Tag: HRT

things

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.

sert

This was interesting and I must read in more detail:

https://www.sciencedirect.com/science/article/pii/S0006322314007094?via%3Dihub

Essentially
longitudinal imaging in MtF and FtM under HRT. I _think_ what they
conclude are testosterone increases serotonin binding (so goes up under T
HRT and down on anti-androgens) which may affect mood. Sufficient E
supplementation may counter, meaning in some sense one wants to avoid
being low on both hormones. Again, need to read more.

demi-ann

So, six months on HRT. Not disappointed. (Refusing the “tranniversary” term, I think.)

Feeling of calm largely still there (relative to life and all). Doubts largely gone, helped also by being fully out.

Body changes modest but there. Need to take weight cycling/loss seriously now. All the same, breasts slowly growing, hips may be slowly manifesting. Lips may be a little fuller. Body hair growing back soft. Feeling OK.

Plenty of other posts here already about my growing genital dysphoria and surgery ruminations, so need not repeat. Instead I’ll say laser has delivered – after a year now there still is the feel of stubble in places left to remove, but I don’t think I have much of a shadow any longer even without makeup, and shaving has become mostly a habit.

Sexuality evolution: Happily mellow bi girl open for almost anything but with more important things to think about? See also: I transition into the type of person I used to crush on.

Emotional availability: Crying and, to a smaller extent, laughing. Still not there where I want. I seek moments to express and feel emotions I don’t have a word or proper association pathways for. Given those exist, I think I still have not broken through dissociation fully, there is something in there that I want to reach. I’m moving slowly in that direction. Probably a matter of time, with the three aspects (medical, social, internal) of transition interacting. Will see.

I wonder where I will be after a year, or two, or five?

sodality chlorides

So beating the dead horse a little more still (tenderize!), just short of the six month mark of HRT I certainly weep easier. Today from dysphoria, frustration, love, being moved, and, a first since childhood, from saying goodbye to a loved one for at least a month.

Of course it is hard to tease apart what is deprogramming toxic masculinity and what is neurological. My belief firmly remains it is both; that deprogramming goes easier with an appropriate endocrine state. I also could recognize something; it is here not necessarily that the emotion was not there, but I have an easier time now feeling it in my body – face scrunching up, voice breaking, eyes tearing up, and also perhaps laughing and shaking in other cases. The body creates a feedback, it makes me notice the emotion more clearly and persistently.

Thus perhaps I adapt my body to be a proper canvas for my emotions, so I can more easily see them. Interesting, and with implications for minds without such bodies.

Sitting in airport waiting until I can check in. Trying to make a dent in the mountain of neglected research tasks. Feeling like the conduit for a storm, and feeling somewhat content with that. Now if you’ll excuse me, need to make sure my makeup is not totally ruined by my silent weeping. Much love!

lacuna maris

I’ve really been crying a lot lately, for happiness, for stress, fear, sadness and without knowing why. Thinking thus I can likely conclude emotional volatility increasing, and loving it.

Also, I probably should find a short-form description of my gender model (e.g. “gender is the reflection of sex characteristic continua in the space of human perception, emotion and action, involving opt-in/opt-out clauses in modern contexts“) to make it clearer to communicate.

nocebo

I ran a tiny, anecdatal and flawed double blinded test of my estradiol HRT. I feel so much better on it that I wanted to see if I could demonstrate it as a direct effect somehow. In this case I tested 8 time points of consecutive 12h periods, for each taking either a placebo (biotin pill) or estradiol. Blinding was done by choosing a placebo of similar shape, place random numbers of each in individual envelopes, writing inside what each was, and writing a random number sequence on outside of envelope, taking them in turn. Then I would take the pills without looking at them.

Readout was whether I could guess from my mood whether I received placebo or estradiol, as checked upon final unblinding.

First night: Received placebo. Nonetheless remained calm.

First morning: Received estradiol. Remained calm.

Second night: Received placebo. Was restless and slept poorly, did not restore from day.

Second morning: Received estradiol, became calm, restored from night.

Third night: Received estradiol. Confounded by first feeling happy while drinking, then surprise misgendering here: https://lost-in-transition.tumblr.com/post/175757193179/lacrimosa . I believe I would
have been calm otherwise, but due to this, believed wrongly it was placebo.

Third morning: Received placebo. Stayed restless, also due to sleep deprivation.

Fourth night: Received placebo. Believed it was estradiol, and felt calm.

Fourth morning: Received estradiol. Remained calm.

In summary thus, guessed 5/8 correctly which is a minor success, but data really is too sparse. Out of morning doses, I was restless the one time I got placebo, and calm the three days I got estradiol. I was calm on all periods I got estradiol, excepting due to a misgendering triggering. However, there were several nights on placebo where I still was calm, possibly because of other factors. Nights I break my 24h intermittent fast, sometimes drink wine, and watch cartoons, not making any demands on myself; nights it makes sense I am anyway quite at peace.

