Wavering a lot on the extent of transition

[noneatall]

I am pre-op/non-op FT on hormones for over 5 years. I am struggling a lot now, even wondering if I really have gender dysphoria anymore.

I transitioned after my mid 20s. I started on estrogen under medical supervision following all protocols. At first, estrogen felt no different - no better and no worse. Simultaneously, I got facial hair removed. Soon, I began to look childlike, like I used to when I was 5 or 6 years old, but more girly. That change in my appearance made me feel good. I started living FT.

That good feeling encouraged me to increase estrogen dose. I even felt the urge to get SRS and feel complete. My doctor had already said that my dose was lower than needed for the female level. My doctor agreed to up the dose. I was very excited. I was so happy!

However, my sexual function began to die. My penis lost all sexual sensitivity, inside and out. I could tell if it was touched, but nothing more. The ejaculate completely disappeared. Orgasm never happened. I sometimes got close to orgasm, but it was frustratingly absent in the end.

Over months, I did everything that's been suggested to cis and trans women to reach orgasm. I even got medical assistance. My doctor reached the conclusion that I need more testosterone in my body for my sexual function to return. Under supervision, I gradually reduced estrogen dose to almost zero. My sexual function returned.

Return of my sexual function only encouraged me to get back on higher estrogen dosages and contemplate surgery. My second therapist along with a psychologist wrote letters for my SRS. I was very excited about finally being able to live as a woman and never having to tuck. That is, until my sexual function was dead again.

I went through a few more cycles of this routine of losing sexual function on high estrogen doses and feeling the need to transition with SRS while on lower doses. Eventually, I lost trust in myself. I cannot trust myself anymore around my need for SRS.

In the meantime, I was living FT. I was well accepted and well adjusted as a woman. My dysphoria had begun to disappear, except my cyclical need to increase dose and get SRS.

Now my old doubts about whether I'm trans at all have returned due to this turmoil in decision making. Given that my inner self is fickle, how do I know if I was trans at all?

I've been contemplating experimenting living as a man again. I recognize that I will look very different as a man now. However, I fear that my old gender dysphoria may return if I do.

Has anyone else gone through anything similar?

[JoanneB]

In my early 20's I test drove transitioning twice. Went on E and tried part time. After several months when lost sexual function the reality of it all  hit me. What got to me the most was the big conflict inside of being trans vs just trying to be normal... again. Being only sexualy attracted towards women, ED certainly got in the way of normal big time.

The feeling that I am truely trans never abated. I never had the overwhelming desire for SRS. To me it is not what is in my panties that counts. Passing and being accepted generally as a woman is what does. I have been achieving that part time now. Sometimes the dysphoria does not seem all that intense as it was. WHen I examine why it often comes down to my old favorites which I call the 3Ds, Distractions, Diversions, or Denials, as to why.

[DawnL]

I am reasonably certain you are trans.  No one would go through all the steps you have if they weren't.  It seems your dysphoria must have been quite strong.  You've lived full time and followed transition protocol to the letter with a therapist and a psychologist.  You shouldn't doubt that you're trans but you are also absolutely right to question the extent or course that your transition should follow.  Your sexual function seems very important to you and that is a reasonable concern.  We are sexual beings and it sounds like you are still quite young.  Sexual function does exist on the other side of transition (for most of us) but it will be quite different from what you know now. 

If you are questioning the need for SRS or fearful of the consequences, you should postpone any decision until you are more certain of what you want.  While the experiences of others may be helpful,  they shouldn't have too much influence on your decision.  This is a highly personal, IRREVERSIBLE procedure.  If you are uncertain, doing nothing might be the most prudent course for now.

[justmeinoz]

It sounds like the non-op route might be worth a try for a while at least.  I have spent quite a while debating whether to have SRS or possibly just an Orchi.

Karen.

[Ms. OBrien CVT]

I battled for years, off and on.  I never really had an interest in sex.  So that was no big deal.  But I was sucidial when I tried to be a male.  I just never was.  But now 4 years HRT, orchidectomy, and livinf full time for most 4 years, I am happy.  Except I am still trying to get SRS.  I don't wish to live with tucking.

