HRT

 

CW: Needles & My Butt

 

I thought it would be beneficial to provide my experience with Hormone Replacement Therapy (HRT); the commitment required, as well as basic info on my process for both cis people and those thinking about medical transition. First, I am not a medical professional. This is in NO WAY meant to be instructional in nature. Let me be clear that this is my regimen as prescribed by my physician. It is customized to me. This is not a one-size-fits-all solution. Nothing I do or say here should be taken as medical advice. Got it? Good.

Secondly, it’s important to know that not all trans women choose this route – or have the option for hormones due to a variety of factors – and that doesn’t make them ANY less trans. I’m fortunate. This is available to me.

So, I thought I’d provide a Saturday morning tour of the HRT realities in my weekly life. If you are squeamish about needles, stop now! First, a little bit of background on my HRT journey.

Every Saturday morning, I inject myself with Estradiol Valerate. It is a bioidentical form of estrogen, meaning it is a synthetic hormone nearly identical to hormones naturally produced by the body. This is the primary hormone treatment for trans feminine people. Injectable hormones increase risk for blood clots and stroke; with a higher risk for people who smoke (people like me).

Estrogen is typically administered in sublingual pill form at the onset of transition, along with a testosterone blocker (anti androgen) like spironolactone (more on Spiro later). It is then titrated up. Blood tests are done every 3 months in the first year of treatment to check levels. Then every six months to a year after that.

Treatment produces variable results including:

  • breast growth
  • softening of the skin
  • reduction and fining of body hair
  • change in body fat distribution
  • reduced muscle mass and strength in the upper body
  • emotional change
  • decline in libido
  • decreased spontaneous erections
  • testicular shrinkage and cessation of spermatogenesis.

 

I have experienced all of the above plus: 

  • absence of libido
  • blood in semen (minimal)
  • pain from erection (inconsistent)
  • abnormal erection (inconsistent)
  • complete lack of ability to climax (inconsistent)
  • changes in taste
  • improvements to digestion

The detail here is self explanatory to those who are trans; however, I include this level of detail for cis friends, so people get a better idea of the commitment required for this one element of transition. Why? Because I’m sick and fucking tired of seeing TERFs (Trans Exclusive Radical Feminists) posting stupid comments and stories about how a “man” may simply transition, win a gold medal in sports by participating in women’s events, and then “change” back. This is literally the dumbest fucking thing I’ve ever head and is a complete insult to the commitment required to transition.

At this point in my life, I will essentially have to do this for the rest of my life. My regimen may change based on age and additional surgeries, but there will likely never be a time in which I don’t have to intervene with medications and hormones.

Anti Androgens 

As an aside, I wanted to touch on anti androgens quickly. These are commonly know as testosterone blockers. While I am not a doctor, I can say without a doubt that Spironolactone was terrible for me. It caused a general fogginess, balance issues, general depression, anxiety increase, and I even began losing my vision. These were severe in me. After doing some of my own research I found a group on Facebook specifically about trans feminine HRT. It discusses the anecdotal and documented dangers of Spiro. I highly recommend that all trans women who are considering taking it, or taking it, read this articleThe Case Against Spironolactone. Furthermore, following the Dr. Will Powers method of transition, I found that I didn’t even need it. My experience has been that Spiro is not necessary at all for most trans women. A high enough dose of Estradiol will push down testosterone levels to where they should be. My blood work verifies that; in fact, my testosterone dropped with I began injections and ceased Spiro (currently < 10pg). I had to actively advocate for myself with my doctor to get off Spiro and move to injections. I have been off Spiro since my 6 month on HRT. I saw nothing but improvement in every way – physically, mentally, and emotionally – after ceasing Spiro. Obviously, this may not be the case for everyone and you should do your own research and make the best decision for yourself.

Estradiol Injection

Back to injections. I recorded this video to demonstrate what my Saturday injection routine looks like. Again, if you don’t like needles or don’t want to see my ass, you might not want to watch it.

raising-brooklyn

Cis Women are often full of encouragement about what trans women don’t need in order to be a woman. It’s all well-meaning, kind, and, on the surface, sounds legitimate and empowering. But, how do you experience womanhood without, well, experience? People – their perceptions, beliefs, coping mechanisms, behavior, personalities – are largely made up of millions of daily experiences; experiences that are rooted in their perceived gender. Cis woman are, in large part, who they are based on a continuous and incredibly complex series of interactions with the world around them – good, neutral, and bad. Those interactions begin with the perceived notion that they are a “woman,” based on their physical features and mannerisms; mannerisms and character traits that were largely learned.