So all in all, I cannot say I always become restless without estradiol, nor that I always am shielded from restlessness on estradiol. Placebo and good things may help and unlucky circumstances may harm. I also cannot rule out that there may be a short-term statistical mood effect, it would need further testing. There is a very slight tendency that there may be, driven by morning doses.

Beyond this, of course there may be long-term mood effects, and there are other types of nervous system effects (differences in sexy scent processing comes to mind), and there are all the bodily effects. This day I am on actual estradiol, and still quite moody, but getting better. Some part of me worries that it would be an issue if I overattach to the concept of mood effects, fog lifting etc., in case it really is mostly placebo, but what if? My trans alignment ultimately is about how my brain cannot relate to me as a person unless I understand myself as a woman; I think this applies analogously to cis persons but the fact of their lifelong lack of misalignment hides it. Ensuring my body and brain and social self has as little of statistical difference to other women as possible is what I need, alongside work in affirming my self-perception as who I need to be to be happy. If I become more calm and happy even as a result of placebo from the medication I take to change my body, that is not a problem, that is an opportunity. Part of me worries that if short-term mood effects really largely are placebo then it might become harder for me to summon them up, but I’ll look into ways of preventing that, and in the end, this study just shows one needs a larger, cleaner study to be able to tell, and that there also are other factors impacting.

Major limitations: First, this tests only short-time effects. It occurs under confounding that my 24h dose was half it should be. It was dirty blinding; my guess from mouthfeel of what pill I received was correct in every case though I never felt certain and think I did not use this for mood assessment. Sampling without replacement from a limited number constrains the readout. Statistical power is woeful, and most problematically, I had only one morning placebo pill, so the power for daily restoration under E vs placebo was not well tested. It also is a test of low-E, low-T conditions, not low-E, high-T, as I did not include my androgen blockers (and since intrinsic production now is low, that would also not have worked). A larger study could be done contrasting 3-day patches with identical placebo patches. This would simplify blinding, give more time for effects to be seen during days. Tracking could be done during this period at regular intervals of mood on a scale using app. Power could be made much higher. The relevant point I want to make is that I think meaningful tests can be done this with with randomly placebo-sabotaged extant HRT, it is not necessary to work on treatment-naïve subjects.

hearing

Somewhat scared. Apparently there is a hearing loss condition (otosclerosis, ossification of the middle ear structures) that may be worsened depending on estrogen levels. One minor thing I had this year was feelings of clogged ears ever so often, for which I had a hearing test. I have no reduced hearing, but it did seem as though I have some sort of middle ear constriction. My father has significant hearing loss, so worry of the morning is that my HRT may be accelerating a hearing loss condition, which would be horrible. Now, I absolutely need hormonal transition, but I also want my hearing to remain good. So need to have this investigated further, and to check it regularly, and to do all I can to prevent it while still getting the treatment I need.

EDIT: Mother believes I do not have father’s otosclerosis, but rather her tendency to constricted ear canals. And it is true, early otosclerosis symptoms are still hearing loss or dizziness, not ears feeling clogged, so even if I were to have some early stage otosclerosis, that would still mean no hearing reduction, and more importantly not be the reason behind my clogged ears. Will still take fluoride preemptively if I find it, and ensure proper hydration…

trifecta

I think I can conclude a few more things on emotions, a few more HRT related things trending now significance. Some were visible today so I noticed.

Four months in, I have mood spells lasting a few hours. Sometimes vulnerable/raw/melancholic/sad, like feeling emotionally bruised, more often being irritable/angry. Perhaps once or twice a month? No pattern to them, and nothing external triggering. I can wake up like this, or it comes slowly online. Like I am on a hair trigger and easily irritated, growling, impatient, angry. I can and do ignore it. But it’s there, rarely, and I think it’s new.

Another set are times when I am just huggy and needy, wanting to be held and comforted, and it feels very much like I need it. I note that while libido is down, there is a strong physical reaction of a different kind sometimes when sensuality rises. I can get weak-kneed from being kissed, which lasts for minutes and makes me more cuddly, but without me really wanting to escalate or even to maintain, just feeling dizzy from the pleasure of the nearness.

Then I think also I end up more tired at night. Some is getting up earlier, some perhaps a changing body needing more sleep, and some may be S no longer holding back, so that she lives more fully without noticing tiredness until it is quite high, or rather, not getting emotionally tired before cognitively or somatically tired.

Thinking these may indeed be filed under mental effects of my HRT. Other things happening, many good. Moving forward.

trajectory

Feeling better on more sensible E2 dose.

Parents becoming more clearly acceptance, they read some of what I write online too. That is good. Still a lot of deadnaming but they do say they try. This touches me a lot, I will process it and write more.