Testosterone, blockers and estrogen

[Elizabeth]

A bi- orchiectomy is an option, as I was advised some years ago by a noted guru, however as I understand a minimal dosage of oestrogen is required to inhibit embarrassing hot flushes. Something to consider.

[Anonymous]

Im going on low dose estrogen via the pill for the same physical benefits you list .I have been told my man boobs will increase slightly in size only and any growth in female looking boobs would also be small .When I go to the beach /[pool i see so many hairy chested men with man boobs that I think its taken as a “normal ” variation in the male being..
Also , Ive been told by many tg women that estrogen ,even in small doses , produces a feeling of ‘calm ‘ that is quite profound … so Im hoping for that (muchly )

[Adrian]

Madeline,
To ask questions and explore options is healthy. After all it is your health and well being you are making decisions about – and what is ‘right’ for one person may not be right for you. But if you expecting definite answers then be prepared to be disappointed.

MadelineC wrote:

I expect that the GP or an Endo will be able to answer these questions

You can approach your GP/Endo with two attitudes. You can just choose to believe everything you are told, or you can question it and discover the thin ice ‘medical opinion’ is currently based on.
Most people seem to go with the first option – as the fastest route to a perceived end result. That is why many girls find my , perhaps more rational, approach annoying.

But at the risk of annoying some, if you want to take a more pro-active approach to your transition then I’d suggest some elements on which to base your questions.

1. Drop any idea you may have been given that Testosterone makes boys and Estrogen makes girls. The reported side effects of taking testosterone include growing breasts and shrinking testicles. Hormones are artificial chemicals that have been created by the pharmaceutical industry to meet marketing goals – those goals may not match exactly what you hope or expect to achieve.

2. Remember that the human endocrine system is a complex self-regulating system that is poorly understood. Do your own research on how the endocrine system organises itself to give genetic women a monthly fertility cycle – it is amazing. Adding or removing hormonal agents to such a complex system will often produce unexpected (and possibly unwanted) results. Certainly the results will be hard to predict in a particular individual

3. Understand that the biological force behind homosexuality and gender identity is still obscure and subject to debate. This is true, even though you may choose treatments that are based on an assumption that we do understand what makes us the way we are.

4. Don’t ask your clinician for statistically valid, peer reviewed, clinical trial data for the journey you are going on. It just doesn’t exist. In the absence of scientific data you have to accept that the treatments you elect to have may be shown in future times to be at best ineffective and at worst dangerous. Endocrinology has a history to date littered with well meaning but ill conceived treatments.

I could go on…but I don’t want to cloud the issue too much. At the end of the day, it is your body, and I can vouch that HRT can make you feel much more comfortable with that body.

Just be prepared to monitor, experiment and adapt!

[Lisa_W]

Adrian
I guess I could be one of the girls that you mention, but I am not offended. I wish to thank you for the opportunity to correct some misconceptions.
“The reported side effects of taking testosterone include growing breasts and shrinking testicles. Hormones are artificial chemicals that have been created by the pharmaceutical industry to meet marketing goals – those goals may not match exactly what you hope or expect to achieve.”
I assume there is a typo here, or are you referring to the peripheral aromatisation of T to E? When giving advice outside of your specialty you must be careful. Hormones are hormones. They are chemically active compounds produced by the body’s endocrine system. The chemicals that we swallow are indeed produced by the pharmaceutical industry. They try to mimic the action of hormones. Some are more successful at this than others and possibly with fewer side effects.
Do not be deluded, there are no drugs/hormones specifically produced by the pharmaceutical industry for TG’s. It is just not profitable because there are so few of us. The drugs/hormones that are used to treat TG’s have been selected from drugs used to treat genetic women, treat conditions in genetic men eg; prostate cancer, or the known side effects of certain drugs may be beneficial in TG’s eg; Spiro. Is it any wonder that the ” goals may not match what you hope or expect to achieve “, plus throw in the inherent variability of the absorption and metabolism of these drugs/hormones.

“Do your own research on how the endocrine system organises itself to give genetic women a monthly fertility cycle – it is amazing. Adding or removing hormonal agents to such a complex system will often produce unexpected (and possibly unwanted) results. Certainly the results will be hard to predict in a particular individual”.
I agree that the endocrine system is amazing, but modifying the menstrual cycle in a TG female???? I know there have been uterine transplants with successful pregnancies but these have been in genetic females. Are you really suggesting that trans females can have a menstrual cycle?

“Don’t ask your clinician for statistically valid, peer reviewed, clinical trial data for the journey you are going on. It just doesn’t exist. In the absence of scientific data you have to accept that the treatments you elect to have may be shown in future times to be at best ineffective and at worst dangerous.”
In general I would agree that there was a lack of studies about the treatment of TG people. I have been to the last two biannual WPATH world congresses and I can assure you that information about TG’s and their treatment is expanding exponentially.

Madeline as you can see the answers to your questions are very complex, and I agree with Adrian that you should ask these questions but be very careful about where you seek your information from. People with incomplete knowledge can give you incomplete or worse wrong answers. Remember anecdotal evidence is not “statistically valid”.

[Martina]

I have no experience of taking estrogen and I have no desire to start. I do, however, have friends who have taken the pills with differing results. As Adrian suggests, we are all as individuals very different and what works for one person may or may not work for another.

One of my friends took estrogen for a few months but found that she became so depressed that she had to stop. Another friend had a similar reaction but changed to estrogen patches which she says have less side effects (for her) except that her nipples “itch like crazy”. :S

I guess the key thing is to be prepared to experiment and find what works for you. Horses for courses as they say.

[Sana]

Hi Maddie,

Let me share my experience too. It might become helpful.

I’m a38 years old,] and I tried to start HRT less than a year ago. I started with estrogen pills, but in 5 days a superficial vein in my left foot pumped up, which was because of blood clot. So I had to stop it immediately.
Then I found one of my options is to take non harmonic androgen blockers, and if I wish to go further, I can go with cosmetic surgeries. The pill is called “Spironolactone”.
https://en.wikipedia.org/wiki/Spironolactone

I started taking it and after a while the skin is obviously smoother, less hair growth, and just a bit man boob, which I like it. And also about changes in my personal feelings, I feel like a teenager .

Cheers

[Carol]

I wouldn’t worry too much about rapidly growing a big pair of bazookas and frightening your new boss. At age 50 growth will be slow to start with and, while you will feel great, to an outside observer they won’t raise any more alarm bells than ordinary man-boobs. The rule of thumb is that it will be a couple of years before you reach your full potential. Anyway your GP/Endo will have ideas about how to manage the introduction of anti-androgens and estrogen. You’ll just have to follow instructions. If there is any hint of male pattern baldness the sooner you get onto anti-androgens the better. I wouldn’t presume to comment on castration versus anti-androgens. I’m still dithering about that step myself.
Enjoy your journey.

[Anonymous]

Thanks everyone, I knew this would throw up a variety of responses (which was what I was looking for) that has given me plenty to think about and more questions for the GP/Endo.

Carol, FYI its way to late for the male pattern baldness. While both of my brothers (which are significantly older than me) have a full head of hair, I drew the short straw and had a large bald spot and receding hair line by the time I was 35. I used to use it as an excuse (one of many) why I didn’t want to transition. But now I see it is just another challenge as I move forward.

Maddie