Did a woman decide to do the things she does? To cock her head that way, or place her hand just-so on her hip, to inflect her voice in that subtle way, or did she begin learning that from the first moment light hit her pupils? We all know the answer to this. Certainly there is some level of nature, but a tsunami of nurture. I suspect it’s beyond comprehension – how we become who and what we are. We know that if feminine behavior was modeled differently, by and large, women would behave differently. Simply look to other cultures and see how easily that’s proven. Yet, so many cheer from the sidelines with the conviction of infallible answers; seemingly as though they are above the subtle, cunning manipulations of the world around them. In fact, they are not. No one wakes up at point “z.” They had to walk to get there. Their programming has been so slow for so long – a glacier of psychic imprints rolling over them their whole life – they can’t even perceive it. Certainly, our essence, that beautiful lamp that lights us from the core, is less malleable. It is the beacon that tells us so clearly who we are. How that lights shines, though, its intensity and direction, its temperature, are all influenced by the world around us. We are, after all, social creatures. Our existence is one life-long attempt to fully communicate with others our essence; an essence that is forever shapeshifting.

So, when I hear, you don’t need men’s validation or desire to be a woman. You don’t need the acceptance of others. You don’t need pronoun validation. You don’t need sex. You don’t need makeup or hairstyles. You don’t need hips to be a woman, or tits to be a woman. I hear the sentiment behind it, and agree with the premise. I hear the spirit of this encouragement and advice. However, the truth is I do need social experience to explore, understand, shape, and grow into my womanhood. It’s easier to speak from a place of having. When you’ve had those experiences, learned your own lessons, perhaps it’s harder to see their significance. We learn through interaction. We learn what we like and don’t like. We learn what makes us feel confident and what makes us feel small; what we’re attracted to and what we’re not attracted to; how to have good sex, from having bad sex. We learn how to stand after falling. We grow. We evolve. We become. An important figure in my life once said to me, “Allowing people to make their own mistakes is a gift. Don’t take that from them.” I’ve arrived at a more personal understanding of that truth.

Today, I long for things that perhaps I shouldn’t – achingly so at times. They feel necessary; they feel shallow; they feel atomic. I need a lived female identifying experience to unlock the parts of myself that only experience can unlock. So, cis female allies – the wonderful humans that often make trans life bearable – encourage us, love us, and hug us. Feed us your experience and understanding, but don’t diminish. Build us up without robbing us of the gift of our own mistakes and understanding. I am trans. I will always be trans. Ultimately, my experience will be the trans woman experience. It is an honor; something so unique that only a small portion of the world will ever truly understand it. I also know I am a woman of trans experience who often wants to be a trans woman of cis experience. I want to know for myself. I want to fit through experience; give me that gift.

I started Raising Brooklyn for two primary reasons. First, there is almost no information on the lived trans-feminine experience online, or the lived trans-feminine experience outside the typical narrative. Often, it’s difficult to find stories, or information, about the nuances and daily realities of trans-life, and, while there is more information these days regarding topics such as health care and support, it’s often contradictory, out-dated, or unreliable. There are many more topics that are either non-existent or sparse. Important things like: details of coming out to family, co-workers, clients, and friends; what to expect from HRT; different approaches to HRT; advocating for health care; how to fucking shop and find clothes (hopefully my trial and error will help someone else); navigating relationships in a completely new way; straight talk on sex; misgendering yourself internally; walking into a nail salon for the first time; or being on dating sites as a trans woman and all the complexities that lie therein. I hope this site can help other trans feminine folx navigate these waters and find identification – and just maybe provide intelligent, honest, and eye-opening information for cis people.

Second, I wanted a place to make sense of my ever changing self, body, life, thoughts, and perceptions; a quiet place to record my journey and reflect on who I’ve been, who I am, and who I want to be. One thing I can say with certainty is that whatever I say today is likely subject to revision. The “I definitely feel this way” mentality was a mistake recognized in hindsight, which I have worked to remedy. This is my experience. This is not every trans woman’s experience. All I claim is my exploration is honest and sincere, based on my self awareness at the moment. I don’t have all the answers; I don’t have a magic formula. I do, however, have strong opinions on some things and a lot to talk about. But, at the end of the day, all I offer is honest, sincere entries of my life.

So, welcome to Raising Brooklyn – one middle-aged trans woman’s journey to finding myself, living through it, and reveling in all the beauty therein – unapologetically.