Hormones: Dream Goal or Time Bomb?

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This article has been included in Susan's Place Transgender Resources Wiki for its historical interest. Some or all of the information herein may be out of date and thus be inaccurate. More recent information may be available that contradicts the information in this article.

Hormones: Dream Goal or Time Bomb?
By Anonymous, GIC Inc.

There are an extremely high number of people with the [Gender community] today who have begun hormone therapy. Most people are blind to the potential side effects of this activity, and many are misinformed regarding the consequences of being on hormones. Hormones are not "happy pills", or "breast pills"; hormones are not an innocent drug to be used within the play-fantasy world.

The following information is provided by Ayerst Laboratories, Inc., the manufacturer of Premarin: You should not take more estrogen than your doctor prescribes. It is important to take the lowest possible dose of estrogen and to take it only as long as is needed. Your doctor should re-evaluate your physical condition every six months. You may have heard that taking estrogens for long periods (years) will keep your skin soft and supple and keep you feeling young. There is no evidence that this is so, however, and such long term treatment carries important risks. Estrogens increase the potential for cancers of the breast and/or liver, as well as gall bladder disease when taken over long periods, especially if there is a history of breast cancer within your family. Estrogens increase the risk of blood clotting in various parts of the body. This can result in a stroke if the clot is in (or moves into) the brain, or can result in a heart attack or angina (clot in a blood vessel of the heart), or a pulmonary embolus (a clot which forms in the legs or pelvis, then breaks off and travels to the lungs.)(This possibility increases with the dosage taken.) Any of these can be fatal.

There are other side affects as well. The most common is nausea, and vomiting. Another common side effect is mental depression. (This would be in addition to whatever you might now be experiencing as a result of your gender conflict.) Estrogens may cause breast tenderness, and may cause the breasts to secrete a liquid. These side effects are not dangerous, but consider the effects these might have on your normal (male) job, particularly if you carry things or move things. (When bumped, the pain of a tender breast is not unlike a poke in the testicles.) It is also possible to contact yellow jaundice, especially if you have had it in the past. Estrogens may cause excess fluid to be retained in the body. This may make some conditions worse, such as asthma, epilepsy, migraine, heart disease, or kidney disease.

Estrogens have serious risks. You must decide, with your doctor, whether the risks are acceptable to you.

In addition to the information from Ayerst, you should be aware that generic estrogens, while they may represent a savings of money, carry a special danger. Generic medications cost less because they are manufactured with much looser quality control standards. For example, the dosage tolerance for generic estrogens is +30%! This means that from day to day you could experience 60% dosage swings. Because hormones (in general) act as triggers, or as catalysts, for many important bodily functions, these swings in dosage will severely upset your body. A number of people have reported massive mood swings while on generic estrogen, leading generally downhill (worsening mental depressions). Your body cannot quickly adjust its ability to make its own hormones, in response to sudden changes in dosage, or to changes when hormones are available through your digestive or muscular system.

In other words, if you really must, use a good quality estrogen only, and use it on a regular (same time each day) basis.

In males, very large dosages of estrogens, besides generating the risks listed by Ayerst Labs, will cause atrophy of the penis. Remembering that penile skin becomes the vagina, this means that you will end up with a very shallow vagina! Is that a worthwhile trade for the possibility of all the health problems described earlier?

There seems to be a large amount of misinformation among the gender conflicted population concerning breast development. One theory is that if you stop taking hormones the breasts will go away. This is NOT true. Depending on the amount of development, breasts may reduce in size a slight amount; there are a significant number of people who have found it necessary to bind down (Ace bandage?) their breasts in order to obtain employment in the male role after spending time on estrogens. This is especially bothersome in hot and/or humid climates, and may not be practical for a given job situation.

Taking estrogens in large doses will not necessarily cause breasts to grow as large as you think you want them, and especially will not cause them to grow as quickly as you think you want them to. Breast development potential is determined by your genetics; if your mother, sister(s), or other close blood relatives are small breasted, you will likely be small breasted as well. Having well endowed blood relatives does not, however, guarantee "adequate" breast development. In any event, genetic woman's bodies develop breasts, generally, over a period of a few years. You cannot expect your body to change any quicker.