[noneatall]

Thank you all for your responses!

> I never had the overwhelming desire for SRS. To me it is not what is in my panties that counts. Passing and being accepted generally as a woman is what does.

This is very useful!

I guess I was stuck up on the label woman. For perhaps thousands of reasons, I was unwilling to see myself as a woman as long as I still have a penis. It was my mental block. However, recognizing that all tissue which forms female organs are bio-identical to the tissue that forms the male ones, I see that it was merely hormones in the womb that resulted in one set of organs or the other. It's a bit comforting to think about it this way.

In addition, I cannot appear more feminine, which I want to, without increasing my estrogen dose. Specifically I'm talking about hair growing on my head. Whenever I've been on the doses of estrogen that brought my blood estrogen to female ovulation levels, I had luscious hair. However, those levels depress my sexuality. I could not see myself as a woman without being as feminine as I biologically can with higher estrogen levels.

And finally, I was previously unwilling to accept that my gender identity was predominantly a social matter with a social root cause. If passing and being accepted as a woman were sufficient for me, I felt that I would be denying my biological need to be female. This has been very difficult for me to admit that I was wrong. However, I am coming to the realization that I may not be  trans in the biological sense, in terms of needing my entire body to be female. I only need others to believe I'm female and treat me accordingly and allow me to exercise all my rights as female. This is still hard to accept for me, but I'm getting better to being more open to it.

I'm probably not trans at all. I don't know. However, I'm worrying less about which label applies to me.

Meeting a new therapist who has no experience with gender for a lot of sessions in the last few days has really helped! His fresh perspective and logical reasoning has been fantastic! I guess I'm also more open to the idea that I may not be trans in the traditional sense, which helped too.

> Your sexual function seems very important to you and that is a reasonable concern.

Yes, this has been the stumbling block for me. I was caught between my sexuality and my need to be feminine. To your point, I probably cannot give up on either and I will need to balance out the two to feel right.

This has been a very valuable exploration for me. I don't entirely know where I go from here. I already live as a woman and I pass well too. I'm very happy with the social aspect of my life, except with dating but that's another issue. I will continue where I'm at staying steady with the estrogen dose which maintains my balance, until I feel I need to make any huge changes. And I'll ignore the feeling which estrogen gives me to up my dose and get SRS because I know that's a dead end for my sexuality as I know it.

[Randi]

Psychologist Anne Vitale has written of this cycling phenomenon.

When you have high testosterone your dysphoria increases.  As testosterone decreases and estrogen increases, the dysphoria goes away.  You reverse course and as testosterone increases dysphoria comes back.

I've observed this myself for several cycles.  When I have high estrogen/low testosterone I wonder what all the fuss was about, my head is clear and I don't see what the problem was with being male.  If I ramp up the testosterone and cut back on the estrogen the dysphoria returns.

Randi

http://www.avitale.com/TNote15Testosterone.htm


"It is also known that the administration of cross sex hormones MUST be maintained to sustain the anxiolytic effect. It is not unusual for some patients, feeling better after starting hormones, to believe they are cured and no longer need to continue the medication. Unfortunately what they experience is a quick return of their gender dysphoria. If there is any physical test to determine who should seriously consider partial or full transition, taking cross sex hormones is it."

Return of my sexual function only encouraged me to get back on higher estrogen dosages and contemplate surgery. My second therapist along with a psychologist wrote letters for my SRS. I was very excited about finally being able to live as a woman and never having to tuck. That is, until my sexual function was dead again.

I went through a few more cycles of this routine of losing sexual function on high estrogen doses and feeling the need to transition with SRS while on lower doses. Eventually, I lost trust in myself. I cannot trust myself anymore around my need for SRS.

[noneatall]

Thank you! Thank you! Thank you!

This is the first time I've read any literature from a researcher describing my situation. Anne Vitale's conclusion is definitely plausible and it actually matches a previous hypothesis I had about data correlating with my own dysphoria.

My testosterone level pre-transition was close to the upper end of the male normal range and my estrogen level was also close to the upper end of the male normal range. That was my base reading. That alone should highlight some significant conversion of testosterone to estrogen via aromatase.

