Seriously though, what the fuck, it feels like there is so much research involved.
Please post HRT tips and resources in the comments.
Shoutout to @BrookeBaybee's posts for helping to crack my egg. We love our trans comrades. :cat-trans:
Also @TransComrade69 for forcing a bunch of libs to read enough queer liberation theory that Leslie Feinberg was still being recommended when I first showed up here 6 months ago.
I've always been so happy to hear that my posts helped brighten someone's day, but hearing that they helped crack someone's egg? That's just made my entire fucking month. So happy you've been able to gain a better understanding of yourself, comrade! :cat-trans:
As for HRT tips, I've been getting good results from spiro and estradiol pills, but I would like to not have to deal with spiro's side effects. One random thing I've noticed is how it just gets progressively better over time. Pictures that made me absolutely euphoric after six months on E feel like they're of a completely different person at this point. You're going to be watching your body so intently for changes and before you know it, you'll be able to look back and see how they've all added up.
Also, :rat-salute: TC
Notes below because hopefully me writing this out helps other trans folx. Feel free to comment with your own thoughts.
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My sitch
- I’ve got decent health insurance for now.
- I live somewhere that does informed consent
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Notes.
This is a summary of how I'm thinking about this so far, I've got waaaaaay more reddit posts and websites saved.
- Research into trans medicine very limited, but slowly improving.
Estrogen
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Estrogen-only (monotherapy) works for many trans women, AA not always needed.
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Sublingual multiple times / day to start then switch to injections?
Labs
- Need to get labs for T, DHT, E1, and E2 levels?
- What else? How often?
Other Meds
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Bica another option for AA, less side affects and can sometimes even cause breast growrh
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Spiro = piss dragon? Still fine if needed, very inexpensive
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Finasteride orally at too high of a dose can cause depression, but DHT blocking properties also help prevent hairloss + even regrowth
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Progesterone via boofing after 1-2 years of E? Increases breast growth, but apparently should only be done after tanner stage 3?
Honestly the main reason I moved off pills is cus estradiol fucks with your liver and 10 years of dysphoria drinking fucked the shit outta that. A consideration if you have substance abuse problems in your past.
I got labs every month for the first six to develop a baseline and then once every 6 after that.
10 years of dysphoria drinking
Oh. Ohhhhhhh.
:deeper-sadness:
I am fucking good now! Sober and never been happier! Just a consideration for any trans fem siblings who have had a troubled past as well. Gotta stay healthy and keep an eye on things to be happy! :cat-trans:
Really glad to hear you're doing better, seriously! I honestly mostly commented that because it made me realize why I like alcohol as much as I do.
I really need to switch over to pot. I just want to be able to go on at least a couple dates where I get to be the pretty girl in a nice dress with a fancy cocktail idk.
That said, sobriety is probably a good thing for me to try out and explore as well. Booze is just not great for the body in general.
We do what we need to do to survive. Sometimes drugs are a rational choice. What's important is we don't let bourgeois moralistic prevent us from being open and honest with those who we need help from or let that bullshit ideology prevent us from taking the steps we need to be happy.
So much needless shame is wrapped up in how we hide and sublimate our pain. We don't need to be alone.
Also you are already a pretty girl, the world just doesn't know it yet.
Interesting, do you do injections now or something like patches?
I got labs every month for the first six to develop a baseline and then once every 6 after that.
Noted, did you get them ordered yourself or by a doc?
Your comments here are really helpful, thanks. 🖤
I go to a queer friendly clinic in the local city and the doctor there helps me with everything. I am very lucky in this regard.
Here's something I wish I could tell my past self: injections are more effective and if there was a real chance you could hurt yourself then the doctor wouldn't give it to you
Sage advice, thank you! Do you mind if I ask how long were you taking pills before you switched over to injections? Also, what kinds of improvements did you see?
I was on e pills for about 8-9 months I think before I switched over to injections
There were a few differences I noticed, mainly I gained a lot of weight (20 lbs over one year, which is a lot for me) and that helped thicken my butt and thighs a bit, although a good amount went to my tummy too. It also started reducing my t levels and I stopped taking spiro because the injections just made my t so low that my skin started getting extremely dry. It kickstarted my breast growth a little after a stall but it tapered off after a few months, which made me start taking progesterone in addition to the injections.
I would recommend injections over pills to anyone that doesn't have a phobia of needles or already has serious weight problems
Say you need it for treating covid since that's what all the chuds are up to these days
HRT in general is a complicated mess. I've been on 6mg estrogen + 200 mg spiro for 2 years and I'm pretty satisfied with my results.
In terms of estrogen, pills are the cheapest option and sublingual provides the best absorption. Injections are more expensive but you generally get better results and you don't need to take it as often (once a week for injects vs daily for pills). Estrogen + AA works for most people and is generally the standard starting point. If your e level is high enough then you can reduce the amount of AA (or eliminate it entirely). If you end up getting SRS or an orchi then you won't need anymore AA
I'm not that well versed on AA but Spiro is the most common and the cheapest in the United States. It's a potassium sparing diuretic so it makes you pee a lot and you get salt cravings. Some people also report getting brain fog which can be an issue.
Progesterone is not as well studied but anecdotally people have reported getting more mature breast development and a higher sex drive.
