Hello precious community! I'm hoping someone or multiple someones can help provide me with answers on this. So I have finally gotten a therapist. Unfourtnately she's newer to the gender identity and doesn't yet get the whole of it (although my gender identity isn't the entire reason why I'm seeing her), but she's the best one I can get access to locally without having to travel like three hours. Anyways, she's definitely willing to work with me on HRT, but she also doesn't know the whole ins and out yet, so we've both got research to go. (I think I'm rambling.) Anyways, there's a few questions I have and I'm just going to briefly list them. What all things should I consider or make sure of before deciding or starting HRT? Besides the extra hair, clitoris enlargement, and voice deepening, are there any other benefits or even negative consequences with HRT I should be aware of? Are there any ways besides through doctors that I can find an endocrinologist or do I have to go through my primary care physician and/or therapist? Is there anything that could disqualify me from being able to take hormones? Is there anything I should be doing to prepare myself for HRT? Even if I have to wait I'm 18, which is less than a year away - but I also don't know the local standards for HRT yet - I'd rather have this info to chew over. Any details, advice, or anything you might also think is useful would be greatly appreciated.
Well, I'll answer what I can for you. 1. I suppose the main thing to consider is if you're sure. There are lots of permanent physical changes which occur by taking hormones: what grows stays, that deep voice stays, and so on. You know yourself and you'll know if you're ready. Also it may be a bit of a "body shock" because many changes occur pretty fast and it could take some getting used to. Be prepared to pass a whole lot better too. 2. You'll go through, essentially, a regular male puberty and also be more susceptible to male-relatedhealth conditions (which usually results in a shorter lifespan, but that's a general fact unrelated to being trans). I'll list everything I can recall insofar as changes: voice deepening, muscle growth, heightened metabolism, increased aggression (the level depends on the person), increased libido, body hair growth, skin texture changes to rougher and more oily, increased acne including body acne, clitoral growth, receding and thinning hair, body fat redistribution, as well as taking away the effects of female hormones (such as menstruation). There are probably more I'm missing but that is quite a few. If you want an estimate of how you'll end up looking, look to male relatives such as father and brothers. Chances are you'll end up with a similar level of bodyhair, muscle growth, etc. due to genetics. 3. The only way I know of is via referral from a primary care or therapist. Perhaps someone else may know of an alternative. 4. Only if you have some serious medical condition which would interfere with the effect of testosterone. Of course there are generalities like being emotionally/psychologically ready for it, which your therapist should help you with. 5. Mental preparation? Also it never hurts to star working out and eating healthy, as building muscle should also become much easier with T. That's all I have. Disclaimer: I'm not a doctor and everything I've written is only from my personal experience and observations. Please verify it as you see fit. Hope this helped in some way.
Well, Kodo gave a ton of info on most of your questions, and I think I'll help you out with 3. 3. I know some areas have informed consent policies where you need to visit an endocrinologist to make sure you can take T, and then you basically sign a form saying you know what you're taking and the risks. However, I don't really know the ins and outs of this as I'm taking the therapy approach. I would probably recommend that way so that you can get all your feelings sorted out and ensure you want to take hormones, which obviously have a huge effect on the body. Just my take!
5. Is there anything I should be doing to prepare myself for HRT? Kodo already mentioned a lot, so I'm not gonna repeat everything, but generally, just be prepared for anything. ^^ Sounds easier than it is, but be prepared for the good things as well as the bad. Some people have serious problems with acne, my acne actually cleared up after starting T, so you know how unreliable this stuff is. You might grow a mono-brow, you might not grow any facial hair at all or you might grow a full beard in mere months. It's all happened before and it's important to know about all the consequences. While it's important to look at many different people to see all the possible outcomes, it's also important to not compare yourself to others too much. While changes could be happening very fast, they can also happen very slowly, so it's important to know T works different for everybody. I know you haven't started HRT yet, but I guess it's easier to start practicing patience now than later. It's also true that you'll take some time to adjust to the changes. I've always wanted facial hair for example, but now that I've actually started to grow some, it's still kinda weird. I sometimes look in the mirror and think "I can grow facial hair... but how?!?" it's sorta weird to explain. :lol: And I've just realized that I'm rambling and not saying anything helpful so I'm going to stop now...
