I'm really not sure whether this belongs here in Non-Binary (because it's related to me being nonbinary) or one of the Transitioning forums (because it's related to my hormones). If you think I'd be better off just posting this in one of the Transitioning forums, I'd appreciate your input on that. Anyway...

Some background information:

I identify as a AMAB nonbinary transfeminine person, and also sometimes as a demigirl. In October 2014, I started a HRT regimen comprised of  Spironolactone and  Estradiol daily. I have always had a slight tendency to get weak and dizzy at random times, and especially when moving from a lying or sitting position to a standing position. However, over the next couple years after starting HRT, these fainting episodes became increasingly common. It was eventually determined that my natural tendency to have low blood pressure combined with a side effect of Spironolactone was the cause. In October 2016, I made the decision to stop taking Estradiol, as I had come to the realization that my breast development and some other effects were actually making my body dysphoria worse. I also realized that I've become unwilling to further modify my body all at. My fainting episodes continued to increase in frequency and seriousness, until a few months ago, when my PCP made the decision to cut my dose of Spironolactone down to half, and then to a quarter following yet another fainting episode. During this time, my PCP also became increasingly concerned about the possible health risks of my having low sex hormone levels for an extended period of time.

Here's the problem:

A little over two weeks ago, my PCP sent me an email in which he informed me that he was giving me a deadline in 30 days (now 13 days remaining) to meet with the nurse practitioner I normally work with for HRT to decide on one of two options:
A. Resume taking Estradiol, likely with a much lowered dose of Spironolactone
B. Stop taking Spironolactone completely, and let my body resume its normal testosterone production.

This is an extremely difficult decision for me to make because the effects of estrogen and testosterone on my body both make my dysphoria worse. For me, being nonbinary means desiring a completely sexless body, without primary and secondary sex characteristics. Unfortunately I was born with a penis and testicles, so the best I can manage is trying to keep my body as close to my prepubescent one as possible. I've failed pretty spectacularly at that, too, but being on just Spironolactone alone these past six months has at least slowed things from getting worse. And now I'm going to lose that, too.

I really just have no idea what to do. I know that there are serious health risks related to having low sex hormone levels, and I know that Spironolactone was causing my fainting episodes. But I don't want my body to further maculinize or feminize. I already can't handle the levels of breast development and body hair growth I have. I don't even want to imagine what it will be like if either of those gets worse.

In a perfect world, I would just find some way to indefinitely end my body's production of testosterone, and do my best to mitigate the risks with lots of calcium, vitamin D, and load-bearing exercise. Actually, in a ~really~ perfect would, I would have been born with something resembling XY gonadal dysgenesis. But whatever. It's not a perfect world. So I have to make a choice.

I guess what I'm trying to ask is... Have you ever had to make a decision like this? What did you do? What has it been like? Do you regret the decision you made? Do you also feel like the medical system for trans people has failed you? Do you even feel like your life is worth living anymore? Do you think I'd be better off if I just bite the bullet and get rid of my testes?

Your thoughts, please.

First off, no DIY surgery. We have a member who attempted this, called emergency services before "surgery" and still almost bled out before emergency services arrive. Now that we have that settled, because of bad advice I received, I went 10 years with the only hormones my body produce without harmful physical damage but it did a number on my fat distribution and I ended up with sunken cheeks and body fat where I didn't want it so that was a bad idea.

I suggest you consider another goal and that would be to receive one or two surgeries. Naturally an Orchi a to deal with the blocker issue if no other blockers are available. The second would be a mastectomy so you are able to take any level of estrogen without breast development. This would solve the problem of skin texture, soften your face and deal with hair issues giving you pretty much everything you need to reduce your dysphoria.

Quote from: Butterfly on March 30, 2017, 08:14:32 PM
This is an extremely difficult decision for me to make because the effects of estrogen and testosterone on my body both make my dysphoria worse. For me, being nonbinary means desiring a completely sexless body, without primary and secondary sex characteristics. Unfortunately I was born with a penis and testicles, so the best I can manage is trying to keep my body as close to my prepubescent one as possible.

You might find this interesting

Finally had a penectomy
https://www.susans.org/forums/index.php?topic=186475.0

You can find pictures if you search for them, though not on this site.

@Dena: Regarding your second suggestion... I might be misinterpreting you, but do you mean that having a mastectomy now would prevent my breasts from growing further if I resume taking estrogens in the future? Because that's definitely news to me.

@AnonyMs: Regardiing your penectomy - if it's not too personal to ask - what was your relationship with your genitals like prior to having the surgery? And after? I've never had the opportunity to ask someone who actually had that prcedure performed.

A complicating factor in my situation is that I currently have a general aversion to surgery. Up until May of 2016, I was planning on getting an orchiectomy and a penectomy (as well as several other surgeries), but a lot of things have changed since then, and I think I'm no longer in a mindset that will allow for surgery. A big part of this is that I previously had some surgery performed on my genitals, and it made my dysphoria worse as a result. I really don't want to risk making that mistake again if I can help it. Another part of it is that my therapist has been actively working with me to help me accept the way my body is. Which is never going to happen, but I feel like I still have to make an effort at least.

As much as I dislike having a penis and testicles, and would prefer to have been born with a vagina or no sex organs at all, it is what I was born with. I've always had them. I worry that if I have them further altered or removed, I'll feel it as a loss instead of as a relief.

That's not me in the link and Penectomy is definitely not something I'm interested in. Its the usual mtf srs for me.

If you'd rather have a vagina than what you have now perhaps that would be a safer option than a penectomy to start with. You can always do that as a next step if you need to. It would be a lot of extra bother though.

@AnonyMs: Ah, sorry! Apparently my brain is slow today. I was aware that the post you linked to wasn't about you, but when you posted the link with "finally had a penectomy" above it, I assumed you were referring to having had a similar operation yourself. But now I see that you were just giving me the title of the original post. Silly me. Again, sorry, and I hope I didn't make you uncomfortable.

Regarding my own genitals, vagionoplasty is something I stopped considering a long time ago, due to potential complications from my previous injuries and surgeries, as well as issues relating to my OCD. My more recent desire to not be on estrogen has kind of cemented that for me now. Maybe in another life...

Quote from: Butterfly on March 31, 2017, 11:07:20 AM
@Dena: Regarding your second suggestion... I might be misinterpreting you, but do you mean that having a mastectomy now would prevent my breasts from growing further if I resume taking estrogens in the future? Because that's definitely news to me.

If the proper tissue is removed, you will be and remain flat as a board. Much like the surgery the FTMs receive, the muscle is retained but the breast/milk producing tissue is removed. Should you only have a reduction, all bets are off because you have to reach the end of your development before you can be sure a reduction will remain the same size.

Quote from: Dena on March 31, 2017, 09:05:02 PM
If the proper tissue is removed, you will be and remain flat as a board. Much like the surgery the FTMs receive, the muscle is retained but the breast/milk producing tissue is removed. Should you only have a reduction, all bets are off because you have to reach the end of your development before you can be sure a reduction will remain the same size.

I see... Thank you for the information. I was aware that there were differences between a mastectomy and a breast reduction, but I didn't know it was to such an extent. I guess I'll have to think on that more before I make my decision.