About 6 months before I eventually decided to transition, I began to take a DHT blocker, finasteride, which pushed my testosterone level up further. This is normal. The testosterone that did not get converted to DHT remains as testosterone, thereby increasing the total testosterone in the body. I felt more dysphoria. So, I had my doctor prescribe a stronger DHT blocker, dutasteride, which made my tesosterone level about 1/5th higher than the base level. My dysphoria got much worse.

This was the reason I started on HRT. I stopped the androgen blocker within 3 months because I had very bad health reactions to it. Estrogen alone has been sufficient since then to temper down my dysphoria. On small doses, I feel the need to increase doses and get SRS, but on higher doses I feel sexually suffocated and need to go down on the doses. This cycle is a trap.

It's good to hear that there are others who feel the same way.

Thank you again!

[Vanora]

Vitale has an interesting theory.  I think her theory is on the right track but slightly incorrect for many people.  I don't believe that the dysphoria is caused by high estrogen caused by high testosterone.  I believe it is the testosterone itself that causes the problem.  There is no way she could know precisely which hormone is causing the problem without doing significant research along with blood tests. 

Her theory is correct in that testosterone via aromatase is converted to estradiol.  That is a medical fact.

The way to test it would be to take some gender dysphoric people and keep their testosterone high while giving them an aromatase inhibitor and see who has a greater reduction in gender dysphoria.

[noneatall]

I don't believe there is a single root cause of everybody's gender dysphoria. I believe there are many reasons and trans individuals we meet come likely from several different root causes and in some cases they come from a combination of root causes. It is the search for the grand unifying theory of gender dysphoria's root cause that prevents us from figuring them out.

So Vitale's theory is unlikely to apply to the majority. Also, neither high aromatase of testosterone into estrogen nor high testosterone will be sufficient conditions for gender dysphoria. These two conditions are likely to require other conditions to also be true in order for them to cause gender dysphoria. However, both are likely causes in some individuals and I believe Vitale seems to qualify this nuance in her statements.

That said, I agree that the best way to test the aromatase theory is to use aromatase inhibitors. I'll evaluate this option with my doctors and see where it goes. And I doubt high testosterone alone would be sufficient as little kids with low testosterone also get gender dysphoria and some adults with gender dysphoria never had high testosterone levels, which is the reason I favored the idea that something in addition to the high testosterone must be true, for which high aromatase seems like a candidate.

[Vanora]

Vitale has an interesting theory.  I think her theory is on the right track but slightly incorrect for many people.  I don't believe that the dysphoria is caused by high estrogen caused by high testosterone.  I believe it is the testosterone itself that causes the problem.  There is no way she could know precisely which hormone is causing the problem without doing significant research along with blood tests. 

Her theory is correct in that testosterone via aromatase is converted to estradiol.  That is a medical fact.

The way to test it would be to take some gender dysphoric people and keep their testosterone high while giving them an aromatase inhibitor and see who has a greater reduction in gender dysphoria.

Agreed. 

[Tristan]

Do t feel bad. I did the same thing sort of. Let friends talk me into. It in my teens. And then transition after 18. I only fallowed through because its like a habit and I hate to not finish something. But it all works out in the end hun. If your not trans and can stop then I say do it. You will save your sugar mamma a lot of money

[noneatall]

Thanks Tristan!

I find myself trapped though as a woman now. Making that switch back does not feel easy.

For one, I really don't care personally anymore about the labels "man" and "woman". Those feel irrelevant to me. They are molds into which I had been trying to fit in. I just don't fit in.

I look closer to a man, but I can also look closer to a woman, that is per social stereotypical definitions. However, this book has nothing to do with its cover! These labels do not define who I am.

My personality consists of a whole lot more than man/woman and even more than a combination of man and woman. I am male biologically and I understand the immutability of that biology, but I can't relate to just man or just woman as my identity.

However, to live in this society, I feel pressured to adopt one of the two genders. In that sense, I feel transgender.

Because I have been known as a woman for the last few years, most of my friends known me as a woman. I never had friends as a man, well, I did, but I did not feel like I could ever open up to them. It's hard to give up on the life you've created.