What all things should I consider or make sure of before deciding or starting HRT? Why do you want to do it? Do you want all of the effects? Can you deal with how people will react? Besides the extra hair, clitoris enlargement, and voice deepening, are there any other benefits or even negative consequences with HRT I should be aware of? There's also hair thinning once you're old, cessation of menstrual periods, increased musculature (and consequentially, weight gain), fat redistribution (this is gradual, and only really happens when you lose weight), a change in smell, increased perspiration, acne, increased energy, and a more prominent adam's apple. As for health issues, you'll have increased red blood cell count, which can cause issues. People also say T increases your risk of ovarian, uterine, cervical, and endrometrial cancer, but no studies have been done on the prevalence. So long as you get regular pap smears, you should be okay. Also they'll do a blood test before prescribing it to ensure you'll be safe to go on it. Are there any ways besides through doctors that I can find an endocrinologist or do I have to go through my primary care physician and/or therapist? Typically, you have to go through therapist who specializes in gender, who will get you a letter to an endocrinologist. How long therapy takes depends on you and your therapist, so I can't even give you a general timeframe for that. There's also the informed consent method, where you sign a waver and get on with no therapy. It's up to you, but I would highly recommend you go to a specialist rather than your primary care physician because most of them are uneducated on trans issues. Is there anything that could disqualify me from being able to take hormones? Yes. If you have irregularly high red blood cell count, diabetes, or unusually high testosterone level to begin with that might not completely disqualify you, but it'll probably complicate the process a bit. Your endocrinologist will help you with all of this. Is there anything I should be doing to prepare myself for HRT? Know all of the changes it will bring, and have realistic expectations for how it'll affect you. Know that it's irreversible, know that you might have an awkward androgynous phase, and know that exactly what it will do is unpredictable. It takes a different amount of time for everyone, and you might not grow a beard right away. Also understand that dysphoria shifts while you transition. If you have dysphoria from your voice or amount of body hair, when that goes away it'll probably shift to your chest or to bottom dysphoria. Be ready for that.
Wow. These are all great, and honestly I got more replies than I expected, so even better! Some of these I remember hearing, but I'm happy for the reminders and all the extra info. Appreciate everyone's answers!
Wow thanks! I had a lot of questions related to this, bit you've all cleared them! And thanks to H20 for asking the question
What all things should I consider or make sure of before deciding or starting HRT? - It's extremely important that you take time to think things over (like if this is what you really want) and to do your research on things that can come with starting HRT; especially testosterone, because hormones aren't something to take lightly. Some of the permanent changes can happen within a short amount of time. This is why some people say once you start, you can pass the point of no return quickly. Many people have sued their doctors and clinics because of things like this, which then makes it harder for people who desperately need and want transition material to access them. Besides the extra hair, clitoris enlargement, and voice deepening, are there any other benefits or even negative consequences with HRT I should be aware of? - Sites like Hudson's Guide have a layout of all the changes that can come with taking testosterone; and your results will vary. Something people talk about a lot are the health related effects; such as a more increased risk for heart disease, cholesterol changes, high blood pressure, and potential liver problems. This is why it's important [which I can't stress enough] that you get blood work done every six or so months to make sure your vitals are in good standings. A guy on youtube made a video a few years ago stressing this, after his friend failed to get labs done for a long time and his T levels were dangerously high--and now he needs to have liver screenings a few times a year. It's also important to get labs done often to keep an eye on your T levels for another reason--which is that when your levels get too high, your body will convert it back into estrogen. Are there any ways besides through doctors that I can find an endocrinologist or do I have to go through my primary care physician and/or therapist? - If you know of any LGBTQ friendly clinics in your area, like Planned Parenthood, they could be able to help you find someone who could be of assistance if you're not having much luck with your doctor or therapist. If this happens, then you're likely talking about informed consent; which, if this is the case, you'll have to check in with them to see if that's something they offer. Is there anything that could disqualify me from being able to take hormones? - My therapist said, after getting in touch with a case worker at the clinic I go to, the only thing that would bar me from starting HRT was if I was actively suicidal. I was worried a thyroid condition I have would give me trouble, but my endo said I was fine and that he'd monitor me for the first few months to be safe. Another thing I've heard was from those who said they were told they had to work on losing weight or managing their overall health first before they could begin--such as if they had high cholesterol or blood pressure for example. This is something you'll have to talk to your doctor about, since everyone has different policies. Is there anything I should be doing to prepare myself for HRT? - Study, study, study. Be sure you know what the risks are and that you know what you're doing. And as others said, you'll have to keep that changes are unpredictable--so there's no telling what you'll experience and how, and that will be out of your control. You might experiences changes that you don't like, and that's something you just need to be prepared for. As of now, I've been on T for 13 months, and I still don't like my voice or think I pass as an adult--and that's something I'm still trying to accept. The last thing I can think of (aside from what baconpox said about dysphoria) is to remember that T might not make everything better, or be a total miracle drug that takes all the bad vibes away. You might still deal with dysphoria and issues with confidence and self-esteem. You might still be unhappy. While I'm much happier than I was almost six years go, I still struggle quite a bit and there are things that T hasn't improved--such as some inner demons I face; which was a dream I had that I thought would happen. It's a crappy thought, but it's something to keep in mind since many people go in with the intention that HRT will just flip the switch off and make things perfect. Much of your growth as a person starts from within, and that's something to keep in mind.