


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If it's continuing to happen a lot then besides talking with a therapist you might want to see a psychiatrist. I dealt with anxiety for many years. After prodding from my SO I finally saw a psychiatrist. I've been taking Zoloft for about 5 years now. It's effect for me was incredible. It also greatly helped with my depression.