Be aware, also, of the possibility of sudden growth spurts in the size of your breasts. There are many cases of impatient people having silicon breast implants after a few months on estrogens, only to have their natural breast suddenly develop shortly after, leaving them with overly large breasts. These in turn cause discomfort, backaches, etc., as they would for any other woman.

"But if I grow breasts, I have to live as a woman then! That would be OK!" NO, NO, NO! You may feel that you "have to live as a woman", but the world does not have to accept you as a woman just because of breast development. The world will NOT accept you as a woman based upon breast development alone.

Another bit of mis-information concerns taking estrogens to reduce or eliminate facial hair - to get rid of a beard. This is NOT true, either. After a lengthy period of time on estrogens, your body hair may become softer, and may not grow as fast, but estrogens will not affect the quantity or quality of facial hair. The only way to permanently eliminate facial hair is professional electrolysis. Estrogens can make the process of electrolysis more painful and time consuming because estrogens make your skin softer and more sensitive.

As a (genetic/born) male on estrogens, there are a number of other potential problems to consider as well. Your ability to have sex as a male will be greatly reduced, or eliminated. This includes masturbation. If you do engage in sex, even occasionally, you will find that your penis is very tender, and that erections have become painful. The relatively sudden loss of sexual function as a male may very likely cause prostate infections with symptoms very similar to many venereal diseases (discharge, painful urination, etc.).

The loss of desire for sex, and the pain from having it, present another interesting problem. Many post-operative people report that the ability to have orgasm as a woman is directly related to whether your body remembers how to orgasm at all. It appears that having orgasms up to the time of surgery allows orgasms to continue after surgery. This situation is even more complex because telling nearly any psychiatric/psychological professional that you have sex to orgasm as a male will usually result in a loss of recommendation for sex reassignment surgery.

In addition to all of this, after a period of time on hormones, you will be permanently sterile, sexually; going off of the hormones will not restore your fertility.

You may find an interesting "Catch-22" connected with taking estrogens in that while your body becomes feminized, your desire for that effect may be severely reduced. The loss of control over your emotions, coupled with increased risk of mental depression, may leave you crying suddenly over nothing! Or worse, it may leave you suddenly crying in the middle of a meeting with your co-workers, supervisors, etc. The feminization of your features will likely leave ;you with a very androgynous appearance, not fitting either gender role, which is disconcerting to many other people (employers, clients, customers, etc.) and which could likely affect your ability to hold any job, especially one with any responsibility (with any reasonable paycheck).

"But I know I can stop taking hormones as easily as I started on them . . . " This is not true. Your body requires hormones from some source. After it becomes conditioned to receiving the hormones of shot and/or pills, it will take some time to begin developing its own hormones again. During this period the reduction or lack of hormones necessary for functioning will be felt acutely, as depression, lethargy, and irritability. As crippling as these symptoms are, they are nothing compared to the return of male hormones to your system. With the return of testosterone, you will experience sudden intense periods of aggression, belligerence, and driven compulsions that characterize the male reality. These will be especially difficult to deal with, both for you and for the people around you, as your system has forgotten all of the control mechanisms it had to learn in adolescence. These behaviors, emotions, etc. make going off of hormones as difficult as stopping any drug. Hormones are every bit as addictive as any drug available!

You must fully recognize the addictive nature of the hormones, and the health risks associated with the use of hormones. You must then also fully recognize that continued use of the hormones will cause you to change into an androgyne, making any plans of regaining the credibility and social acceptance of a male very difficult. And finally, you must accept that the world does not have to accept you as a woman, and will not, based only on a few flimsy visual clues.

Taking estrogens, and/or any other hormone therapy is a dangerous procedure mentally, physically, emotionally, and socially. Taking estrogens without the supervision of therapists and physicians is setting a course for personal disaster. The potential for the benefits MUST be weighed against the certainty of the losses.

SOURCE: GIC, Inc., Denver, CO. Copyright 1988