Rediscovering Pema

[Pema]

Today was a major milestone. I met with my GP and got my prescriptions for estradiol (patches) and spironolactone. I'll pick them up tomorrow and start down this path.

As I've mentioned before, I'm a pretty even-keeled person, so my dysphoria was challenging to demonstrate. On the other side, I've been outwardly very calm today, but inside I'm screaming with excitement. I told that to my wife just before my appointment today, and she said, "Pay attention to that. That's the euphoria that highlights the dysphoria." Fair enough.

I'll be starting with low doses of both (50mcg E and 25mg S), because I'm definitely "sensitive" and already have low blood pressure. If nothing untoward happens during the first month, we'll increase them. There's no hurry, and it's wise to be cautious.

Absolutely giddy.

[Lori Dee ✅]

I'll be starting with low doses of both (50mcg E and 25mg S), because I'm definitely "sensitive" and already have low blood pressure. If nothing untoward happens during the first month, we'll increase them. There's no hurry, and it's wise to be cautious.

Absolutely giddy.

Congrats, Pema!

Providers usually start on low doses. First, to see how your body reacts to the new meds. Second, to see how your hormone levels are affected at that dose. For some people, Spironolactone is very effective at suppressing testosterone; some require higher doses, and for me, it had no effect at all.

Spiro is a "potassium-sparing" diuretic. You will pee a lot, so stay hydrated and avoid foods high in potassium. Your doctor will order labs to monitor all that.

I am so happy for you that you get to take those first steps. Remember that day. I call it my second birthday, when I started taking hormones, Jan. 11, 2020.

Don't forget to celebrate!
🥳🥂🎈🎉

[Lilis]

Today was a major milestone. I met with my GP and got my prescriptions for estradiol (patches) and spironolactone. I'll pick them up tomorrow and start down this path.

Omgash, there she is!

Sorry Ashley, I couldn't resist stealing the line, lol.😁

Pema, what a sacred moment. The embodiment has began of the woman you've always been.

Congrats, sister! 🫂💞


~ Lilis 🌷

[Pema]

Thank you, @Lori Dee and @Lilis! It is a huge day, no question.

I'm blessed to have a wife who's a physician who has helped many patients transition, so we went into this appointment extremely well prepared. We suggested initial dosages that are half of what most protocols recommend. My doctor gladly went along with our plan.

I'm so ready.

[Dances With Trees]

Congratulations, Pema!

[Emma1017]

Pema, I am so late to your party, and now another reason to celebrate.  You realize when you take the first fearful dose of hormones that it is exactly what you have been waiting for. 

CONGRATULATIONS!!!!

I hope you are finding all the joy that you deserve!

With a warm hug,

Emma

[Pema]

Thank you all. After one week, I can't say I've felt anything - and that's exactly what we want. The dosages are so low because we want see whether there are adverse effects. So far, there aren't. All good.

Even so, it does bring a sense of comfort, of feeling that I'm moving in the right direction.

[Northern Star Girl ✅]

Thank you all. After one week, I can't say I've felt anything - and that's exactly what we want. The dosages are so low because we want see whether there are adverse effects. So far, there aren't. All good.

Even so, it does bring a sense of comfort, of feeling that I'm moving in the right direction.

@Pema
Dear Pema: 
I am so very excited for you that you have taken the BIG step of starting HRT in your transition journey

As I am most certain that you are aware regarding how HRT may work in your body, PATIENCE IS REQUIRED.
Usually nothing happens very quickly with HRT, some will see more dramatic changes more quickly and others
will see less significant changes more slowly.  It is all up to your unique body and your genetic makeup.

A phrase that is used here on the forums is YMMV,
meaning Your Mileage May Vary. 

There are so many variables in how each body will respond to HRT. 
Remember, puberty in pre-teen girls and pre-teen boys takes many years to come to fruition... 
... give it time, things will happen... but again,  PATIENCE IS REQUIRED !!!!

Along with your other avid followers and readers, I will be eagerly looking for your updates here on
your Blog thread and elsewhere around the Forum.

I am wishing you success and happiness as you continue in your journey.
HUGS,  ❤️
Danielle [Northern Star Girl]

[Sephirah]

I think you started moving in the right direction a while back, Pema. This is another step on your path, albeit a big one. I am very proud of you for taking this step and excited for what it brings you.

*massive hugs* <3

[Pema]

Last night marked the start of Month 2 of HRT. Seeing zero effects from Month 1 - exactly what we'd hoped - we bumped the dosages up by 50% so that I'm now taking 75% of the low-dose protocol. If there are still no effects at the end of Month 2, we'll bump them up to the full low-dose protocol. Is this level of caution absolutely necessary? Who knows? But I'm in no hurry and am very interested in ensuring that I don't respond poorly to either medication - as I have to others in the past. A month goes by very quickly.