Even more of a trap is my occupation. It's hard to switch genders, especially back and forth, when you work with people who just can't get it.

I was never self-confident in my occupation although I was extremely successful until before my transition. After transition, I struggled to find and keep jobs, which also coincides with the recession and I cannot blame myself.

[Julie Wilson]

I am pre-op/non-op FT on hormones for over 5 years. I am struggling a lot now, even wondering if I really have gender dysphoria anymore.

I transitioned after my mid 20s. I started on estrogen under medical supervision following all protocols. At first, estrogen felt no different - no better and no worse. Simultaneously, I got facial hair removed. Soon, I began to look childlike, like I used to when I was 5 or 6 years old, but more girly. That change in my appearance made me feel good. I started living FT.

That good feeling encouraged me to increase estrogen dose. I even felt the urge to get SRS and feel complete. My doctor had already said that my dose was lower than needed for the female level. My doctor agreed to up the dose. I was very excited. I was so happy!

However, my sexual function began to die. My penis lost all sexual sensitivity, inside and out. I could tell if it was touched, but nothing more. The ejaculate completely disappeared. Orgasm never happened. I sometimes got close to orgasm, but it was frustratingly absent in the end.

Over months, I did everything that's been suggested to cis and trans women to reach orgasm. I even got medical assistance. My doctor reached the conclusion that I need more testosterone in my body for my sexual function to return. Under supervision, I gradually reduced estrogen dose to almost zero. My sexual function returned.

Return of my sexual function only encouraged me to get back on higher estrogen dosages and contemplate surgery. My second therapist along with a psychologist wrote letters for my SRS. I was very excited about finally being able to live as a woman and never having to tuck. That is, until my sexual function was dead again.

I went through a few more cycles of this routine of losing sexual function on high estrogen doses and feeling the need to transition with SRS while on lower doses. Eventually, I lost trust in myself. I cannot trust myself anymore around my need for SRS.

In the meantime, I was living FT. I was well accepted and well adjusted as a woman. My dysphoria had begun to disappear, except my cyclical need to increase dose and get SRS.

Now my old doubts about whether I'm trans at all have returned due to this turmoil in decision making. Given that my inner self is fickle, how do I know if I was trans at all?

I've been contemplating experimenting living as a man again. I recognize that I will look very different as a man now. However, I fear that my old gender dysphoria may return if I do.

Has anyone else gone through anything similar?

Have you tried adding Progesterone to your HRT?  If not having a doctor add testosterone without having tried progesterone seems kinda prejudiced.

[Julie Wilson]

To me it is not what is in my panties that counts. Passing and being accepted generally as a woman is what does.

I used to feel this way and I had no intention of ever getting SRS.  Then my girlfriend had SRS and I realized that our relationship was over.  I had no interest in her body after that.  Still I was depressed and heart broken and though I thought I would never be able to afford to have SRS anyway, the funds became available to me via a loan.  Because I didn't really know what else to do I went ahead and had SRS.  I was in a depressed and emotionless state.

It didn't take very long for me to begin to realize that it was my genitals that had caused my GID and my worthless, nothing life.  I had heard of people who hated their genitals and I couldn't relate and thought them extreme but now I was beginning to realize that my genitals were the source of all my woes.  They prevented me from having female socialization, my testes producing a hormone that was entirely at odds with my being, causing facial hair growth and masculinization, even causing my skeleton to become masculine.  My testes and penis were what caused the doctor to say, "It's a boy!" Thus beginning a conundrum that would sap every little bit of joy and social functionality out of my life.

I went to Marci Bowers and my SRS results were absolutely awful.  Ghastly even.  I couldn't allow people to see my genitals because they outted me as trans and were hideous.  But I changed my name and I was able to change my gender markers on everything, DL, SOC, everything... The registration for my car, the deed to my house.

