These are somewhat harsh times, I am under stress from many different work deadlines at once. Then as I started following more trans people on Twitter, I get their reposts of TERF stuff and sometimes at least briefly go down rabbit holes I would rather avoid, plus other things. Dieting, have not slept enough recently (because I had early meetings three days in a row, including laser), and ending up worrying about things. Not super happy with estradiol patches, will ask to try gel next time. Feeling the weight of stress and low sleep. I will make things better.

Would even more like injections, I now think, as it might have a spike+fall pattern actually similar to E2 levels in cis women (where some recent paper claimed those were on average the same as for cis men, but the data does not look like that for me). I’m speculating that occasionally _very_ high levels may trigger some differentiation. In theory I can use leftover material do to this myself occasionally though. Injections are not a thing in my country of residence. Looking forward though to next assessment. In best case might switch to patches+gel or something, and try out progesteron as well.

Continuing the discussion on hormones, looking around literature some (when I should have been working on other science), there are various scattered and sometimes incompatible findings pointing in different direction. There are also online communities of cis men doing DIY cis HRT, supplementing testosterone and reducing estradiol, some saying they feel bad from too high estradiol. I did not know this. Not scientifically validated but interesting, and it would make sense from a perspective of individual-specific optima.

Continuing the gender identity speculations, a recent look again at some papers show mixed conclusions on whether CAH people more often end up trans men. They may be, but it’s not clear if so if their medicine compliance during childhood plays roles, and at least some are raised as boys or reassigned girls quite late. These things might also confound some of the conclusions of that CAH vs gendered learning study I keep mentioning. Echoing my comment from two posts ago though; I am me, and retain my identity and needs, whether I can be sure there is some prenatal hormone effect driving my alignment or not.

Oh, and also did the awkward and asked my laser provider if she can help me with genital hair removal in preparation for surgery. Language barriers salient but she seemed possible. So that might happen.

theorizing

Model: For some significant fraction of trans people the following thing holds: gendered self-socialization is impeded and flawed because mismatch between assigned gender and innate gender identity potential. From this stems a lot of the comorbidities and components including anxiety, depression and dissociation. Transition helps in part by allowing successful gendered self-socialization absent this mismatch.

Predictions:

– Success of transition in reducing discomfort would be helped by doing this second socialization in a supportive community, less efficient otherwise. Transitioning body and brain would not solve all things immediately. Long-time gender anchoring might.

– A sex-transitioned cis adult would often not gain severe dysphoria overnight, and might not as often have it as bad as someone growing up and maladapting under a gender mismatch.

– I long thought trans comorbidity with autism was due to autism making such self-socialization harder. But perhaps it is reverse? That is, trans might be an autism risk factor, not the reverse. Then one might expect that there would exist autism gene markers _less_ common among trans autists than other autists. Also, just learned (more work from Melissa Hines) CAH, who are usually cis but unusually often trans, are not more often autistic.

I think some of these may bear out.