HRT Update: June 24, 2015

At this point, I have been on hormone therapy for 4 months. Having just done a series of tests again I thought everyone would appreciate an HRT Update. To think a third of a year has passed it seems like time has gone so quickly. It was time for a 3-month checkup after my one-month checkup.

Current Dosages:

Estradiol: 6mg total two 3mg doses taken sublingually.

Spironolactone: 100mg total two 50mg doses taken orally.

Hormone Table of Fun:

Hormone Baseline Value Target Value Current Value
Testosterone 616 ng/dL 50 15 ng/dL
Estradiol 23.8 pg/mL 150-300 172 pg/mL

Next HRT Appointment: In 3 Months (Late September)

HRT & Transition Detail:

In regards to Estrogen/Estradiol, I have been taking the Estradiol sublingually for a while. Which is to say I have been dissolving it under my tongue and that has made it more effective. Last time I saw the doc we increased my dosage from 4mg/day to 6mg per day. In theory that would have increased the Estradiol to around 150, which would be in range, but taking it sublingually brought it up to 172… In addition, taking it sublingually has reduced the stomach upset that I did not realize was attributable to taking this medication orally. If we had to bump the dose of Estradiol again, to 8mg, that would have been the limit of oral medication, and again increase risk. I am glad that we did not need to do that!

In regards to Testosterone/Spironolactone, There has been no change. This is my original dosage and my original directions yet testosterone has become further reduced. I do not yet know why but the doctor said it was nothing about which to worry. Our target was to suppress to 50 we reached that last time. To see the further decline to 15 worried me at first but he said that a range was acceptable and this was within that range. I should be informing him if I feel particularly lethargic or overtired, which I do not. In fact, I have been sleeping and feeling much better in terms of rest in the last couple of months. I am going to follow up with him in a little more detail about the continued drop in testosterone but his reaction makes me think it is non-issue. In fact after following up with him I was happy to see a response from him this afternoon, less than an hour after asking the question, along these lines:

I was thinking about that too.  Sometimes the numbers overcorrect a bit, and then even out.  This is the first time we’ve been in our goal range.  I was thinking about increasing the estradiol dose further to get into the middle of goal range, but this actually might suppress the testostrone too far.

These number are fine to maintain on for now.  I’d suggest we keep there for now.  If testosterone drops any further, we can back off on the spiro next visit.  If it evens out, we’ll have room to try a little higher estrogen dose.

It is so nice to have a doctor that not only thinks along the same lines I do, but responds quickly and effectively. He also puts a great detail of thought into my medication which I appreciate so much.

In regards to the emotional and mental transition, it all falls into place. That is all there is to say. Things have just been feeling right lately. Now, the medical science confirms that. The mental transition is coming along well, although in many ways I still feel like a teenager going through puberty, adult decisions are starting to form themselves in my head with more regularity. I am finally growing up in a natural way. What does that have to do with hormones? Puberty is about growing up… My first puberty failed to grow my mind. This second one appears to be doing the job without me trying to grow up. In some ways those adult decisions that I always struggled with and found myself incapable of making, have now become natural. I forced it before, adult decisions were not natural to me, and I made decisions that made no sense to me. I just accepted them because they were the ‘right’ thing to do for someone of my age. Now, I want to grow up. Slowly, naturally, I will now.

That is the major theme of the transition for me. I am trying to do things as naturally as possible. This is not an overnight thing. It seems like many transgender people just want to rush though the transition and flip a switch. Each step cannot come fast enough and in some cases, I have felt the same way. What I have realized is that things do come naturally if you are patient enough and do not push them. Wearing lip makeup came early for me but the rest of makeup is not nearly as naturally do not know that I will ever get there. If I try to force pieces of the transition, it feels uncomfortable, just like when I tried to force myself to make adult decisions that I knew I should.

Until now, my mind has refused to grow up. I never understood why being an adult was so hard for me. I was forcing myself to be not myself but I was 20+ and my body had grown up… People expected my mind had as well…. I had a mind constructed to fit my body I had a heart constructed in a shell not to get hurt… Turned out I had a heart of glass…

(Seeing the World Trade Center in the beginning of this video made me unexpectedly sad…)

In regards to the physical transition, I was trying to figure out if this story deserved its own post. I was trying to figure out where to put this hilarious story that it would both be super relevant and get as much viewership as possible. I feel like this story sums up where I am physically and where I am mentally at the same time. Therefore, here is my story:

A couple of times ago, when I went to see my birth mom, she said that it was time for me to start wearing bras. Just that statement caught me a little off-guard. It took me a couple days to even warm up to the idea. She said she would go out, buy some, and deliver them to me. Then I asked, “How do I measure?” After a little instruction that was easy to do. Then began my waiting game, I had no idea what would happen next.

Given my age, she went to the women’s section. That generated a conversation with the salesperson about my situation and her ending up with bras that, well, increase my endowment. I cannot find another way to put that… It was a recommendation from the salesperson who had interacted with transgender women before, which alone surprised me. In addition, honestly, I would have done the exact same thing. Nobody was at fault or should be embarrassed about the situation. In retrospect, it is funny what happened next.

I received instruction on putting them on but it became natural after short order. My birth mom says that reading back that text conversation is so cute. I have yet to do so; and probably will not. Although for me it was more natural than some instruction, I received in some male things like shaving… However, it was so odd jumping what amounted to one or two cup sizes in a matter of moments! Yikes! I can see how a good number of transgender people like them. Transgender people many times feel they must overcompensate for their perceived flaws, like breasts that have not grown yet. I had quite an adverse reaction at first. I wore them a couple of days and they got in my way quite a bit. I even wore them to work… Jumping such an amount ended up getting in my way at every turn. I just was not able to get used to it.

I suggested that we go to the girls section instead. She went to a girls section online eager to correct the ‘error’ made. Honestly, it was not that much of an error. Hell, I would have done the same thing if I had a transgender daughter not realizing… That resulted in the acquiring of the bras I needed mere days later. No padding just the little bit of support/coverage I needed. Moreover, they are helpful for learning purposes. This whole experience reinforced to me that this experience should be as natural as possible. I am not a woman yet, I am a girl growing into a woman. Of course, that means society does not know what to do with me… A twenty-nine year old, who is neither man nor woman?

Things have been going quite well for me. This next bit is going to somewhat feel like a tangent, but it will wrap around. I believe everyone has their own world inside their mind. A world and existence they define for themselves. That world has a version of me that I see internally, it has a version of my friends and family, as I would describe them. It has pictures and views of places as changed by my opinions. For instance, in the world inside my mind Inner City Toronto is far more beautiful than the English Countryside. I do not think many people would agree with my world on that particular thing.

Here is the thing my world. External things have heavily modified the world inside my mind over the years. Other people’s worlds have forced their versions of me into my world. I have not come to my own conclusions about places or things that I have seen or done. Hormones have allowed me to take back control over my world. Hormones have welcomed me back to my own life. Now, I can rule my own world.

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