This week I also had Beard B Gone (laser) session #5. After 3 sessions, I'd estimate that 95% of the dark whiskers were gone. Then I missed 2 (backpacking), so 3 months passed before Round 4. By then, nearly all of the dark whiskers had returned. Session 4 eliminated them back to the post-Session 3 level, maybe even a bit beyond. So there wasn't much to work with in Session 5. I paid for 6 sessions. I'm tempted to wait 2 or 3 months to see whether they come back again before committing to that final round. If they do, I think I'll find it difficult to justify continuing. They'll probably recommend doing it and then buying more rounds. I'm not a fan of throwing good money after bad. At that point I'd probably just call it an interesting experiment.

[Jessica_Rose ✅]

You may not 'see' any effects for several months. You will probably feel the changes first. Since everyone reacts differently, starting off slowly is a good idea. The key is, you have started.

Some people have great results with laser, but my experience was varied. While it worked great on body hair, it didn't seem to do much for my facial hair. If laser doesn't work for you, find a good electrologist. While it is slower, it is very effective. It also works on any color of hair.

Love always -- Jessica Rose

[davina61]

Worked for me but it was over a year once a month, only a few dark ones under my nose now but the free on the NHS money has run out. Shame it did not touch the grey ones so its still a good shave every morning for me. As for body hair I only have a few chest hairs remaining and that is from the HRT I think, not that I ever had a very hairy chest.

[Charlotte_Ringwood]

Last night marked the start of Month 2 of HRT. Seeing zero effects from Month 1 - exactly what we'd hoped - we bumped the dosages up by 50% so that I'm now taking 75% of the low-dose protocol. If there are still no effects at the end of Month 2, we'll bump them up to the full low-dose protocol. Is this level of caution absolutely necessary? Who knows? But I'm in no hurry and am very interested in ensuring that I don't respond poorly to either medication - as I have to others in the past. A month goes by very quickly.

This week I also had Beard B Gone (laser) session #5. After 3 sessions, I'd estimate that 95% of the dark whiskers were gone. Then I missed 2 (backpacking), so 3 months passed before Round 4. By then, nearly all of the dark whiskers had returned. Session 4 eliminated them back to the post-Session 3 level, maybe even a bit beyond. So there wasn't much to work with in Session 5. I paid for 6 sessions. I'm tempted to wait 2 or 3 months to see whether they come back again before committing to that final round. If they do, I think I'll find it difficult to justify continuing. They'll probably recommend doing it and then buying more rounds. I'm not a fan of throwing good money after bad. At that point I'd probably just call it an interesting experiment.

Heyya, in terms of laser treatment there are a few important points. If those earlier hairs fell out then they have gone for sure. I noticed them dropping out 3 weeks after treatment. Any that come back are the next cycle of dormant hairs. They are not new...just were not active. You should space treatments about 5 to 6 weeks usually, as if you miss that growth phase then you'll need more treatments later when they active again.

The other factor. Many providers I found put the laser too low. My current one is expensive, but my skin feels sunburnt for a day after. It's painful but nuked the hairs real good. Some go for comfort so it's real slow. I work on no pain, no gain.

For HRT, results are less dependent on E levels than they are on getting T levels very low. I'm DIY and essentially got buds end on month 2. But that's using Cyproterone as a blocker which kills testosterone quick. If you're on spironolactone you'll need a high E dose to shut down T before seeing results generally. Gnrh agonists are also strong blockers but normally introduced later if used.

As long as you're happy to wait you will get there as your E dose is titrated up. There are so many different styles of HRT depending on location too as in US Cyproterone isn't approved and gnrh agonists are seen as too expensive. In UK under NHS gnrh agonists are the first line blockers. Spironolactone is in reality a very poor blocker. Most effect is from high E doses shutting down T production.

Charlotte 😻

[Pema]

@Jessica_Rose: I fully expect to feel the changes before I see them. I just want to make sure the feelings aren't very bad ones, so...patience. And yes, just being on the path already feels pretty wonderful.

Electrolysis was a given from the beginning since at least half of my beard is gray/white. My hope was that I could knock out a good fraction of it in bulk. If that doesn't happen, I'll tell myself it was worth a gamble.

@davina61: It's encouraging to know that it did have some lasting effects for you. I'll continue hoping I get something from it. I'm envious that NHS covered some of yours.

@Charlotte_Ringwood: My beard was very thin to begin with, and at least half was gray/white, so I'm absolutely certain that nearly all of what came out in the first 3 rounds did return. No question. The treatments are spaced 5 weeks, and this is at a dermatology clinic, so it's pretty high-end. The technician is definitely cranking the power, and increasing it each time. There was a very discernible sunburn-like sting afterward.

I'm not a "no pain, no gain" subscriber. I seek a middle path where there may be discomfort, but it's very tolerable. I have a weird combination of being a highly-sensitive person (HSP) whose body often reacts bizarrely to the most innocuous stimuli and also having an absurdly high pain threshold. It's not great, because I *really* have to pay attention to what I feel and make unemotional assessments of whether it's harmful or not. I'm much more in @tgirlamg's camp: "Gently, but with undeniable will."

