outforhealth:

QT Says: Considering HRT? What’s right for you?There’s a lot to consider when
you’re thinking about starting hormone replacement therapy (HRT), especially if
you’re nonbinary, questioning or just generally not 100%, “give me hormones now”
about the whole process.

Here are some questions you
may have and our best answers to them. If you think of more, let us know in our
ask box! (We won’t be able to answer
specific medical questions about your personal care but we can share thoughts,
resources, and questions!)

1. What does
testosterone/estrogen do to my body, anyway?  

Good question. Take a look for
yourself!

2. Okay, that’s fine, but what
if I don’t want all of that right away?

You get to decide what’s right
for you! For some people, it can be a bit overwhelming to think about ALL of the
changes – some of them may seem exciting, others not so much. One of the things
you get to do (need to do!) as a person considering hormones is weigh the pros
and cons of all of the changes and decide what feels like the right path for
you. You can do that on your own, with a mental health counselor, with your care
provider. Thinking it through and making an informed decision for you is incredibly important.

(Some of our
patients benefit greatly from therapy and report
positive experiences and that’s important. However, at PPSFL we do not require our patients go to therapy to prove
their true gender, or to get permission to change their bodies. One of
the ways we approach our transgender services program at our health center is
called an Informed Consent Model. That means you get to decide what is right
for you and we support what you choose for you.)

Some of our patients are very
happy on a smaller dose of hormones; others feel better on a higher maintenance
dose. We have rules (called medical protocols) that give us guidelines but we
work with our individual patients to make sure they are comfortable with their
care and hormone plan.

We find that most of our patients
are really good at figuring out how they ~feel~ on hormones, emotionally and
psychologically, before some of the bigger changes occur. The key is to keep
checking in with yourself. How do you feel? What’s going on for you? Does this
feel exciting and like a “click” of cool, yes, THIS! Or are you feeling ambivalent
like, huh, sure, I guess, maybe? If you’re feeling less enthused we recommend chatting
with your care provider and deciding what’s right for you. You get to choose
when to start, if you wish to continue, and help make decisions about your
dosage. You get to choose. It’s your body! The time it takes for some changes to
occur can be good news and/or bad news for some folk. The good news is you have
some time to see how you feel. The bad news can be the waiting.

3. Okay, my dude, but what if
I want to stop taking hormones. Can I do that? Will I explode?

Yes, you can stop taking HRT,
and no, you will not explode. That said, like with most medication, just
stopping taking it, cold turkey-style, is not a thing we recommend. 

Talk to your care provider about
how you want to stop and you can come up with a plan together on how to lower
your dose or take you off HRT. We look at your care as a partnership. We are
experts in a lot of things when it comes to health but you are the expert on
you and how you feel. 

4. Can I just take, like, a
smaller dose of HRT, but permanently?

Yes. Most providers start
their patients on a lower dose and then make adjustments based on the patient’s
experience and medical protocols. Key thing here: what’s right for you? People take different doses of HRT for
a multitude of reasons, and “I just want to see how I feel” is a totally valid
reason to stay on a lower dose for a few weeks, a few months, and also forever. Neutrois has written extensively on this topic, from their POV.

5. If I stop taking HRT, which
changes are permanent?

For trans men/ transmasculine folks, the irreversible (won’t
change back to how they were before taking HRT) changes may include:

• Deepening of the voice
• Growth of facial and body hair
• Changes in hair (possible hair loss, thinning, or male pattern baldness)
• Growth/changes in genital erectile tissue (clitoris)
• Breast tissue atrophy – possible shrinking and/or softening of tissue

For trans women/ transfeminine folks, the irreversible (won’t
change back to how they were before taking HRT) changes may include:

• If sperm production has ceased it may not return if hormone treatments are stopped; it may be irreversible (this can depend on length of time and dosage on HRT).
• breast development/growth

Bottom line, if you are
considering HRT and wondering what’s right for you, you get to decide!  Ask a ton of questions. Read a bunch. Talk to
your care provider and ask all the questions you have (write them down before
you go for an appointment to help you remember them!). Good luck and take good
care!

This speaks so much to me. I wish there were informed consent options in Europe.