Although my SRS results were hideous I had no fear of being found out in a restroom or a locker-room as long as I didn't shave or trim down there.  I was legally female which made a huge difference.  Also when I bathed or went to the bathroom I wasn't reminded of the very thing that had destroyed my life.  Having a vagina takes time to get used to (in my experience) it takes a while to begin having dreams with a female body.  Really having a vagina opened doors for me that I wasn't even well aware of and it changed aspects of my life that I never would have imagined it could.  I realize some of that is due to my physical appearance as well as my genital geography but the effects of vaginoplasty go much farther than most people can begin to realize.

ED? I don't have to worry about that. And although I didn't hate my genitals, I didn't love them either.  I had no real attachment to them and my attachment lessened with time on HRT.  Having a life was much more important to me than sexual function, still is.  Though I do have sexual function and due to a revision by Dr. Chettawut I am no longer afraid to let someone see me naked. 

[Julie Wilson]

In this life what most of us want is to be loved.  For the majority of people women have a vagina and men have a penis.  Sometimes we need to fit in, sometimes we can be our own creation and find someone to love us.  Who am I to speak, I haven't dated since I had SRS?  But I have had sex with more men than I can recollect.  Not saying that's a good thing.  But the freedom I experienced was a good thing, the freedom to have sex with men without giving them a trans 101 lecture or having to explain that I was a woman with a penis.

SRS and transition allowed me to be myself.  However, in my own experience being myself was not something I was entirely born as.  Being myself was a growing and maturing process much like what typical men and women go through.  For me being a woman was something I had to grow into.  I had the seed of it planted in me but it had to grow, mature...  It wasn't until I was able to be perceived as female, in the streets and in the sheets that I was able to begin to get the kinds of authentic experiences that would allow me to grow.

Looking back on what my life was like before I was able to pass as a female in the streets and in the sheets, for me it was like living in limbo-land as an eternal outsider.  I was never able to get any authentic experiences and I never had the satisfaction of 'being' my true self.  Instead being my true self was a protest and in some ways it still is because some people know I transitioned and they tell other people about me which causes my interactions to become forced and artificial.

Anyway...  Transition can be really amazing and life changing when you give it a hundred percent but in my experience when you haven't quite gotten there the merits of going all the way seem fuzzy and uncertain.  I am reminded of a quote from the movie the Matrix Reloaded, "People can't see past a decision they don't understand."

[Apples Mk.II]

About 6 months before I eventually decided to transition, I began to take a DHT blocker, finasteride, which pushed my testosterone level up further. This is normal. The testosterone that did not get converted to DHT remains as testosterone, thereby increasing the total testosterone in the body. I felt more dysphoria. So, I had my doctor prescribe a stronger DHT blocker, dutasteride, which made my tesosterone level about 1/5th higher than the base level. My dysphoria got much worse.

This is a bit offtopic, but... On September I was planning to start with dutas, but since I want to bank sperm prior to transition and thing can cause malformed fetuses (or something like that), and takes 6 months to leave the body, I think I'm going to start with Finas, which only needs 1 month to leave the body so that I can store it prior to starting HRT. I think of the bank as a plan B in case I feel that I screwd it.


BTW, That's the only thing that makes me consider SRS... Social functioning. I want to be more than "the girl that hides a secret and always goes home alone at the end of the party". If I only fixed my body, The dysphoria would go away, but my problem with relationships would become harder to deal with. The only problem is making enough money for FFS and SRS...

[JoanneB]

I went to Marci Bowers and my SRS results were absolutely awful. 

My wife is Biber baby, Marci's mentor. Her results weren't spectacular either but sort of OK. She was  told back then (~20 years ago) that she might consider returning in a year or so for a labiaplasty(?) to improve the cosmetic results. She never did. I haven't heard any complaints from a couple of women in my group that went to Marci. Although they all had "complications", as did my wife. I don't know about that labiaplasty option these days. Perhaps the techniques improved?

[Julie Wilson]

I wouldn't let Marci touch me a second time.  I have seen her revisions.  If I could go back in time I would go to Suporn.  Suporn was unworkable regarding a revision on Marci's work.  Dr. Chettawut came to the rescue.  Eventually if things go well I would like a second revision from Chettawut.

[Apples Mk.II]

But is that Marcy as bad as they say? On her website it says something like "911 surgeries made up to 2011". If that many people go, it can't be that bad, is it?