The same is true of HRT. I need to start with the things that have the lowest risk and hope that they don't conflict with my chemistry. Even with the E patches, I have to hope that I don't get an allergic reaction to the adhesive. Fortunately, that hasn't happened. Now I need to make sure I get the same brand every time.

Slow and steady has always been my mantra.

[Lori Dee ✅]

My beard was very thin to begin with, and at least half was gray/white, so I'm absolutely certain that nearly all of what came out in the first 3 rounds did return. No question. The treatments are spaced 5 weeks, and this is at a dermatology clinic, so it's pretty high-end. The technician is definitely cranking the power, and increasing it each time. There was a very discernible sunburn-like sting afterward.

I had a similar experience. Most of my beard was gray/white. My dermatologist tried using a laser. She said that the laser is not very effective on facial hair. The hair needs to be dark so the energy from the laser can be carried to the hair root to zap it. Facial hair (terminal hair) has deep roots that laser has difficulty reaching. She had to crank up the power, and I got the sunburn, too. It can be great for body hair, though, which lies closer to the surface. She did a complete report to the VA explaining all of this, and the VA then approved electrolysis for beard removal. (They never did it, but it was covered.)

Another problem is that hormones do not affect facial hair once it has been growing for a while. Testosterone causes the hair follicles to develop in the skin, and removing testosterone does not remove them. Once they are there, they are there. Just like the way T causes the larynx to grow and the voice to deepen. Once they have been affected, hormones alone will not change it.

Estrogen can cause hair to become finer, but the roots will continue to grow. The only way to get rid of them is with electrolysis.

[Emma1017]

Pema, you have so many excellent and experienced coaches here. 

In my opinion, other than a vaginoplasty, electrolysis is the toughest.  There are clinics with doctors that do all-day beard clearing.  I did that once, and did two days back-to-back.  My face swelled like a pumpkin for almost a week.

Since I need to present male for my job, I have opted for a half hour, once a week.  It is so slow, but at least I am making some progress.

You get to figure out what works best for you.

I would love to have anyone who thinks we are transgender by choice to get electrolysis for just five minutes...

[Pema]

Thank you, @Emma1017. Yours is another excellent contribution.

Wow. Two all-day sessions on the face. That is serious "let's get it done" energy.

[Emma1017]

At the time, I was committed to a full transition, and I wanted my beard gone as soon as possible. The clinic predicted three more sessions, one every three months, based on the growth of the beard follicles.

My transition path was altered because my wife and I compromised because we wanted to stay together.  We've been together since 1976. It has been a tough decision for me, but one that I have never regretted.

So I went from full-blown electrolysis to a slow-and-steady approach.  I am graying, so I have the electrologist focus on the black beard hairs.

[Pema]

Susan wrote beautifully here in the "Looking up to women" thread about some experiences that resonated with me.

In particular, this:

When you are a trans girl who does not know she is trans yet, the world hands you a script that does not fit. You get grouped with the boys, expected to bond with them, expected to see girls and women as "other." But something does not line up. You find yourself drawn to women—not in the way everyone says boys are supposed to be, but in a softer, sideways way. You are watching, learning, feeling pulled toward them

And this:

Underneath all of that is a kind of recognition. You see something of yourself in women long before you know why. Their spaces and conversations feel more like home. The way women relate, listen, and share emotions often matches how we move through the world inside, even when everyone around us insists we are supposed to feel and act like "one of the boys."

And this:

The uncomfortable part is not the admiration itself—it is the gap between what you were told you were "supposed" to feel and what you actually felt.

Once you start to understand who you are, that gap starts to close.

For me, the aspect that "felt weird" wasn't that I had this affinity for girls and women; it was that I was being told in every way imaginable that I was supposed to be and to feel something else. For some reason, "the rules" (of pretty much any kind) never struck me as facts that I used to evaluate myself but were instead a reflection of the society I found myself in. More often than not, I found myself saying, "What a bizarre system. Who would want this?"

So, from a very young age, I navigated the social world - not gender specifically, but in multiple areas - with the question "Is it worth it to oppose this or is it more advantageous just to play along (at least for now)?" I became quite accustomed to being called "weird," and for the most part, it felt like a badge of authenticity. It also served as an extremely effective filter for authenticity and sincerity in other people. There were times when I found none and felt lonely, but those were also times when I got to know myself more deeply.

As I grew older, I opted out of increasingly more expected behaviors. Today I'm called "eccentric," and I still consider that a compliment. I'm awake, present, and making conscious choices.

I still think gender is a contrived social construct, and that gives us the option to just be who we are and not concern ourselves with how others label us within that system. I feel like I knew that instinctively as a child but I didn't have the experience to put the pieces together and articulate it. Even today, it's very difficult to convey my perspective to someone who is fully conditioned to see only a cis-binary world.

I marvel at the children who declare so clearly that they are who they are and have no concern for what they've been told to the contrary.

[Dances With Trees]

still think gender is a contrived social construct,

Beautifully said, Pema, and I whole-heartedly agree with you.