Spiro is a pretty ineffective AA with some potential unpleasant side effects. The Main reasons it is still prescribed is 1) criminally little research* in to trans Healthcare and doctors just doing what has always been done 2) it's super fucking cheap and has very few serious side effects.
*I don't know if Spiro goes all the way back to the 20's and the initial research in Germany or not, but it wouldn't surprise me if it did.
Interesting. Do you have any opinions on bica / bicalutamide?
I already struggle with brain fog and the idea of potentially adding more of it because of spiro side affects is stressful.
No idea, was only on Spiro for 6 months before I went on injections. I have a friend who is on finesteride and likes it well enough.
you might be able to go to quest or something and order the tests yourself. planned parenthood makes me go there so I know they have the capability
i can vouch for lena, excellent service and much cheaper than other options (previously i was getting E pills from inhousepharmacy)
In the U.S. you can’t just order your own diagnostic labs. (I’d argue this is usually good and prevents Theranos level fuckery. Theranos was actually trying to get state laws changed in AZ so people could purchase testing as a retail item at Walgreens, but I digress)
the good news is, so long as the test is ordered by an MD, or in many cases a NP (nurse practitioner) or even a PA, with a legitimate reason or diagnosis, you can just walk into a regional clinic or hospital primary care center, get your blood drawn.
The hardest part about HRT is finding a doctor who knows what they're doing and isn't some sort of asshole. There are a lot of stories about trans women being put on completely inadequate regimens and being told to wait months before being put on proper dosages, or doctors being wildly inappropriate.
Early on you'll probably feel like you have to micromanage every detail of your HRT regimen, but IMO it really doesn't matter that much in the long run. I've known people on pills (oral and sublingual), patches, injections, people on spiro, people on bicalutamide, or some doing E monotherapy and I've seen a wide array of results across each of these regimens. I'm of the opinion that results are mostly based on genetics once you have the proper, stable hormone levels. So really, think about what would be convenient for you and start with that. Most people start with pills and spiro in my experience.
The biggest hurdle will be getting your estrogen levels up to where they need to be (usually around 150-300 pg/mL) and suppressing your testosterone. Your doctor should work with you, blood testing regularly (I do every 3 months) to try and reach the targeted hormone level. Worth mentioning that a higher estradiol level does not mean more results past a certain point, in fact it's my understanding that too high of an estradiol level will trigger your body into breaking down excess estradiol, so don't like sneak in an extra dose thinking it'll give you an extra boost lol.
For what it's worth, I started on 4mg of estradiol pills and 200mg of spiro daily, one set of pills in the morning, the other at night. I took the estradiol pills sublingually (dissolved under tongue). At 3 months my estradiol levels were a bit low (I think around 100 pg/mL?) and I was bumped up to 8mg of estradiol pills daily. I did that until about the one year mark and I switched to EV injections and bicalutamide, which I've been on for over a year now. Injections are nice because you only do them once a week (I actually do every ten days) and you're done. It's important to have regular blood work done with injections, it's much easier to accidentally cause your hormone levels to skyrocket on injections. One time I got my blood work back and it showed I had over 1000 pg/mL estradiol in my blood, and that was at it's lowest, ten days after injection! Bicalutamide is nice because it has fewer side effects than spiro, but from what I hear it can be difficult to get doctors to prescribe it for you, I think because it hasn't been formally approved for use as an anti-androgen but idk. I tried Progesterone for a few months around the 1.5 year mark and it didn't do anything for me so I stopped.
Anyways, hope this helps! Good luck on your journey! :trans-heart:
This is so encouraging, thank you!! I'm reading this over and will probably send you another comment with more questions later. 🙏
Been on HRT for 12 years now, most of the time on sublingual pills + spiro, and later cyproterone acetate.
Last winter I switched to estradiol valerate injections and holy moly I wish I could travel back in time and tell myself this was an option. Remembering pill times and packing them for travel was always a pain and it's way easier to just jab myself in the thigh once every 5 days. Also my boobs and butt got bigger which I really didn't expect to happen this late or at this age. Very cool.
I'm a teensy bit uncomfortable with the fact that I have to buy my meds from some rando in Brazil or Ukraine though. Not because I've ever had problems with the medicine but because I'm worried about them being shut down, especially after the last controversy with Otokonoko. I got a new job with health insurance and I'm hoping to get a doctor to give me a legit prescription. Hope I get one that's cool with me having self-medded for the last decade.
People taking injections, do you also take an antiandrogen? My last blood test had my testosterone a little higher than I would like and I'm considering whether that means I should up my e dose a little from the current .18ml, or add a blocker. I still have plenty of cyproterone from my pill popping days, but I hear bicalutamide is the new hotness?
This is so helpful, thank youuu. That's another rec for potentially starting with injections. I'm willing to go for that if it makes sense.
did you switch from spiro to cyproterone acetate or just add cyproterone? What did you think about the difference?
I switched from spiro to cyproterone because I was getting tired of pissing all the time and finally got brave enough to change meds. I was just reordering my meds one day and thought "hey maybe I'll give it a shot." Taking one tiny pill a day was nicer than one at day and night that made me pee a lot.
It was a nice change. I didn't notice any side effects.
