Hi, Justin.
I'm 61 years old and I'm not much further along than you. It was only about 11 months ago that it occurred to me that I might be transgender. It very quickly became obvious.
The first thing I did was to talk to my wife about what I was experiencing. I didn't say, "I think I'm transgender;" I just shared with her the feelings I was having and the observations of myself that I'd been accumulating. We've been together for 18 years, so she knows me better than anyone ever has, and it was very valuable to get her feedback. It was through those conversations that it became clear. I was extremely fortunate that she was and is very supportive.
The next step was gender therapy. I found a decent, qualified counselor in my community and began working with her. As Paulie mentioned above, I wanted someone who wouldn't just tell me what I wanted to hear. In that respect, I think she was a good match for me. She made me work at convincing her, so I dug deep and ended up convincing us both.
During those 3 or so months of therapy, I began laser treatment for my facial hair. The dysphoria of seeing it was mild but also felt like something I could start working at eliminating. Somewhere in there, I had an annual physical exam, and I told my primary doctor that I was transgender and what I was doing. I felt that it was important that she be aware and involved as necessary.
After getting the Gender Dysphoria diagnosis, I began HRT. I chose to pursue it through my primary doctor because she knows my medical history better than anyone else - except for my wife who was also a primary doctor and helped many transgender patients transition. Between the two of them, I felt like I had a solid team to advise and monitor me.
My body has always been very sensitive in multiple ways, so we knew there was a chance that the anti-androgen and estradiol could affect me differently from the average person. One specific risk is that spironolactone lowers blood pressure, and mine is already quite low. For these reasons, we agreed to start at a very low dose - a quarter of the typical starting dose - for the first month. After that month, seeing no effects (of any kind), we increased the dose to half the typical starting dose. Still with no effects (except possibly some increase in emotional intensity), we increased to the full starting dose for the third month - which is still low.
I'm now in the final week of that third month of HRT, and I can tell you that my breasts have been tender for 2 or 3 weeks. There is no doubt that they are increasing in volume. So, despite the low dosage and being only 3 months in (and really only 1 at the full starting dose), I'm seeing changes. My wife confirms it.
So, I agree with everything said above recommending that you:
- Include your wife to the degree that you are able as soon as you are able,
- Seek gender therapy to help you work out what is best for you,
- Involve your primary care doctor before starting HRT so that they are aware and tuned in,
- Take it slowly; there's no hurry, and this* is a step-at-a-time process,
- Everybody is different, so you have to find out who you are and what you need,
- Some people are different in ways that might accelerate things; you could be one,
- There are likely to be changes that you didn't anticipate; moving slowly will help prevent those from overwhelming you (and others in your life).
this* = Becoming who you were meant to be - your true self. It's critical to remember that this is your mission. You're not trying to emulate anyone or anything; you're discovering who you really are and how to be that person completely.
Through it all, don't forget to enjoy every moment. You've made an amazing discovery that will open up your life to experiences you never imagined possible. Even when it's difficult or unpleasant, it's an opportunity to grow and expand.
We will be here to support you in whatever you choose. Please keep us updated.
Love,
Pema
